Ranking Two Specialties in the Military Match

I have gotten a lot of questions recently about ranking a second choice specialty in the military match. The Joint Services Graduate Medical Education (JSGME) application allows you to rank two specialties if you desire. If have a pretty good idea of how the JSGME (military) match works, then read on. If not, check out this article to review the basics of the military match.

How does it work?

Within the multi-page JSGME application, there is a form called the second choice form, which allows you to rank two specialties, like you can in ERAS. There are a couple of things you need to know about ranking a second specialty in the military match.

First, you have to rank all programs within your first choice specialty ahead of any programs in the second choice specialty. For example, let’s say that you are planning to rank programs in OB/GYN and in family medicine, with OB/GYN as your first choice specialty. The way the JSGME works, you match to a specialty first, and then to a program within that specialty. Therefore, you have to rank all OB/GYN programs, then all family medicine programs.

Second, unlike the civilian (ERAS) match, applicants are matched to programs by an actual group of people, who sit down at a table and review the applications. In the civilian match, applicants and programs each submit rank lists, and a computer program matches these up – the programs never see where you ranked them. In the JSGME match, the people who decide whether you will match in OB/GYN will also see that you ranked family medicine programs as a second choice, and the people who decide whether you will match in family medicine will see that you ranked OB/GYN first, and family medicine second. Who gets a seat at the table? Program directors and assistant program directors (or other delegates) from each of the military residencies in that specialty.

How does the actual process work? You give your rank list for your first-choice program in the main application. There is an additional page that asks if you plan to rank a second choice specialty, called the second choice form (original, I know). If you do want to, you need to say which specialty you plan to rank as your second choice, and then give your rank list of the programs in your second choice specialty.

You are required to interview, in phone or in person, with the program director of at least one program in each specialty which you rank. So if you rank two specialties, you need to complete at least two interviews.

Completing at least one (ideally two) away rotations in your specialty of choice is highly recommended. That is, of course, much harder to do in two specialties at the same time.

Should you do it?

If the programs know that you ranked a second specialty, how do they view applicants who rank two specialties? A program director in a very highly competitive specialty with only a few spots per year once told me that he doesn’t hold it against people who rank a second choice, because he knows that over 80% of people who apply to his specialty won’t match. Someone else, in a moderately competitive specialty (about a 50% match rate) told me that they feel it is best to be fully committed to your first-choice specialty. As always, your mileage may vary.

Anecdotally, I know only one person who ranked two specialties. Both were at least moderately competitive specialties (match rate of 60% or less that year). That individual didn’t match into either specialty and ended up doing an intern year only, leading into a flight surgery tour. What does that really mean, though? I don’t know. I don’t know if she chose to rank a “backup” specialty because she was worried that she wouldn’t match into her first-choice specialty, or if the choice to rank a second specialty worked against her.

Is that clear as mud?

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