What is good about the match?

[luckrules]

Just read this article: http://www.forbes.com/sites/theapot...dency-matching-system-for-newly-minted-m-d-s/

And I'm wondering what exactly is good about the match. For patients? For attending doctors? For hospitals/training programs? For the public?

Is it JUST an historical anachronism or are their ANY pros. Looking for both personal stories and well reasoned analysis out there.

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[evilbooyaa]

Of course there are pros. Read the comments that were posted as replies to the article. One of them agrees with the author, then laments the fact that medical students have to do a residency after finishing medical school. If you believe residency shouldn't be a requirement to practice medicine, then it casts the article in a completely different outlook and deserves its own thread.

Pretty much every other comment refutes the original article. I've had two friends at different medical schools post this article on facebook, and here's the cliffnotes of my response to them:

1) Including US Seniors who successfully SOAPed, while excluding DOs that were withdrawn from the ACGME match due to getting an AOA spot, the 5.6% and 22.3% numbers aren't valid. The 25% "unemployment" total is largely due to IMGs.

2) Regarding the salary, the median is 75k-85k for people between 25-34. If you went straight from college to medical school, you will likely be an attending by the age of 30 (depending on fellowship/length of residency), at which point you should be making at least 150k. IMO, that balances out.

3) Resident salaries are funded by Medicare. If you paid each resident 50% more, there wouldn't be enough Medicare funding in the current model to maintain all of the resident spots that currently exist. With the "physician shortage" present, there's no way it's going to change.


I will say the ONE legit criticism that the article has is that some people end up not matching, and have to SOAP into a field completely different from their original aspirations. This is why medical schools harp so much on "having a back-up plan" if you're a borderline residency candidate. For people that are 100% dedicated to one field, that year may be spent doing research. If the desire to get out into practice is greater than the desire to stick to that one field, then do a pre-lim year and re-apply, or SOAP into a different field.

If we got rid of the match, there would be absolutely 0 reason for the old system to not rear it's ugly head again.

She also suggests no alternative. It's not a flawless system due to the fact that a small proportion of students don't get their 1st specialty choice, but what is in this world?

 

[caffeinemia]

I would argue that the match should only be held responsible for the 5.6% US allopathic non-match rate.

The Match cannot be responsible for DOs who attempt to find a spot. The DO's have their own set of residencies and their own match (https://natmatch.com/aoairp/) and if they want to jump into the over-saturated MD fray, that's totally one of those "buyer beware" situations. (I do realize that accreditation for DO and MD residencies will soon fall under the same jurisdiction and I wonder how this will affect both matches...)

I think it's also important to clarify whether the 5.6% non-match rate is pre or post SOAP. If a significant fraction of the 5.6% manage to find positions with SOAP, then I wouldn't say that the Match did a terrible job.

Regarding the salary issue, I think it's safe to say that medical training is not a free market in many ways. I also don't think the Match is entirely responsible for the depressed salaries. Congress has frozen the funding for residency spots since 1995... so our salaries are roughly 20 years in the past -- that may contribute significantly to this problem.

Regarding pros, I think the Match is moving towards greater fairness than one would think. In my specialty, all the programs committed to no communication with the applicants after the interview, which saved many applicants from the heartbreak of broken promises/biased decisions based on said promises.

 

[SouthernSurgeon]

I think the main problem with the article is that none of the criticisms it raises are specific to the match. They are due to the changes in the ratio of slots to applicants over time, particularly in competitive fields.

I also find the title of the article very strange, as she doesn't bring up the Nobel prize winner until the concluding paragraph, and even then doesn't clearly explain his role or what that has to do with the current problems.

 

[evilbooyaa]

I think the main problem with the article is that none of the criticisms it raises are specific to the match. They are due to the changes in the ratio of slots to applicants over time, particularly in competitive fields.

I also find the title of the article very strange, as she doesn't bring up the Nobel prize winner until the concluding paragraph, and even then doesn't clearly explain his role or what that has to do with the current problems.

Welcome to the ramblings of a (likely disgruntled) 4th year medical student.

 

[SouthernSurgeon]

Welcome to the ramblings of a (likely disgruntled) 4th year medical student.

