Is there a tool that allows programs to reserve prelim spots only for applicants who match advanced at that same institution?
For example, Ben interviews at Big City Program for an advanced radiology position and medicine prelim position and the interview goes incredibly well with each of them expressing their interest in the other. Big City radiology program says they coordinate with the internal medicine department to try and match their top ranked applicants with prelims also at that institution so that they can conveniently consolidate their training in that city. If Ben ranks Big City radiology #2 on his ROL and Big City Program ranks Ben #1 for advanced radiology and #1 for the medicine prelim, but Ben matches to his #1 advanced program somewhere else, will Ben still automatically be offered the medicine prelim at Big City by the match algorithm because he is ranked #1, or does Big City have a way to ensure that their prelim spots are reserved only for those who match at that institution in advanced spots?
Yes, there is.
Warning: Nerd alert. None of the following really matters to anyone who is matching, just rank programs in the order you want to go to them, But you asked.
There are two solutions to this problem.
#1 is a categorical match. The program gets rid of their Advanced Rads slots, and an equal number of Prelim slots, and instead puts an equal number of Categorical Rad spots into the match. This simplifies everything. Now everyone who matches gets both Rads and Prelim IM training at the same institution. It also simplifies the couples match issue, since you're guaranteed the prelim. The major problem is that if an applicant wants to do their prelim in a different place than their advanced training, they no longer have that choice -- it's all or nothing.
#2 is linking the prelim program to the advanced program. This is somewhat complicated, and is explained here:
http://www.nrmp.org/wp-content/uploads/2015/08/Joint-AP.pdf Basically, it works like this:
Let's say I have 10 prelim spots. And let's say that my rads program has 4 spots, and wants to guarantee prelim positions for those 4 positions. Here's what I would do:
I start with a prelim program 12345678P0 (that's an NRMP program number. 12345678 is my program's number, P = prelim, and 0=default track) with 10 spots.
I create a new match 12345678P1, and assign 4 slots to it.
I decrease the quota of 12345678P0 to 6 slots, so I still match a total of 10 prelims.
I link 12345678P1 to the radiology program (I believe this is done by the rads program)
Now, what happens is that you (the applicant) enters their rank list of radiology programs on your main list. When you create your supplemental list for my institutions Rads program, you'll be able to rank 12345678P1, but you won't be able to rank that number for any other possible match.
Meanwhile, I submit both a P0 list and a P1 list, and I might list applicants on both lists.
See what happens? Because you can only rank the P1 option on the supplemental where you've matched to the Rads program at my institution, the only people who can match into those spots are the 4 people who have already matched to rads, so you're guranteed a spot. But you're not forced to take a spot as an applicant, you'd still be able to rank a different program. And, if you chose to match to rads somewhere else and still wanted a prelim with me, you could rank the P0 program and try to get a spot.
If I just wanted to make it "more likely" rather than guaranteed, I could put 2 or 3 spots into P1. If I only had 2 prelim slots and rads was still matching 4 (perhaps I have more prelims then that, but some are "promised" to other specialties), then either we link my 2 spots on P1 to their 4 spots on their A0 list (and there's no guarantee), or they create two tracks A1 and A0, each with 2 spots, and then link A1 to the P1 list (so those two people are guaranteed prelims) and the A0 isn't linked. Then, as an applicant, you could rank me twice on your main rank list if you want -- the A1 track which guarantees (but doesn't demand) a prelim with me, and then A0 which would make no promises about a prelim.
Sounds great, right? Well, there's a problem, on my end. Let's say we go back to the original example -- I put 4 spots in P1 and link to a rads program with 4 spots. Now, let's say someone matches to rads, but matches somewhere else for prelim (because the applicant ranked another prelim higher than my program). What happens? I end up with an unfilled spot that goes into SOAP. There's no way to rank that spot unless you match rads with me, so the spot goes vacant.
But there's a fix for that, called a reversion. This allows me to take a track that's unfilled, and add the spots to another track to try to fill it. So in this case I'd revert the P1 program to the P0 program -- any unfilled spots in P1 will then increase the quota of P0, and I'll try to fill with people who didn't match in my rads program.
Done correctly, this solves the issue you brought up. But there's still two problems. First, it's complicated and I bet some people will screw it up. Knowing that the "guaranteed" prelim track has a different code than the "non guaranteed", and some people will simply fail to rank the open prelim list on their other lists, and some program will screw up the reversions, etc. It's certain to get messed up, or applicants will be unsure what's guaranteed and what's not. And applicants might fail to rank all the various advanced tracks (A1, A2, A0, etc) because of confusion, etc.
The other problem is that you can't have a track with a quota of zero. I might be willing to try to set this up for my program, but I have multiple advanced programs who are interested in prelims. The sum total of advanced spots in all of these programs is > than my total number of prelims. If I link all of my prelim slots to my advanced programs, then I have none left for my P0 list. I actually tried to do this one year, with the plan to have a quota of zero for my P0 list but then revert anything that didn't fill in my P1, P2, P3, etc (one for each specialty) to P0 so I could fill with anyone. But it can't be done, since if you set teh quota to zero the track isn't processed at all and you can't revert to it. So it left me the option of linking for some programs, and then leaving one program unlinked and ranking their candidates on my P0 list. In the end we all decided it was simply too complicated, so we leave it all unlinked.
That was certainly more than you asked for.
