Is hemepath going through a match system starting 2013

[Bugati]

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I have heard rumors from current and recently graduated hemepath fellows that the fellowship will be on a match cycle starting 2013. I cant find any conclusive source to answer that. Anybody heard anything besides rumors?

 

[zao275]

This will be discussed at the Residents Forum at CAP 10 next weekend in Chicago. Although at last survey, the hemepath directors were divided 50/50 (for/against match), if I recall. My understanding is that the winter APC/PRODS meeting is when the final decision will be made by the pathology chairs. If they decide to go push the Match, then I believe that program directors will pretty much have to go along with it. The other subspecialties will follow suit. That is my understanding of the plan (briefly retold) that Dr. Crawford (Chair of the APC) is proposing. He has a paper (that very nicely explains the whole history of the fellowship situation and why a Match is the only thing that will work) that is pending publication. I had the privilege of reading the draft, and I felt that it was very neutral, thorough, and concise. I will post a link to it once it is published. Hope this info is helpful (albeit second hand).

 

[KCShaw]

Interesting.. thanks. I admit that while I'm not real fond of the current fellowship race, I'm not sure a match is the ideal alternative -- not that I have a better idea. But I'd like to see that paper.

 

[lipomas]

Would they make sure ACGME accreditation for the program is based on participating in the match? Because if they don't, then programs could just not participate in the match at all and take whoever they want before the match. And are they going to include the 2-year fellowships as well? Despite the fact that some corrective action is needed in the fellowship match process (I think fellowship applications are currently due the first week of residency 😉 ) I don't know if forcing a match is going to make the difference unless you are prepared to REALLY enforce it and punish those who don't abide by the match rules.

It's also problematic if people are considering something else in addition to hemepath or if they don't get into hemepath.

 

[pathstudent]

Totally needed and appropriate. All the I.M. specialties and Peds specialties do it. I'll support it 100%

 

[yaah]

Problem with a match system in fellowships is that you need programs to be on board. Many will try to get around the requirements and take people outside the match (will there be exceptions for "researchers" or for two year fellowships or for internal candidates?). And it is hard if only one subspecialty does a match - because the others will still be on their own timeline. To me it's a bit of a recipe for chaos, although it might be successful. There is a lot of literature about radiology fellowships and the failures that resulted from trying to institute them.

 

[sirenomelia]

All the match will accomplish is waste peoples time as programs will be forced to host bogus interviews with outside applicants to pretend they are "matching" when they will already have an under the table agreement with their own internal candidate

 

[LADoc00]

the entire match system is ******ed...

I thankfully never participated in any of it, even as a medical student.

I think trainees should fight tooth and nail to stop its stretch to fellowships. That is really really bad.

 

[KeratinPearls]

All the match will accomplish is waste peoples time as programs will be forced to host bogus interviews with outside applicants to pretend they are "matching" when they will already have an under the table agreement with their own internal candidate

Totally agree and the applicant will be spending money (*plane ticket, hotel, match fees) for absolutely nothing. The match system is bogus.

 

[malchik]

Why would a program be forced to host bogus interviews? As far as I know a match doesn't force you to interview anybody, although it all depends on what the rules are. If they want their internal candidate, then they can just rank only that person. Critics of a match, please explain why you think it is so "bad."

 

[Thrombus]

Why would a program be forced to host bogus interviews? As far as I know a match doesn't force you to interview anybody, although it all depends on what the rules are. If they want their internal candidate, then they can just rank only that person. Critics of a match, please explain why you think it is so "bad."

The program will still interview other people in case that "internal candidate" decides to go elsewhere. Until both parties have an agreement in writing, which will only be legal after the match, there will be no "locks".

Without a match, residents can stay internally already and be given a spot on their own timeframe and possibly would not even have to interview. If they do interview, they can interview one place at a time until they have a spot -- saving tons of $$ and time. If there is a match, you will be forced to interview all over the place potentially to get a spot. Very bad and stupid.

 

[deleted314957]

the entire match system is ******ed...

I thankfully never participated in any of it, even as a medical student.

I think trainees should fight tooth and nail to stop its stretch to fellowships. That is really really bad.

I never did either, it never crossed my mind-internship,residency or fellowship. That was because of the military. Did that play a part in your situation LADoc00? It sure made life easier.

 

[malchik]

The program will still interview other people in case that "internal candidate" decides to go elsewhere. Until both parties have an agreement in writing, which will only be legal after the match, there will be no "locks".

Without a match, residents can stay internally already and be given a spot on their own timeframe and possibly would not even have to interview. If they do interview, they can interview one place at a time until they have a spot -- saving tons of $$ and time. If there is a match, you will be forced to interview all over the place potentially to get a spot. Very bad and stupid.

