2009 Scramble and Un-matched students

[winthug]

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I heard that this year's match was pretty bad across the US in that a lot of people had to scramble. Anybody mind posting their school's results? Mine had 12 students who had to scramble and I've heard 6 still haven't matched.

 

[Dirt]

I heard that this year's match was pretty bad across the US in that a lot of people had to scramble. Anybody mind posting their school's results? Mine had 12 students who had to scramble and I've heard 6 still haven't matched.

I don't think the match was bad. I heard the scramble was absolutely terrible though.

I won't post a match list but I will say that only a handful had to scramble at my school and from what I hear all of them deserved it. (Not to say that they actually deserved it, just that they didn't rank any safety programs, or reached for a specialty that was far beyond their means)

 

[Taurus]

This year's match was brutal. It was harder to match across the board, even FM. Why? Because the allo class sizes are increasing and more MD and DO schools are opening. Next year's match will be even worse. Unless the cap on residency spots gets lifted, I pity those graduating in 2011 and later. You'll have to be a freaking superstar to get even into gas or rads.

 

[copingmethods]

Next year's match will be even worse. Unless the cap on residency spots gets lifted, I pity those graduating in 2011 and later. You'll have to be a freaking superstar to get even into gas or rads.

Class of 2013 right here... 🙁

 

[phospho]

Class of 2013 right here... 🙁

lol, i was just about to say...😡

 

[bioteach]

From what I've heard, we had more people scrambling than usual. I'm worried about the trend for the next few years...

 

[WellWornLad]

Advanced match stats are available:

http://www.nrmp.org/

Looks like there was a big increase in applicants from international med schools and DOs, although their match rates were consequently hammered.

93.1% of U.S. seniors matched, 6.9% didn't match.

Bad by last year's standards (94.2%/5.8%), not so different from 2005-2007.

 

[TexasPhysician]

Advanced match stats are available:

http://www.nrmp.org/

Looks like there was a big increase in applicants from international med schools and DOs, although their match rates were consequently hammered.

93.1% of U.S. seniors matched, 6.9% didn't match.

Bad by last year's standards (94.2%/5.8%), not so different from 2005-2007.

I don't think a 1.1% change is much to worry about, unless this is a 1% decrease every year. Some students rank too few programs, there has been an increase in students choosing competitive lifestyle specialties, etc. Students choosing tough specialties and only ranking 5 programs is a huge mistake made way too often.

 

[njbmd]

Whether or not students from a particular medical school scrambled or did not scramble is not such a big deal. Some people scrambled because they didn't know how to maximize their chances of matching and that is personal problem not a school problem.

The match lists for various schools is on the Pre-Allo sites. Again, where a person matches is specialty and personal choice dependent and not school-dependent. Because someone matched in Derm at Hopkins in 2009 does not mean that if you attend a particular school, you will match into Derm at Hopkins.

If you are a current medical student, you need to spend some time with a good faculty adviser who can gage your competiveness for programs and if you are even competitive for a particular specialty. If you are a first-year medical student, the situation for the match may be entirely different from 2009 and you will have to make adjustments for that particular match not sit and worry about the one that just passed.

 

[tkim]

Advanced match stats are available:

http://www.nrmp.org/

Looks like there was a big increase in applicants from international med schools and DOs, although their match rates were consequently hammered.

93.1% of U.S. seniors matched, 6.9% didn't match.

Bad by last year's standards (94.2%/5.8%), not so different from 2005-2007.

The DO's and USIMG's match rates went down no doubt.

http://www.nrmp.org/data/advancedatatables2009.pdf

USMD 93.1% (-)1.1% from last year
USDO 69.9% (-)1.7% from last year
USIMG 47.8% (-)4.1% from last year

Of the three groups, USIMG's took it the worst. A sign of things to come for everyone.

 

[marcus8]

I heard that things were bad at my school too. I am a third year, so I am nervous about next year. Apparently, we even had someone who applied for psych not match.

 

[phospho]

Some students rank too few programs, .

can you rank as many programs as you want? For example, let's say you apply to 30 programs, and get 20 interviews, can you rank all 20?

if so, wouldn't that theoretically almost gaurantee you a match if you rank so many programs?

