How does the NRMP process work?

[DMC0303]

Currently I am an undergrad senior and will be graduating in December, plan is to do a year and half post-bacc and then med school. While I feel like I know some general info about the Match, I'm still confused on some parts. I saw a post similar back in 2006 but with no good responses, so maybe I'll have better luck with my post. My questions are:

- How do you your USMLE scores get used? Can you only apply to certain places or specialties if you have x score? Or is just like anyone can apply to anywhere or any specialty but the higher scores will be first pick?
- Can you apply to more than one specialty?
- Is it possible to match into more than one specialty?
- On average how many places do you apply to?
- What is the San Fransisco Match? I know its for certain specialties, usually the more competitive ones, but do you apply early for those? I'm interested in plastics and was wondering if the SF match has integrated plastics programs, just the plastics fellowships, or both?
- What does "transitional" mean?
- What does it mean to match into research?

Any info would be appreciated 🙂 Sorry for all the questions but I just cant seem to find anyone around here to ask about The Match to.

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[tiedyeddog]

If I were you is worry about
1. Getting in
2. Doing boss on step 1.
3. Doing research.
4. Making contacts in your field.


Worry about the other crap at the end of our third year.

 

[the argus]

I agree that you are putting the cart wayyyy before the horse, but I'll answer your questions.

1. anyone with any score can apply to any specialty. Scores are one factor used to determine competitiveness for certain specialties, and program tiers within all specialties. Depending on specialty/program, their importance ranges from minimal (i.e. family medicine you usually just have to pass) to extremely important.

2. Yes

3. No, you can only match to a single program, and you must go to that program. By entering the match you are signing a contract saying you will go where you match.

4. Depends on the applicant and the specialty. In general, US MDs < DOs < IMGs. That said, there is huge variability depending on specialty and individual applicant. For instance, a US MD applying to dermatology is likely an excellent applicant (high USMLEs/GPA, AOA, publications, etc) but will still apply to >50 programs because it is a super competitive specialty. That same applicant would only probably apply to 15 family medicine or internal medicine programs. IMGs routinely apply to >100 programs, regardless of specialty.

5. Certain specialties (for residency) and subspecialties (for fellowship) use the San Francisco match. It is a separate application process from the NRMP, and the timing depends on the specialty. In some cases it is before the NRMP match (i.e. ophthalmology), in some cases after (independent plastics).

6. I assume you mean in the context of a transitional year. It is a specific type of intern (PGY 1) year. It can be thought of as a mix between a medicine prelim and a surgical prelim year. It depends on the program, but often you will do medicine inpatient wards, surgical services, ICU, etc. They are usually competitive because they are generally considered to be more relaxed than medicine and surgery prelim years. They serve 2 major purposes. 1) Can be used in place of a prelim medicine/surgery year to fulfill the requirements of an advanced (i.e. PGY 2) position. 2) Used when a person is not sure what specialty they want upon completion of medical school. This will give exposure to the daily experience in multiple different specialties.

7. Often means a match into a research pathway position. Many programs have dedicated research pathways, meaning when applying to residency you are actually applying to a residency/fellowship position. For example, the normal pathway to being an oncologist is a 3 year internal medicine residency followed by a 3 year heme/onc fellowship. Certain programs offer pathways where while applying for residency you apply for a 5 year program which includes 2 years of internal medicine residency followed by 3 years of heme/onc fellowship. The fellowship years will have a large chunk of dedicated research time (i.e. 2 years) with some amount of guaranteed funding. These are usually reserved for people with PhDs, but not always.

Now, go volunteer at a nursing home!

 

[DMC0303]

I agree that you are putting the cart wayyyy before the horse, but I'll answer your questions.

1. anyone with any score can apply to any specialty. Scores are one factor used to determine competitiveness for certain specialties, and program tiers within all specialties. Depending on specialty/program, their importance ranges from minimal (i.e. family medicine you usually just have to pass) to extremely important.

2. Yes

3. No, you can only match to a single program, and you must go to that program. By entering the match you are signing a contract saying you will go where you match.

4. Depends on the applicant and the specialty. In general, US MDs < DOs < IMGs. That said, there is huge variability depending on specialty and individual applicant. For instance, a US MD applying to dermatology is likely an excellent applicant (high USMLEs/GPA, AOA, publications, etc) but will still apply to >50 programs because it is a super competitive specialty. That same applicant would only probably apply to 15 family medicine or internal medicine programs. IMGs routinely apply to >100 programs, regardless of specialty.

5. Certain specialties (for residency) and subspecialties (for fellowship) use the San Francisco match. It is a separate application process from the NRMP, and the timing depends on the specialty. In some cases it is before the NRMP match (i.e. ophthalmology), in some cases after (independent plastics).

6. I assume you mean in the context of a transitional year. It is a specific type of intern (PGY 1) year. It can be thought of as a mix between a medicine prelim and a surgical prelim year. It depends on the program, but often you will do medicine inpatient wards, surgical services, ICU, etc. They are usually competitive because they are generally considered to be more relaxed than medicine and surgery prelim years. They serve 2 major purposes. 1) Can be used in place of a prelim medicine/surgery year to fulfill the requirements of an advanced (i.e. PGY 2) position. 2) Used when a person is not sure what specialty they want upon completion of medical school. This will give exposure to the daily experience in multiple different specialties.

7. Often means a match into a research pathway position. Many programs have dedicated research pathways, meaning when applying to residency you are actually applying to a residency/fellowship position. For example, the normal pathway to being an oncologist is a 3 year internal medicine residency followed by a 3 year heme/onc fellowship. Certain programs offer pathways where while applying for residency you apply for a 5 year program which includes 2 years of internal medicine residency followed by 3 years of heme/onc fellowship. The fellowship years will have a large chunk of dedicated research time (i.e. 2 years) with some amount of guaranteed funding. These are usually reserved for people with PhDs, but not always.

Now, go volunteer at a nursing home!

I know that this is still years away from me, but I was just more curious more than anything about the process goes. I see people talking about the match into great depth on here in some of these forms and there were some things that I didnt understand. At the moment I'm focusing on the pre-med stuff I'm supposed to, but its still useful to know how the match works for future references 🙂

But thank you for your thorough response, it cleared away any confusion 🙂