Match 2024

[mmag]

I had a 260 step 2, 4 peer reviewed pubs, multiple honors, USMD, no red flags and I had 7 interviews out of 54 applied. It was definitely a rough cycle. I matched my #5 which surprised me honestly, but I’m going to be an anesthesiologist so I really have nothing to be upset about.

Like college admissions, it's about institutional and faculty priorities. Thus you shouldn't be surprised at the number of sub 240 step 2 applicants who match.
There are academic programs that heavily favor their own med students or those from the local area. Perhaps important faculty members are DO or USIMG themselves. Perhaps there's a strong push for DEI because the demographics of the city/state needs to be reflected. Some might only interview those who signal or automatically interview everyone who does an away.

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[Dr. Anonymouss]

Like college admissions, it's about institutional and faculty priorities. Thus you shouldn't be surprised at the number of sub 240 step 2 applicants who match.
There are academic programs that heavily favor their own med students or those from the local area. Perhaps important faculty members are DO or USIMG themselves. Perhaps there's a strong push for DEI because the demographics of the city/state needs to be reflected. Some might only interview those who signal or automatically interview everyone who does an away.

Yeah I mean I’ll never know why I didn’t get more interviews or why I didn’t get taken at the programs higher in my list. Does it suck? Yeah of course, but I’ll be an anesthesiologist and that’s what is most important.

 

[BLADEMDA]

Yeah I mean I’ll never know why I didn’t get more interviews or why I didn’t get taken at the programs higher in my list. Does it suck? Yeah of course, but I’ll be an anesthesiologist and that’s what is most important.

But you can guess as to why you didn't get more interviews- You simply didn't bring enough diversity to the program. It's just that simple. You can be bitter about it or just move on with your life as you will be an Anesthesiologist. Depending on where you end up as an attending there will be many more examples of "injustices" in your career. I strongly advise you to find a place where the money and culture are both to your liking.

 

[BLADEMDA]

Like college admissions, it's about institutional and faculty priorities. Thus you shouldn't be surprised at the number of sub 240 step 2 applicants who match.
There are academic programs that heavily favor their own med students or those from the local area. Perhaps important faculty members are DO or USIMG themselves. Perhaps there's a strong push for DEI because the demographics of the city/state needs to be reflected. Some might only interview those who signal or automatically interview everyone who does an away.

I completely agree with your initial sentence. This means "merit" and "fairness" have nothing to do with the outcome for a Match at a particular program. Those are purely subjective metrics along with everything else.

 

[chessknt]

I completely agree with your initial sentence. This means "merit" and "fairness" have nothing to do with the outcome for a Match at a particular program. Those are purely subjective metrics along with everything else.

Equating scores on a standardized test to merit is part of the problem with your perspective. Standardized tests have been the lazy way of selecting for higher education for decades. You know absolutely nothing about those candidates including the STEP scores. But even if their scores are lower what if their extracurricular activities are top notch like starting a non-profit, running a soup kitchen, or some other civic activity showing dedication to a community and a work ethic beyond just medicine? Is that not worthy of the 'merit' title you enjoy throwing around? What if they failed high school because their parents got arrested and they had to raise their siblings then worked their way through college? But their scores are lower so clearly they are inferior to the other candidate?

Thinking beyond scores is not DEI, it is actually making a real effort to pick good candidates.

 

[Dr. Anonymouss]

Equating scores on a standardized test to merit is part of the problem with your perspective. Standardized tests have been the lazy way of selecting for higher education for decades. You know absolutely nothing about those candidates including the STEP scores. But even if their scores are lower what if their extracurricular activities are top notch like starting a non-profit, running a soup kitchen, or some other civic activity showing dedication to a community and a work ethic beyond just medicine? Is that not worthy of the 'merit' title you enjoy throwing around? What if they failed high school because their parents got arrested and they had to raise their siblings then worked their way through college? But their scores are lower so clearly they are inferior to the other candidate?

Thinking beyond scores is not DEI, it is actually making a real effort to pick good candidates.

