This is one of the most ridiculous threads I've ever stumbled upon.
I'm not "missing" anything. I understand how the match works as I've been through it twice. It seems that you don't however. To suggest that someone is applying to multiple surgical sub-specialties in the AOA match, then applying IM programs in the ACGME match (let alone exclusively to university programs as a DO) and then settling for an unmatched (i.e. bottom of the barrel) AOA IM spot is laughable. No one in their right mind would do this let alone be able to create multiple strong applications for all these specialties. You very clearly have no clue what you're talking about. Having to scramble is not a strategy or gaming the system and is almost always a disaster/worst case scenario. I get that you're trying to polish this turd but your lack of experience and naivete are on full display with this absurd post.
No one is applying for multiple surgical subspecialties, I think what he meant was someone applying to one of those multiple subspecialties.
While it may not be wise, and you interpret that to mean no one is doing it, I've talked to a lot of DOs that failed to match (and ultimately scrambled AOA), and they are split pretty evenly between those that had major redflags and didn't apply broadly enough and those with surprisingly good apps that attempted a strategy like the one Mad Jack is describing. It happens a descent amount actually. Part of it probably has to do with the poor career & app/match advising many DOs have.
Many of these people recognize that they made a mistake, but they realized it far too late. For those in pre-lims and TRIs, they rectified their mistakes and all the ones I know matched in their second residency app. Those that scrambled into categorical spots just seemed to accept their situation.
In any case, what I'm saying is that while it may not be ideal or recommended, don't be so sure that there aren't people actually doing it.
I'll add that you really, really don't want to end up scrambling into AOA IM or FM if you can at all avoid it. I haven't gone through the match but have rotated through a hospital that fills up its resident slots during the AOA post-match and the residents gave us very clear warnings not to end up in their shoes. Better to match into a program that fills up during the match, even if it is low-tier.
Yeah, they realize it after the fact unfortunately.
As far as this whole creating tiers for FMGs/IMGs (that apparently resulted in a more ridiculous discussion about national immigration, genocide, xenophobia, etc.), well that's just ridiculous. The system is already set up such that US MDs get preference, DOs next, US IMGs after that, and stellar FMGs are anywhere in the mix with average and below average FMGs at the bottom.
A hierarchy already exists without it being legislated. It exists because of the cost/difficulty of sponsoring non-permanent residents. And to be honest, I'd rather have a permanent resident/new citizen here working as the physician they are already trained to be than as a gas station attendant ultimately on social services.
And the whole argument that we're paying to train them so we should train our own is erroneous. We didn't start paying for residents to train our own, we started it for the welfare of our own citizens, to guarantee that all physicians had adequate training to treat our citizens.
As far as the whole exporting our training goes, it's short-sighted to cut off the benefits that a foreign US-educated individual has on our country. It sets our training as a standard, and that standard is what brings in money (self-pay to get treated in the US), research grants, and in general maintains our reputation.
And finally as far as the whole "we need to make sure the individuals that couldn't go to a med school in the US and take out US Federal loans get residency" argument goes: for one thing, we lose money on those people as compared to US med students. US med students are spending their entire loan in the US, so it's essentially an infusion into our economy with the principle.
If we really want to do something, we shouldn't give out loans to students who attend schools that can't guarantee a high percentage will graduate let alone match. We should be giving them an incentive to stay stateside. Anyone that makes it out of the Big 4 could probably have gotten in to a US school, but we've made the process of sending them to the Carib way too easy. So when 20-50% drop out, they're stuck with loans they can't pay off. Then you have the 15-30% of what's left that never get GME. You really want us to create a loophole to make the Carib school money when we could just as easily deincentivize going abroad in the first place? With all the US MD and DO expansion, we're already keeping more of the population that traditionally went to the Big 4 stateside. All we need to do is shut down the loans to schools (and by this I really mean any schools, even DO schools) that have >25% attrition and we can call it a day.
Obviously this is a more debatable topic, but it comes up so often that I just needed to reiterate some things that everyone seems to forget everytime it comes up. I'm not interested in rehashing this discussion, especially this close to Step 2, but just putting out there.
I assumed all internships were 1 year...is this not the case? Looks like LECOM had around 50 students do traditional rotating and around 30 do a transitional year. Whats the difference between these? What else should they distinguish?
So that's around 80 without residency? That's pretty high...Most DO matches I have seen are much less.
I don't think LECOM is double listing them all. Sometimes they just don't get a full report of the advanced positions. In any case, we usually get reports about how our individual campuses do, and from what I remember its traditionally like ~8% that only have an internship lined up. So for LECOM all campuses, that's like 40-some people. It's safe to assume virtually everyone with a transitional year has an advanced position and at least some with TRIs do as well.