 

[Taurus]

can you rank as many programs as you want? For example, let's say you apply to 30 programs, and get 20 interviews, can you rank all 20?

The $40 fee to register with NRMP gets you 20 places to rank. If you go over that, it's $30 for each one.

If the field only has categorical programs, this is usually not a problem. However, if you have to do both prelim and advanced programs, you could exceed 20 because of the way you structure your rank list. It will make more sense when you actually go through it.

 

[Taurus]

The numbers everyone should focus on are the total applicants per year. For allo, it was 15638. Notice the upward trend for allo, osteo, and IMG's. Next year, it probably will exceed 16000 and in 5 years it will reach 20000 for allo, yet the number of residency spots will barely budge from this year. That's the reality that med students in the next few years will have to deal with. I'm so glad I went through this process now instead of later.

 

[Law2Doc]

can you rank as many programs as you want? For example, let's say you apply to 30 programs, and get 20 interviews, can you rank all 20?

if so, wouldn't that theoretically almost gaurantee you a match if you rank so many programs?

Statistically likely. But not guaranteed. There are many who applied to the very competitive fields who went very deep into their ROL. But yes, you can rank anyplace that interviewed you.

 

[Law2Doc]

I don't think a 1.1% change is much to worry about, unless this is a 1% decrease every year. ...

I think the % can stay the same if folks get smart and take notice that they need to apply to more programs and be more realisticly open to more specialties. But what is clear is that US allo numbers will be continuing to increase for the next few years (more people are already in the pipeline at most schools), so the 15.6k US seniors this year will be 16k next year and so on. That makes the competitive things more competitive and a lot of US students needing to contemplate more realistic options. And a lot of FMGs/IMGs getting bumped out of the game altogether over time.

 

[Therapist4Chnge]

The numbers everyone should focus on are the total applicants per year. For allo, it was 15638. Notice the upward trend for allo, osteo, and IMG's. Next year, it probably will exceed 16000 and in 5 years it will reach 20000 for allo, yet the number of residency spots will barely budge from this year. That's the reality that med students in the next few years will have to deal with. I'm so glad I went through this process now instead of later.

The same exact thing has been happening in Clinical Psychology....and it is only getting worse. I'd be worried.

 

[virusgirl]

The numbers everyone should focus on are the total applicants per year. For allo, it was 15638. Notice the upward trend for allo, osteo, and IMG's. Next year, it probably will exceed 16000 and in 5 years it will reach 20000 for allo, yet the number of residency spots will barely budge from this year. That's the reality that med students in the next few years will have to deal with. I'm so glad I went through this process now instead of later.

This scares the crap out of me. I will graduate in 2013, and while I don't have my sights set on derm or anything, even primary care fields seem to be experiencing a significant crunch relative to previous years.

What is the purpose of increasing the number of med school seats if there is no concurrent increase in residency slots?

 

[PerpetualPupil]

Again, where a person matches is specialty and personal choice dependent and not school-dependent. Because someone matched in Derm at Hopkins in 2009 does not mean that if you attend a particular school, you will match into Derm at Hopkins.

Would any residents out there care to chime on this?

Is the name of your school important in the minds of residency directors?

Should someone who has options for medical school be cognizant of 'brand power' as one factor in the decision making process?

 

[hermit]

This scares the crap out of me. I will graduate in 2013, and while I don't have my sights set on derm or anything, even primary care fields seem to be experiencing a significant crunch relative to previous years.

What is the purpose of increasing the number of med school seats if there is no concurrent increase in residency slots?

There are plenty of unfilled residency spots. Thousands. One problem: they are things like family practice.

Pre-meds do not know this. Mention it to your friends.

