Chittur A. Sivaram, MD, FACC

In the coming days, many cardiology fellowship program directors will finalize their rank order lists for submission to National Resident Matching Program (NRMP) — the final step in the recruitment of fellows for July 2016. Simultaneously fellowship applicants will also be giving finishing touches to their own rank order lists of training programs. The inevitable suspense that shrouds the days leading to up to the Match Day in early December is stressful to both parties. Each program director would want the best applicants in his/her program, but there is no guarantee how the applicant makes his/her choices in the rank order list.

A recent report from NRMP (the Applicant Survey of 2015) sheds some light on factors that medical students (US graduates as well as international medical graduates) take into consideration while ranking residency positions. This survey was conducted after the students submitted their rank order lists, but before the Match results were announced, thereby eliminating any bias in the responses due to the Match outcome. Overwhelmingly, geographic location was cited as the most important factor for the residency applicant while making the rank order list. The other two important considerations were reputation of the program and perceived personal fit within the program. These preferences were similar for both US medical graduates as well as the others (International Medical Graduates predominantly). While there were minor variations in the factors governing rank order preferences amongst various residencies, the overall theme that geographic location trumps all the other factors came through loud and clear in the survey. Surprisingly, the survey respondents ranked salary, board pass rates of the program and similar items usually very prominent in the training program leadership’s radar at the bottom of the list of priorities.

Why do the results of this survey matter to the Cardiology training program directors? While the above NRMP survey was a Student survey, the typical cardiology fellowship applicant is not too far removed generationally from the residency applicant. As such, it is very likely that geographic priorities might still be the predominant factor that influences ranking order of the fellowship applicant. For many of us this approach to ranking of priority of training programs is a major shift from one or two generations ago. As such, cardiology fellowship training program directors might be well advised to be sensitive to the importance of geographic location to the present day applicant as the rank order submission day approaches. Ironically, geographic location is one feature of a training program that a program director cannot change. At least, the 2015 NRMP survey should help fellowship program directors understand with a bit more clarity why applicants rank their programs occasionally in unexpected ways.

Reference

National Resident Matching Program, Data Release and Research Committee: Results of the 2015 NRMP Applicant Survey by Preferred Specialty and Applicant Type. National Resident Matching Program, Washington, DC. 2015