Afer Getting a Rejection email from a school, ever wanted to send back a email saying F*** you guys!

[milski]

Sorry I meant to be more clear on that. Take away a little of those fields' pay, pay the shortage fields with that surplus.

How exactly do you suggest this to happen? Impose an additional tax on the well paid specialties which would go towards funding residencies in FM?

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[sourdoughllama]

It's not like government is taking that money and will send a check to all the family docs out there. Patients will save a couple hundred dollars for their ortho procedures and they have no obligation to spend it on a primary care doctor visit. You seem to advocate government set salary, now that's dangerous territory. There's no reason to increase the number of ortho position if we have enough. Now if we can change the medicare reimbursement rate for ortho procedures, now were talking about possibly fixing the problem.

Sure I mean, I'm not 100% savvy on the whole economics of how reimbursements work, but just simplistically speaking, there is a huge discrepancy in the amount some specialties make over others. So if like you said, medicare reimbursements are something to look at, then that sounds good.

And why is everyone so upset every time something that challenges the status quo is talked about? Are we not the next generation of leaders in the country? I also clearly stated that my points are simplified, and I am aware it's a lot easier said than done. But if we took the attitude of always saying "that's obviously too difficult to change" then nothing will improve ever.

 

[solitarius]

What is with this fully-funded nonsense? They would obviously BORROW it and add to the NATIONAL DEBT.

 

[sourdoughllama]

I'm willing to bet Congress puts in the fix the day before the deadline. Seems to be how they like to roll.

Only if their holiday break is coming up

And btw, I'm actually in favor of keeping the residency spots/system the same as now. I just like to give the opposite argument a chance and see it from their perspective to try to learn something new. There's never a black and white argument so I think it's a good thing to give your opposition a chance

 

[KnuxNole]

Sure I mean, I'm not 100% savvy on the whole economics of how reimbursements work, but just simplistically speaking, there is a huge discrepancy in the amount some specialties make over others. So if like you said, medicare reimbursements are something to look at, then that sounds good.

And why is everyone so upset every time something that challenges the status quo is talked about? Are we not the next generation of leaders in the country? I also clearly stated that my points are simplified, and I am aware it's a lot easier said than done. But if we took the attitude of always saying "that's obviously too difficult to change" then nothing will improve ever.

Yes, you are the leader of tomorrow

Bring dat change that Obama was talking about, but actually deliver

 

[sourdoughllama]

Yes, you are the leader of tomorrow

Bring dat change that Obama was talking about, but actually deliver

I had high hopes for Obama too! haha

 

[Amazingmuzmo]

sourdoughllama I'm not really sure what you're trying to argue here? Are you advocating increasing FM/PEDs residencies or salaries for primary care docs?

 

[sourdoughllama]

sourdoughllama I'm not really sure what you're trying to argue here? Are you advocating increasing FM/PEDs residencies or salaries for primary care docs?

I was saying that there is a surplus of money going to the high paying specialties that could pay for more peds/FM people (who would all keep the same pay), but that's it. Like I said earlier though, that's just a thought that came from trying to see where OP is coming from. I don't actually think that is viable.

 

[BurberryDoc]

At my undergraduate university, a peer of mine was famously rejected, but sent back a "I reject your rejection" letter and was eventually accepted.. Unfortunately I don't think that'll work for med, eh??

Sounds like you go to brown..

 

[user12]

want to hear something funny? alright, well i'm gonna tell you either way.
This is my second time applying. I was kind of stupid when I applied 2 years ago. I didn't have much clinical experience, I applied late, I didn't apply to enough schools, and I didn't apply to reasonable out of state schools. I applied to university of Miami even though i'm not from florida. now, obviously if I didn't hear anything from them by april, I kinda got the idea that they weren't going to have me. when june arrived, this is what they sent

Your application has been withdrawn from further consideration. Thank you for giving us the opportunity to review your application. We wish you success with your medical education.

