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Post-interview contact is an enormous issue. Ethical conduct is not always the overriding principle on either the applicant's or the program's side. An article published in The Journal of Urology (Teichman 2000) revealed that there is a considerable amount of post-interview contact. This article, by the way, is a must read. The general rules of the match state that programs can contact you by letter at any time, and vice versa (see AUA post interview contact). Many programs (though certainly not all) send out letters or e-mails after the interviews have taken place.A lot of these letters are simply to say thank you for visiting, and let you know that "you will be highly considered for one of our spots." These are meaningless unless you know for a fact that other people who interviewed at the same program received no letter or a less flattering letter (you can usually find out from the UrologyMatch discussion board). DO NOT let these letters affect your rank list. Phone calls from the programs have, thankfully, become very rare in urology (as these are indeed illegal), so you should not have to worry about what you might say to a program that is not your number one choice. Know that the Journal of Urology article by Teichman revealed that 31% of program directors (and 44% of applicants) acknowledge dishonesty, and that 82% of program directors thought applicants "lied." Additionally, 81% of program directors were "skeptical" or "did not believe" when informed they were a "high" or "number 1 selection." As far as contact from your side goes, there are many philosophies:
1) Thank you notes: Should you send them? Absolutely. Should they be handwritten? Typed? Sent to everyone you interviewed with? Just the chair and program director? These questions are much harder, and, truthfully, less important. Thank you notes are certainly part of your application, but probably the least important part. Sending off one or two letters to most if not all of your programs should be fine. Just let them know you enjoyed your visit, and mention some things that make it clear you aren't just writing a form letter. Click here to see some samples. Be aware that these will end up in your file.
2) Telling programs where you are ranking them: Should you tell your number one program where they rank? Definitely--it can only help you. Should you tell multiple programs you are ranking them number 1? Absolutely not--people do talk in the urology world, and this would be a horrible start to your career. The key question is what to do about your other programs. Do you use words in your thank you notes like "highly ranked" or "extremely highly ranked" to indicate where you are ranking a given program? Do you tell all your programs that they are "highly ranked"? Hopefully not. Overall, how you approach this issue is really up to you and what you consider ethical. Of course, programs often assume you are lying when you use these terms (see article), not to mention that using a phrase like "highly ranked" may come off simply as "not number 1." You have to go with what you think is appropriate for yourself and the programs you applied to.
3) Revisits: After you are done interviewing, you should strongly consider revisiting your top choices. Many programs will explicitly invite you during your interview to do so. In addition, there are several programs that will only highly rank applicants who have done a Sub-I or a revisit. These programs are very adamant about matching only the applicants that want to be in their program, and a revisit is your way of showing utmost interest. If you are very interested in a program, it is worth asking the residents how important the revisit is to the admissions committee. To arrange a revisit, contact the residency director and plan to scrub into a case or two with the chairman (it is definitely worth revisiting on the day when the chairman is in the OR). Don't sweat the details, the residents will tell you what to do. After the revisit, consider sending another thank you letter to the chairman and/or program director. If you haven't sent your original thank you letters yet, definitely be sure to mention your second trip to the department.
4) The final lap: This is the period in early January after you have finished your interviews, sent in your thank you notes, and you have a good idea of your rank list, but before programs have sent their lists in. It is well within reason to send a last-minute e-mail or leave a brief voice-mail message at the top 2 or 3 programs on your rank list. This may be a good time to let these programs know where they stand (particularly your number 1 program), if you didn't do it in your thank you notes. Also, it may be reasonable to have your advisor or chair of your home program make a call to your first-choice residency at this time. These calls are not typical, and are usually reserved for fellowship applications, but if it seems appropriate in your situation, it could help you significantly.