How is residency a bottle-neck when it seems most everyone is matching?

[MisterFutu]

---

Members do not see this ad.

How is residency a bottle-neck when it seems most everyone is matching to places, even though it might not be their first choice?

Lastly, how important are rotations(3rd and 4th year), especially if the rotation mainly lets you watch?

Thanks in advance SDN!

 

[AnatomyGrey12]

1. Theoretically because the # of residencies is fixed and limits the number of new docs that enter the field each year. As of right now however we have about 6000 residency slots more than the total number of American medical graduates each year (MD/DO)

2. Rotations are pretty important and are where you learn the practical part of medicine , AKA filling out paperwork, charting, getting pages from nurses... 😉 and you don't want to be "just watching" because I can do that by just signing up to shadow any Dr. Bob in my community. But as someone who is not a medical student yet I defer to those with more experience and knowledge than I.

 

[Seth Joo]

How is residency a bottle-neck when it seems most everyone is matching to places, even though it might not be their first choice?

Lastly, how important are rotations(3rd and 4th year), especially if the rotation mainly lets you watch?

Thanks in advance SDN!

Its mostly US graduates that are matching, its IMGs that are left out in the cold these days.

 

[Ismet]

How is residency a bottle-neck when it seems most everyone is matching to places, even though it might not be their first choice?

Lastly, how important are rotations(3rd and 4th year), especially if the rotation mainly lets you watch?

Thanks in advance SDN!

3rd and 4th year rotations are incredibly important, and no U.S. medical school should have you "just watching" the majority of the time. Yes there is some shadowing and observing during rotations, especially for things that are more sensitive (for me it's been a couple occasions in obgyn, psych, peds) but for the most part you are supposed to be providing direct patient care and functioning as a contributing member of the care team.

After board scores, your grades in clinical rotations are typically next in importance. You also need 3 solid clinical letters of recommendation. The first 2 years really only matter to lay the foundation for your clinical knowledge and to prepare for Step 1. No one cares what grade you get in biochem.

 

[Spector1]

Its a bottleneck because LCME won't let there be (or at least isn't supposed to let there be) that many more med school slots than residency slots. That said, lcme seems more lax with accreditation as of late cough northstate cough

 

[Throwaway41785]

Its a bottleneck because LCME won't let there be (or at least isn't supposed to let there be) that many more med school slots than residency slots. That said, lcme seems more lax with accreditation as of late cough northstate cough

 

[goldy490]

My understanding (from people I know in residency/administrations) is that there are currently enough spots, although just barely given the number of new US MD and DO schools. Every year new med schools open, and at this rate, it'll only be a couple years (Class of two-thousand-twenty-something) until US Schools are matriculating more students than there are residency slots.


Now for a conspiracy theory from an OM-4 friend at LECOM:
The DO-MD residency merger is actually a takeover, and the main purpose is to expand the number of residencies available for new MD schools (like northstate). Because the government wont increase funding for new residences, the ACGME is going to take the AOA residencies and open them up to MD students. Basically, it will serve as a way to ensure MD grads continue to have somewhere to go, but could end up leaving people from low level DO schools out in the cold when there is no longer enough spots for the US grads. I'm not claiming this to be fact, just something someone told me that sounds plausible (and terrifying).

 

[goldy490]

Sorry @gonnif, I wasn't trying to spread false info...Like I said, "Conspiracy Theory"!

 

[deleted480308]

There is no shortage of slots for US grads.....there is a huge shortage for IMGs and a large shortage of spaces in certain fields (when compared to how many want in).

If you don't match as a US grad who actually passed your boards first try and didn't get a crazy red flag it's because you didn't apply safely enough. A 205 with no honors on rotations and you applied only ortho in big cities? You're an idiot. A 205 can absolutely still land a family med spot

 

[TooMuchResearch]

How is residency a bottle-neck when it seems most everyone is matching to places, even though it might not be their first choice?

Lastly, how important are rotations(3rd and 4th year), especially if the rotation mainly lets you watch?

Thanks in advance SDN!

1. It isn't.
2. Incredibly important.

 

[deleted480308]

Because of more MD and DO grads now applying for the same number of slots, there is increased competition in what slot you may get. While in 2015, US allopathic seniors match 51% into their first choice and 25% into 2nd/3rd choice. So about 25%, which is about 4500 seniors matched into slots lower on their rank list. Additionally some 1200 slots were filled post-match via SOAP. My point to this is some 5,000-6,000 US allopathic seniors got less desired slots, or about 1/3 of the total graduating class. So yes enough slot but more competition to get the slot you want

I get the competition for desired slots is getting tighter....but still plenty of slots for US grads

 

[Oh_Gee]

but does jet fuel melt steel beams???

 

[moisne]

I think you got it mixed up... Entering medical school is the bottle neck.

What's the number? 95+% MD candidate will graduate and of that 95+% will match (MD's)? If you didn't match - you were being stupid - because there are spots unfilled every year. Low step scores and grades trying to match highly competitive fields and not enough programs applied are usually the reason.

How is residency a bottle-neck when it seems most everyone is matching to places, even though it might not be their first choice?

Lastly, how important are rotations(3rd and 4th year), especially if the rotation mainly lets you watch?

Thanks in advance SDN!

 

[BphysDoc]

It makes sense that residency should not be a bottle neck for AMGs - huge amount of educational debt...

 

[Law2Doc]

I think you got it mixed up... Entering medical school is the bottle neck.

What's the number? 95+% MD candidate will graduate and of that 95+% will match (MD's)? If you didn't match - you were being stupid - because there are spots unfilled every year. Low step scores and grades trying to match highly competitive fields and not enough programs applied are usually the reason.

I think the concept of bottleneck here is in terms of generating doctors. For residency you have something like 30k people applying for 20k spots. Its the real life restriction of the number of new doctors. You could increase or decrease the enrollment of med school all you want and it won't impact the number of new doctors.

 

[MisterFutu]

It makes sense that residency should not be a bottle neck for AMGs - huge amount of educational debt...

Quick question. I browsed SDN and google, and could not find what AMG meant. My googlefu is weak.

Thank you to everyone who has enlightened me on this subject matter. I asked this because one of my interviewers mentioned this during my interview.

 

[caffeinemia]

Quick question. I browsed SDN and google, and could not find what AMG meant. My googlefu is weak.

Thank you to everyone who has enlightened me on this subject matter. I asked this because one of my interviewers mentioned this during my interview.

American medical graduate versus international medical graduate. It is everything.

 

[Law2Doc]

...
The match creates an artificial psychology of rejection by having the whole process play out at once, rather than a drawn out process like the med school application where your ups and downs come at more manageable intervals.

Depends where you are on the spectrum. Lots of SDNers sit on multiple acceptances for med school, while in real life people sit on waitlists praying. i think you get more people desperate to just get about anything in the med school process while in the match people are often more annoyed and whiney that their top X choices didnt want them. I'm not sure which is more a psychology of rejection. Neither system is great for all comers.