Sincerely,
Office of Admissions
University of Miami Miller School of Medicine

I felt that this was a half hearted rejected. i mean, they didn't even write "we regret to inform you" which is crap. hell, they didnt even ADDRESS me by my name. I was already depressed about not getting in anywhere, and i knew i wouldnt apply there again. so I wrote them back the following

Dear sir/madam,
This is very discouraging news. I have recently purchased an apartment in Miami. I've been checking my e-mail daily every morning as I wake up for the past 6 months. When the 1st of June arrived, I just assumed I got accepted and made preparations for my move to Miami. I also began dating a nice Cuban girl when I moved down here. Does this mean I have to dump her? I thought she could have been the one. Does this mean she's not?
Help.



they never wrote back. but yeah, that's how I deal with rejection sometimes.

 

[kyamh]

Why would anyone advocate increasing the number of medical schools without an equal or greater increase in residency spots? Best case scenario you're shooting yourself in the foot and making it that much harder to match into the residency you really want in that perfect location. Worst case scenario you may have to apply twice in the match.

The reason residency spots are so low is because the government doesn't want to increase it's spending for GME and (at least for certain competitive fields) the residency spots are artificially limited to secure the salary of their field. The main appeal of US MD is that nice ~95% match rate. If you just increase the number of med school then you mess up the whole appeal. You need both.

Throughout my time posting (and silently loitering around) SDN the topic about the shortage of residency spots has come up several times. If we ignore expected physician shortages in the future and just think about the current situation of medical graduates > residency spots then I have the following question: why is it a bad thing? There are stringent hoops to jump through to get into medical school, true. But is it necessarily true that every medical school graduate ought to go on to see patients? Is there not a lower 1%, 5% of medical school graduates who will not make successful physicians after all? Graduates who have poor interpersonal skills and fail residency interviews, graduates who had poor clinical skills and have low grades/LORs from their rotations, graduates who have poor information retention and scored particularly poorly on their exams?

 

[solitarius]

why is it a bad thing?

debt that has to be repaid + wasted time of 4 years

um, if you're kind of suggesting that med school becomes premed part 2, I can't sign off on that.

 

[histidine]

Throughout my time posting (and silently loitering around) SDN the topic about the shortage of residency spots has come up several times. If we ignore expected physician shortages in the future and just think about the current situation of medical graduates > residency spots then I have the following question: why is it a bad thing? There are stringent hoops to jump through to get into medical school, true. But is it necessarily true that every medical school graduate ought to go on to see patients? Is there not a lower 1%, 5% of medical school graduates who will not make successful physicians after all? Graduates who have poor interpersonal skills and fail residency interviews, graduates who had poor clinical skills and have low grades/LORs from their rotations, graduates who have poor information retention and scored particularly poorly on their exams?

I somewhat agree with you. However, there are several unintended consequences of squeezing out 1-5% of US MD graduates from getting a residency slot. Primarily, those graduates are stuck with huge amounts of debt with no secure job to pay it off. Add undergraduate debt into the equation, and they may be forever under water. This risky situation severely affects premeds in the lower socioeconomic class. It's a lot riskier to enter med school and take on huge debt burdens if you don't have a wealthy family to bail you out if worse comes to worse.

I forget where I read it, but I heard a proposal that takes the funds that pay residents in lucrative specialties and uses it to reduce med school tuition. This way, med students have lower debt, and the ones that are entering ortho, rads, derm, etc, will take out loans during residency. Since they can expect to make 300k+, those loans won't be risky. Those entering primary care specialties will still get the residency stipend, so when they enter practice and make 100-200k, their undergraduate and med school loans won't be overwhelming.

 

[kyamh]

debt that has to be repaid + wasted time of 4 years

um, if you're kind of suggesting that med school becomes premed part 2, I can't sign off on that.

I'm not suggesting anything of the sort. Only about 50% of medical school applicants get in somewhere, there are plenty of qualified applicants who don't get in. But are you really saying that not ever 1-5% of medical school graduates have poor enough skills to be barred from continuing into residency? I think that the scale is very different....


