Suggestion on how to improve match process

[Throwaway2016]

Hi All!

So I was thinking about this tend of medical students over applying to residencies and creating more work for PDs while also making it more difficult for programs to identify applicants actually interested in their program. Several of my fellow M4s will most likely agree that there has been increased "tone from the top" over the past couple of cycles to encourage their applicants to apply to more programs/broadly than what is historically suggested by the applicants competitiveness in their specialty of choice. This is totally understandable from each student affairs office as that unmatched students are a nightmare and the cost of interviewing is shared between the applicants and the residency programs.

So I was thinking why not change ERAS to include a ranking of each residency program created by the applicant before ERAS is released? For example, each applicant could rank their top 10 choices numerically and then have a general category for all of the other residencies after 10. This way, PD can identify which applicants are actually interested in their programs instead of using them as backups or what have you. Ideally, it is the goal of each applicant and each residency program to find the best fit.

Thoughts?

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[Psychotic]

Hi All!

So I was thinking about this tend of medical students over applying to residencies and creating more work for PDs while also making it more difficult for programs to identify applicants actually interested in their program. Several of my fellow M4s will most likely agree that there has been increased "tone from the top" over the past couple of cycles to encourage their applicants to apply to more programs/broadly than what is historically suggested by the applicants competitiveness in their specialty of choice. This is totally understandable from each student affairs office as that unmatched students are a nightmare and the cost of interviewing is shared between the applicants and the residency programs.

So I was thinking why not change ERAS to include a ranking of each residency program created by the applicant before ERAS is released? For example, each applicant could rank their top 10 choices numerically and then have a general category for all of the other residencies after 10. This way, PD can identify which applicants are actually interested in their programs instead of using them as backups or what have you. Ideally, it is the goal of each applicant and each residency program to find the best fit.

Thoughts?

So kind of like fantasy football draft? Ehh...I think more people would rank the nose bleed programs too high, and might still get shut out at the other "tiers."

The solution for applicants as it now works? Send out more apps.

What might help? If programs all held interview invites until, say, October 15, and then dumped them. Applicants get 48 hours to schedule, and then all unclaimed interview slots expire and another batch of invites is sent out. Etc. Sort of like what happens in the SOAP?

It also might help if the MSPE date matched the ERAS submission date.

 

[MacDonaldTriad]

What would be the least of all evils?
1. Limit applicants to 10 interviews (interviews, not applications)
2. Drop the expectation that you will be individually interviewed and we create polished videos about how wonderful we would be for you coupled with some very brief skipe time.

 

[downwithDTB]

What would be the least of all evils?
1. Limit applicants to 10 interviews (interviews, not applications)
2. Drop the expectation that you will be individually interviewed and we create polished videos about how wonderful we would be for you coupled with some very brief skipe time.

Both of these violate the theoretical assumptions of the match algorithm, the first much more so than the last... The match is only valid in a state of ideal knowledge.

Instead of limiting applicants... Why not firmly require that programs provide comprehensive information about themselves *before being able to view applications*. For example: %AOA, %PhD, %IMG, %DO, %clinical honors, % residents from top 40 med schools, average step scores, average prite scores, full list of resident publications and grants, source of funding for resident research electives department funding, board pass rate, etc all over the past 5 years with St devs and where all graduates did fellowships and have current academic appointments over the past 10 years.

Perhaps requiring comprehensive and up to date information from programs would allow applicants to apply more appropriately. The argument against this will be that it would take too much time... But in reality it would be about 1-2 person days and could save on the total number of applications received. Further... This is all information that really, really should be publicly and easily available for publicly funded training programs. Of courses.

 

[Throwaway2016]

So kind of like fantasy football draft? Ehh...I think more people would rank the nose bleed programs too high, and might still get shut out at the other "tiers."

Ideally I would hope you would see applicants take more consideration and rank their programs in "tiers" anyway with the classic 1/3, 1/3, 1/3. I don't think the "top" rank programs will see a huge impact on the number of applications but it might allow them to better identify and sort out their applicants based on the applicants expressed interest in their program.

In my own case, I applied to 30 (following my own student affairs office "recommendation") and I am sitting on 11 invites. Out of those, 9 of them I am interested in and I am waiting to hear back from another 4 programs that I feel would be a good fit but might not be apparent based on just my ERAS. I would love to receive some sort of closure on the programs that I am waiting on so that I can free up the invites that I am less interested in at the moment.