 

[Taurus]

While the difference in total applicants between 2008 and 2009 doesn't seem great, pretty much everyone in this year's match experienced its effects. To give you some perspective, rads saw an increase of 20% in applications in 2009 compared to 2008. People didn't get the interviews at the places that people last year would have gotten. People with 240+, even 260's, didn't match into rads this year. Part of that may have been due to poor planning because there are many factors to successfully match but it was also due to the greater number of applicants. If you extrapolate to 20000 allo grads, you can just imagine how difficult it will be to match into anything besides IM, peds, FM. Even in these fields, it will get more competitive to go to the program of your choice. By then, it will be as difficult to get into rads as it is to get into derm now. If this year is any guide, don't bet on being able to scramble into your desired specialty. Rads had 5 spots when in previous years there would have been 20+. Most likely, you'll see more and more people spend an extra year doing research to increase their competitiveness. Good luck to everyone who has to match in future years.

 

[MsKrispyKreme]

Class of 2013 right here... 🙁

Perhaps I should peruse ERAS in order to familiarize myself with the process...

 

[Taurus]

Here's a rough projection.

 

[howelljolly]

This scares the crap out of me. I will graduate in 2013, and while I don't have my sights set on derm or anything, even primary care fields seem to be experiencing a significant crunch relative to previous years.

What is the purpose of increasing the number of med school seats if there is no concurrent increase in residency slots?

The purpose is to force the hand of the best and brightest Americans to take a Primary Care spot.
In theory (physicians are good at this sort of thing), the applicants that will need to scramble will be American grads who didnt play their cards right, US citizen - International grads, and mediocre foreign grads. 224 Family Practice positions were available for the Scramble. The most qualified applicant is going to be the American grad who didnt match where they would have liked.

 

[badasshairday]

I think the % can stay the same if folks get smart and take notice that they need to apply to more programs and be more realisticly open to more specialties. But what is clear is that US allo numbers will be continuing to increase for the next few years (more people are already in the pipeline at most schools), so the 15.6k US seniors this year will be 16k next year and so on. That makes the competitive things more competitive and a lot of US students needing to contemplate more realistic options. And a lot of FMGs/IMGs getting bumped out of the game altogether over time.

I just have to ask this. How does a residency director discriminate a Caribbean student's step 1 score compared to a US MD student's score? When my family asked me when and how long I get to study for step 1, they were surprised that I get only about 1 month, while my sister's friend at a Carib school is getting 3 months to study for Step 1. If US students got that long, a lot more people would rock the exam.

 

[howelljolly]

I just have to ask this. How does a residency director discriminate a Caribbean student's step 1 score compared to a US MD student's score? When my family asked me when and how long I get to study for step 1, they were surprised that I get only about 1 month, while my sister's friend at a Carib school is getting 3 months to study for Step 1. If US students got that long, a lot more people would rock the exam.

A Carribbean student's Step1 score it taken with a bucket of salt.

You could take the "US Citizen Students/Graduates of International Medical Schools" data, as shown on the chart on Post#10 of this thread, as an indication of how they do in the match. 47.8% this year. The actual stat for Caribs is probably lower, because many US-IMGs go to school in the UK, Poland, Hungary, and India... and those grads do much better.

 

[Ashers]

I just have to ask this. How does a residency director discriminate a Caribbean student's step 1 score compared to a US MD student's score? When my family asked me when and how long I get to study for step 1, they were surprised that I get only about 1 month, while my sister's friend at a Carib school is getting 3 months to study for Step 1. If US students got that long, a lot more people would rock the exam.

Or they'd start losing information because they don't study effectively.

Or they'd still take 3-4 weeks to study and 2 months of vacation instead of 2 weeks.

You REALLY don't need more than 3-4 weeks of straight up full time studying to do well.

 

[Law2Doc]

...
What is the purpose of increasing the number of med school seats if there is no concurrent increase in residency slots?

Simple. The AAMC issued a number of press releases in 2005 stating that US med schools should generate enough manpower to fill all US healthcare needs and that we shouldn't be resorting to importing talent from offshore schools not under LCME oversight. Since then schools have been encouraged to increase their enrollment 10-15% (not including new school openings). By doing this without a concurrent increase in residency slots, you drive the offshore folks out of business because US students are matching at a rate of 93%, and will fill all the residency slots over time. It also has the added corollary that howelljolly suggests, of driving a greater % of the US grad matches into primary care slots previously snared by the offshore crowd (because those are what slots remain as competition for the specialties gets more fierce), but I doubt that is the main purpose, just a bonus. Bottom line, if the current trend continues, offshore students who don't graduate in the next few years are going to miss the window.