Edit: I totally agree, I'm barely coping with undergrad loans as is so I can't imagine another 200-300k on top That said, we want good physicians out in the wards. While we can't directly correlate academic performance to ability to be a good doctor, I think experienced physicians could spot the severely underachieving medical students during clinical years and pass that information along to residencies. Perhaps if there was a more publicized risk of not matching if you perform poorly (until the last year or so I didn't know about the residency spot shortage and plenty of other pre-meds similarly assume medschool = eventual license to practice) then students would go through more rigorous self-reflection to figure out whether their personality and goals fit with the realities of medicine. They would take shadowing more seriously, they would take time off to explore other career options etc..

 

[solitarius]

I'm not suggesting anything of the sort. Only about 50% of medical school applicants get in somewhere, there are plenty of qualified applicants who don't get in. But are you really saying that not ever 1-5% of medical school graduates have poor enough skills to be barred from continuing into residency? I think that the scale is very different....

I'm curious what is the number of people who drop out / fail USMLE/ are dismissed. Would it equal this number? I'd like to think those would be the channels to thin the herd rather than another funnel mechanism that applies to everybody.

Consider: You're stuck with $300,000 and can't match. You had to go through the type of app. cycle we've already endured and take on more debt to enter a profession that will pay less and be more difficult to cope with/survive in. Regardless of the situation, I'd feel bad for the person caught in that scenario. At least with Caribbean, that risk is known from the outset. But for a US allopathic grad, that's a tough pill to swallow.

 

[Ismet]

Throughout my time posting (and silently loitering around) SDN the topic about the shortage of residency spots has come up several times. If we ignore expected physician shortages in the future and just think about the current situation of medical graduates > residency spots then I have the following question: why is it a bad thing? There are stringent hoops to jump through to get into medical school, true. But is it necessarily true that every medical school graduate ought to go on to see patients? Is there not a lower 1%, 5% of medical school graduates who will not make successful physicians after all? Graduates who have poor interpersonal skills and fail residency interviews, graduates who had poor clinical skills and have low grades/LORs from their rotations, graduates who have poor information retention and scored particularly poorly on their exams?

Because the people who get cut won't necessarily be the people who shouldn't see patients/won't be successful physicians. Many times people who do not match are trying for competitive residencies of which there are only a handful of spots in the country. It's easy for someone to say that those people should have applied smarter, but the pre-med logic of applying to med school doesn't necessarily apply to the residency application process.

 

[kyamh]

Because the people who get cut won't necessarily be the people who shouldn't see patients/won't be successful physicians. Many times people who do not match are trying for competitive residencies of which there are only a handful of spots in the country. It's easy for someone to say that those people should have applied smarter, but the pre-med logic of applying to med school doesn't necessarily apply to the residency application process.

Interesting, thanks

Do you think that the system is still fair in that medical students who choose to apply to these super competitive residencies know the risks and accept them? I imagine that there are students who may be interested in the really hard to get into fields but don't choose to apply there because they don't want to chance not matching. Can you expand a little on how pre-med logic doesn't apply? Do you just mean traditional applicants? Non traditional applicants juggle families, huge importance of location etc in the way that residency applicants must...

 

[Syndicate]

Take out all the IMGs. Stop creating new medical schools. Keep residency positions the same as it is. Start cutting DOs.

 

[TreadLightly]

Start cutting DOs.

So brave.

 

[Ismet]

Interesting, thanks

Do you think that the system is still fair in that medical students who choose to apply to these super competitive residencies know the risks and accept them? I imagine that there are students who may be interested in the really hard to get into fields but don't choose to apply there because they don't want to chance not matching. Can you expand a little on how pre-med logic doesn't apply? Do you just mean traditional applicants? Non traditional applicants juggle families, huge importance of location etc in the way that residency applicants must...

Since I'm still pretty far from residency application, everything I know is what I've heard from upperclassmen and advisors, so n=1 and I'm sure current upperclassmen and residents on here can provide more insight and correct me if I'm wrong. From what I know so far, the people who are going for competitive residencies are very aware of the risks. If you have good advisors, they help guide you to what would be best. But the fact still remains that there are only a relative handful of spots in these competitive residencies and even though an applicant might be pretty competitive for that specialty, they still might not make it if they're not quite competitive enough.

