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The other day one of my residents applying for fellowship called to ask for some advice. She received an e-mail from one of the programs where she had interviewed letting her know how much they liked her and to reinforce the reasons why it would be a good place for fellowship. She didn’t know how to respond, because while she thought it would be a good place to train, she wasn’t sure it was one of her top choices and she didn’t want to be dishonest or “burn any bridges.” She told me that she almost wished that it wasn’t allowed for programs and candidates to be in touch with each other after the interview until after the match. After all, she reasoned, shouldn’t programs just rank the candidates they wanted in order of their preference and shouldn’t candidates do the same without any pressure? This was after all the intention of why the match was developed in the first place.
This business of post-interview contact is one that programs are grappling with, and it is likely that policies will soon be developed to govern what kind of contact, if any, should occur after the interview. Neurosurgery residency programs already have a firm policy in place that restricts any contact between the program and candidate until after the match. I still recall when I was early in my career as a program director how I called up the candidates I’d hoped would rank us highly to let them know how much I appreciated their qualities, how happy I’d be to see their names on our match list, and to reiterate why I thought my program would be a fantastic place to train. Most expressed thanks for my confidence in them, but there were some candidates with whom the conversation was awkward. Now I regret having put anyone in that kind of position. On the other side of that equation, I still remember how one candidate actually winked at me as she told me how high she was going to rank our program. Though we ranked her high enough to be matched in our program, come match day, she was nowhere on our list.
In my good old days when I was applying for residency, a well placed phone call from one of the residents of a program I was considering highly made all the difference in how I ranked the program. This resident, a graduate of my medical school, flattered me by telling me how much the program liked me and hoped that I was ranking them highly. I realized that while I really liked the program, I had some pre-conceived notions that the patient population I’d be caring for was not the medically underserved population I wanted to work with given the hospital’s location in a relatively wealthy part of town. Because I was speaking to a resident, and not feeling intimidated by a faculty member, I was able to be honest about my concerns. She completely reassured me about the diversity of the patient population, and I ranked the program first on my list. I never regretted my decision, and wonder what would have happened had I not received that phone call.
As a program director, I value the ideas of not having awkward conversations, not putting our candidates on the spot, nor causing undue stress. Our interview days are meant to be comprehensive enough to truly convey the feel of the program and provide all of the relevant information. Now I tell candidates who ask about second looks that it’s fine if they genuinely feel that they need another chance to try the program on for size – it is after all such a big decision, and one must feel sure – but that another visit will in no way impact how we will rank them. I feel confident that I speak for most program directors.
What should never go out of style is a genuine thank you note from the candidate expressing appreciation for all that was done to provide information and to make the candidate feel at home during the interview. As program director, I am also thankful for the opportunity to talk about why I think our program is so special, and for the candidates’ interest in us. I guess I’m on the fence about post-interview contact, but guidelines that err on candidate comfort and mitigate anxiety about the process are welcome and necessary.
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