No system is perfect but I do think the trend of increasing number of applications (and not just applicants) will continue until there is something done to limit it. Just don't do what ENT did this year!

 

[downwithDTB]

Other ways to improve it:
1) Allow US MD/DOs to take spots outside the match with a required 10 day offer to acceptance waiting period starting, with offers starting 12/1.
2) Similar to suggested above... allow application submission from 9/1-15. Programs see applications on 9/15. Programs must offer 90% of interview slots on 10/15. Applicants must respond to offers by 10/20, or 48 hours, whichever is later. Once an interview offer is rejected or cancelled, programs have 48 hours to invite another applicant. Programs can save 10% of offers for late applicants or those who provide compelling updates.

 

[Pursuitofsanity]

I do think that a system by which interview invitations were issued in formal waves and applicants had a limited time to accept or reject would benefit everyone. Right now, my sense (and others can correct me if I'm wrong) is that less competitive programs tend to offer interview invitations earlier, while more competitive programs take more time. Students are then very motivated to accept their first interview offers, regardless of their feeling about the institution in question, because we're anxious and we don't know where we stand. When the offers from other programs trickle in, they are left with either (1) more interviews than they want or need leading to cancellations and late openings for others (2) problems fitting interviews into a schedule that did not allow them to give their top choices priority in scheduling.

My proposal, 3 wave interview scheduling period for the first 3 weeks of October.
1st Monday -all programs issue their first round of interview invitations. Monday and Tuesday - Applicants have 48 hours to respond and schedule. Wednesday - Applicants can submit their application to additional programs for review if not happy with their initial interview yield. Thursday & Friday - Programs review new applications and plan their next wave. 2nd round of invitations goes out the following Monday. 2-3 official waves, and then a free for all on what's left in the last week of October.

If we did this, all interviews are scheduled in approximately the same time frame, but students can create a reasonable interview schedule that prioritizes the programs that matter to them, (and perhaps allows them to efficiently group places close together) applicants get a sense of where they stand in the pool for a particular program (i.e., I got a first wave invitation vs. a 2nd or 3rd wave) so they can plan accordingly when considering what invitations to accept. Programs will know that applicants are scheduling interviews with all their options in mind, and if applicants apply after the initial date, they would have a better sense of being back-ups. Overall, people still have the option to apply to as many programs (and go on as many interviews) as they would like, but the chaos is reduced, and there will be FAR less dropping and rescheduling of interviews, because people won't feel the need to accept offers just because they came in 1st.

Thoughts?

 

[MacDonaldTriad]

Both of these violate the theoretical assumptions of the match algorithm, the first much more so than the last... The match is only valid in a state of ideal knowledge.

Instead of limiting applicants... Why not firmly require that programs provide comprehensive information about themselves *before being able to view applications*. For example: %AOA, %PhD, %IMG, %DO, %clinical honors, % residents from top 40 med schools, average step scores, average prite scores, full list of resident publications and grants, source of funding for resident research electives department funding, board pass rate, etc all over the past 5 years with St devs and where all graduates did fellowships and have current academic appointments over the past 10 years.

Perhaps requiring comprehensive and up to date information from programs would allow applicants to apply more appropriately. The argument against this will be that it would take too much time... But in reality it would be about 1-2 person days and could save on the total number of applications received. Further... This is all information that really, really should be publicly and easily available for publicly funded training programs. Of courses.

actually, we are already force to collect all of this in an annual report.

 

[bd290]

actually, we are already force to collect all of this in an annual report.

I don't doubt that. But information isn't very readily available to applicants.

 

[MacDonaldTriad]

Probably for every program that would be willing to publish this, there would be two who would not be.

 

[downwithDTB]

Probably for every program that would be willing to publish this, there would be two who would not be.

If either ERAS participation, ACGME accreditation or if DGME payments were contingent upon publication of this information, I'd be willing to bet that almost every program would make it available. It's easy to see why applicants are so frustrated by the lack of transparency in this process and end up over applying! We have no clue was programs are really offering or who they are really getting!

Here's another possible improvement: giving applicants (only) access to anonymous resident surveys along with the % of residents who completed them. Sort of like LORs, but for programs.

