MD & DO co'21 Residency Panic thread

Started by kraskadva
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Sure it is. There were many more applications to our program this year than in years prior. But it’s not like there was some dramatic increase in graduating students. It was the “I don’t really want to go there, but since I don’t have to travel or pay for a hotel... whatever” applicant.
I think the effect was more so due to the “unpredictability” of the corona cycle, not necessarily boredom. People applied to more to hedge their bets. But then attended more because they had no travel/time conflicts. So the initial motivation wasn’t necessarily “for funsies.”
 
I think the effect was more so due to the “unpredictability” of the corona cycle, not necessarily boredom. People applied to more to hedge their bets. But then attended more because they had no travel/time conflicts. So the initial motivation wasn’t necessarily “for funsies.”
There maybe some truth to that as well.
 
I don't know how many spots are filled by scrambled applicants. But that's not really the point. I'm talking about applicants who are generally good applicants applying broadly and taking interview spots at places they don't have any real interest in going to but applying and taking the interview because it is of no burden to them. They end up taking away from other applicants who maybe have a slightly less impressive application on paper, but who actually want to match to that program.
This is exactly how high performing med students fall through the cracks into SOAP/gap year. Top places are an absurdly competitive crapshoot, and average places won't interview you because they don't believe they'd get you. You end up with someone with 260/270 boards, first author papers, honors, and great letters choosing between dead end prelim or a year of unpaid labor.

I apologize for my tone in my last few posts. I've lost a lot of faith in the process and my school.
 
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This is exactly how high performing med students fall through the cracks into SOAP/gap year. Top places are an absurdly competitive crapshoot, and average places won't interview you because they don't believe they'd get you. You end up with someone with 260/270 boards, first author papers, honors, and great letters choosing between dead end prelim or a year of unpaid labor.

I apologize for my tone in my last few posts. I've lost a lot of faith in the process and my school.
I mean, we interview people who look good on paper. Now, if the people who look good on paper are applying to places that they have no interest in going to, that's all well and good, but they are still usings the program's and faculty's time on something that they know is a waste. For instance, this past year, there was an applicant. Superb on paper. Like blew everyone out of the water. On the interview day however, it was very clear to me at least that while this person was a star and would likely do well no matter where they went, they were just sightseeing and actually wasn't really that interested in matching to the program. I mean, we still ranked them high because as an applicant in total, they were strong and programs want to have superstar applicants to toot their own horns later ("our trainees go on to be presidents of XYZ.... yeah us!"), but that interview spot maybe could have gone to someone who was also a good applicant and who actually was interested in coming. I mean, the MATCH ranking system filters them out anyway, because they knew they didn't want to match at our program, but I don't think many applicants realize that resources and time are finite. You just can't simply interview every applicant and there is a trade off. I'm not sure there is a good solution to it, but making people travel for interviews is at least one step that helps regulate sightseeing interviews to some degree.
 
A lot of programs will take a weaker applicant that has expressed more interest in them, like sending a letter of interest to get an interview or a letter of intent to get a higher ranklist position. It's the opposite of how the process is supposed to work. Unless your program is truly inundated with HMS grads and would fail to fill if you interviewed all your superstar applicants, that'd be an exception.


"I wanted to stop higher on my ranklist" is a pretty weak basis for "preference" but I guess it's up to each PD to do whatever they want at the end of the day. Sending emails to people you actually aren't gonna match? Why not, they prefer it that way, it makes the recipients of the email more interested 🙄
Maybe I'm somewhat biased coming from a surgical sub, but our program director has talked multiple times about how a happy resident is going to be a better resident, and one of the things that most impacts the happiness of the residents is how much they want to be at that specific program, vs having fallen to it as #15 on their rank list.
 
This is exactly how high performing med students fall through the cracks into SOAP/gap year. Top places are an absurdly competitive crapshoot, and average places won't interview you because they don't believe they'd get you. You end up with someone with 260/270 boards, first author papers, honors, and great letters choosing between dead end prelim or a year of unpaid labor.

I apologize for my tone in my last few posts. I've lost a lot of faith in the process and my school.
I'm a little surprised at the kind of advising you got. I wonder how much of it was based around a miscalculation of the benefit of the JHU name, especially if many of those advisors are coming out of internal medicine. Although the stats are pretty similar between top 20 IM programs and surgical subspecialties/derm, I do believe that name carries a lot more weight in IM. I bet the IM match list is going to be as impressive as it always has been though.
 