The cynical part of me thinks the title was deliberately misleading...as I initially thought I was reading an article written by a Nobel winning economist...until I started seeing the funny math contained within and looked up at the byline.

 

[Kaputt]

This is such a terrible article. None of the criticisms of the process are actually about the algorithm itself -- it's just a rant about how there aren't enough spots, it's expensive to apply, and resident pay isn't 6-figures (and how MD/JDs don't get a bigger salary for their...added skills? What might those be by the way?)

The old way sucked and that's why the match exists. The match takes power out of programs' hands and protects the applicants. Anybody who doesn't agree with the match in principle probably doesn't understand how bad the alternative was.

 

[DermViser]

Just read this article: http://www.forbes.com/sites/theapot...dency-matching-system-for-newly-minted-m-d-s/

And I'm wondering what exactly is good about the match. For patients? For attending doctors? For hospitals/training programs? For the public?

Is it JUST an historical anachronism or are their ANY pros. Looking for both personal stories and well reasoned analysis out there.

Yes, one big pro: without it, it would be absolute chaos with coercion of applicants.

 

[DermViser]

Welcome to the ramblings of a (likely disgruntled) 4th year medical student.

No she matched into EM according to the link in the comments.

 

[ValentinNarcisse]

There should be an equivalent to Early Decision for residency selection. If a student knows where they need to be geographically or otherwise, I do not see why is wrong for them to secure a position. The problem with competitive specialities is every applicant applies to 50+ programs. As a result, programs have to use numerics to sort people even though those that may NEED to be in a location would be likely to rank programs higher. Why should someone from Alabama, who could happily live anywhere, take a New York position from someone with strong family links to the area?

 

[SouthernSurgeon]

There should be an equivalent to Early Decision for residency selection. If a student knows where they need to be geographically or otherwise, I do not see why is wrong for them to secure a position.

You have to think about the potential for abuse in any of these hypothetical scenarios.

If you have a binding early decision option (in which presumably an applicant can only apply to one program as it is binding?) -> What's to stop the program from saying - this year we will be filling all of our slots via Early Decision? Then they force applicants who weren't sure about a program to give up their aspect of choice in favor of securing ANY spot.

The problem with competitive specialities is every applicant applies to 50+ programs.

As long as applicants >> slots in competitive fields, I don't see how this changes, match or no match.

Why should someone from Alabama, who could happily live anywhere take a New York, position with strong family links to the area?

What?

 

[username456789]

Why should someone from Alabama, who could happily live anywhere, take a New York position from someone with strong family links to the area?

Lolwut

 

[caffeinemia]

When?

 

[ValentinNarcisse]

Ok, I will clarify. Given that a speciality is competitive, an applicant from any location will have to apply to almost all programs in all locations. The programs will sort based on other metrics (step1, grades, etc) to select and interview candidates. All candidates will rank all programs they interview at, even if it was not their top geographic choice. As a result, applicants from location X is just as likely to match in location Y, as is an applicant from location Y itself. Personally, it is a huge problem to the applicant from Y, while the applicant from location X would have been just as happy with location Z.

 

[Brain Bucket]

Ok, I will clarify. Given that a speciality is competitive, an applicant from any location will have to apply to almost all programs in all locations. The programs will sort based on other metrics (step1, grades, etc) to select and interview candidates. All candidates will rank all programs they interview at, even if it was not their top geographic choice. As a result, applicants from location X is just as likely to match in location Y, as is an applicant from location Y itself. Personally, it is a huge problem to the applicant from Y, while the applicant from location X would have been just as happy with location Z.

And I didn't get into a U.S. med school? wtfhax.

 

[SouthernSurgeon]

Personally, it is a huge problem to the applicant from Y, while the applicant from location X would have been just as happy with location Z.

This is an exceptionally selfish, narcissistic perspective. Why should an applicant from (in your hypothetical) Alabama be denied an opportunity to seek out their training program of choice just because they didn't happen to be born there? Who are you to say that wanting to live in the city, or falling in love with the particular training program are not perfectly valid reasons for an applicant to seek a program?