 

[Law2Doc]

I just have to ask this. How does a residency director discriminate a Caribbean student's step 1 score compared to a US MD student's score? When my family asked me when and how long I get to study for step 1, they were surprised that I get only about 1 month, while my sister's friend at a Carib school is getting 3 months to study for Step 1. If US students got that long, a lot more people would rock the exam.

There are programs that won't look at offshore grads regardless, and there are programs that would only look at an offshore grad with absurdly high numbers. An offshore grad who doesn't score better than his/her US counterparts has an uphill climb. There are, however, residencies which need the bodies more than the LCME seal of approval, and so currently offshore folks snag the shortfall between the 15.6k US allo seniors/ 1k prior year grads/2k DO grads and the total 22.4k positions. So basically 4000 of the 10,000 non-US med school applicants will land a spot in the match.

 

[frikarika]

Great, I was planning on backpacking through South America my entire summer...now I feel like I should do research.

 

[Richspiders07]

Great, I was planning on backpacking through South America my entire summer...now I feel like I should do research.

Combine the two! Do some public health work at the villages you go through, learn about natural medicine along the way, improve your spanish, etc.

 

[flip26]

The numbers everyone should focus on are the total applicants per year. For allo, it was 15638. Notice the upward trend for allo, osteo, and IMG's. Next year, it probably will exceed 16000 and in 5 years it will reach 20000 for allo, yet the number of residency spots will barely budge from this year. That's the reality that med students in the next few years will have to deal with. I'm so glad I went through this process now instead of later.

Is this a known fact, or simply the trend over the last few years with an assumption extrapolation?

Who controls these numbers?

 

[4Doc4]

I believe it is regulated by funding from the government. Comes out of medicare. No funding from the gov't, no extra spots.

 

[flip26]

I believe it is regulated by funding from the government. Comes out of medicare. No funding from the gov't, no extra spots.

Is it implied that we have "too many of these" and "not enough of those" that goes beyond the complaint that there are not enough primary care docs in rural and underserved areas?

Like, can anyone point to some key congressional committee report that lays this out for the foreseeable future? Like "we got too many radiologists and not enough pediatricians" logic?

I can accept the fact that the number of US allo grads is going up, meaning that overall competition in the match will go up, too, but if we have shortages, won't the number of residencies also have to go up eventually?

 

[4Doc4]

Is it implied that we have "too many of these" and "not enough of those" that goes beyond the complaint that there are not enough primary care docs in rural and underserved areas?

Like, can anyone point to some key congressional committee report that lays this out for the foreseeable future? Like "we got too many radiologists and not enough pediatricians" logic?

I can accept the fact that the number of US allo grads is going up, meaning that overall competition in the match will go up, too, but if we have shortages, won't the number of residencies also have to go up eventually?

We have shortages in the number of applicants wanting to go into primary care, not a shortage in the number of available spots.

 

[DocWalken]

Is it implied that we have "too many of these" and "not enough of those" that goes beyond the complaint that there are not enough primary care docs in rural and underserved areas?

Like, can anyone point to some key congressional committee report that lays this out for the foreseeable future? Like "we got too many radiologists and not enough pediatricians" logic?

I can accept the fact that the number of US allo grads is going up, meaning that overall competition in the match will go up, too, but if we have shortages, won't the number of residencies also have to go up eventually?

Yea, this would be really great to see. How are the relative numbers needed of each type of specialist determined? What happens when there's a surplus/shortage of a type of specialty?

Anyone have any speculation as to what types of doctors will be needed when we 2010+ 'ers are graduating med school and residency?

 

[flip26]

We have shortages in the number of applicants wanting to go into primary care, not a shortage in the number of available spots.

I understand it this way: that we have shortages in the number of primary care physicians, particularly in rural and underserved areas. We are also anticipating shortages in the numbers of docs who serve older populations.

I have read other reports that there is a bubble of retiring docs that is going to create shortages.