This is exactly how high performing med students fall through the cracks into SOAP/gap year. Top places are an absurdly competitive crapshoot, and average places won't interview you because they don't believe they'd get you. You end up with someone with 260/270 boards, first author papers, honors, and great letters choosing between dead end prelim or a year of unpaid labor.

I apologize for my tone in my last few posts. I've lost a lot of faith in the process and my school.

This happens too often in medicine and schools are just blindly like "take it and go" to boost their match rate. Students hopefully have a backbone to stand up to it knowing how hard they've worked and how good of candidates they are. That being said, I think some of them to end up with happy endings as they prelim initially and find an open surgical subspecialty a a year down the road.
 
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This is exactly how high performing med students fall through the cracks into SOAP/gap year. Top places are an absurdly competitive crapshoot, and average places won't interview you because they don't believe they'd get you. You end up with someone with 260/270 boards, first author papers, honors, and great letters choosing between dead end prelim or a year of unpaid labor.

I apologize for my tone in my last few posts. I've lost a lot of faith in the process and my school.
There’s also a BIG misunderstanding with how the algorithm works in the first place. I’ve heard from people directly involved with ranking applicants that “no one actually knows how the match works” or “I’d love to have him here, but I know he’s from X and I don’t want to rank him too high and trap him here.” It’s insane that some people have this much power.
 
I don't know how many spots are filled by scrambled applicants. But that's not really the point. I'm talking about applicants who are generally good applicants applying broadly and taking interview spots at places they don't have any real interest in going to but applying and taking the interview because it is of no burden to them. They end up taking away from other applicants who maybe have a slightly less impressive application on paper, but who actually want to match to that program.
With all due respect, I agree with those above that if I took the time to apply to, research your program, interview at your program, and then thinking about where I am ranking your program, it is no different than a program's decision to rank the majority of applicants. I've often heard that "if you got an interview with a program, that means you've got a real shot," and I think that equally applies to applicants' POV. This year, I had interviews on the east coast, west coast, and the midwest in the span of 3 days. In a normal year, I probably had to cancel one of them because of costs and not being able to fly coast-to-coast in time. In a normal year, I would have scheduled the interviews in the order that I got invites (first-come, first-serve). Does that mean I wasn't interested in coming to that third program? Absolutely not. It just means that for the first time, I didn't have to make a decision based on how many programs I could afford to fly to.


This is exactly how high performing med students fall through the cracks into SOAP/gap year. Top places are an absurdly competitive crapshoot, and average places won't interview you because they don't believe they'd get you. You end up with someone with 260/270 boards, first author papers, honors, and great letters choosing between dead end prelim or a year of unpaid labor.

I apologize for my tone in my last few posts. I've lost a lot of faith in the process and my school.
I was absolutely shocked at my school's confidence in our ability to match as well as we always have. Every student were told to apply as if it were a normal year. And there were definitely anecdotal reports of people coming back and saying "I didn't get enough interviews" and the advisors saying "I have absolutely no idea why you didn't based on the strength of your application." There was no SOAP prep guidance, and to be perfectly honest, I'm not sure the advising office even knows how to help students SOAP given their "historic lack of SOAP-ers" (their words, not mine).

I'm a little surprised at the kind of advising you got. I wonder how much of it was based around a miscalculation of the benefit of the JHU name, especially if many of those advisors are coming out of internal medicine. Although the stats are pretty similar between top 20 IM programs and surgical subspecialties/derm, I do believe that name carries a lot more weight in IM. I bet the IM match list is going to be as impressive as it always has been though.
I'm not at a T20 medical school, and I felt my school was really confident in its brand name (which again is ridiculous to me...). But all of our uro people matched (n=4), all our ortho people matched (n=5-7 maybe?), we had 15 people apply to derm (wtf...), the list of crazies go on. I do wonder if the students actually listened to advising or went ahead and did what they thought they had to maximize their chances.
 
