2017 match day

[WilcoWorld]

To all that matched in EM today, I would like to extend my congratulations and my condolences.

You've just entered one of the world's best, and toughest, careers.

Also, I hope that most of you are drunk by now. It's already past lunch time!

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[RustedFox]

6 spots unfilled as per Medscape news.

I have to work overnight tonight.

No Irishy Drinky for me.

CONGRATS TO ALL !

 

[SalemK]

Medscape is wrong. The NRMP table that came out on Monday did show 6 unmatched spots, but apparently this was an error. Those of us "fortunate" enough to be able to view the actual open positions saw zero EM, zero IM/EM, zero FM/EM. One Peds/EM that went quickly.

 

[gamerEMdoc]

Medscape is wrong. The NRMP table that came out on Monday did show 6 unmatched spots, but apparently this was an error. Those of us "fortunate" enough to be able to view the actual open positions saw zero EM, zero IM/EM, zero FM/EM. One Peds/EM that went quickly.

Yeah, zero unfilled spots was my understanding.

 

[EMapplicant2017]

I hear zero from the SOAP folks. The advanced match data today said 4. I'm not sure what the real number was -- but 6 was clearly incorrect.

 

[Doctor-S]

Congratulations to everyone who matched EM today.

You made it!

Welcome to your new home-away-from-home!

 

[EMedGrrl]

Medscape is wrong. The NRMP table that came out on Monday did show 6 unmatched spots, but apparently this was an error. Those of us "fortunate" enough to be able to view the actual open positions saw zero EM, zero IM/EM, zero FM/EM. One Peds/EM that went quickly.

Weird - the NRMP data tables also list 6 "unfilled" EM spots. Maybe those programs (for some unfathomable reason) chose not to participate in SOAP?

Edited to add NRMP link: http://www.nrmp.org/wp-content/uploads/2017/03/Advance-Data-Tables-2017.pdf

 

[AlmostAnMD]

My PD said those spots are deliberately not filled--ie, several programs did not want to fill the quota they're allotted. So basically no open spots.

 

[bravotwozero]

That seems like a dumb thing to do from a PDs perspective. You're shortchanging your program out of additional manpower.


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[RustedFox]

That seems like a dumb thing to do from a PDs perspective. You're shortchanging your program out of additional manpower.


Nahhh. Those spots are *outside the match only*. Pay-for-play with foreign students, etc.

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[deleted109597]

That seems like a dumb thing to do from a PDs perspective. You're shortchanging your program out of additional manpower.


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Residents aren't free man. You're looking at $100K/yr minimum. 3 residents times 3 years? That's a million dollars a year. Not every hospital has that kinda cheddar around.

 

[bravotwozero]

Maybe I'm missing something here, but my understanding is that those residency slots are funded by Medicare, not the residency program or the hospital - so it's not like it's a financial loss for them.

Residents can get sick, have to take maternity leaves, you might get short staffed at a shift etc...I would always want to have more residents around then less, especially when that isn't coming out of my own programs pocket. If you don't fill that spot, you may not get the funding for it anyway, or have the funding pulled permanently. That's happened to programs that routinely don't fill their spots.

Now, rusted fox's point is a valid one though. I can totally see pd's doing that. Where I trained, the Saudi government was funding spots that were reserved for its own residents.


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[Arcan57]

Congrats to all that matched. To those that didn't, there's a lot of medicine that isn't EM that is still worthwhile and satisfying. We need good doctors in every specialty and some much of a physician's satisfaction comes from caring about their patients. If you can find a way to genuinely do that, you'd be surprised how little your actual specialty matters to your happiness.

 

[tux4]

Residents aren't free man. You're looking at $100K/yr minimum. 3 residents times 3 years? That's a million dollars a year. Not every hospital has that kinda cheddar around.

Many programs want to fill their spots because they get paid by government to have them. Each resident is paid around 30% of the amount of money the hospital gets per resident per year. The rest goes to maintaining the program + offsetting losses from sick patients. Not every program comes out in the green with their programs but they definitely are not incurring major costs to have them.


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[gamerEMdoc]

Many programs want to fill their spots because they get paid by government to have them. Each resident is paid around 30% of the amount of money the hospital gets per resident per year. The rest goes to maintaining the program + offsetting losses from sick patients. Not every program comes out in the green with their programs but they definitely are not incurring major costs to have them.

I think they are paid more than 1/3 of the money. One article I found said just over 100K per resident. ACGME website said about 75k per resident. Residents make 55-60K at my institution in years 1-3. Then you factor in education stipend and benefits package (subsidized health care is a huge cost for every hospital employee) and you've eaten up a large chunk of the money. And programs still have to pay a program coordinator (or sometimes two), and all the academic time for the faculty, but I suspect little to none of that cash comes from the CMS funding. I assure you, programs are not getting rich off the funding they get from CMS.

I would argue though, that some specialties make enough money off the work of their residents (not the CMS funds) that, from a budget standpoint they shouldn't need to take the CMS funding. Maybe allocate all CMS GME funds to primary care to fill that huge gap in our health care system.

 

[deleted109597]

Many programs want to fill their spots because they get paid by government to have them. Each resident is paid around 30% of the amount of money the hospital gets per resident per year. The rest goes to maintaining the program + offsetting losses from sick patients. Not every program comes out in the green with their programs but they definitely are not incurring major costs to have them.

Appreciate the input, but not quite. CMS funds were capped in 1996, so every resident after that isn't "paid" for by the government. Lots of residencies have opened since then. They're all operating on grants, independent funding, or other sources.
http://www.acgme.org/Portals/0/PDFs/2015 AEC/Presentations/PC001/PC001g_Financial.pdfhttp://www.acgme.org/Portals/0/PDFs/2015 AEC/Presentations/PC001/PC001g_Financial.pdf

Maybe I'm missing something here, but my understanding is that those residency slots are funded by Medicare, not the residency program or the hospital - so it's not like it's a financial loss for them.

Residents can get sick, have to take maternity leaves, you might get short staffed at a shift etc...I would always want to have more residents around then less, especially when that isn't coming out of my own programs pocket. If you don't fill that spot, you may not get the funding for it anyway, or have the funding pulled permanently. That's happened to programs that routinely don't fill their spots.

Now, rusted fox's point is a valid one though. I can totally see pd's doing that. Where I trained, the Saudi government was funding spots that were reserved for its own residents.

See above. Also, while some programs have Saudi spots, realize that this is a very politically charged issue. Even if the program wants it, the rest of the GME may not. When there are US residents that go unmatched every year, people get offended pretty quickly when there are spots held for highly paying foreign countries.