This topic is such a double-edged sword. Yes, individuals with hardships in their lives deserve to be given the opportunity to succeed if they show that they have the drive and desire, but at the same time there HAS to come a point where the standard is equal to their peers. When do we stop lowering the standard... admission to college? admission to medical school? Matching into orthopaedic surgery? I get the idea behind wanting those who had hardships in life to succeed, but the standard can't be forever lowered to accomodate for this otherwise we are simply letting underqualified persons perform jobs that should be going to more qualified persons. Are we going to become a nation that passes up on the brightest minds because they simply weren't black, female, LGBTQ?

The second issue I have is that what you are mentioning is not truly what is happening in academia. What you mentioned is a valid reason for wanting to "lower the bar" to allow those who show promise and desire to succeed. The issue is that all academia cares about is skin color and just because you are black does not mean you grew up poor and with significant hardships. Growing up in a low socioeconomic status with barriers to education is not a color things; there are plenty of white americans whom this happens to, but they don't get the same privelages afforded to them. The reason I hate academia so much is because everything is about skin color, injustices, and equity at the expense of others.

 

[chessknt]

This topic is such a double-edged sword. Yes, individuals with hardships in their lives deserve to be given the opportunity to succeed if they show that they have the drive and desire, but at the same time there HAS to come a point where the standard is equal to their peers. When do we stop lowering the standard... admission to college? admission to medical school? Matching into orthopaedic surgery? I get the idea behind wanting those who had hardships in life to succeed, but the standard can't be forever lowered to accomodate for this otherwise we are simply letting underqualified persons perform jobs that should be going to more qualified persons. Are we going to become a nation that passes up on the brightest minds because they simply weren't black, female, LGBTQ?

The second issue I have is that what you are mentioning is not truly what is happening in academia. What you mentioned is a valid reason for wanting to "lower the bar" to allow those who show promise and desire to succeed. The issue is that all academia cares about is skin color and just because you are black does not mean you grew up poor and with significant hardships. Growing up in a low socioeconomic status with barriers to education is not a color things; there are plenty of white americans whom this happens to, but they don't get the same privelages afforded to them. The reason I hate academia so much is because everything is about skin color, injustices, and equity at the expense of others.

Why are the people who score the highest the brightest again? I'd get it if the test couldn't be studied for and was a measure of aptitude but we know that isn't the case. People with resources (time and money) can study for and do better on standardized tests. It doesn't mean you're going to be a better doctor.

 

[neutro]

Interesting points made.
In my opinion, acceptance into a program needs to be a simple calculation based primarily on merit, interview, and personality match.

I don’t like extreme DEI initiatives but these are important to keep everyone’s ignorance in check. Diverse work force is an automatic check against people’s unconscious bias in their treatment of their colleagues. I personally treat others exactly how I like to be treated - nothing more nothing less. I expect the same.

Unfortunately, in my experience things aren’t always as plain and black and white like that.

DEI initiatives don’t serve any other real purpose imo.

I also think that they should go back to out of match offers and acceptances.

If a program and candidate are a good fit just sign up and stop wasting all this money interviewing and wasting time. It will help the candidates plan their lives better too and be less anxious.

I think doing out of match acceptances will make this process far more fair.

It’s no different than a regular job.

For instance if the program feels that they really want to pursue 4 residents out of match of the 10 spots, just sign those 4 docs and just put the 6 up for match.

 

[nimbus]

Equating scores on a standardized test to merit is part of the problem with your perspective. Standardized tests have been the lazy way of selecting for higher education for decades. You know absolutely nothing about those candidates including the STEP scores. But even if their scores are lower what if their extracurricular activities are top notch like starting a non-profit, running a soup kitchen, or some other civic activity showing dedication to a community and a work ethic beyond just medicine? Is that not worthy of the 'merit' title you enjoy throwing around? What if they failed high school because their parents got arrested and they had to raise their siblings then worked their way through college? But their scores are lower so clearly they are inferior to the other candidate?

Thinking beyond scores is not DEI, it is actually making a real effort to pick good candidates.

Point is fair. But it is difficult to select for candidates who will prioritize service to community. A lot of the activities you describe are performative and many people will never do them again after they become attendings.

If only there was a way to weed out people who’s most important goals are:

1. getting the highest paid jobs.
2. exploit, take advantage of, and outright rip off their own colleagues
3. wish only to take care of the healthiest and least needy people if the money and hours are good (plastic surgery offices)
4. take $40k vacations
5. cheat or game their taxes
6. retire as early as possible (FIRE) which exacerbates the manpower shortage.

