yaah

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New article in Human Path (not published yet in print but available "early view.")

http://www.ncbi.nlm.nih.gov/pubmed/21035167

Abstract
The specialty of Pathology and Laboratory Medicine has entered into a phase when the 4-year sequence of Anatomic Pathology and/or Clinical Pathology Residency Training is almost universally followed by 1 or more years of Subspecialty Fellowship Training. Such training may occur in one of the American Board of Pathology-recognized subspecialties or any number of "subspecialty fellowships" that, although not leading to subspecialty board certification, may nevertheless fall under the oversight of the local institutional Graduate Medical Education Committee and the Accreditation Council for Graduate Medical Education Review Committee for Pathology. Unlike the application process for first-year Pathology Residency, which is run through the National Resident Matching Program, applications for Subspecialty Pathology Fellowships are not coordinated by any consistent schedule. Competition for Subspecialty Pathology Fellowships has consistently resulted in undesirable drift of the fellowship application process to dates that are unacceptably early for many fellowship applicants. Responding to widespread dissatisfaction voiced by national pathology resident organizations, in 2007, the Association of Pathology Chairs began evaluation and potential intervention in the fellowship application process. Three years of intermittently intense discussion, surveys, and market analysis, have led the Council of the Association of Pathology Chairs to recommend implementation of a Pathology Subspecialty Fellowship Matching program starting in the 2011 to 2012 recruiting year, for those Applicants matriculating in fellowship programs July 2013. We report on the data that informed this decision and discuss the pros and cons that are so keenly felt by the stakeholders in this as-yet-incomplete reform process.


It is a pretty good article laying out a lot of history and pro/con arguments. It seemed to me as though it was a little thin on how they will go about getting programs to comply or participate - seems like the honor system almost. I don't think there is any chance this will get underway in 2011-12, personally.
 

icpshootyz

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Probably won't happen in any sort of timely manner, but it will be a huge improvement over the clusterf$%& that exists right now. I wholeheartedly support a fellowship match program.
 
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Yeah the current system is totally ****ed. I really don't see much chance of a fellowship match being successful though, especially because so many fellowships are unaccredited and really don't have to answer to anyone.
 

zao275

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Everyone answers to a chair (well, with a few exceptions I guess). If most chairs want it, then they can put pressure on PD's to do it or else. Once enough programs agree to a match (70%), then there is a critical mass that serves to pull in most of the other programs as well. That is my understanding of it (from what the director of the NRMP said at the RF at USCAP).

I agree with yaah. Very thorough article, esp in regards to the history that led to our current state.
 

gbwillner

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It seems to me that the big issue is for people at programs they are wanting to (or needing to) leave, since it also seems like most programs prefer their own for fellowships. For those who want to stay at their own institutions, this just looks like a way for them to get more $$ sucked out of them by whatever match program is created.
 

malchik

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It seems to me that the big issue is for people at programs they are wanting to (or needing to) leave, since it also seems like most programs prefer their own for fellowships. For those who want to stay at their own institutions, this just looks like a way for them to get more $$ sucked out of them by whatever match program is created.
Exactly. But I submit that this apparent preference for internal candidates is a byproduct of the current uncertainties in the fellowship application market. It is simply easier for both parties. Better to go with a known quantity, even if they may be less than the ideal candidate, than to risk losing that above average person in an extensive search for the perfect one. But in a match system that risk is gone, and both parties simply rank their preferences.
 

zao275

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But I submit that this apparent preference for internal candidates is a byproduct of the current uncertainties in the fellowship application market.
That. Precisely.

The article nicely explores the concept of what would/might happen regarding internal candidates in the wake of a Match system. Intriguing ideas.

Also, the cost is fairly minimal to do the Match itself. Travel is another matter, of course.
 

gbwillner

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Exactly. But I submit that this apparent preference for internal candidates is a byproduct of the current uncertainties in the fellowship application market. It is simply easier for both parties. Better to go with a known quantity, even if they may be less than the ideal candidate, than to risk losing that above average person in an extensive search for the perfect one. But in a match system that risk is gone, and both parties simply rank their preferences.
However, I think that it may be justified at top programs. You already recrutied the people you think are best. You trained them. Taking an outside person IS a risk, and a one-day interview is not going to give you real insight into their capabilities.

Every year my institution takes outside people for fellowships, and every year I wonder how many of them passed the boards. I find that the internal candidates are almost always better- they know the system, they are used to the workflow, and the volume.
 

malchik

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However, I think that it may be justified at top programs. You already recrutied the people you think are best. You trained them. Taking an outside person IS a risk, and a one-day interview is not going to give you real insight into their capabilities.

Every year my institution takes outside people for fellowships, and every year I wonder how many of them passed the boards. I find that the internal candidates are almost always better- they know the system, they are used to the workflow, and the volume.
I see the point. But again, I think you may be seeing a selection bias. The outside fellows are probably accepted into the less competitive slots that no internal person wanted.
 
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I see the point. But again, I think you may be seeing a selection bias. The outside fellows are probably accepted into the less competitive slots that no internal person wanted.
That's not true. Programs behave differently in regards to internal candidates. While there are some that will almost always take an internal candidate over someone else, even if the outside person is much more qualified, other programs will not. One competitive spot where I trained was illustrative - internal candidate was not taken because an outside candidate looked impressive and expressed a desire to do research and be in academics. Flash forward several years and the candidate they took (the outside candidate) is in a completely private job and the one they passed over is in academics as a rising star.
 

green mantis

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Having a match doesn't really affect internal candidates. However, it does level the playing field for external candidates.

My residency program only had 1 fellowship, one which I wasn't interested in doing. Every time I interviewed at another program, it felt like I was begging them to take me. When I started my residency, doing a fellowship wasn't as "required" as it was when I finished.

I think one reason internal candidates may be "better" is partly because there's no adjustment period. You don't need to ingratiate yourself to your new colleagues, which can take a while or may not happen at all.


----- Antony
 

2121115

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Having a match doesn't really affect internal candidates. However, it does level the playing field for external candidates.
Unfortunately, it does not level the playing field at all.
 

KCShaw

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Unfortunately, it does not level the playing field at all.
How do you mean?

It should relatively open the door for external candidates to apply, at least to those institutions which historically take internal candidates very very early and do not look at other potential applicants. They may still not be ranked highly, but it seems they would at least have more opportunity.

Similar could be said for individuals who stay local despite possibly having interest in going elsewhere, because accepting local early is the safe option, and in the current system they have little reasonable opportunity to seriously look at other programs.
 

malchik

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Yaah, can this thread be merged to the other one, they seem to have converged.