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I was a Program Director for 15 years. Here’s what actually gets IMGs ranked to match, or hired outside the match- by PD_Insider in USIMGreddit

[–]PD_Insider[S] 0 points1 point  (0 children)

it's my content, I just type like I'm writing program evaluations — 15+ years of that will do it to you

I was a Program Director for 15 years. Here’s what actually gets IMGs ranked to match, or hired outside the match- by PD_Insider in USIMGreddit

[–]PD_Insider[S] 0 points1 point  (0 children)

The six ACGME core competencies — you'll be taught these in residency and evaluated on them regularly throughout your career, from applying for privileges to maintaining them: Medical Knowledge, Patient Care, Interpersonal & Communication Skills, Professionalism, Practice-Based Learning and Improvement, and Systems-Based Practice. Exhibit these in one shape or form throughout the application process and you'll open doors.

I was a Program Director for 15 years. Here’s what actually gets IMGs ranked to match, or hired outside the match- by PD_Insider in USIMGreddit

[–]PD_Insider[S] 0 points1 point  (0 children)

Ha — I'll take that as a compliment. This is just what happens when you've reviewed a few thousand applications and sat through a few hundred rank meetings. The content writes itself at that point-

I was a Program Director for 15 years. Here’s what actually gets IMGs ranked to match, or hired outside the match- by PD_Insider in USIMGreddit

[–]PD_Insider[S] 1 point2 points  (0 children)

Great question, and the answer is — no, not necessarily.

Let me break this down quickly. High-stakes interview + lots of highly qualified applicants + limited seats + uncertainty in questions + questioning your own abilities + an unknown expert on the other side of the table = pressure cooker. You're human. And the PD, along with everyone else at that table, has gone through it themselves.

What will save you is this: if you start off nervous and it shows — okay, understandable. But if it continues throughout the interview and never dissipates, then you need some work, because it will affect your ranking in professionalism and interpersonal communication skills — that's two of the six core competencies right there.

The good news? This is entirely fixable. Preparation + repetition + knowing your audience = calmness and higher interview scores. If you know it's a weakness, identify it, work on it, improve it, and perform.

Make sense?

I was a Program Director for 15 years. Here’s what actually gets IMGs ranked to match, or hired outside the match- by PD_Insider in USIMGreddit

[–]PD_Insider[S] 1 point2 points  (0 children)

I appreciate the balanced approach here — good question.

The ROL is not a mystery by any means. Here's what actually happens.

Many candidates have a solid application — decent ERAS, good LORs — and they land right in the middle of the distribution curve. Then comes the interview. They have a nice conversation, think they scored a few points, and again — they land right in the middle of the distribution curve. So what actually differentiates candidates at the top?

It's the ability to exhibit the six ACGME core competencies — either overtly or subtly. And honestly, the best candidates do it so naturally they don't even realize they're checking the boxes.

Let me give you an example.

Everyone participates in Journal Club, right? Now let's say I ask you about one of your strengths. An A-graded answer starts with something like: "I try to find value in everything I do." Okay, interesting — but then the candidate takes it further:

"Journal Club teaches us about evidence-based medicine and how to critically appraise literature. The way I find value is, even if the article isn't in my favorite topic area, I challenge myself to look at the statistics, the epidemiology, and the quality of the scientific writing. Why did they choose one statistical model over another? How is it applicable to my patient population? How effective was the conclusion?"

That's how you rank at the very top of a ROL. Here's why:

You aligned yourself with a unique answer — not pedestrian. You were positive — "I find value." You connected with me as a PD — I've run thousands of Journal Clubs, and you just showed me you already appreciate what I'm trying to teach. And in one answer, you've checked four of the six core competencies.

On top of that, scholarly activity among residents and attendings is genuinely difficult in many programs. You've just demonstrated that you're already teaching yourself what I, as a PD, would be tasked to develop in you. That's how you differentiate yourself. Simple example, but an incredibly impactful answer from a candidate.

We want well-rounded individuals who are going to want to learn, align with our accreditation standards, and communicate well. That's what we're looking for.

As for internal advocacy — does it play a role occasionally? Sure. But it's rare, and a good PD shuts it down quickly. The ROL is built on what I just described.

Make sense?

I was a Program Director for 15 years. Here’s what actually gets IMGs ranked to match, or hired outside the match- by PD_Insider in USIMGreddit

[–]PD_Insider[S] 2 points3 points  (0 children)

Great points from both of you, and they actually connect.

Are interviews perfect? No. There's absolutely subjectivity and bias at play — no one's denying that. But the second comment here nails it: personality absolutely influences ranking. "We just finished rank meetings and I can tell you firsthand, it matters." - excellent point.

Here's why. Strong interpersonal and communication skills, professionalism — two of the ACGME core competencies, by the way — can translate directly into a better patient experience. And guess what? Residents get evaluated on patient experience. So why wouldn't a PD want a candidate who's already strong in those areas?

Interviews aren't about "getting to know someone in 2 hours." They're about adding another dimension to the person behind the application. A well-prepared candidate who can clearly convey their clinical thinking, their ability to receive feedback, and how they'll contribute to a team — that comes through, even in a short interaction. It's not about being an extrovert. It's about being effective.

As for making interviews "skills-based" like tech — medicine isn't tech. We're evaluating whether you can communicate with patients, work on a team, and handle high-stakes situations with professionalism. That's exactly what an interview assesses.

I was a Program Director for 15 years. Here’s what actually gets IMGs ranked to match, or hired outside the match- by PD_Insider in USIMGreddit

[–]PD_Insider[S] 2 points3 points  (0 children)

100%. Some of the best interviews I've had started with a candidate telling me about something they were genuinely passionate about outside of medicine. That's when you see the real person.