Not that anyone would answer honestly but FIRE should be a universal residency interview question.

 

[pgg]

I was browsing a USMLE tutoring site and saw a significant number of anesthesia resident/tutors with 260-270+ USMLEs. They’re probably not the only ones at their programs. Anybody with 240+ USMLEs will have no problem passing their anesthesia boards so beyond that it becomes a non-factor.

Program directors are primarily looking for
1) people who can do the work and pass their boards (i.e. won't bring shame or extra work to them)
2) people they can tolerate or enjoy working with for the next 3 years

Totally agree that anyone 240+ is going to be fine with point 1. Once you've hit a certain threshold of academic ability and proven performance, there are rapidly diminishing returns. After that, the issue isn't whether the person will succeed, but who "deserves" the opportunity.

 

[Dr. Rude]

Point is fair. But it is difficult to select for candidates who will prioritize service to community. A lot of the activities you describe are performative and many people will never do them again after they become attendings.

If only there was a way to weed out people who’s real goals are:

1. getting the highest paid jobs.
2. exploit, take advantage of, or outright rip off their own colleagues
3. wish to take care of the least needy people if the money and hours are good (plastic surgery offices)
4. take $40k vacations
5. cheat or game their taxes
6. retire as early as possible (FIRE) which exacerbates the manpower shortage.

Not that anyone would answer honestly but FIRE should be a universal residency interview question.

A corollary to point 6 is that it we should be looking to identify people looking for a work/life balance situation. This would tend to lean against choosing women as they on average work less hours than men.

 

[pgg]

I completely agree with your initial sentence. This means "merit" and "fairness" have nothing to do with the outcome for a Match at a particular program. Those are purely subjective metrics along with everything else.

That's a little hysterical, don't you think?

"nothing to do" with merit or fairness

C'mon

I agree with you that the DEI movement has had some excesses and well-publicized headscratching moments, to be polite, but let's not pretend that all of a sudden grades and board scores and references don't matter.

 

[Guillemot]

Score inflation is a real thing. IE one’s numerical score on the USMLE is only comparable within the same year the exam was given, and you cant compare your score from years ago with a more recent score. Back in the day they didn’t give percentiles, but they now do. These days a 260 step 2 is < 1SD above average. Not the case back when I took the exam. Therefore IMO percentile is the actual meaningful number.

Anyway, point being that the scores these days aren’t ridiculous, they’re just different.

 

[Gern Blansten]

I also think that they should go back to out of match offers and acceptances.

If a program and candidate are a good fit just sign up and stop wasting all this money interviewing and wasting time. It will help the candidates plan their lives better too and be less anxious.

I think doing out of match acceptances will make this process far more fair.

It’s no different than a regular job.

For instance if the program feels that they really want to pursue 4 residents out of match of the 10 spots, just sign those 4 docs and just put the 6 up for match.

I feel like you believe this for the right reasons, but you likely don’t know what the process was like prior to the NRMP. There were lots of underhanded deals struck. The programs almost always had the advantage. Take it or leave it deals were offered. Candidates rarely got to see what other programs had to offer. Decisions were frequently made very early in the process. Even as early as third year of medical school (or earlier). The pressure was on the candidate to accept early or risk being taken off of the program’s list. It may seem like a panacea, but for many candidates, it was the peak of loss of control and loss of choices. Great candidates were often never seen by anyone else other than their home program. Candidates without a home program were often left out of the process and had few options. Imagine committing to your terrible home program early in your third year because you feared you may not have any other options…before you even realized it is a terrible program.
Certainly, your method would be advantageous for someone who had strong reasons for staying out at their home program and they are a great candidate. Both sides win in that scenario. But that scenario can also still be addressed in the NRMP system, admittedly, at increased cost. The hybrid system you mentioned seems reasonable at first glance, but the administration of such a system would be a logistical nightmare.
I guess I would just warn that we should be careful what we wish for. The other method has been done in the past and definitely had a bunch of problems. The inherent unfairness is what led to the creation of the NRMP.
I think the new signaling system will be a way to keep people from applying to one hundred or more programs. Because, stats will show that programs rarely invite someone who did not signal them. In our specialty, by not signaling the program, you have automatically told them that they are not in your top 15 programs to consider. Since most candidates don’t do 15 interviews or go down to number 15 on their rank list, it should cause a reset of how candidates apply to programs and steadily bring the numbers down to more reasonable levels like they used to be.
Just my opinion. I will admit, I’m no fan of the heavy handed NRMP, but I do think it serves a purpose in this very difficult process. It’s not perfect, but neither was the system in place prior to creation of the NRMP.

