Unfilled in Prev Yrs

[FMGuy]

Hey Everybody

Right now, I'm going through my top programs... Whippin' out my excel spread sheet... And tryin' to crank out a rank list (And I've got a feelin' I'm not alone.. )

And amidst all of the factors, one red flag that stands out for programs... is not filling in previous years. And so my question (which is probably more for residents... just cuz they've had first hand experience)... how important is whether or not a program consistently fills (especially if the program is always filled after the scramble)?

Does it affect workload (pickin up slack for weaker residents)? Comraderie? General standing/reputation of the program (and how hard it might be... getting a job afterwards)? And is it possibly an indication of a larger problem? (and if so, what?)

Or... in the whole scheme of things, is it just more important that, after scramble, the program is full? (Maybe, for example, the program is simply a little more selective, initially, when choosing whether or not to rank an applicant)

Any thoughts are much appreciated! Thanks in advance, everyone! And g'luck!!


By the way, Here's a couple links for others who are interested:
*the code (in the below links) is...total slots third number from end (right), matched spots (before scramble) second number from end, and unfilled spots (before scramble) last number on end

2004, 2005
http://www.medfriends.org/match_statistics/index.htm
(scroll to bottom)

2006
forums.studentdoctor.net/attachment.php?attachmentid=7882&d=1173342004

2007
http://forums.studentdoctor.net/archive/index.php/t-380096.html

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[secretwave101]

My second-favorite program in the country (Pueblo, CO) rarely fills all 6 spots. They pick up good people in the scramble, so they're pretty much always 6-6-6 and work is even. But I wouldn't read too much into fill rates. 10 times more important is how you feel about the PD and the program itself. I'm happy with my program, but sometimes I still wish I'd gone to Pueblo.

 

[lowbudget]

Does it affect workload (pickin up slack for weaker residents)? Comraderie? General standing/reputation of the program (and how hard it might be... getting a job afterwards)? And is it possibly an indication of a larger problem? (and if so, what?)

Or... in the whole scheme of things, is it just more important that, after scramble, the program is full? (Maybe, for example, the program is simply a little more selective, initially, when choosing whether or not to rank an applicant)

I don't think you can read so much into 1 statistic. It can be all those things you listed *and/or* none of those things you listed. What sucks about the scramble is just how random it is. You don't know if you picked up a ****** or a gunner dumb enough to only list 1 program on their rad-onc match list. And, off cycle students (i.e. those who failed as well as those who simply took a few months off to raise their children) can't participate in the Match because they can't start July 1st and so many of them will interview with a program then scramble in, but as a "known quantity".

Yea, I used to think the Fill rate was an indicator for quality but it's not. Programs can manipulate the numbers by submitting a large rank list with weak candidates on the bottom. Other programs would rather risk the Scramble and will submit a short list of their strongest candidates.

To me, I think it's fair to say that big programs that every now and then don't fill 1 or 2 positions are probably ok. Small programs that consistently must scramble every position every year would be a place I'd rather not be. Everything else in the middle is in the gray zone and subject to other the consideration of variables.

 

[MeowMix]

One program I know of typically fills 2-3 of 8 spots and then scrambles for the rest. They get very good people in the scramble, but let's face it, when half your residents are spending the beginning of intern year feeling regret about not matching into their first choice specialty (let alone their first choice program), the program's vibe is going to be affected.

If it was only 1 of 8 spots, it would be completely different. That, I don't think is a big deal at all.

 

[sophiejane]

In general, it's not a good sign when a program consistently fails to fill. It may be related to location, or other factors beyond the control of the program itself, but I think you should think pretty hard about programs that have to scramble every year. Are there too many spots? Are there problems with the training? Certainly many programs occasionally go unfilled, but on the opposite end, when you look at programs that almost never go unfilled and always have strong, competitive applicants, those tend to be the stronger programs.

 

[Faebinder]

Some programs don't fill cause they are too arrogant to build a long enough ranking list and would rather pick some high scorers in the scramble. So beware of those.