With all due respect, I agree with those above that if I took the time to apply to, research your program, interview at your program, and then thinking about where I am ranking your program, it is no different than a program's decision to rank the majority of applicants. I've often heard that "if you got an interview with a program, that means you've got a real shot," and I think that equally applies to applicants' POV. This year, I had interviews on the east coast, west coast, and the midwest in the span of 3 days. In a normal year, I probably had to cancel one of them because of costs and not being able to fly coast-to-coast in time. In a normal year, I would have scheduled the interviews in the order that I got invites (first-come, first-serve). Does that mean I wasn't interested in coming to that third program? Absolutely not. It just means that for the first time, I didn't have to make a decision based on how many programs I could afford to fly to.
I mean sure, I'd travel anywhere if it didn't cost anything to travel and I didn't take have to take any time off. But that's completely unrealistic on how things work. I mean, I get the whole hedging the bets things, but people should also be able to prioritize too. Programs asking people to prioritize is really not asking too much.
 
Maybe I'm somewhat biased coming from a surgical sub, but our program director has talked multiple times about how a happy resident is going to be a better resident, and one of the things that most impacts the happiness of the residents is how much they want to be at that specific program, vs having fallen to it as #15 on their rank list.
I imagine I would be ecstatic about training at #15 relative to the alternative of not training!

I was absolutely shocked at my school's confidence in our ability to match as well as we always have. Every student were told to apply as if it were a normal year. And there were definitely anecdotal reports of people coming back and saying "I didn't get enough interviews" and the advisors saying "I have absolutely no idea why you didn't based on the strength of your application." There was no SOAP prep guidance, and to be perfectly honest, I'm not sure the advising office even knows how to help students SOAP given their "historic lack of SOAP-ers" (their words, not mine).
Our school already had a relatively bad year last year with 5 unmatched. To follow that up with even more unmatched this year is ridiculous. During my dean's letter meeting I was the one showing them resources they hadn't heard of like the NRMP interactive charting outcomes tool.

In the past I was able to dismiss it, thinking people must have known it was a dangerous move up front, like maybe they were applying with average boards or a lack of research. Now, I know firsthand that some of the best students in the class are doing everything they're supposed to and still failing. Depending what fields they're interested in, I don't know if I could tell a prospective student to come here in good faith anymore.
 
I imagine I would be ecstatic about training at #15 relative to the alternative of not training!


Our school already had a relatively bad year last year with 5 unmatched. To follow that up with even more unmatched this year is ridiculous. During my dean's letter meeting I was the one showing them resources they hadn't heard of like the NRMP interactive charting outcomes tool.

In the past I was able to dismiss it, thinking people must have known it was a dangerous move up front, like maybe they were applying with average boards or a lack of research. Now, I know firsthand that some of the best students in the class are doing everything they're supposed to and still failing. Depending what fields they're interested in, I don't know if I could tell a prospective student to come here in good faith anymore.
Wow does your school usually go 100% matched? LOL I don't actually know what's considered good for most med schools but 5 unmatched seems great to me!

So I applied into pathology. It's such a small and neglected specialty that any guidance I got from deans, I was told by residents at my home program to ignore because they don't know what they're talking about. At the end of the day, I think students are gonna have to go out of their way to find their specialty-specific mentors because aggregate advising just ends up hurting everyone it feels like. To be fair though, I probably had a slightly-above average app for my very uncompetitive specialty, but I would be scared s***less if I were applying to IM or anything surgical this year so I guess I can understand where the advisors were coming from.
 
Wow does your school usually go 100% matched? LOL I don't actually know what's considered good for most med schools but 5 unmatched seems great to me!

So I applied into pathology. It's such a small and neglected specialty that any guidance I got from deans, I was told by residents at my home program to ignore because they don't know what they're talking about. At the end of the day, I think students are gonna have to go out of their way to find their specialty-specific mentors because aggregate advising just ends up hurting everyone it feels like. To be fair though, I probably had a slightly-above average app for my very uncompetitive specialty, but I would be scared s***less if I were applying to IM or anything surgical this year so I guess I can understand where the advisors were coming from.

One thing I took away from this entire process is how nuanced and individualized it can be. The NRMP's charting outcomes is a great tool to utilize, but it has its limitations. As does home advising. Similarly, I was applying to competitive programs in an uncompetitive specialty, to institutions that my school has never sent anyone to, regardless of speciality.

