title: Insights from San Francisco match rank lists, part II: are programs doing it wrong?
abstract: BACKGROUND
  It is well known that the ideal method of creating rank lists for the match is the "true-preference" strategy. However, there is anecdotal and survey-based evidence that programs and applicants often deviate from this strategy. We analyzed rank lists of applicants and programs participating in the Plastic Surgery San Francisco Match to investigate whether programs were following an optimal strategy.
  
  
  METHODS
  We obtained deidentified program and applicant rank lists and their match results from SF Match for 4 years (2010-2013). Statistical analysis was carried out with Microsoft Excel.
  
  
  RESULTS
  The number of applicants, applications submitted, interviews offered, and match rate were all relatively stable over this 4-year period (range, 117-138 applicants, 36-41 applications, 9.0-10.3 interviews per applicant, and 78%-86% match rate). The "number needed to match" for programs was 4 (range, 1-21). A subset of applicants had poor average ranks on program rank lists but was nevertheless ranked to match by one program. Forty-six percent of these applicants matched at their top choice compared to 20% of matched controls.
  
  
  CONCLUSIONS
  The independent Plastic Surgery Match has become less competitive over the last decade. The low average number needed to match in the context of a high applicant match rate supports the hypothesis that programs and applicants may be modifying rank lists from a true-preference list. Noncompetitive applicants are occasionally ranked to match by a program, and these applicants tend to match at their top choice far more often than the average applicant-providing further support to this hypothesis.
authors.affiliation: From the *Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX; and †Department of Plastic Surgery, Ohio State University, Columbus, OH.
authors.forename: Purushottam A
authors.initials: PA
authors.lastname: Nagarkar
authors.forename: Menyoli
authors.initials: M
authors.lastname: Malafa
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Janis
mesh_terms: D002321:Career Choice; D004503:Education, Medical, Graduate / Q000458:organization & administration*; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D012495:San Francisco; D012570:School Admission Criteria; D013518:Surgery, Plastic / Q000193:education