How does match work?

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UnderdogMD

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I need some general info. If anybody could help me out I'd really appreciate it.

1. How does match work?
2. Do people get to choose where they want to go and what specialty they want to go into? What prevents everybody from going into derm, rad, or other highly competitive specialties?
3. Does the school have any say in what you place into? Can schools force certain specialties-ie those focusing on primary care?
4. What happens to those people that fail to place?

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They throw all the students who are applying names in a big hat, the PD's take turns drawing them out.

Just kidding.

1. How does match work?

To make it simple, you first apply for interviews at programs. They'll offer one or not based on your CV or whatever. Then you go there and you do the interview thing. The way it's different from med school interviews is they rank each candidate on a list about how much they "want" them (as opposed to just offering admissions to those they're interested in). Similarly, when you're done you rank which programs you liked the best. This data gets sent to a big computer algorithm that matches people to make everybody happy.

2. Do people get to choose where they want to go and what specialty they want to go into? What prevents everybody from going into derm, rad, or other highly competitive specialties?

Well, not everyone's interested in those fields first of all. Second, there's only so many slots for derm and rads (these programs are kinda famous for limiting the number of new docs they train so that they ALWAYS stay exclusive and make money). So you've got to be competitive (high class rank, AOA, Board scores, research, knowing somebody) etc. People fail to match into these programs every year.

3. Does the school have any say in what you place into? Can schools force certain specialties-ie those focusing on primary care?

No. Even if your school has trained primary care for decades you can apply for Pathology or Neurosurgery if the interest strikes you. School doesn't have any say on what you rank. Your school DOES submit a Dean's letter though where they sum up all your acheivements, and you want it to be complimentary.

4. What happens to those people that fail to place?

Well, there's a "scramble". You're notified if you failed to match. Programs are then notified if they have spots that didn't get filled. People frantically call around and try to find a place to be next year.

Or, you can try to apply again next year.

That's the (too) simple version.
 
check out the NRMP's website (google it) and they have a nice, thorough explanation of how the algorithm works. it doesn't answer all your questions, but it's a good place to look at for someone in your position. in case you're wondering, the NRMP is the national residency matching program - it's the group that runs the match (along with certain fellowship matches).
 
Okay so factors like grades and class rank go into determining which spot you place into. Having said that, is it better to be a big fish in a small pond or a small fish in a big pond. What I mean is, is it better to go to a better school with a better reputation and more competitive students or a lesser known school with a lesser reputation and with less competitive students. My rudimentary understanding is the better school affords more opportunities (has the match list and reputation to prove it), but at the less competitive school someone could potentially perform better and be much higher ranked in the class. I don't think I am doing a good job of explaining my question but I hope you get what I mean.
 
Okay so factors like grades and class rank go into determining which spot you place into. Having said that, is it better to be a big fish in a small pond or a small fish in a big pond. What I mean is, is it better to go to a better school with a better reputation and more competitive students or a lesser known school with a lesser reputation and with less competitive students. My rudimentary understanding is the better school affords more opportunities (has the match list and reputation to prove it), but at the less competitive school someone could potentially perform better and be much higher ranked in the class. I don't think I am doing a good job of explaining my question but I hope you get what I mean.

No, I see what you're saying. Is it better to be average at John Hopkins than top of the class in North Western Butt*Bleep* Middle of Nowhere Medical School.

Personally, I say your personal achievement comes first. Stuff that standardizes you against other students like Step 1 is great. If you're getting a 250, 260 etc. even if you're at a "no name" medical school, you're a good candidate...period!

Now big time schools do afford you a bit of cred, but they also give you exposure to people "known" in the field who can give you connections to program directors and such. But remember that you have the ability to do away rotations at most places, so once again, even if you're in the middle of nowhere, you still have an opportunity to work with, for example, that Neurosurgery guru in his New York hospital if you can get into the rotation.
 
Each year many candidates who do not meet NRMP deadline in February are taken off the MATCH automatically ... Now is there a chart or information about those candidates [ US AMG's . US FMG's , IMG's ] and the specialties the applied to ?

Again for instance if a candidate did not have a Step score , and was not invited to the programs he/ she applied to [ maybe the most preferred location/ program] ....if he/ she passed the exam in December 2007 ... the he/ she would be able to update programs through ERAS ... will the programs automatically detect such updates ? also even if you notify programs will all interview slots filled up by the time your score is released... what should one do ?
 
Each year many candidates who do not meet NRMP deadline in February are taken off the MATCH automatically ... Now is there a chart or information about those candidates [ US AMG's . US FMG's , IMG's ] and the specialties the applied to ?

Only IMG's are removed from the match this way, for not having their step scores in by the ROL deadline. US grads, regardless of citizenship / background, are only removed from the match if they will not graduate from medical school by July 1st.

As far as I know, the NRMP does not publish any data on these candidates. Because they are removed from the match, many may not submit an ROL and hence the NRMP may not know what field they were interested in.

Again for instance if a candidate did not have a Step score , and was not invited to the programs he/ she applied to [ maybe the most preferred location/ program] ....if he/ she passed the exam in December 2007 ... the he/ she would be able to update programs through ERAS ... will the programs automatically detect such updates ? also even if you notify programs will all interview slots filled up by the time your score is released... what should one do ?

I'm not 100% clear on what you're asking.

As mentioned in multiple other threads, as an IMG it is tremendously in your favor to have both step scores reported by Nov 1st.

If you don't, but get your scores back in Dec/Jan/Feb, the results will update to ERAS if you release your scores. Will programs "notice" this? Yes -- in two ways. First, everytime we download information the system allows us to print out all the new downloaded information -- so your new score report would be printed and added to your file.

More importantly, any filters created by PD's to screen for "complete" applications would see your new scores. Each PD can define a complete application any way they want, but if you assume that the program you are interested in wants both Steps, once you have both reported the next time the PD runs a report looking for complete apps, yours will appear.

Having a late application might cause all of the interview slots to be filled. In this case, many programs have waitlists -- but it can be quite expensive / inconvenient to be told 48 hour beforehand that there is an interview slot open.

Or, for example, what I do is collect IMG applications in October, reject the people I'm sure I'm not going to interview, and then the first week of November I sort through the group of quality applications I have and choose who to interview and who not. After that, I keep an eye out for other good IMG applications, but you would really need to stand out to get an interview.

So, the best answer is not to get in this position in the first place by having all of your exam results by Nov 1st. If you are in this position, you apply and hope for the best. Once rejected from a program, it's unlikely that you will get an interview when your scores come in. Once they do, you could consider contacting all of the programs that have not offered you an intervew nor rejected you and alert them to your new scores.
 
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