It’s that time of year again. The NRMP has finally published all statistics regarding the recent match data. Of note this year is the Program Director Survey Report. The results were interesting to review since I had not had a chance to respond to the initial survey. This report took responses from the program directors in hopes of stratifying the recruitment criteria for fellowships and residencies. For us on Sports Medicine, they had a total of 58 Program Directors respond. Lets take a look at the data and try to demystify it for this next cycle –

match graph 1

On first glance the top three recruitment criteria appears to be:

  1. Letters of Recommendation in Fellowship Specialty (97%)
  2. Perceived Commitment to Specialty (91%)
  3. Any Failed Attempt in USMLE/COMLEX (91%)

Letters of Recommendation

I cannot stress enough how important those letters of rec are. I routinely call and speak to some of the letter writers if I need additional information. Sometimes the letters are too short and offer no real tangible feeling of who the applicant is. Other times the letters can be overly vague and gloss over certain aspects of professionalism. It is important that you know your letter writers exceptionally well. You really need their support when applying to a fellowship. Their letter is viewed by 97% of program directors as an integral part of the application.

Perceived Commitment

I often get questions about the perceived commitment. What exactly does this mean?

Well to be honest, no one wants to be someone’s consolation prize. We all want our applicants to be passionate. Commitment is a dangerous word, one that my wife used to tell me I was afraid of… Commitment though can be viewed subjectively and often looks different to different people.

I would venture to say that the average program views commitment as a longitudinal application of ones efforts to a sport specific venture. Did you cover a high school football team through an entire season? Did you attend every AMSSM national conference through residency? Did you give regular lectures to your fellow residents on sports related topics? Were you involved in a sports medicine club in medical school?

The ultimate question of commitment is “why”… Why do you want to be here? Why Sports Medicine? If you can truly understand WHY you want to do what you do, you will not only exude your passion but you will also have a more fulfilling career. Those of you out there having a hard time really understanding this concept, take a look at this lecture from Simon Sinek.

Failed Attempts on a Board Exam

We all know testing is a terrible way to measure ones aptitude. Unfortunately this imperfect system is literally all we have to go on. Tests are the only objective measure we have to stratify applicants. You could argue that grades are also objective but when you look at hundreds of transcripts and they all vary by half a grade point… Things start to blend together. Recruiting is a difficult animal to tackle. Our recruitment techniques are mostly based on subjective analysis and an imperfect interpretation of other subjective measures submitted for review.

It makes sense that this objective measures carries so much weight on the recruitment side. When all other factors appear to be equal, a failure on a board exam can be a deal breaker. However, when all other applicants are reviewed and there are other qualities that may be lacking, the prior failures may become the best qualified applicant. In this respect, a failure on the boards is not an automatic disqualification but it does bump the application down the list.


Hundreds of applications come in and they are all very similar. It is difficult to nail down an algorithm that puts one individual over another. There are simply too many variables to state it in this blog post. The key to standing out is a consistent theme in your overall application and not some compartmentalized experience to satisfy a check box. Ask yourself “did I do XYZ because I’m supposed to or did I do XYZ because I wanted to?” Like I stated earlier… No one wants to be someone’s consolation prize. Stay true to yourself and do what you love. The interviewers will easily tell the difference between someone going through the motions vs. someone who is excited about the field or the program.

Best of luck to all of you.