 

[Gern Blansten]

On the DEI issue, I pointed this out on the forum long ago. The system was set up with the intent of giving underrepresented minorities in the US a chance to break out of poverty cycles and get a chance. The typical inner city youth plagued by poverty, poor home life situations (surrounded by gang violence, drugs etc).
Because it has been attached only to skin color, the reality has been that academia has filled these spots with affluent west African candidates predominantly. It happens in CRNA training programs as well. Thoughtfully consider underrepresented minorities that you work alongside. How many were born in the inner city and grew up in difficult situations. Then consider how many are first or second generation west Africans who were affluent enough to afford steerage to the US for additional training. In my experience, the latter accounts for at least 90% for medicine and for CRNAs.
It just seems to me that the intended goal of elevating the opportunity of the inner city youth who have huge barriers to medical school and other careers, has been abandoned in favor of the safer choice that still check the correct box on the DEI checklists.
Some may spew hate for this being pointed out, but when it became obvious to me many years ago, I haven’t been able to unsee it. The downstream effect is that this group (west African heritage candidates) has no better ties to the inner city disadvantaged population than a rich American white kid would. They certainly don’t seem to preferentially choose to move to and care for those communities when training is completed either.
I point this out to say, the intent of the policies was honorable and good, but the way it has evolved is not serving the intended purpose, in my opinion.

 

[Agast]

Well, if top candidates are getting blocked from traditional anesthesia programs then I guess they can go to the new HCA and USAP anesthesiology residency programs that you guys are freaking about over in the other thread. And then you don’t need to worry that the programs are being saturated with less qualified people.

 

[Fpg1245]

Well, if top candidates are getting blocked from traditional anesthesia programs then I guess they can go to the new HCA and USAP anesthesiology residency programs that you guys are freaking about over in the other thread. And then you don’t need to worry that the programs are being saturated with less qualified people.

I feel like that would be a huge disservice to top candidates to basically be thrown into a sweatshop like that. Candidates rise and fall to the level of the program.

 

[triggermaster]

On the DEI issue, I pointed this out on the forum long ago. The system was set up with the intent of giving underrepresented minorities in the US a chance to break out of poverty cycles and get a chance. The typical inner city youth plagued by poverty, poor home life situations (surrounded by gang violence, drugs etc).
Because it has been attached only to skin color, the reality has been that academia has filled these spots with affluent west African candidates predominantly. It happens in CRNA training programs as well. Thoughtfully consider underrepresented minorities that you work alongside. How many were born in the inner city and grew up in difficult situations. Then consider how many are first or second generation west Africans who were affluent enough to afford steerage to the US for additional training. In my experience, the latter accounts for at least 90% for medicine and for CRNAs.
It just seems to me that the intended goal of elevating the opportunity of the inner city youth who have huge barriers to medical school and other careers, has been abandoned in favor of the safer choice that still check the correct box on the DEI checklists.
Some may spew hate for this being pointed out, but when it became obvious to me many years ago, I haven’t been able to unsee it. The downstream affect is that this group (west African heritage candidates) has no better ties to the inner city disadvantaged population than a rich American white kid would. They certainly don’t seem to preferentially choose to move to and care for those communities when training is completed either.
I point this out to say, the intent of the policies was honorable and good, but the way it has evolved is not serving the intended purpose, in my opinion.

You are correct that racist admissions policies whether called Affirmative Action (in my day) or DEI (today) has never functioned as stated. Their goals were never honorable though. It has always been intended to discriminate on the basis of skin color. If it had been about poverty, the primary beneficiaries would have been poor white kids. They made it about skin color so the primary beneficiaries became recent Caribbean or African immigrants’ kids.