 

[boogaloo]

Ok, I will clarify. Given that a speciality is competitive, an applicant from any location will have to apply to almost all programs in all locations. The programs will sort based on other metrics (step1, grades, etc) to select and interview candidates. All candidates will rank all programs they interview at, even if it was not their top geographic choice. As a result, applicants from location X is just as likely to match in location Y, as is an applicant from location Y itself. Personally, it is a huge problem to the applicant from Y, while the applicant from location X would have been just as happy with location Z.

Thanks for clarifying. That being said, who cares about applicant Y? If X matched, then X was ranked higher by the program, and X ranked that program higher than location Z (i.e., "just as happy" is not up to applicant Y to decide).

 

[username456789]

Ok, I will clarify. Given that a speciality is competitive, an applicant from any location will have to apply to almost all programs in all locations. The programs will sort based on other metrics (step1, grades, etc) to select and interview candidates. All candidates will rank all programs they interview at, even if it was not their top geographic choice. As a result, applicants from location X is just as likely to match in location Y, as is an applicant from location Y itself. Personally, it is a huge problem to the applicant from Y, while the applicant from location X would have been just as happy with location Z.

I'm trying to believe that you're not truly this stupid, but . . . well, you're not helping.

 

[Wordead]

There should be an equivalent to Early Decision for residency selection. If a student knows where they need to be geographically or otherwise, I do not see why is wrong for them to secure a position. The problem with competitive specialities is every applicant applies to 50+ programs. As a result, programs have to use numerics to sort people even though those that may NEED to be in a location would be likely to rank programs higher. Why should someone from Alabama, who could happily live anywhere, take a New York position from someone with strong family links to the area?

Why don't you just be a better applicant than the kid from alabama....should easy considering how inbred he/she probably is, amiright

 

[DermViser]

This is an exceptionally selfish, narcissistic perspective. Why should an applicant from (in your hypothetical) Alabama be denied an opportunity to seek out their training program of choice just because they didn't happen to be born there? Who are you to say that wanting to live in the city, or falling in love with the particular training program are not perfectly valid reasons for an applicant to seek a program?

I'm trying to believe that you're not truly this stupid, but . . . well, you're not helping.

It's location protectionism at its finest. I'll go even further, all medical students should be restricted to only their state for residency positions in their specialty. (sarc off).

 

[DermViser]

Why don't you just be a better applicant than the kid from alabama....should easy considering how inbred he/she probably is, amiright

Psst...UAB is a great, stellar institution. USA on the other hand...

 

[Wordead]

Psst...UAB is a great, stellar institution. USA on the other hand...

A lotta stellar institutions I couldn't ever see myself at - Pitt, Iowa come to mind.

 

[DermViser]

A lotta stellar institutions I couldn't ever see myself at - Pitt, Iowa come to mind.

You mean bc they don't want you? Pitt is a top notch institution. Don't really know much about Iowa.

 

[greg1184]

Psst...UAB is a great, stellar institution. USA on the other hand...

Yeah, USA was definitely a smallish hospital. Mobile is a pretty town though.

At least the institution I am going to, MCG, is a nicer hospital.

 

[greg1184]

As for the match itself, it is supposed to benefit the applicants. I certainly did not feel the benefit of it despite playing the numbers game (11 interviews). Just felt the waste of thousands of dollars of money and energy of going to these interviews, lots of great feedback on the trail, hours of painstaking decisions regarding my rank list, months of nervous anticipation, only to get the infamous "We're 'sorry'..." email, and then barely getting a spot in the 2nd offer period based on a 5 minute interview on the phone during the scramble. Talk about an emotional rollercoaster while everyone else was experiencing the elation of matching. But that was just my experience, which is probably irrelevant to the bigger picture... since just about everyone of my friends matched to their heart's desire.

The SOAP is a major improvement from the previous scramble. However the timing of applying to additional programs during the offer period is horrendus given the fact you don't know if that program will fill during the offer period. Made for a lot of wasted programs on the list.

