jephyboy

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This is a really stupid question, but I'd thought I would ask anyways. I know that various programs (depending on the specialty, of course) don't fill all of their spots. My logic tells me that programs would what to fill all their spots. Is this true? Or do some programs simply don't fill all their spots on purpose (program X has 8 spots but will only put 6 residents there and leave 2 unfilled)? And if they do purposely not fill all the spots, why?
 

14022

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Programs are reimbursed by the government for each resident/fellow that they have. I don't know the exact amount, but it is way more than they pay their housestaff, I think around $100,000 or more. Therefore, yes, it is very important for places to fill their spots.

Other reasons include resident happiness...if spots are left unfilled, residents have to pick up the slack of the work of the missing resident. For example, take pediatrics. Programs usually have tough rotations like NICU and PICU for their residents. They also have easy rotations, like clinic month or subspecialty months where call is very infrequent. If a program is missing a resident, they may be short on residents to cover the NICU and PICU overnight and still meet the 80 hour work week requirements. Therefore, the resident on the easy rotation may have to take call in the NICU or PICU a few nights a month.
 

jazz

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jephyboy said:
This is a really stupid question, but I'd thought I would ask anyways. I know that various programs (depending on the specialty, of course) don't fill all of their spots. My logic tells me that programs would what to fill all their spots. Is this true? Or do some programs simply don't fill all their spots on purpose (program X has 8 spots but will only put 6 residents there and leave 2 unfilled)? And if they do purposely not fill all the spots, why?
obviously programs want to fill because of resident schedule and workload but also because of reputation. if you are on the unfilled list year after year, it usually indicates there is a problem with the program.

say a program has 8 spots and interviews 100 people. they may NOT rank ALL 100. and instead only ranks 90. why? well, the remaining 10 may have some problems (for instance -- crazy on interview day, misrepresents themselves on the initial ERAS application, seem like a poor fit, pissed off the wrong person, etc) and the program would rather take a chance of not filling. on the tuesday of scramble day, the people left over scrambling may be good, strong candidate (i.e-- the AOA derm candidate that didn't match and now is looking to go into say radiology, the overconfident AOA med student who only ranked 2 medicine programs), etc
 

obg2005

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And EVEN IF a program wanted to leave some spots unfilled on purpose, that will be hard to control considering how the match works. If for 8 spots, they only rank 6 applicants, they take the huge risk of matching none of them. The only way to be sure to match all 6 applicants would be to make them sign illegal contracts before the match. And since that would be against the rules, it wouldn't be 100% guaranteed.
 

AJM

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obg2005 said:
And EVEN IF a program wanted to leave some spots unfilled on purpose, that will be hard to control considering how the match works. If for 8 spots, they only rank 6 applicants, they take the huge risk of matching none of them. The only way to be sure to match all 6 applicants would be to make them sign illegal contracts before the match. And since that would be against the rules, it wouldn't be 100% guaranteed.
I think there is a way that the programs can inform the NRMP how many spots they want to fill. The fellowship program I matched to last year during the fellowship match (run in the same way by NRMP) didn't fill on purpose. They had 9 designated spots, but decided they only wanted to take 7 applicants, so only 7 ended up matching. This was because they had taken in a couple extra people earlier as 2nd year fellows, and didn't want the program to be over-filled. I got the impression that they simply told the NRMP to just block out 2 of their spots. Anyway, they got quite a headache when the scramble came around and everyone was calling the program about the "empty spots" -- they had to keep explaining to callers that those positions were not available.