The advice that I got from my advising was more balanced, which I was surprised by, but the advice from some mentors and Deans (who trained within the specialty) was quite frankly appalling. Such as, I only need to apply to 1-2 programs ("like I did back in the day"). Or, giving blanket advice for applying within the speciality, but ignoring the fact that I was applying to more competitive programs, or interested in pursuing a fellowship later on.

In the end, I sought far better advice from peers, Reddit, and SDN. It seemed to have worked--we shall see come Friday!
 
Wow does your school usually go 100% matched? LOL I don't actually know what's considered good for most med schools but 5 unmatched seems great to me!

So I applied into pathology. It's such a small and neglected specialty that any guidance I got from deans, I was told by residents at my home program to ignore because they don't know what they're talking about. At the end of the day, I think students are gonna have to go out of their way to find their specialty-specific mentors because aggregate advising just ends up hurting everyone it feels like. To be fair though, I probably had a slightly-above average app for my very uncompetitive specialty, but I would be scared s***less if I were applying to IM or anything surgical this year so I guess I can understand where the advisors were coming from.

I used to think people were being elitist in medical school when they asked if this XYZ faculty member was actually an MD/DO, but now I get it. You have to be part of this system to understand it. I'm sick of places hiring consultants/counselors who stick around for one year and know nothing. There are exceptions out there like I imagine Goro is, but most of these non-clinical advisers are garbage. It's quite sad because to me it begs the question what the heck is even proprietary to M1/M2 in medical school? The teaching can be done online given that some schools aren't willing to integrate the curriculum with clinical year (#biochemiswhatseparatesnursesfromdoctors), the advisors aren't good, there's hardly any meaningful clinical experience.
 
Was IM competitive this year? Thought it was pretty easy to match, but haven't spoken with others who applied IM.

The rumor is there were not any midtier IM cats in the SOAP (similar to years past). Doesn't bear well for my "everyone overapplied, programs underinterviewed, and everyone should slide up" theory, but doesn't disprove it either.
 
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Wait, to confirm, do we get our results by email as well at 12 PM? I wasn't planning on doing the "virtual" match ceremony at my school...


It still says this on the NRMP site when you log in "Match Day! Match results released in R3® system at 12:00 noon ET."
 
Wait, to confirm, do we get our results by email as well at 12 PM? I wasn't planning on doing the "virtual" match ceremony at my school...
Yeah now im really confused, i wasnt gonna do my schools match ceremony but if i can find out an hour earlier i may end up doing it...
 
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^Gotcha, I might have jumped the gun?

This is hella confusing. Can someone just call NRMP and figure out what's up. The site everyone's posted an image of says 12pm, the document says 1 pm. The document has been updated to reflect the whole SOAP error thing that happened yesterday. Let us know when there's a consensus.
 
This is hella confusing. Can someone just call NRMP and figure out what's up. The site everyone's posted an image of says 12pm, the document says 1 pm. The document has been updated to reflect the whole SOAP error thing that happened yesterday. Let us know when there's a consensus.
It’s not going to change anything so just roll with it. They’ll be tweeting and emailing all of the official info over the next couple of days. And the WEBSITE ITSELF says 12. Wouldn’t trust some document, website is more reliable.

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It’s not going to change anything so just roll with it. They’ll be tweeting and emailing all of the official info over the next couple of days. And the WEBSITE ITSELF says 12. Wouldn’t trust some document, website is more reliable.

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I know it seems like a first world problem but my girlfriend is taking time off work to be there with me :/ at 11:55-12:15ish and it’s going to be our little match day celebration. I think I’ll call and post what’s up here.

I would trust a website over a document too but there are two caveats. The document is on the same page as the website AND it’s been updated to reflect the SOAP delay yesterday.
 
Yeah now im really confused, i wasnt gonna do my schools match ceremony but if i can find out an hour earlier i may end up doing it...
It has always been like this, you can find out earlier by going to your Match Day ceremony. If there is a Match Day ceremony at your school, most schools cancelled theirs in March 2020.
 
I called NRMP just now. It took 1 minute for me to connect and I was brief because I didn’t want to take time away with SOAPers.

The email time is 12 PM EST.

