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Ranking Time

February 04, 2018
by Mark David Siegel

Hi everyone, 

Tomorrow afternoon, we’re holding our residency ranking meeting, so this is “ranking weekend” for me.  Except for a brisk hike up East Rock, I spent all day yesterday staring at a computer screen, trying to quantify the non-quantifiable. 

Some aspects of residency applications lend themselves to ranking.  Board scores for instance.  We can rank by grades too, but we have to be careful because some schools give Honors to 90% of the class while others give them to only 10%.  We also have to remember that some schools give “Honors with Distinction” or “High Honors” (i.e., better than Honors), so we have to avoid being misled.  The same is true for Dean’s and Department letters.  Which adjectives are better- Exceptional?  Outstanding?  Superior?  Excellent?  Each school deploys its own cadre of superlatives.  What’s always true is that “very good” is never very good, and “good” is always bad.

The reality is that grades, board scores, admission to honor societies, and department and school rankings only tell us so much.  All the applicants we interviewed are stellar.  They all rocked in medical school.  How can you possibly choose between brilliant scientists and accomplished leaders?  How can you compare future cardiologists with future endocrinologists?  The answer, of course, is you can’t. 

We seek qualities in future residents that aren’t always captured well in applications.  We can only get a hint of these qualities in letters of recommendation and personal statements and when we meet applicants in person.  Who shares our values?  Who will enhance our diversity?  Who will make the extra phone call so an uninsured diabetic gets her insulin?  Who will set tasks aside to console a frightened patient?  Who will stay late on Wednesday evenings to care for refugees?  Who will become the resident who unloads her intern when he’s swamped, or go over blood gases and EKGs when he’s caught up?  Who will create the next cultural competency curriculum?  Lead one of the Distinction groups?  Join the Executive Council, PEC, or Welcoming Committee?  Who will revise a survival guide or create a new one?  Who will collaborate with fellow residents on a research project?  Or bake brownies for report?  Who will volunteer to cover for a colleague whose best friend is getting married?  Or pitch for the Beeson Bombers?  Or sing or dance or recite poetry at Arts Night?  Or write for the Beeson Beat?  Most importantly, which applicants will devote themselves to Paul Beeson’s ideals of collaboration, community, and kindness?

The good news is that this year’s applicant pool overflows with students who are poised to make their mark.  They are talented enough to go anywhere, but 42 categorical interns and 14 preliminary interns are about to place our residency at the top of their rank lists.  I don’t know which schools they will come from, let alone their names.  I also don’t know what contributions they will make, but I have no doubt they will inspire us.  I do know one thing for sure, however, which is that the ones who join the Yale family next summer will be, as Dr. Kantor says, “as good as any, and nicer than most.”

Enjoy Super Bowl Sunday everyone,

Mark

PS: for further reading, check out this essay on the importance of considering emotional intelligence when selecting medical students. Undoubtedly the same holds true for residents. 

https://jamanetwork.com/journals/jama/fullarticle/2671354

Mark

Submitted by Mark David Siegel on February 04, 2018