Hi everyone,
We reject most residency applicants. Last year, 3830 candidates applied to our categorical track, which has 38 positions. We can only interview a fraction of these applicants, so we’re forced to turn away many students with high scores, impressive publications, and major leadership experience.
I’m glad so many candidates are interested in us, but I also know a major reason we get lots of applications is because candidates apply to lots of programs. The average US MD student applies to more than 30 IM residencies, and the average IMG applies to more than 100. This means most candidates are applying to many other places, and one of our challenges is to identify who sincerely wants Yale. We don’t want to offer precious interview slots to candidates who aren’t interested in us while rejecting those who are.
The recent advent of signaling made it easier to identify who’s truly interested. Candidates can convey division preferences (New England, other, none), a setting preference (rural, suburban, urban, or some combination), and up to 15 program signals: Gold (top 3) and Silver (next 4 to 15). Last year, among our categorical candidates, 373 signaled Gold and 1108 signaled Silver. We rejected most candidates who didn’t signal us, assuming they were almost certainly prioritizing other places. We paid less attention to division preferences and no attention to setting preferences since most candidates chose “urban.” Signaling allowed me to spend more time reviewing fewer applications and made me more confident we were choosing well.
This year for the first time, many but not all fellowships will be using signals. The number and type of signals will vary by specialty: endocrinology and A&I will have 5, while cardiology will have 20. PCCM, GI, and Heme-Onc will offer Gold and Silver, similar to internal medicine.
Those of you applying to fellowship this year will have to consider your strategy. For specialties with lots of signals, you should assume most if not all your interviews will come from programs you signal. For specialties with fewer signals, you may still get interviewed without a signal, but your chances will be less. Similarly, your chances will be better with Gold than Silver, though you will almost certainly get interviews from programs you designate as Silver since the number of Golds available is small.
Here’s my advice: signal fellowships with research and clinical programs that meet your professional goals and those located in places you want to live.* Most of you will be strong candidates at most programs; but be realistic: if you’re clinically oriented, you should pause before signaling programs that prioritize research. If you have specific clinical and research interests (e.g., metabolic liver disease, TB, food allergy, CAR-T, lung transplant) you should signal fellowships with relevant strengths. If you’re on a visa, you should signal programs that will support your needs, not those who don’t.
Some final thoughts: first, signaling should obviate sending special emails to programs emphasizing your interest; your signals should speak for themselves. Second, run your list by a trusted advisor to ensure you’re choosing wisely, neither overestimating nor underestimating your potential. Finally, remember that most programs will be thrilled to see a signal from a talented resident, and they will review your application accordingly.
For more information, please join us for Fellowship Night, this Wednesday at 6:30PM in Harkness Auditorium, hosted by Dr. Shaili Gupta. Come with questions, enjoy dinner, and get the inside scoop from our expert fellowship directors.
Enjoy your Sunday, everyone. I’ll be on MICU Red today and for the next five days. Pop by the ROFFICE if you want to say hi.
Mark
*If you imagine any place being more enticing than New Haven.
P.S. If you’re applying to fellowship this year and haven’t told me yet, now’s the time. I need to start writing those letters!
P.P.S. What I’m reading:
“We Are the Most Rejected Generation” By David Brooks
For One Hilarious, Terrifying Day, Elon Musk’s Chatbot Lost Its Mind By Zeynep Tufekci
Medicaid Work Requirements Are Cruel and Pointless By Matt Bruenig
Upholding Our Duty to Care for Undocumented Immigrants By Cary P. Gross, Ilana B. Richman, et al.
The Professors Are Using ChatGPT, and Some Students Aren’t Happy About It By Kashmir Hill
Your A.I. Radiologist Will Not Be With You Soon By Steve Lohr
Front yard rhododendron
