Thread by @ClinicalPearl

All right, I'm gonna level with you. This is going to be unpopular (especially with med school faculty/admin), but please know I'm speaking from experience here. Maybe this isn't universal, but here we go.

Med students heading into #Match2022 (or any match in subsequent years), please know that any and all advice from your med school administration is specifically designed to make sure *your school* is successful. They want you to match, period.

Your school does not need to worry about whether you are happy when/where/in what you match, as long as you match. You are a metric. You *not* matching is an unacceptable outcome not because it would be personally devastating to you, but because then they have to explain it.

So yep, they're going to tell you to:
- over-apply (to dozens more programs than you probably need to
- double dip in your applications into a "backup" specialty
- avoid "reach" programs
- avoid "reach" specialties altogether

In my experience, they also give *incredibly dubious* advice about personal statements, interview prep, etc. This advice comes from the dark ages, I tell you - it's like some of these advisors haven't actually emerged from their cocoon in 25 years.

So what are you supposed to do about it?

Well, the problem is, it depends on what you're applying in, where you're coming from, where you want to go, and what your application looks like. I wish I had easier answers, but I'll try to keep things as universal as possible.

First, talk to people who have successfully applied in what you're applying in. This means residents and recent grads. It's okay to talk to fellow M4s, but they really don't know any more than you do about what will make someone successful.

Also, while we're on the subject...for anyone not yet in the match process (i.e. M1-3s), do not exclusively rely on M4s for residency application advice! For 3/4ths of the academic year, they still haven't completed the process! Make sure you get some faculty and residents too.

When structuring your application, remember that you, as an applicant, get to have priorities. Are you looking for a high volume of a certain patient population? Do you need to be close to/far away from family? Will you have a religious community there? Make notes of this!

Also, does the hospital make residents pay for parking? How's the gender/ethnic/other diversity of the program? Do they feed you? Do the residents get along? Whatever matters to you, look for that! It's okay!

Your application is your application. Don't hide or minimize something significant about yourself as a person during the application process unless you're prepared to stifle it for much, most, or all of your training. Parenthood? Osteopathic degree? Passion for advocacy?

Be appropriate, but be you. If a program is going to discriminate against you for that in the application process, they absolutely will discriminate against you for that once you get there. Allow programs to weed themselves out.

Write an authentic personal statement. It's fine if it's generic (I've talked about this before)! But don't feel like you have to fit some kind of magical unspoken mold. I'm still mad I changed something about mine because of advice from my school. I wish I hadn't.

On the interview day, again, if you wouldn't be caught dead in an all-black suit/heels/makeup/no makeup/whatever...you don't have to do that. Look nice. Dress up. But again, if a program won't take you because you dared to wear a color, do you want to be there???

You are not entirely powerless in this process. It feels like you are, and it benefits the schools for you to feel that way, because if you feel like you have to be perfect to match, you'll blame yourself if you don't match rather than try to figure out if they prepared you right

That said, this is an incredibly precarious system that will, invariably, lead to disastrous results for (way too) many people. Everyone participating in it accepts a level of risk, but some are at significantly more risk than others.

If you choose to deviate from the "typical" (read: safe) path, you are taking on a higher level of risk that you won't match, either in your specialty of choice or at all.

I personally think that going unmatched is much more common (and much less permanently devastating) than schools let on for reasons outlined above, but I recognize this comes from a place of privilege - I have never gone unmatched, so I can't say. I do wish we normalized it more.

Always have a plan. Never assume your first plan will go through, and know what you'll do if things go completely sideways.

But for Pete's sake, remember that you are a highly trained person attempting to get a job in which your employer stands to gain significantly more $ than you do during the period of your employment!! You make them a lot more money than you cost them!

So yes, you get to have standards.

Yes, you get to decide where to apply, how many places to apply to, what to apply in (or not apply in), and what you're willing and not willing to put up with during your next incredibly intense period of training.

Also, and here's my last piece of advice (that nobody asked for):

If you interview or do an away rotation at a place you would rather go unmatched than work at, don't rank them.

If you know that before you even apply there, save your money. Apply elsewhere (or don't!).

Prioritize your happiness. You're going to be at a place for 3-7 years. The culture of those places will shape your practice, in some ways, forever. You don't have to be at a place you love, but don't choose to be at a place you hate.

THANK YOU FOR COMING TO MY TED TALK