I matched lower on my rank list than I was expecting – and I couldn’t be happier.

I fretted for weeks over the details of my rank list. Should I rank this program #1 or #2? #2 or #3? And do you know what happened then? I, like most of my friends, matched to a program that was not in my top 3, but where I am much happier than I would have been at any of my top 3 picks. Seriously. I ended up in a program that is a great fit and where I am very happy. So how did that happen, if this program wasn’t in my top 3?

This might sound silly, but the programs know a lot more about you than you know about them. For example, the programs know what you have done research on, if you have done research. They know where you are from, where you went to undergrad, and what your hobbies are (at least the ones you were willing to tell them about). If they know people at your medical school, they might have made some phone calls and gotten some extra info on top of that. In contrast, how much did you really know about the residents at the programs where you interviewed?

The programs also know themselves better than you know them. How do you really know what the culture is at the program? The programs know a lot more about whether you will fit in at their program than you do. Everyone tries to put their best foot forward in the interviews, but when the programs discuss applicants, they can have an honest discussion about how your interests fit up with the program’s strengths and weaknesses. If you are really gushing about how much you loved your experience doing an international rotation and the program doesn’t have any global health connections, they may feel like you won’t be happy there. If you say you are really passionate about family planning education and abortion access and look forward to gaining competence performing D&Es, and the program doesn’t do a lot of D&Es, you may not be happy there. They probably don’t exactly advertise that they don’t do a lot of D&Es since that isn’t a selling point, but the program will know if there is a big reason that you won’t be happy there, even if you don’t want to admit it to yourself. 

Case in point: Everyone has different feelings about elective pregnancy termination. It’s a hot topic in OB/GYN and probably always will be. One of the programs where I interviewed was excellent, and I ranked them highly. In retrospect, though, most of their residents’ stance on pregnancy termination was very different from my own, and I might not have fit in there – not just because of the abortion issue, but the other political and social views which frequently come along with particular extremes of the abortion spectrum. I liked so many other things about the program that I convinced myself that it would be ok, but it probably would have been an issue in the end.

The point is this: If you matched, congratulations!! Be happy and be thankful. You have accomplished something wonderful. Even if you didn’t match where you thought you would, I expect that you will be happy and successful. You matched where you did for a reason, and you will probably be happier there than you would have been at a program that was higher on your list. Residency is what you make it. Go out and make it great!

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