 

[DermViser]

As for the match itself, it is supposed to benefit the applicants. I certainly did not feel the benefit of it despite playing the numbers game (11 interviews). Just felt the waste of thousands of dollars of money and energy of going to these interviews, lots of great feedback on the trail, hours of painstaking decisions regarding my rank list, months of nervous anticipation, only to get the infamous "We're 'sorry'..." email, and then barely getting a spot in the 2nd offer period based on a 5 minute interview on the phone during the scramble. Talk about an emotional rollercoaster while everyone else was experiencing the elation of matching. But that was just my experience, which is probably irrelevant to the bigger picture... since just about everyone of my friends matched to their heart's desire.

The SOAP is a major improvement from the previous scramble. However the timing of applying to additional programs during the offer period is horrendus given the fact you don't know if that program will fill during the offer period. Made for a lot of wasted programs on the list.

Did you apply to few programs? Thus not getting more interviews? That being said you made it into the specialty you wanted: Radiology (must conserve my sympathy for those who deserve it). The SOAP was a hindrance, but hardly life-changing in your case. Imagine how much worse it would have been with the Scramble. You wouldn't even have gotten your app in by faxing.

 

[BurghStudent]

I think the main problem with the article is that none of the criticisms it raises are specific to the match. They are due to the changes in the ratio of slots to applicants over time, particularly in competitive fields.

I also find the title of the article very strange, as she doesn't bring up the Nobel prize winner until the concluding paragraph, and even then doesn't clearly explain his role or what that has to do with the current problems.

It's an op-ed piece. Less editing I guess.

 

[greg1184]

Did you apply to few programs? Thus not getting more interviews? That being said you made it into the specialty you wanted: Radiology (must conserve my sympathy for those who deserve it). The SOAP was a hindrance, but hardly life-changing in your case. Imagine how much worse it would have been with the Scramble. You wouldn't even have gotten your app in by faxing.

Don't mind me, I am just a lowly resident venting on an internet forum.

 

[DermViser]

Don't mind me, I am just a lowly resident venting on an internet forum.

No I understand you. I wouldn't wish that on anyone. That moment must have felt like sheer terror. I'd be drinking all the way till the start of internship if that had happened to me. That being said you should be overjoyed to match into radiology and at an academic program. I feel like you need a big hug!

 

[Wordead]

You mean bc they don't want you? Pitt is a top notch institution. Don't really know much about Iowa.

I'm sure they probably don't - and I'm sure I'd eat my words and go if they offered an interview. But Pittsburgh is just the worst.

 

[rocketbooster]

The match is bogus and should be changed. Everyone in competitive fields applies to 50+ programs because they think they won't match otherwise. You have the top top applicants taking and going on way too many interviews that the average applicant could have used. Of course most programs are going to first choose to interview the top applicants, so these ppl get all the interviews, go on way more than needed and just waste the interview spot someone could have used, or even cancel the interview last minute without enough time for programs to find replacements. You have ppl from the west coast with no intention of leaving the west coast applying to east coast programs and vice versa. It's all a scam and it causes many ppl to either not match or be thrown to a completely different geographic area they're not interested in. Programs also get pissed that they have so many ppl applying because it makes it so hard and subjective on who they interview.

Solution? Limit every applicant to apply to 10 programs. That'll actually make ppl look closely on where to apply and programs will not waste interview spots on ppl who have no real interest in attending the program. Until this happens, everyone will continue to apply to 50+ programs and the applicant must be prepared to end up at any program in the country.

 

[ValentinNarcisse]

The match is bogus and should be changed. Everyone in competitive fields applies to 50+ programs because they think they won't match otherwise. You have the top top applicants taking and going on way too many interviews that the average applicant could have used. Of course most programs are going to first choose to interview the top applicants, so these ppl get all the interviews, go on way more than needed and just waste the interview spot someone could have used, or even cancel the interview last minute without enough time for programs to find replacements. You have ppl from the west coast with no intention of leaving the west coast applying to east coast programs and vice versa. It's all a scam and it causes many ppl to either not match or be thrown to a completely different geographic area they're not interested in. Programs also get pissed that they have so many ppl applying because it makes it so hard and subjective on who they interview.

Solution? Limit every applicant to apply to 10 programs. That'll actually make ppl look closely on where to apply and programs will not waste interview spots on ppl who have no real interest in attending the program. Until this happens, everyone will continue to apply to 50+ programs and the applicant must be prepared to end up at any program in the country.

