I swear if residency interviews are virtual this year

[FindersFee5]

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No. It’s about an 8% reduction. 6/82

The absolute risk reduction is 6%. The relative risk reduction goes from 18% chance of not matching to 12% (12/18), so is 1/3 reduction, or 33%.

 

[sella.turcica]

No. It’s about an 8% reduction. 6/82

Step 1 is a b****, huh?

 

[Matthew9Thirtyfive]

The absolute risk reduction is 6%. The relative risk reduction goes from 18% chance of not matching to 12% (12/18), so is 1/3 reduction, or 33%.

Yeah relative risk reduction can make things look a whole lot more dramatic than they are. Penicillin provides a relative risk reduction of rheumatic fever in a GAS pharyngitis of 70%. But the absolute risk reduction is like 1.67%.

Gotta take them in context with each other.

 

[FindersFee5]

Yeah relative risk reduction can make things look a whole lot more dramatic than they are. Penicillin provides a relative risk reduction of rheumatic fever in a GAS pharyngitis of 70%. But the absolute risk reduction is like 1.67%.

Gotta take them in context with each other.

Although in this case I'd argue that the RRR actually provides a decent idea of how important penicillin is for treating strep throat because the cost of intervention is low and the possible lifetime consequences of RF are so great.

 

[Matthew9Thirtyfive]

Although in this case I'd argue that the RRR actually provides a decent idea of how important penicillin is for treating strep throat because the cost of intervention is low and the possible lifetime consequences of RF are so great.

A lot of physicians disagree with you, particularly in EM. The overall incidence without antibiotics is like 1.43% and it’s 0.74% with antibiotics. So actually the point is that while there is a huge RRR, the ARR is very low. More people will get c diff from the abx than would get rheumatic fever with or without the abx.

 

[MakeLifeHappen13]

A lot of physicians disagree with you, particularly in EM. The overall incidence without antibiotics is like 1.43% and it’s 0.74% with antibiotics. So actually the point is that while there is a huge RRR, the ARR is very low. More people will get c diff from the abx than would get rheumatic fever with or without the abx.

A difference of 0.69% is quite significant when extrapolated over millions of children. Thousands of them would develop Rheumatic fever if we all just said 'eh not enough of a difference let's not treat them'.

I'm not saying that's what you're suggesting, but I just had to point out that that line of thinking is actually not safe from a Public health standpoint.

 

[Matthew9Thirtyfive]

A difference of 0.69% is quite significant when extrapolated over millions of children. Thousands of them would develop Rheumatic fever if we all just said 'eh not enough of a difference let's not treat them'.

I'm not saying that's what you're suggesting, but I just had to point out that that line of thinking is actually not safe from a Public health standpoint.

That’s not what I’m saying. But many physicians disagree with you. You would need to treat a lot of people to prevent a single case of rheumatic fever, and you create a risk of adverse antibiotic reactions that have a higher incidence that rheumatic fever even when you don’t treat.

I know the idea of not giving antibiotics to prevent rheumatic fever seems heretical since it’s such a dogma, but if you look at the actual studies on rheumatic fever and strep and then read some of the literature on whether it’s actually worthwhile, you might change your mind.

But this is off topic so if you want to keep talking about it feel free to PM me!

 

[Matthew9Thirtyfive]

I mean you just need to go to a developing country and see the valvular disease cases, lots of rheumatic fever

We’re not a developing country. The data here doesn’t support that. But again, off topic. I’d love to continue the discussion in a group PM or in the social thread or something.

 

[throwaway1000000]

We’re not a developing country. The data here doesn’t support that. But again, off topic. I’d love to continue the discussion in a group PM or in the social thread or something.

I mean we are not a developing country but the reason they developed rheumatic heart disease is due to lack of antibiotic use as far as we know. If there are other factors that make the developing countries prone to developing RF other than lack of abx, would be interested to hear that.

 

[Matthew9Thirtyfive]

I mean we are not a developing country but the reason they developed rheumatic heart disease is due to lack of antibiotic use as far as we know. If there are other factors that make the developing countries prone to developing RF other than lack of abx, would be interested to hear that.

I'll PM you.

 

[Eye-eye]

Although in this case I'd argue that the RRR actually provides a decent idea of how important penicillin is for treating strep throat because the cost of intervention is low and the possible lifetime consequences of RF are so great.