It’s amazing to me that every school and hospital has a DEI office now. Who is forcing this? It’s offensive to walk past an office every day whose goal is to discriminate against you, and if you complain against the explicitly racist program, YOU’LL be called a racist. It’s completely insane.

 

[rowsdower88]

You are correct that racist admissions policies whether called Affirmative Action (in my day) or DEI (today) has never functioned as stated. Their goals were never honorable though. It has always been intended to discriminate on the basis of skin color. If it had been about poverty, the primary beneficiaries would have been poor white kids. They made it about skin color so the primary beneficiaries became recent Caribbean or African immigrants’ kids.

It’s amazing to me that every school and hospital has a DEI office now. Who is forcing this? It’s offensive to walk past an office every day whose goal is to discriminate against you, and if you complain against the explicitly racist program, YOU’LL be called a racist. It’s completely insane.

 

[rowsdower88]

On the DEI issue, I pointed this out on the forum long ago. The system was set up with the intent of giving underrepresented minorities in the US a chance to break out of poverty cycles and get a chance. The typical inner city youth plagued by poverty, poor home life situations (surrounded by gang violence, drugs etc).
Because it has been attached only to skin color, the reality has been that academia has filled these spots with affluent west African candidates predominantly. It happens in CRNA training programs as well. Thoughtfully consider underrepresented minorities that you work alongside. How many were born in the inner city and grew up in difficult situations. Then consider how many are first or second generation west Africans who were affluent enough to afford steerage to the US for additional training. In my experience, the latter accounts for at least 90% for medicine and for CRNAs.
It just seems to me that the intended goal of elevating the opportunity of the inner city youth who have huge barriers to medical school and other careers, has been abandoned in favor of the safer choice that still check the correct box on the DEI checklists.
Some may spew hate for this being pointed out, but when it became obvious to me many years ago, I haven’t been able to unsee it. The downstream effect is that this group (west African heritage candidates) has no better ties to the inner city disadvantaged population than a rich American white kid would. They certainly don’t seem to preferentially choose to move to and care for those communities when training is completed either.
I point this out to say, the intent of the policies was honorable and good, but the way it has evolved is not serving the intended purpose, in my opinion.

Do you have any evidence that schools are "abandoning" African American youth in favor of African Immigrants? I don't mean you just seeing black immigrants around you and concluding that, I mean evidence from people who study race in schools. Seeing many black immigrants around you does not automatically mean that schools are "abandoning" African Americans. It could be the case that it is harder to recruit and retain the African American students we believe deserve to benefit from these programs and there could be dozens of reasons for this.

The problem (and I agree it's a problem, but not as much as you) of African migrants benefiting from programs designed to benefit African Americans IS being studied. There are good reasons to blame SCOTUS for this problem following the Bakke and Grutter decisions and now especially after the 2023 decision.

Here's someone smarter than me looking into the problem:

https://www.repository.law.indiana.edu/cgi/viewcontent.cgi?article=1008&context=ijlse

 

[Gern Blansten]

Do you have any evidence that schools are "abandoning" African American youth in favor of African Immigrants? I don't mean you just seeing black immigrants around you and concluding that, I mean evidence from people who study race in schools. Seeing many black immigrants around you does not automatically mean that schools are "abandoning" African Americans. It could be the case that it is harder to recruit and retain the African American students we believe deserve to benefit from these programs and there could be dozens of reasons for this.

The problem (and I agree it's a problem) of African migrants benefiting from programs designed to benefit African Americans IS being studied. There are good reasons to blame SCOTUS for this problem following the Bakke and Grutter decisions and now especially after the 2023 decision.

Here's someone smarter than me looking into the problem:

https://www.repository.law.indiana.edu/cgi/viewcontent.cgi?article=1008&context=ijlse