I see your point, but it seems to me that internal candidates are the only ones who have anything to lose in a match scenario. But even then, if the candidate is set on staying internal, and the program is also set on that, there is no reason not to wait until the match for it to be official. An applicant can change his mind and go elsewhere even in the absence of a match. It happens all the time. Even if there is something in writing, it's not like the hospital is going to sue the resident or something.

 

[Thrombus]

I see your point, but it seems to me that internal candidates are the only ones who have anything to lose in a match scenario. But even then, if the candidate is set on staying internal, and the program is also set on that, there is no reason not to wait until the match for it to be official. An applicant can change his mind and go elsewhere even in the absence of a match. It happens all the time. Even if there is something in writing, it's not like the hospital is going to sue the resident or something.

Because that applicant could change his mind, countless token interviews will be given wasting time and $$ of many other applicants. The program is not stupid and will not passively wait around to be left empty in the scenario you describe.

In the end, the program will get its candidate one way or the other. If I am a resident that is going to many interviews in far away places where some other guy has a 90% lock on it if he/she wants it....I will not be very happy.

Always consider the inevitable but unintended consquences of any and all actions.

 

[malchik]

My point is that this is happening right now without a match. I was offered a fellowship spot. I said I may want it but would like to look around before committing. The director said fine, we'll interview some other people, but if you want it it's yours. If in the end I take it, there will have been some money and time wasted. But really, is it that onerous to go to three or four places for interviews, and try out a new restaurant or two?

 

[Thrombus]

My point is that this is happening right now without a match. I was offered a fellowship spot. I said I may want it but would like to look around before committing. The director said fine, we'll interview some other people, but if you want it it's yours. If in the end I take it, there will have been some money and time wasted. But really, is it that onerous to go to three or four places for interviews, and try out a new restaurant or two?

Yes. I and most residents I know went through on a shoe-string budget as we tried to provide for our families.

I would have had to apply to at least 5 programs all a fair distance away to get the fellowship I would have liked in a match system. Instead I was able to secure it after it was offered in a mutual agreement shortly after the interview.

I would be extremely agitated if a program director was interviewing me and they had an internal candidate who had top priority staked out even before the interview -- and this was not disclosed (this seems less than honest and forthright to me). In a match based system, all bets are off and that is the way they must proceed.

 

[zao275]

I would be extremely agitated if a program director was interviewing me and they had an internal candidate who had top priority staked out even before the interview -- and this was not disclosed (this seems less than honest and forthright to me). In a match based system, all bets are off and that is the way they must proceed.

Is it possible that the program might actually like you and decide to rank you highly, even with an internal candidate? Say they rank you number 2, and the internal number 1. Maybe the internal guy does some outside interviews, and decides that program X is even better, so he ranks them 1 and his own program 2. If program X ranks this guy as 1, then he goes to X and you go to the program that ranked you as 2.

A match opens up a lot of possibilities, although it comes with some restrictions, of course. It stops the insanity of "decide now...deal or no deal" type offers that are common in the current situation.

Regarding the article I mentioned, I asked Dr. Crawford and he said it will be published as follows:

HUMAN PATHOLOGY
-ePub sometime in November 2010
-hardcopy in a special "Education" issue in "Spring 2011"

AM J CLIN PATHOL (simultaneous publication; revised version)
- just accepted; no publication date information yet

Just FYI.

 

[rockit]

At spring's Resident's Forum most of the people I talked to were against the match as we felt it took away any certainty you had in finding a fellowship. The programs get all the benefit with none of the cost outlay in terms of time and especially money.

Yet it seems that the leadership of the RF supports Match, another selling out of the populace by the leaders of pathology.

 

[zao275]

At spring's Resident's Forum most of the people I talked to were against the match as we felt it took away any certainty you had in finding a fellowship. The programs get all the benefit with none of the cost outlay in terms of time and especially money.

Yet it seems that the leadership of the RF supports Match, another selling out of the populace by the leaders of pathology.

I don't think I have received my check yet for "selling out". Maybe I am out of the loop somehow? 😉

Seriously, though, I am truly sorry if any of us have done something to make it seem that way. In the face of such an accusation, however, I would like to clarify a few things:

-The leadership of the RF doesn't receive money, payment, or any other benefit that I know of, to either support or stand against any issue. Speaking for myself at least, I know I may be biased by my own beliefs or opinions, of course, but I try to remain objective. Regardless, remember that the RFEC doesn't have any special vote on any issues of this sort, and certainly we have no power to force the APC (who are in charge of the Match decision) to do anything whatsoever. We have a voice, certainly, but I feel that there are many open mic opportunities at every RF meeting, and ANY resident, fellow, or visitor has a right to voice their personal opinions and views. Do you honestly disagree with this statement?