 

[Doc Oc]

Some programs don't fill every year, or scramble every year, because they are in the middle of nowhere. Fewer people are from that area, there's no family nearby, and definitely fewer job opportunities for spouses. If there's no medical school nearby, there's another negative.

I would only consider this factor seriously in locations that are not rural, near a med school, with lots of jobs.

My program is excellent, great teaching, everyone's happy, we laugh and play pranks on eachother all the time, the comraderie can't be beat, etc, and sometimes we scramble. The last two years we didn't, but most of the time, a couple of the spots are filled in the scramble. We're rural, there's no jobs, and nobody's from here. I'd hate for someone to discount this program because they read that some years we scramble.

 

[Doowai]

One of the programs listed, as having one unfilled spot last year and 2 the year before that is a program that offered me a prematch this year.

Safe small town. Pay is good ($51,000 year), 4 weeks vacation first year (1 additional week CME years 2 and 3), moonlighting for FMG in 3rd year, retirement savings plan in which they match 11% of your income into it and expect you to contribute 5% of your income (meaning you will have at least $20,000 in the bank upon graduation), near major cities (1 hour), slow paced (at home call every night during OB intern year - 2 months without any call at all). So it has alot of plusses - but I think being such a small town keeps people away. Plus it teaches no procedures really, so if you are into procedures that sucks.

However they hired hospitalists, so even if they did not fill its really no extra work for the residents.

 

[FMGuy]

Thanks everyone for replyin'. I really appreciated your insight on factors (location, local med schools, length of the program's rank list, etc) beyond just program strength that can affect whether a program'll fill.

And a quick follow up question: i know to some extent it probably depends on the program, but if there are a couple scramble residents who're not as strong... or if the program ends up being a resident short one year... how do you guys think that could affect everyone else? (with splitting call among fewer residents, some senior residents being slightly less qualified, signing out/having your clinic pts followed by fellow residents you might not completely trust... etc.)

Are these things a big deal? Are there other problems ... w. programs that consistently scramble that might be more important? Or in the whole scheme of things, is having a couple scramble residents (who might be as strong or stronger than the typical resident)... or being a resident down one year probably not a huge issue?


Any thoughts or ideas are much appreciated (especially from ppl whose programs do have scramble residents)! Thanks... and g'luck to everyone! It's hard not to be excited w. ROL due soon... and match day right around the corner !

 

[Doc Oc]

Thanks everyone for replyin'. I really appreciated your insight on factors (location, local med schools, length of the program's rank list, etc) beyond just program strength that can affect whether a program'll fill.

And a quick follow up question: i know to some extent it probably depends on the program, but if there are a couple scramble residents who're not as strong... or if the program ends up being a resident short one year... how do you guys think that could affect everyone else? (with splitting call among fewer residents, some senior residents being slightly less qualified, signing out/having your clinic pts followed by fellow residents you might not completely trust... etc.)

Are these things a big deal? Are there other problems ... w. programs that consistently scramble that might be more important? Or in the whole scheme of things, is having a couple scramble residents (who might be as strong or stronger than the typical resident)... or being a resident down one year probably not a huge issue?


Any thoughts or ideas are much appreciated (especially from ppl whose programs do have scramble residents)! Thanks... and g'luck to everyone! It's hard not to be excited w. ROL due soon... and match day right around the corner !

Those issues have potential to be problems wherever you go. People put differing amounts of effort into what they do. They were also trained in different places, with different biases. Among your attendings, there will be various practice styles, and your colleagues will approach patients based on their adaptations to these experiences and their personal history as well.

I disagree with the notion that "scramble residents" have a higher potential to be inferior in their medical knowledge and practice. I think that anyone, and everyone, from anywhere, has the potential to be a sucky person to work with, or to cause you to not sign out your pager but say you did sometimes based on whoever is assigned to cover you (which is technically not allowed).