It was confusing because it’s normally 1pm given match day is usually 12pm in person and the email comes at 1pm and the document attached to the website reflects SOAP updates but not the match day time!
 
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I'm late to the party, like usual.
So...what I think everyone wants to know now is with this overapplying thing...Seems like NAPD is skeptical of hoarding (better word is interview saturation). Is there still a possibility of it having occurred? Not gonna lie, after interviews were done, I was hoping we would find out it existed so that everyone could end up with a high option. (In my head, if there was interview saturation, the top programs would get the same people but everyone after that would hopefully get high choices as a product of top applicants not ranking midtiers highly) since many solid applicants seemed to have already paid the price in the front end (limited initial interviews).

The "top" applicants would be ahead of us but they wouldn't "therorically" match at my lowly #1 since they probably used it as one of their back up options. Also, places probably don't have rank caps and wouldn't DNR anyone just because went above an arbitrary number since there's no rank cap. Wouldn't be in their best interest to do that since they already used the interview slot. The only case I would imagine a DNR is if they interviewed someone and realized they really don't want them for XYZ reason. It's similar to how we DNR a place... the program would really have to prefer to be one spot closer on their list to being unfilled.

Sorry for the double tap here. I'm still not convinced there was any interview hoarding. I think what's likely to have happened is that 1) programs interviewed more people, either by interviewing more people per day or adding more days; 2) Applicants went on same/slightly more interviews, either because there were more slots and because they cancelled less. The net result will be overall the same. If the difference was big we'd probably see a change -- imagine that programs and applicants both doubled their interviews. Everyone's rank list would be twice as long. All the spots would fill the same way, in fact we'd expect a smaller unfill rate overall. The net result would be that people would match, measured as a percentage, in the same part of their list. Measured as an absolute value, it would be lower. But it's really the same result (but will feel worse, if we use "matched at #1" as a metric). Since I think the difference was probably only 10-15%, I don't think it will make a big enough difference to show. We will see when we see the data -- I may eat my hat.
Alright, could have sworn programs don't rank everyone, but I'll take ya'lls word for it! My friend saw a program he ranked in the soap this year : /.
Pointing out that if your friend matched and saw a program they ranked in SOAP, then that means they probably matched above this program (unless the program didn't rank them). If your friend didn't match, then the program didn't rank them.
They virtual interviews aren’t here to stay, sorry. There isn’t much cost to the programs because most of the financial burden falls on the applicant. And because of that, applicants have to be more thoughtful about where they apply.
This will be the most interesting thing to come out of this COVID mess. I don't think the AAMC can force anything to happen -- residency programs are separate businesses whom can recruit any way they want. Unless the ACGME decides to intervene and somehow make it a program requirement (which I expect would be very unpopular) it will likely be program choice. In a world where everyone is virtual, it's no problem. When "top" programs go back to in person, everyone's going to want to keep up with the Joneses...
There were too many “tourist applicants” this year and no program wants to have a bunch of applicants who actually have no interest in coming to the program but take up an interview spot for funnzies.
With all due respect. This is non-sense. If i am applying to your program, interviewing, and then ranking your program. That is not a tourist application.
Actually, it's not "nonsense" per se. If I knew you're going to rank me #20 on your list, I wouldn't bother inviting you. Sure, you like to have the interview and one more rank because it marginally increases your chance of matching. But it's mostly a waste of our resources. Of course, there's often no way for us to know. That's how some programs end up using (perhaps) meaningless metrics -- like any connection to geographic area, etc.
The rumor is there were not any midtier IM cats in the SOAP (similar to years past). Doesn't bear well for my "everyone overapplied, programs underinterviewed, and everyone should slide up" theory, but doesn't disprove it either.
The data so far highly suggests there's no "slide up" effect. For that to happen, there would need to be extreme interview hoarding. Top applicants would need to get most of the interviews, mid-tier applicants would get a decent number, and a good slice of applicants would need to get few/none. Then, top programs would fill with the top applicants as they always do. Higher / mid tier programs would have also interviewed these superstars, get none of them, and fall lower on their lists -- and those mid tier applicants would slide up relative to prior years. And then a whole bunch of low tier programs would be unfilled, along with the unmatched low tier applicants. The SOAP stats don't support this at all.