-The most recent ASCP RISE survey (which had a large sample size) stated that about 50% of residents support a Match (not a majority by any means, but an increase from past surveys, if I recall). However, something like 80+% support a standardized application process and timeline. If you recall, THAT is what the RFEC began to push in 2007 (based on a UNANIMOUS vote in favor of this item by the entire RF), NOT a Match. Please also recall that the RFEC (with the help of CAP Staff members) drafted, published, and aggressively promoted both a standardized application, as well as a standardized timeline. As you certainly have heard (or experienced), although a decent number of programs will accept the application, very few adhere to the timeline recommendations. Because of the failure of the timelines (let's face it, they cannot be enforced), the idea of a Match was proposed by members of the APC (such as Drs. Crawford and Black-Shaffer) and presented to the RF by these promoters of the Match at the Spring 2010 RF meeting in DC.

-As for my personal views, at least, I can say that I support the idea of a Match. In the past, I did not always feel that a Match would be a good thing, but having recently gone through the tedious application process myself, and having experienced first-hand the frustration of being given an offer with a limited time to accept or reject it, I now favor the idea of a Match (Honestly, can you imagine applying for residency without a Match?). However, if it becomes clear that the majority of residents, even after considering both sides of the argument, reject the idea of a Match, then I feel it will be my duty to not support the institution of a Match in an official capacity, regardless of my personal views. One of the duties of the RFEC is to be the voice of the entire Residents Forum. If I ever fail to do that, I hope to be confronted and corrected at once. But as of yet, I have not been convinced by any reliable data that a majority of residents are opposed to the idea of a Fellowship Match. Please correct me if I am mistaken.

I hope this clarifies things and does so without being argumentative or offensive. I am not intending to be difficult or to give rockit a hard time. But I admit that I don't like the implication that I (or my colleagues) have somehow "sold out", and, thus, I felt obligated to respond. Thanks for the rational conversation on this topic.

 

[2121115]

Other specialties are more appropriate for a fellowship match because their fellowships are longer. In IM most fellowships are 3+ years when you include research, longer than the residency itself. So, their fellowship is a bigger commitment. In pathology, we are talking about spending a bunch of money to interview for a 1 year spot. It is much easier and cheaper (no application costs, interviewing costs, moving costs, etc) to just do an additional year at your home institution. That is why I am not in favor of a match.

 

[KCShaw]

The barbaric inconsistencies in application paperwork and timelines among pathology fellowships are, IMO, a problem. For certain subspecialties &/or certain programs, one may have to apply -- and accept an offer -- 2 to 3 years in advance or risk those positions being filled. A 1st or 2nd year resident deciding what, if any, subspecialty they want to pursue is, IMO, too much to demand as a matter of standard procedure. Programs, however, have considerably less reason to not plan ahead.

A match system would address that part of the problem. It does open up others, such as anticipated increases in average interview time (which may already be limited) and money (even if just paying interest only on med school loans -- residents ain't rich) for same, as previously indicated. The question is whether the added time and freedom earlier in residency to explore subspecialty preferences, and delay life-altering decisions until, on average, one is better prepared to make them..worth the difference?

A match system may also increase the competition for places, which is probably a good thing. Instead of taking the quick & easy early applicant, programs can sift through and rank those truly the most competitive. On the other hand, pathology fellowships are mostly just 1 year, and arranging a relatively late notice move for only one year I can't imagine being fun. There is some back and forth on this.

There may be much more to this, of course, and I'll have to make a calendar note about the publication of that article.

 

[zao275]

The barbaric inconsistencies in application paperwork and timelines among pathology fellowships are, IMO, a problem. For certain subspecialties &/or certain programs, one may have to apply -- and accept an offer -- 2 to 3 years in advance or risk those positions being filled. A 1st or 2nd year resident deciding what, if any, subspecialty they want to pursue is, IMO, too much to demand as a matter of standard procedure. Programs, however, have considerably less reason to not plan ahead.

A match system would address that part of the problem. It does open up others, such as anticipated increases in average interview time (which may already be limited) and money (even if just paying interest only on med school loans -- residents ain't rich) for same, as previously indicated. The question is whether the added time and freedom earlier in residency to explore subspecialty preferences, and delay life-altering decisions until, on average, one is better prepared to make them..worth the difference?

A match system may also increase the competition for places, which is probably a good thing. Instead of taking the quick & easy early applicant, programs can sift through and rank those truly the most competitive. On the other hand, pathology fellowships are mostly just 1 year, and arranging a relatively late notice move for only one year I can't imagine being fun. There is some back and forth on this.

There may be much more to this, of course, and I'll have to make a calendar note about the publication of that article.

A very rational risk/benefit analysis. Nice.

I will be sure to post on here whenever I see the article in print. It addresses almost any issue (pro and con) that I have heard or can think of. It will be nice to have the facts laid out straight for everyone.