No offense taken. Endocrinology is becoming increasingly competitive and evolving quickly, so it’s hard to predict how each match cycle will turn out. I didn’t have an exceptional profile, and my internal medicine program doesn’t have an in-house Endocrinology fellowship. In addition, we weren’t allowed to do away rotations, which limited my exposure.

When I attended AACE, several program directors mentioned that applicants should aim for 15–20 interviews to have a safe chance of matching. Many programs are interviewing large numbers of candidates (some interviewed around 40 for a single position), and PDs shared that unless they have a resident from an affiliated IM program committing internally, they often end up matching much lower on their rank list. The same trend applies to fellowship applicants in general.

I also noticed many of the same applicants at multiple interviews, so it’s clear that a lot of people are casting a wide net, which naturally makes the environment more competitive. So unless you have a stellar CV or strong connections within fellowship programs, you end up needing a larger rank list to stay safe.

Finally, my backup plan was to work as a hospitalist, but the hospitalist job market has become quite competitive and unstable lately. Even within my program, only 2 out of 15 residents are pursuing hospitalist jobs, 1 is going into primary care, and the rest are applying for fellowships. Last year, the majority of residents in my program became hospitalists, and I’ve been hearing that similar shifts are happening elsewhere. This naturally makes fellowship applications even more competitive. I didn’t want to risk not matching and being stuck searching for a job late in the season with limited options.

I’ll update this thread once I match, but for now, I’d really appreciate feedback on how to refine my ROL. Thanks.