It still might be possible -- if the distribution of filled slots is different. If because of virtual inteviewing programs that usually consider IMG candidates decided to more strongly consider DO candidates, then it's possible that DO candidates would "match better" and IMG would "match worse". I have no idea if that's the case -- this is not based on any real data. But I doubt it.

I guess it's actually possible that the match results will be better this year -- that on average candidates will match higher on their lists. As people go on more interviews, they get exposed to more programs. It's possible that you might fall in love with a program that you otherwise might not have considered. If that happens to enough people, everyone might do better.

I think there's too many unknowns, and no matter what the data ultimately show, you can probably spin it to tell whatever story you want. The only story that is certainly not true is that the match this year was a disaster. It seems to have turned out similarly to prior years. Although I certainly recognize that if you have not matched, it certainly seems like a disaster.
 
I'm late to the party, like usual.




Sorry for the double tap here. I'm still not convinced there was any interview hoarding. I think what's likely to have happened is that 1) programs interviewed more people, either by interviewing more people per day or adding more days; 2) Applicants went on same/slightly more interviews, either because there were more slots and because they cancelled less. The net result will be overall the same. If the difference was big we'd probably see a change -- imagine that programs and applicants both doubled their interviews. Everyone's rank list would be twice as long. All the spots would fill the same way, in fact we'd expect a smaller unfill rate overall. The net result would be that people would match, measured as a percentage, in the same part of their list. Measured as an absolute value, it would be lower. But it's really the same result (but will feel worse, if we use "matched at #1" as a metric). Since I think the difference was probably only 10-15%, I don't think it will make a big enough difference to show. We will see when we see the data -- I may eat my hat.

Pointing out that if your friend matched and saw a program they ranked in SOAP, then that means they probably matched above this program (unless the program didn't rank them). If your friend didn't match, then the program didn't rank them.

This will be the most interesting thing to come out of this COVID mess. I don't think the AAMC can force anything to happen -- residency programs are separate businesses whom can recruit any way they want. Unless the ACGME decides to intervene and somehow make it a program requirement (which I expect would be very unpopular) it will likely be program choice. In a world where everyone is virtual, it's no problem. When "top" programs go back to in person, everyone's going to want to keep up with the Joneses...


Actually, it's not "nonsense" per se. If I knew you're going to rank me #20 on your list, I wouldn't bother inviting you. Sure, you like to have the interview and one more rank because it marginally increases your chance of matching. But it's mostly a waste of our resources. Of course, there's often no way for us to know. That's how some programs end up using (perhaps) meaningless metrics -- like any connection to geographic area, etc.

The data so far highly suggests there's no "slide up" effect. For that to happen, there would need to be extreme interview hoarding. Top applicants would need to get most of the interviews, mid-tier applicants would get a decent number, and a good slice of applicants would need to get few/none. Then, top programs would fill with the top applicants as they always do. Higher / mid tier programs would have also interviewed these superstars, get none of them, and fall lower on their lists -- and those mid tier applicants would slide up relative to prior years. And then a whole bunch of low tier programs would be unfilled, along with the unmatched low tier applicants. The SOAP stats don't support this at all.

It still might be possible -- if the distribution of filled slots is different. If because of virtual inteviewing programs that usually consider IMG candidates decided to more strongly consider DO candidates, then it's possible that DO candidates would "match better" and IMG would "match worse". I have no idea if that's the case -- this is not based on any real data. But I doubt it.

I guess it's actually possible that the match results will be better this year -- that on average candidates will match higher on their lists. As people go on more interviews, they get exposed to more programs. It's possible that you might fall in love with a program that you otherwise might not have considered. If that happens to enough people, everyone might do better.

I think there's too many unknowns, and no matter what the data ultimately show, you can probably spin it to tell whatever story you want. The only story that is certainly not true is that the match this year was a disaster. It seems to have turned out similarly to prior years. Although I certainly recognize that if you have not matched, it certainly seems like a disaster.
Who would have thought that taking largely the same number of programs and largely same number of applicants as the year before and making them do the same dance they do every year would result in roughly similar outcomes???

I think there probably are some nuanced differences and some of them might even be specialty specific but I think it just makes good old fashioned sense that a huge effect wouldn't be noticed.