I don’t study the topic. My observations over the years is what I base it upon. I think the western African candidates likely have better scores and are more likely to get into medical school as the path of least resistance, meaning lesser chance of not completing the program successfully. Essentially, an administrator can check the box without incurring the associated risk that may be present in someone that clawed their way up from poverty and may not have the same resources to study and adequately prepare for the MCAT or eventually the USMLE. In my experience, these standardized exams predict how candidates will eventually perform on ABA certification exams. There are certainly some outliers, but far and away, do well on MCAT and USMLE and you will likely do well on ABA written exams. May not be as transferable to oral exams in all cases. Conversely, if you struggle with standardized exams, it typically plagues a candidate at every branch point where a standardized exam is required for advancement to the next phase. In medicine, these occur every couple of years in the training process. This is a huge headache for school and program administrators, thus, the decision to take someone with a higher score that is looked upon as “safer” is an easy one. Plus, they still get to check the DEI box. Schools and programs are graded by how their students and graduates do in matching at residencies and achieving board certification. If a residency program accepts a lot of people with marginal standardized test results, they are setting themselves up for having a low board certification rate.
It’s possible that my observations are regionally skewed, but I have seen it for years and I think it’s pervasive all over.

 

[neutro]

I feel like you believe this for the right reasons, but you likely don’t know what the process was like prior to the NRMP. There were lots of underhanded deals struck. The programs almost always had the advantage. Take it or leave it deals were offered. Candidates rarely got to see what other programs had to offer. Decisions were frequently made very early in the process. Even as early as third year of medical school (or earlier). The pressure was on the candidate to accept early or risk being taken off of the program’s list. It may seem like a panacea, but for many candidates, it was the peak of loss of control and loss of choices. Great candidates were often never seen by anyone else other than their home program. Candidates without a home program were often left out of the process and had few options. Imagine committing to your terrible home program early in your third year because you feared you may not have any other options…before you even realized it is a terrible program.
Certainly, your method would be advantageous for someone who had strong reasons for staying out at their home program and they are a great candidate. Both sides win in that scenario. But that scenario can also still be addressed in the NRMP system, admittedly, at increased cost. The hybrid system you mentioned seems reasonable at first glance, but the administration of such a system would be a logistical nightmare.
I guess I would just warn that we should be careful what we wish for. The other method has been done in the past and definitely had a bunch of problems. The inherent unfairness is what led to the creation of the NRMP.
I think the new signaling system will be a way to keep people from applying to one hundred or more programs. Because, stats will show that programs rarely invite someone who did not signal them. In our specialty, by not signaling the program, you have automatically told them that they are not in your top 15 programs to consider. Since most candidates don’t do 15 interviews or go down to number 15 on their rank list, it should cause a reset of how candidates apply to programs and steadily bring the numbers down to more reasonable levels like they used to be.
Just my opinion. I will admit, I’m no fan of the heavy handed NRMP, but I do think it serves a purpose in this very difficult process. It’s not perfect, but neither was the system in place prior to creation of the NRMP.

That may have been true before social media. And of course, it has to be truly a mutual decision. Threatening a candidate and putting short time restrictions to force a decision speaks volumes of the program and is an automatic red flag.

What I am talking about is - lets say the program offers 30-40% of its spots to candidates with the understanding that they will accept the candidate ahead of match. The candidate should consider this very seriously and if its a program with good reputation and they think they will be a good fit, just take it.

All relationships (residency, job etc) are compromises. If you are looking for a home run in everything you want, you're surely to be disappointed. 100% compatibility and happiness is called fantasy. There is no guarantee that where the candidate matches would yield in more happiness for them. It could be worse. Often times there is disappointment.

This is where sites like SDN and networking are so crucial. The candidate should still perform due diligence. Reputations of programs and attending physicians can be found out.
I am looking at this from a logical and cost savings standpoint. Comparing it to anesthesia job market - the good ones never need advertising. People know which programs are good.

 

[rowsdower88]

I don’t study the topic. My observations over the years is what I base it upon. I think the western African candidates likely have better scores and are more likely to get into medical school as the path of least resistance, meaning lesser chance of not completing the program successfully. Essentially, an administrator can check the box without incurring the associated risk that may be present in someone that clawed their way up from poverty and may not have the same resources to study and adequately prepare for the MCAT or eventually the USMLE. In my experience, these standardized exams predict how candidates will eventually perform on ABA certification exams. There are certainly some outliers, but far and away, do well on MCAT and USMLE and you will likely do well on ABA written exams. May not be as transferable to oral exams in all cases.
It’s possible that my observations are regionally skewed, but I have seen it for years and I think it’s pervasive all over.

My complaint was with your use of the term "abandoned" mostly. I don't doubt all of the things you've said are likely true, but I think you're going a step too far by blaming the schools for this problem.