This is precisely my point.

 

[rocketbooster]

This is precisely my point.

And considering several chairs and PDs brought this up at my ophtho interviews, I'd say this is spot on and desired by both parties.

Unfortunately it'll never happen because sfmatch and eras make tons of money on the current system and they would have to be the ones who enforce a 10 program limit.

 

[SouthernSurgeon]

This is precisely my point.

No, it really wasn't

 

[SouthernSurgeon]

The match is bogus and should be changed. Everyone in competitive fields applies to 50+ programs because they think they won't match otherwise. You have the top top applicants taking and going on way too many interviews that the average applicant could have used. Of course most programs are going to first choose to interview the top applicants, so these ppl get all the interviews, go on way more than needed and just waste the interview spot someone could have used, or even cancel the interview last minute without enough time for programs to find replacements. You have ppl from the west coast with no intention of leaving the west coast applying to east coast programs and vice versa. It's all a scam and it causes many ppl to either not match or be thrown to a completely different geographic area they're not interested in. Programs also get pissed that they have so many ppl applying because it makes it so hard and subjective on who they interview.

Solution? Limit every applicant to apply to 10 programs. That'll actually make ppl look closely on where to apply and programs will not waste interview spots on ppl who have no real interest in attending the program. Until this happens, everyone will continue to apply to 50+ programs and the applicant must be prepared to end up at any program in the country.

I hate to once again be the contrarian. I'm starting to feel like L2D.

1) artificially restricting applicant choice (by limiting number of interviews) is not good for applicants. Among other things it increases the likelihood of "flukes" of the match and a well qualified applicant going unmatched
2) you still haven't addressed the fact that the issue is, in competitive fields, applicants outnumber spots. In some cases dramatically so. Even if by limiting the number of interviews you somehow end up with marginal applicants getting another interview or two, the overall match result would be the same - the best applicants get the spots

 

[Kaputt]

The match is bogus and should be changed. Everyone in competitive fields applies to 50+ programs because they think they won't match otherwise. You have the top top applicants taking and going on way too many interviews that the average applicant could have used. Of course most programs are going to first choose to interview the top applicants, so these ppl get all the interviews, go on way more than needed and just waste the interview spot someone could have used, or even cancel the interview last minute without enough time for programs to find replacements. You have ppl from the west coast with no intention of leaving the west coast applying to east coast programs and vice versa. It's all a scam and it causes many ppl to either not match or be thrown to a completely different geographic area they're not interested in. Programs also get pissed that they have so many ppl applying because it makes it so hard and subjective on who they interview.

Solution? Limit every applicant to apply to 10 programs. That'll actually make ppl look closely on where to apply and programs will not waste interview spots on ppl who have no real interest in attending the program. Until this happens, everyone will continue to apply to 50+ programs and the applicant must be prepared to end up at any program in the country.

No, limiting to 10 applications is dumb. That goes against the spirit of the match -- which allows the applicant to apply to and rank programs based on their actual preference, instead of trying to game the system or only apply to or rank places they think they have a shot at.

Your point about people over-applying is moot. Even when top dog applicants interview at 20 places (which is super common in instances of couples matching), the spots trickle down to us normals later. If the top dogs were actually throwing a wrench into the system, there would be more unfilled spots in the competitive specialties...which there aren't. Programs aren't dumb and lots of them issue interviews not just based on app strength, but also likelihood that the applicant will rank them highly. Which is the much-maligned concept of "regional bias" but I think it's fair for the programs to do that.

 

[ValentinNarcisse]

And considering several chairs and PDs brought this up at my ophtho interviews, I'd say this is spot on and desired by both parties.

Unfortunately it'll never happen because sfmatch and eras make tons of money on the current system and they would have to be the ones who enforce a 10 program limit.

Another interesting thing they could add is the ability to trade within your speciality with another applicant who was at least ranked by your program. This way a person who ended up in an undesired location, can swap with someone in the same boat.

 

[rocketbooster]

I hate to once again be the contrarian. I'm starting to feel like L2D.