Maybe "pre-med logic" wasn't the right term to use, but I couldn't think of anything better. It's just a very different process. There are competitive specialties and less competitive specialties, and within each specialty there are competitive programs and less competitive programs. For the most part, you tailor your application to one specialty. I've heard it compared to putting all your eggs in one basket. If you're pretty competitive but end up not being competitive enough come match time, you're screwed. You SOAP into an open program or you try again next year. And at the end of the day, your fate is decided by an algorithm, so you don't really get to consider location and all that stuff apart from where you put them on your rank list, where you could end up with your #1 choice or your #20 choice depending on a lot of different factors.

 

[EMDO2018]

DO's are awesome. In my opinion people at DO schools actually seem more normal than people at MD schools. But thinking about the original topic, I wonder if schools get frustrated when people withdraw acceptances or don't show up for interviews.

 

[Ismet]

But thinking about the original topic, I wonder if schools get frustrated when people withdraw acceptances or don't show up for interviews.

Depends on the timing. If you withdraw your acceptance 3 days before orientation, the school will probably be frustrated. If you withdraw in April/May/June, it really won't phase them as they can just easily pull from the waitlist, or your withdrawal was already factored into their algorithm. Same with interviews. If you just don't show up to your interview, that's extremely unprofessional and takes away a spot from someone who actually wants it. If you withdraw from your interview with ample time, someone else can be invited.

 

[RogueUnicorn]

Start cutting DOs.

they have scalpels too, what if they fight back?

DO's are awesome. In my opinion people at DO schools actually seem more normal than people at MD schools. But thinking about the original topic, I wonder if schools get frustrated when people withdraw acceptances or don't show up for interviews.

yea man I'm sure your handle doesn't give away your bias at all

 

[KnuxNole]

DO's are awesome. In my opinion people at DO schools actually seem more normal than people at MD schools. But thinking about the original topic, I wonder if schools get frustrated when people withdraw acceptances or don't show up for interviews.

I'm sure there are crazy gunners in DO schools too

There are TONS of normal chill people in MD schools. Or maybe I was just lucky.

 

[Status Sciaticus]

DO's are awesome. In my opinion people at DO schools actually seem more normal than people at MD schools. But thinking about the original topic, I wonder if schools get frustrated when people withdraw acceptances or don't show up for interviews.

Im sure this self-selection bias has nothing to do with the fact that youre applying and most likely attending a DO school right?

As far as the OP's question, yes I would like to point out to the one school that rejected me where I was accepted and where they can stick it, but that is unbecoming of a future physician.

 

[Reckoner]

but that is unbecoming of a future physician.

And of the leader of the Istari and the Fellowship of the Ring, no less.

 

[Amazingmuzmo]

I'm not suggesting anything of the sort. Only about 50% of medical school applicants get in somewhere, there are plenty of qualified applicants who don't get in. But are you really saying that not ever 1-5% of medical school graduates have poor enough skills to be barred from continuing into residency? I think that the scale is very different....

Well first of all, you have to consider that there ARE about 5% (at least for MD) graduates who don't match. Whether that's because they have some blemish on their application or because they are applying for incredibly competitive spots is up in the air, but at least some portion of that number constitutes those graduates that may have "poor enough skills to be barred from continuing into residency" as you mention.

Also to note, besides the financial difficulty that is placed on these non-practicing graduates is the fact that doctors are a very different "commodity" than other professionals. What is the ultimate affect of someone from business school not ending up working in Wall Street? Not much impact on society, that guy just doesn't have the opportunity to get rich. The loss of a doctor ends up being a (variably) negative effect on a society because they offer a social service. Every person admitted to medical school that ends up not becoming a practicing physician is a net loss of a social resource. Also, some portion of state/federal money will go into funding some medical schools, thus a graduate from that school not matching becomes a "loss" of that investment.

 

[Amazingmuzmo]

.

 

[ruedjgtc]

I sorta do, this school has rejected me twice. Oh well, I have four DO interviews in January.