Kinda like the cost of a few extra applications (a good chunk now but chump change in the long run) compared to the potential lifetime consequences of not matching.

 

[Matthew9Thirtyfive]

Kinda like the cost of a few extra applications (a good chunk now but chump change in the long run) compared to the potential lifetime consequences of not matching.

A fear of not matching doesn’t change data. It just changes how rationally you can appraise it.

 

[Eye-eye]

True. But I don't think it's giving in to fear to cover your bases and minimize your risk if you can handle the cost. Perhaps I don't understand the points you've been trying to make with regards to game theory; my thoughts are that regardless of what would be ideal for everyone to do (if everyone self-limited, yes, it would likely be better for all), if we know that some will certainly not follow this advice, perhaps most, doesn't that change what makes sense to do? Even if it's a better experience for those who apply to less places during the applying/interviewing process, that won't hold true if they don't match or interview because others did 3x as many interviews. I do think you should limit to a reasonable amount if you can afford to, but I think that what's reasonable should probably shift a bit this year to cover one's bases. By matching, you're inherently taking a spot from someone else, so if it's not selfish to match, I just don't buy that it's selfish to broaden your application a bit (as some have implied earlier in this thread). If I'm just missing your point, I'm certainly open to hearing more - I do find game theory interesting, and obviously the topic of applying should be rather important to any 3rd year right now.

 

[Lawpy]

New CORD guidelines for EM applicants - can any PD's help?

CORD released new guidelines that only 1 SLOE is needed now. They're also encouraging us to give up our audition spots so that others have an opportunity. I have had 4 auditions set up since before COVID, and all of my programs told me they are continuing with the rotations and to still come...

forums.studentdoctor.net

here's an EM example of recommendations without caps... and i'm left confused.

 

[asdf123g]

I actually don't think this is a win-win, especially because you wouldn't know if that was actually happening or not. More invites for the same number of spots does not mean more people would match. The implications behind "more interviews" are "more interviews for people who under normal circumstances would not be getting that number of interviews". Which could create a false sense of security for those applicants. Applicants tend to look at previous application cycles to determine how many programs they should apply to and how many interviews they should attend to feel "safe". That data wouldn't be useful anymore if programs start significantly increasing interview spots. How do you even begin to conceptualize how many interviews you would "need" to go on? And then would this mean programs would increase their rank list length as well? More people on a given program's interview list and rank list doesn't necessarily help you personally.

You mean lose-lose, where we have to interview more, rank more, and fall lower on our lists, increasing the uncertainty on both ends. Over-interviewing and over-applying is why programs are pushed to yield protect and mistrust applicant statements of interest.

I dunno, but as someone in a fairly unique position of participating in both years' Matches (and suffering the rare, but severe consequences of the already too-high application/interview volumes) I am NOT excited about the prospect of limitless Zoom interviews. As brutal as last year's cycle was, I'd rather do it again than deal with this new setup that people keep proposing.

"It was suggested that a virtual experience might result in a less successful Match; however, initial data reports released by the NRMP revealed the 2021 Main Residency Match to be highly successful and that the pivot to a virtual recruitment season did not constrain the abilities of applicants and programs to obtain more PGY-1 placements. Nevertheless, findings from the NRMP applicant and program surveys offer a more nuanced look at the recruitment season during a pandemic.

Data from both surveys reveal real impacts of virtual recruitment on both applicants and programs but also suggest more resilience on the part of both constituencies than initially anticipated. Although stress levels were reportedly high, so was most applicant respondents’ perceived preparedness for the season and comfort navigating a virtual environment. Not having to travel for interviews, a benefit reported by applicants, likely contributed to increased applications and interviews reported by some applicants; however, the majority of applicant respondents indicated that the virtual experience did not affect the number of programs ranked. Program respondents also reported higher numbers of applications received and vetted and interviews conducted but only at modestly higher levels, and some programs indicated an increase in the number of applications that received holistic review. Based on these findings, it is reasonable to conclude that the pivot to a virtual experience did not create extreme changes in application and interview behaviors amongst respondents."

 

[Gilakend]

Are you applying into a competitive specialty? I personally would prefer online interviews I think (not applying this year so unlikely I’ll have virtual) as someone who doesn’t care as much where they go just wants to match (couple match, competitive specialty). I’d rather be able to do sub-Is than go on interviews. Plus save a lot of money.