1) artificially restricting applicant choice (by limiting number of interviews) is not good for applicants. Among other things it increases the likelihood of "flukes" of the match and a well qualified applicant going unmatched
2) you still haven't addressed the fact that the issue is, in competitive fields, applicants outnumber spots. In some cases dramatically so. Even if by limiting the number of interviews you somehow end up with marginal applicants getting another interview or two, the overall match result would be the same - the best applicants get the spots

It wouldn't help more ppl match. It would help prevent more ppl from ending up in regions they don't want to be.

Another interesting thing they could add is the ability to trade within your speciality with another applicant who was at least ranked by your program. This way a person who ended up in an undesired location, can swap with someone in the same boat.

I'd be fine with this but programs would not be since they may have not even interviewed the other person and have 0 interest in them.

 

[Wordead]

It wouldn't help more ppl match. It would help prevent more ppl from ending up in regions they don't want to be.



I'd be fine with this but programs would not be since they may have not even interviewed the other person and have 0 interest in them.

If people didnt want to be in the region they shouldnt have ranked it. I don't really see what the big deal is. Rather be somewhere unfavorable or go unmatched?

 

[rocketbooster]

If people didnt want to be in the region they shouldnt have ranked it. I don't really see what the big deal is. Rather be somewhere unfavorable or go unmatched?

The point is if you're limited to 10 then the same # of ppl still match but you won't have ppl applying to every region and thus each region would have all residents who want to be there.

 

[boogaloo]

If people didnt want to be in the region they shouldnt have ranked it. I don't really see what the big deal is. Rather be somewhere unfavorable or go unmatched?

Agreed about not ranking a place you don't see yourself at. Their reasoning really doesn't make sense at all and is reminiscent of the incessant whining that goes on in medical school. I'm a competitive applicant because I worked really hard for three years, and I set myself up for success in the Match. Why punish me or the residency programs just to cater to less competitive applicants? I should be able to apply to as many programs as I want to, and the choice to interview or rank me should be in the programs' hands. I don't get what all the hoopla is about. The system is more fair than anything anyone has proposed so far and actually favors the applicant--unless, that is, you sucked it up in medical school and have nobody else to blame.

 

[Wordead]

The point is if you're limited to 10 then the same # of ppl still match but you won't have ppl applying to every region and thus each region would have all residents who want to be there.

There are plenty of people every year that rank lower than #10 though, so those people would go unmatched despite being superior applicants than those who DO match, in your scenario.

And what about the people for whom location is not the overriding factor?

 

[sazerac]

The point is if you're limited to 10 then the same # of ppl still match but you won't have ppl applying to every region and thus each region would have all residents who want to be there.

No, if you are a Californian, and a person from Ohio would rather be in California too, and they are more qualified than you, then the Ohio person will STILL get that position in California instead of you. The only difference is you are going to be out of a job.

Sometimes other candidates would rather work in your region. And they are more qualified to be there than you are, as shown by their successful match. Since you yourself aren't qualified to work in your own region, you should thank your lucky stars the match process allows you to apply to more than 10 programs so you can have a residency position at all.

The match is a beautiful and elegant solution. Those who do not understand the match are condemned to reinvent it, poorly.

 

[KnuxNole]

There should be an equivalent to Early Decision for residency selection. If a student knows where they need to be geographically or otherwise, I do not see why is wrong for them to secure a position. The problem with competitive specialities is every applicant applies to 50+ programs. As a result, programs have to use numerics to sort people even though those that may NEED to be in a location would be likely to rank programs higher. Why should someone from Alabama, who could happily live anywhere, take a New York position from someone with strong family links to the area?

Cause they feel like it? Nothing wrong with this for one iota of a second.

Same can be said for the New York person. After all, there's 100x better places in the US than NYC

 

[ValentinNarcisse]

No, if you are a Californian, and a person from Ohio would rather be in California too, and they are more qualified than you, then the Ohio person will STILL get that position in California instead of you. The only difference is you are going to be out of a job.

Sometimes other candidates would rather work in your region. And they are more qualified to be there than you are, as shown by their successful match. Since you yourself aren't qualified to work in your own region, you should thank your lucky stars the match process allows you to apply to more than 10 programs so you can have a residency position at all.