I say send it off and tell us how it goes

 

[ruedjgtc]

Why would anyone advocate increasing the number of medical schools without an equal or greater increase in residency spots? Best case scenario you're shooting yourself in the foot and making it that much harder to match into the residency you really want in that perfect location. Worst case scenario you may have to apply twice in the match.

The reason residency spots are so low is because the government doesn't want to increase it's spending for GME and (at least for certain competitive fields) the residency spots are artificially limited to secure the salary of their field. The main appeal of US MD is that nice ~95% match rate. If you just increase the number of med school then you mess up the whole appeal. You need both.

Right, the gap between supply demand are filled by logistics, right now GME is the logistics, and its hurting. Enrollment in medical schools has steadily increased over the years, while the residency positions have not kept up with this fact. The AMA has been campaigning under the #saveGME on twitter for a while about this to get premeds/medical students more involved and informed about their (potential) profession.

 

[BurberryDoc]

For my first rejection, yes. I wanted to....but then I realized that that schools hospital was also my first choice for residency, so I decided it would be best to have radio silence

 

[Great White Buffalo]

For my first rejection, yes. I wanted to....but then I realized that that schools hospital was also my first choice for residency, so I decided it would be best to have radio silence

Yes, medicine is a relatively small community, and academic medicine even smaller. Best to never burn bridges.

 

[gettheleadout]

I was saying that there is a surplus of money going to the high paying specialties that could pay for more peds/FM people (who would all keep the same pay), but that's it. Like I said earlier though, that's just a thought that came from trying to see where OP is coming from. I don't actually think that is viable.

A "surplus" of money is a bad way to think about it though; the difference in pay due to earned income, not federal funding for residency positions.

 

[BlueLabel]

This thread was giving me a headache but fortunately there was enough sanity around to keep that at bay. Thanks @Ismet, @zacharyw, @RogueUnicorn, @Amazingmuzmo, et al.

 

[alpinism]

I'm sure there are crazy gunners in DO schools too

There are TONS of normal chill people in MD schools. Or maybe I was just lucky.

yep and a bunch are bitter about being rejected from their state MD school(s).

"I'll show them when I get a 250 and match into plastics"

there are gunners at every med school...

 

[sourdoughllama]

.

 

[Amazingmuzmo]

I'm not sure why you find it necessary to mock people when you could just say why you agree or disagree with someone. I'm plenty aware that things are the way they are for very good reasons, but just because they're good reasons it doesn't mean they're always the best reasons. There's always a balance of things like necessity, benefit, cost, etc and just because necessity is in there, it doesn't mean any other ideas are stupid. I usually agree with the status quo anyhow, but just because it makes sense it doesn't mean other ideas are automatically insane.

You just wrote a whole lot of words that don't really say anything. I get it, you want to better distribution of incomes for primary care. That's great. Just realize that it probably won't happen anytime soon. The new medicare reimbursement outline came out for this year. Pretty much all specialties saw at least a 1-2% decrease in reimbursement, some like Pathology and Pain Management really got the shaft with 4-6% cuts. Guess what they did with that money? Give it to Primary Care docs to attract more med students into FM/PEDS/IM for the physician shortage? No, instead Chiropractors saw a 12% increase. This is the kind of stupidity that runs rampant in our government. You should take this enthusiasm and write strongly worded letters to those in the government that can make a change.

 

[sourdoughllama]

.

 

[hughnguyen22]

I am late to this party, but saying nasty things to schools which rejected you is just terrible. It is immature. Listen to your mama, if you don't have anything nice to say, say nothing at all.

 

[Dbate]

When I got my rejection email from UTMB, I promptly replied with this response below:

"That's okay. Thanks for the opportunity to apply!

I'll be matriculating at UT Southwestern for the 2014 entering class, so everything worked out well.

Have a nice day,"

It was the most polite way to say: "F*ck you, I got into a better school!" I could think of.

 

[Mr Roboto]

Yeah, I nearly did this when I was rejected from a school that I really wanted to go to and was well-qualified for..... then they rejected me less than 12 hours after I submitted my secondary.

dinguses probably didn't even read it, but of course the rejection e-mail was all "only after very careful consideration ... best of luck ... hope you succeed ... thank you for your interest ..."