An Insider’s View Into The Radiology Residency Rank List
From a medical student perspective, the ranking process and rank list seem like a black box. But today, we are going to shed some light on how the process works (at least in our radiology residency!) Of course, I cannot speak for all radiology residency programs. But, many programs do have a similar process.
So, how does this all work? Well, in today’s post, you are going to be the proverbial fly on the wall. More importantly, hopefully, you will gain some insight into what we look for when we meet and what the rank list process entails.
The Basics Of The Rank List Process
It all begins a few days before interviews take place. Each interviewer takes home a pile of applications to review prior to the interview day. Of course, we take into account the usual suspects- the Deans Letter, research, experiences, recommendations, and all the other components of the process (See Cracking The Radiology Residency Application Code!) And, all of these factors are weighted accordingly with the Deans Letter weighted the most in the equation.
Then, we add on our impressions of the candidate from the interview. Based on all these factors, typically, the interviewers give each candidate an overall grade on the day of the interview. Why? Simply, because the applicants stick freshly in our minds on the interview day.
Most importantly, however, after we give the candidates this preliminary grade, we then confirm our impressions with the residents. We call this meeting the coffee clutch. (Other programs I’m sure to have other names for this sort of meeting!) Depending on the gestalt of the residents, we may change that final grade to higher, lower, or to do not rank.
Only then, once we have the input of the residents, does each interviewer finalize the overall grade that the applicants receive. And, we place the interview candidates into three basic piles. The first batch is the pile of applications that satisfy our credential and personality requirements. We like to call these applications the “rankables”. Most candidates fall into this grouping.
For the next category, we call this the question pile. Sometimes, we will revisit these candidates at a later juncture after we have obtained additional information. Other times, we just need to mull over the quality of the rest of the candidates before we decide to finally rank them.
And finally, the last group of applications is those that do not pass muster. We place these into the Do Not Rank list (informally called DNR/DNI!) To summarize, these applications are from those candidates who had either inadequate credentials, personality flaws, or other issues that we think would not fit with our program’s culture and philosophy.
How Do We Create Our Rank List?
If you remember before, I mentioned that each interviewer gives a candidate an overall grade. And, for any given day, we always have two interviewers. Each interviewer gives a score that goes from the number 1 to 11 with 1, the lowest possible score (with the exception of DNR/DNI!) and 11, the highest possible score. Subsequently, we simply sum the score of the two interviewers and that number represents the preliminary grade of the candidate. Now, most applicants congregate somewhere in the middle of the pack (scoring somewhere between 10-14). Those that are exceptional score higher and those that are weaker trend lower.
However, we are not quite done yet! Next, we take into account a couple of other factors. First, folks that submit a thank you letter will receive an additional half point. And then, those that come for second looks will also garner a half point. (We only add points if we did not DNR the candidate!) What is our motivation behind this? Personally, we like to add a little bit onto these folks that take the time to show interest in our program. If you think about it, it makes sense. Candidates who succeed in our program want to be here. And, thank you letters and second looks show additional interest. So, it makes sense to reward these folks.
In the situation of those candidates squarely in the middle of the pack, these small half points can potentially make a humongous difference. Since most candidates congregate around the mean, simply, it puts you a tiny bit above everyone else in your category.
Once we finish our last day of interviews, we check for and add on any extra thank you letter and second look points to all members of the rank pile. In addition, we revisit the question pile, making sure to call who we need to call, get additional information that we need, and make a final determination of whether we will rank these applications.
Only then, we add the numbers together to come up with a final ranking for each candidates’ application. But, we are still not done. We recheck the applicant rank list several more times to make sure that the rank order makes sense and we have not made any additional errors. And then finally, we input the numbers directly into the computer on the NRMP website.
Well, that’s about it. Nothing earth shattering! No system is perfect. But in my own biased view, the process seems to me logical and fair. I like to think that we do a decent job with the information we have. Most importantly, the proof is in the pudding. When I realize the great residents we have accepted over my tenure as Associate Residency Director using our ranking process, it has paid dividends over time. Our residents have been awesome!