 

[DD214_DOC]

Gladitorial Combat. Alter the risk/reward ratio and people will be more selective.

 

[OldPsychDoc]

Gladitorial Combat. Alter the risk/reward ratio and people will be more selective.

I think I already proposed a Hunger Games scenario a few months ago.

 

[DD214_DOC]

I think I already proposed a Hunger Games scenario a few months ago.

Warped minds think alike

 

[Shikima]

Cue star trek fight music....

 

[bd290]

If either ERAS participation, ACGME accreditation or if DGME payments were contingent upon publication of this information, I'd be willing to bet that almost every program would make it available. It's easy to see why applicants are so frustrated by the lack of transparency in this process and end up over applying!

Amen. You get to see everything about me and I get to see nothing about you? Give me my 20$ back.

 

[OldPsychDoc]

Here's another possible improvement: giving applicants (only) access to anonymous resident surveys along with the % of residents who completed them. Sort of like LORs, but for programs.

Like LORs that were written by attendings who didn't really want to write them, don't know what they're for, and are sort of peeved at you for forgetting to bring donuts for morning report that one day...

[Translation: don't get me started on the ACGME.]

 

[MacDonaldTriad]

I sure don’t feel underexposed or mysterious to applicants. We have a couple of score of attendings that are good at HIPPA, but couldn’t keep a good piece of gossip if their lives depended upon it. It’s hard to keep anything secret in a department. None the less, I’m often the last person to hear some types of things.

 

[downwithDTB]

Like LORs that were written by attendings who didn't really want to write them, don't know what they're for, and are sort of peeved at you for forgetting to bring donuts for morning report that one day...

[Translation: don't get me started on the ACGME.]

Fair point.

 

[Psychotic]

In my own case, I applied to 30 (following my own student affairs office "recommendation") and I am sitting on 11 invites. Out of those, 9 of them I am interested in and I am waiting to hear back from another 4 programs that I feel would be a good fit but might not be apparent based on just my ERAS. I would love to receive some sort of closure on the programs that I am waiting on so that I can free up the invites that I am less interested in at the moment.

Umm, this process is working rather well for you - you do realize that, right? I don't see the problem, for you at least, and am not sure why you think the system is flawed.

You say you are interested in 9 of 11 invites received - so go ahead and drop or cancel the 2 you are not interested in. You will be fine with the 9 if no other invites come in, and if the magic 4 show up, and you have to cancel some of the 9 to fit them in, you are golden. Or you can go on all 13 interviews. You win under any scenario.

Stick with the 9. If any other interviews come in, and you aren't interested in them, don't schedule them.

You are not going to get "closure" and no program owes it to you. Some will send a "sorry but we don't like you enough" email but most are silent rejections. Just like med school apps - you do remember the silent rejections, right?

Right now, you have a winning hand. You played the app game very well. Congratulations.

 

[Throwaway2016]

Umm, this process is working rather well for you - you do realize that, right? I don't see the problem, for you at least, and am not sure why you think the system is flawed.

You say you are interested in 9 of 11 invites received - so go ahead and drop or cancel the 2 you are not interested in. You will be fine with the 9 if no other invites come in, and if the magic 4 show up, and you have to cancel some of the 9 to fit them in, you are golden. Or you can go on all 13 interviews. You win under any scenario.

Stick with the 9. If any other interviews come in, and you aren't interested in them, don't schedule them.

You are not going to get "closure" and no program owes it to you. Some will send a "sorry but we don't like you enough" email but most are silent rejections. Just like med school apps - you do remember the silent rejections, right?

Right now, you have a winning hand. You played the app game very well. Congratulations.

Oh, I apologize if it appeared as though I was complaining (or even worse, humble bragging) because I am not at all and I am very grateful for the interview invites that I have received. I know that I have had a successful season so far. I just mentioned the number of interviews to applications to illustrate the "tone from the top" concerning the increasing number of applications to send in cases where they probably were not warranted. I posted the topic because I am interested in the process in general and coming up with ways to improve an issue that I imagine will only get worse before getting better. Since everyone involved has the general goal of finding the best fit.

Also, I know that silent rejections or wait lists are my probable future...such is life. I was just saying how I would love it if I did receive some "closure" on the applications that I am still waiting on. What is the point of setting your hopes small?