I am not so much asking about the demand from US Allo students for any particular spots in the match - I am asking if anybody can cite the studies that feed into the legislative process. Who is forecasting the supply and demand of the different specialties, for instance?

 

[howelljolly]

Is it implied that we have "too many of these" and "not enough of those" that goes beyond the complaint that there are not enough primary care docs in rural and underserved areas?

Like, can anyone point to some key congressional committee report that lays this out for the foreseeable future? Like "we got too many radiologists and not enough pediatricians" logic?

I can accept the fact that the number of US allo grads is going up, meaning that overall competition in the match will go up, too, but if we have shortages, won't the number of residencies also have to go up eventually?

Aye, theres the rub.

While the government decides how many residency seats there are, the academic medical centers decide what types of programs to run. So if a particular institution would rather make the most of their new fancy Interventional Radiology Suite and start a fellowship program, instead of starting an Internal Medicine residency... you'll have an IR fellowship. not an IM residency.

 

[Dr Roboto]

This is probably a horrible question. But what's preventing the AAMC from limiting the match only to grads from schools who have LCME oversight?

 

[tkim]

This is probably a horrible question. But what's preventing the AAMC from limiting the match only to grads from schools who have LCME oversight?

Because it's the AAMC. Why do you think the American Association of Medical Colleges has any say in who residencies take? It's like asking what's preventing colleges from limiting who gets admitted to medical school.

 

[Mr hawkings]

Because it's the AAMC. Why do you think the American Association of Medical Colleges has any say in who residencies take? It's like asking what's preventing colleges from limiting who gets admitted to medical school.

Maybe he/she meant to say ACGME.

They could never do that could they?
I mean, they can tell programs how many residents they can and cannot take. And programs cannot add extra residents even if they need it without jumping through a million hoops. And i'm sure programs that always have spots unfilled through the year probably get reprimanded in some way (i dont know for sure).

 

[sirus_virus]

Why should they create more cush specialty spots when there are ample primary care spots available?

 

[tkim]

Maybe he/she meant to say ACGME.

They could never do that could they?
I mean, they can tell programs how many residents they can and cannot take. And programs cannot add extra residents even if they need it without jumping through a million hoops. And i'm sure programs that always have spots unfilled through the year probably get reprimanded in some way (i dont know for sure).

It's been a while since I looked this up, but as I recall, residency spots that don't fill consistently over some number of years are eliminated.

Now, if you were to limit the ACGME match to LCME school graduates, you'd have 17000 senors and graduates applying for 18000 spots. There are roughly 22000 positions offered each year, subtract rougly 4000 for the TY, prelim med and surg, because you need these for an advance position so most they shouldn't count.

So you'll have 1000 open spots each year that, if they consistently don't fill. will become defunded, decreasing the the number of positions subsequent years. Couple that with the proposed increase in MD enrollment and you have a shrinking number of spots for an increasing number of applicants. Sounds like a nightmare.

With the ACGME match open to DO's and IMG's, the number of open spots should be much less, since there's competition for all available spots, since there are more applicants than spots when you factor them in.

What the AOA should do is to open the AOA match to MDs and make it a combined match.

 

[PistolPete]

What the AOA should do is to open the AOA match to MDs and make it a combined match.

This is a great idea, but do you see this happening any time soon? Because I don't. It'll take them at least a 5 years to get it implemented, and I hear not a peep of anything resembling this plan even being talked about by the AOA.

 

[silas2642]

This is a great idea, but do you see this happening any time soon? Because I don't. It'll take them at least a 5 years to get it implemented, and I hear not a peep of anything resembling this plan even being talked about by the AOA.

No, but why don't the DO's at least try to match first into their system instead of trying to take up spots in ours? I mean, I know that US grads for the most part get preference, however, it does seem kind of unfair that they are participating in the allopathic match when there are perfectly good osteopathic spots available to them. Why can't they be forced to participate in a dual match-- if they don't match into an osteopathic residency because there are too few positions, then they can partipate in the allopathic match.

 

[Law2Doc]

This is probably a horrible question. But what's preventing the AAMC from limiting the match only to grads from schools who have LCME oversight?