The match is a beautiful and elegant solution. Those who do not understand the match are condemned to reinvent it, poorly.

It's a messed up problem unique to medicine. Most other professions such as law and finance are based in major cities. These jobs command the salaries commiserate with the cost of living. If you have a significant other or family in another profession, matching in Ohio is not an option. Every aspect of medical training tries to push people from the coasts to the Midwest and the South for training and practice, while students and residents try to claw their way back to the coasts. Practicing physicians accept huge salary cuts (assistant professors making 120K) just to live on the coast close to family. There is nothing wrong with geographic protectionism, look at the example of Texas. Texas has its own medical school application system, heavily subsidizes tuition, and the vast majority of graduates will match at Texas programs for residency.

I fail to see why a student from a top medical school who performed solidly should have to apply to 50+ programs with no certainty of matching on the coasts. I guarantee a large percentage of applicants in this position would take a early decision type offer if they knew they were getting the speciality and region of their choice.

 

[Wordead]

It's a messed up problem unique to medicine. Most other professions such as law and finance are based in major cities. These jobs command the salaries commiserate with the cost of living. If you have a significant other or family in another profession, matching in Ohio is not an option. Every aspect of medical training tries to push people from the coasts to the Midwest and the South for training and practice, while students and residents try to claw their way back to the coasts. Practicing physicians accept huge salary cuts (assistant professors making 120K) just to live on the coast close to family. There is nothing wrong with geographic protectionism, look at the example of Texas. Texas has its own medical school application system, heavily subsidizes tuition, and the vast majority of graduates will match at Texas programs for residency.

I fail to see why a student from a top medical school who performed solidly should have to apply to 50+ programs with no certainty of matching on the coasts. I guarantee a large percentage of applicants in this position would take a early decision type offer if they knew they were getting the speciality and region of their choice.

 

[Anastomoses]

I hate to once again be the contrarian. I'm starting to feel like L2D.

1) artificially restricting applicant choice (by limiting number of interviews) is not good for applicants. Among other things it increases the likelihood of "flukes" of the match and a well qualified applicant going unmatched
2) you still haven't addressed the fact that the issue is, in competitive fields, applicants outnumber spots. In some cases dramatically so. Even if by limiting the number of interviews you somehow end up with marginal applicants getting another interview or two, the overall match result would be the same - the best applicants get the spots

I looked up L2d but only got images for an aircraft. Or Urban dictionary's "love 2 defecate".

 

[SouthernSurgeon]

L2D is a longtime poster here - Law2Doc

 

[SouthernSurgeon]

Every aspect of medical training tries to push people from the coasts to the Midwest and the South for training and practice

What?

I've felt like every level of training has, and continues to, push me TOWARDS the coast and away from the midwest/south, due to the number/prestige of academic training programs in the Northeast and Cali.

And, to reiterate what I said earlier...the solution to this perceived problem (which I'm still unclear exactly what the problem is other than that you think someone less deserving is going to "steal" a spot in your coveted location) is not to limit applicant choice. Limiting applicant choice takes us even further away from a free market situation. Right now both applicants and programs over-interview. Decreasing applicant interviews would just skim some of the excess of both ends, but would also decrease applicant flexibility and choice.

 

[rocketbooster]

Limiting it to 10 would not prevent the top ppl from matching in Cali. If they wanted to match there then they would apply to some cali schools in their 10.

Every one these days just uses the shotgun approach and applies to as many as possible since it's easy with the click of a button. You used to have to send a packet to every individual program. A person who is AOA and 260 step 1 still applies to 40 programs which makes the average applicants to apply to 70. It's ridiculous and done because it's so easy. When you meet some top applicants at average program interviews, they act too good for it and just bash it the whole time while taking an interview spot. They're usually ranked high by the program because programs pre rank you anyway and interviews arent as big of a factor as ppl think. They match at a better program anyway so just take the spot from another average applicant. These ppl go on 15+ interviews which is completely unnecessary. Why? To feed their own ego. If you can't match with 10, then you did something wrong either applying to only top places or have a bad personality.

And I agree with above about you're basically forced to move to the coast for residency because there are way more programs there.