The current plan will effectively have this result over time. You don't want to do it all at once because you have to drop standards pretty significantly, as well as overload the infrastructure, if you are going to immediately add 4,000 new people across the 120ish US allo schools. So you just ask the US schools to increase their seats 10% per year and over time you get your result, and never have to look like you made a rule to shut out the offshore folks. But right now, we NEED the offshore crowd to fill a lot of the smaller more remote less desirable residency slots.

 

[Law2Doc]

... but if we have shortages, won't the number of residencies also have to go up eventually?

No, for two reasons. (1) it costs money and in an era of healthcare being too expensive no elected official is going to get excited about earmarking even more money for physicians. (2) the current shortage exists due to the baby boomer generation, who is living longer and older and as a result has greater medical needs. However, the generation right behind this one is substantially smaller, and thus as soon as the baby boomer generation dies off, we won't have a shortage any more. We don't want to have a glut because that is bad for medicine. You only have to look to law to see what dangers exist in a profession which has been facing an ongoing glut. Some folks doing very well, and others not finding employment.

 

[jonb12997]

when there are perfectly good osteopathic spots available to them.

The whole problem is the fact that not all osteopathic programs are at high end powerful academic teaching centers. Some are, but there are a number that are at smaller, less "advantageous" places.

Without spending the time to look up the actual numbers, I'm gonna go out on a limb here and say that I believe there are too few osteopathic residency spots out there for the number of DO's that graduate every year or will soon to graduate yearly. Someone can correct me if I'm wrong...... but I'm pretty sure that's one of the biggest reasons so many DO's end up in the MD match.

That and the fact that some areas of the country that are limited in what they have available for DO programs - (admit you looked at or are looking at certain residency programs partially because of the area they are in). For instance, there is one DO pediatrics program outside of New York City that is located in the north-east US. so if you want to do peds in the north-east, not in NYC, and want to do a DO program, you have one choice, and it's a really good program too, so not everyone is going to be able to get into in. Especially when there are a lot of good allopathic peds residencies in the northeast.

 

[builttorock]

What the AOA should do is to open the AOA match to MDs and make it a combined match.

This is currently on the table. What the OGME is supposedly trying to figure out is how to admit physicians who are unfamiliar with osteopathic medicine into their residencies. It's my understanding that most of the questions revolve around whether a summer intensive of manual medicine and osteopathic philosophy equal the two years an osteopathic grad receives?

Without spending the time to look up the actual numbers, I'm gonna go out on a limb here and say that I believe there are too few osteopathic residency spots out there for the number of DO's that graduate every year or will soon to graduate yearly. Someone can correct me if I'm wrong...... but I'm pretty sure that's one of the biggest reasons so many DO's end up in the MD match.

And I think that you're right... there aren't enough osteopathic slots for every osteopathic grad, if not now then certainly in the next 3-5 years.

 

[tkim]

No, but why don't the DO's at least try to match first into their system instead of trying to take up spots in ours? I mean, I know that US grads for the most part get preference, however, it does seem kind of unfair that they are participating in the allopathic match when there are perfectly good osteopathic spots available to them. Why can't they be forced to participate in a dual match-- if they don't match into an osteopathic residency because there are too few positions, then they can partipate in the allopathic match.

Take "our" spots. You know, I hear this all the time. Like it was your friggin birthright or something. The use of the possesive may be inadvertent but it's still annoying.

The sponsoring agencies may be affiliated with allopathic schools or through the ACGME, but the funding is federal and that means through taxes. There are no osteopathic taxes and allopathic taxes, just taxes. I pay them, you pay them. I make no claim to 'our' osteopathic residencies, and I find it as distasteful when federally-funded osteopathic residency training excludes allopathic applicants.

You said it yourself, whatever unfairness you perceive for being allowed to match at MD spots is balanced by the higher bar the DO applicant must clear in order to match. Is that fair?

Force people to apply to DO spots first and I'll guarantee people will apply for one neurosurgery spot, not match, and happily pave the way to apply for whatever specialty they *really* wanted to match in on the allopathic side.

Instead of advocating for more residency spots, you want to thin the competition.

It'll happen soon enough by the sheer number of increasing allopathic school seats.