For instance, if we lived in the world without Bakke, Grutter and Students for Fair Admission, we could have a system that favored acceptance to african american students and excluded first and second generation immigrants if we wanted to.

 

[Gern Blansten]

My complaint was with your use of the term "abandoned" mostly. I don't doubt all of the things you've said are likely true, but I think you're going a step too far by blaming the schools for this problem.

For instance, if we lived in the world without Bakke, Grutter and Students for Fair Admission, we could have a system that favored acceptance to african american students and excluded first and second generation immigrants if we wanted to.

Abandoned was just a word I chose and it may be too harsh. They certainly seem to favor a different demographic, in my experience and better test scores seem to be the main reason that drives this.

 

[Gern Blansten]

That may have been true before social media. And of course, it has to be truly a mutual decision. Threatening a candidate and putting short time restrictions to force a decision speaks volumes of the program and is an automatic red flag.

What I am talking about is - lets say the program offers 30-40% of its spots to candidates with the understanding that they will accept the candidate ahead of match. The candidate should consider this very seriously and if its a program with good reputation and they think they will be a good fit, just take it.

All relationships (residency, job etc) are compromises. If you are looking for a home run in everything you want, you're surely to be disappointed. 100% compatibility and happiness is called fantasy. There is no guarantee that where the candidate matches would yield in more happiness for them. It could be worse. Often times there is disappointment.

This is where sites like SDN and networking are so crucial. The candidate should still perform due diligence. Reputations of programs and attending physicians can be found out.
I am looking at this from a logical and cost savings standpoint. Comparing it to anesthesia job market - the good ones never need advertising. People know which programs are good.

You make valid points and maybe it could be different. I am skeptical that it would operate as designed and I fear abuse of the process would occur, likely to the detriment of the students. Those programs who played by the rules would likely be at a disadvantage and would feel pressure to game the system in order to keep up. I shouldn’t be so skeptical…

 

[Dr. Anonymouss]

On the DEI issue, I pointed this out on the forum long ago. The system was set up with the intent of giving underrepresented minorities in the US a chance to break out of poverty cycles and get a chance. The typical inner city youth plagued by poverty, poor home life situations (surrounded by gang violence, drugs etc).
Because it has been attached only to skin color, the reality has been that academia has filled these spots with affluent west African candidates predominantly. It happens in CRNA training programs as well. Thoughtfully consider underrepresented minorities that you work alongside. How many were born in the inner city and grew up in difficult situations. Then consider how many are first or second generation west Africans who were affluent enough to afford steerage to the US for additional training. In my experience, the latter accounts for at least 90% for medicine and for CRNAs.
It just seems to me that the intended goal of elevating the opportunity of the inner city youth who have huge barriers to medical school and other careers, has been abandoned in favor of the safer choice that still check the correct box on the DEI checklists.
Some may spew hate for this being pointed out, but when it became obvious to me many years ago, I haven’t been able to unsee it. The downstream effect is that this group (west African heritage candidates) has no better ties to the inner city disadvantaged population than a rich American white kid would. They certainly don’t seem to preferentially choose to move to and care for those communities when training is completed either.
I point this out to say, the intent of the policies was honorable and good, but the way it has evolved is not serving the intended purpose, in my opinion.

THIS is exactly what I am talking about. Skin color is completely meaningless if you didn't grow up with significant barriers and hardships. Growing up black with two parents as physicians does not mean you were disadvantaged and thus should need a lower MCAT/GPA/STEP score. Looking solely at skin color to check a box is as racist as it comes. Looking at their upbringing, household income, zip code, specific circumstances is what makes individuals disadvantaged and this is what admissions committees should be focusing on.

 

[nimbus]

Well, if top candidates are getting blocked from traditional anesthesia programs then I guess they can go to the new HCA and USAP anesthesiology residency programs that you guys are freaking about over in the other thread. And then you don’t need to worry that the programs are being saturated with less qualified people.

And here are actually random samples of “top programs”.

 

[Cornfed101]

I guess being a non trad and having 3 kids isn’t “diverse” 🤷🏻‍♂️

 

[BLADEMDA]

There is a limited pool of qualified minority applicants to Residency programs and depending on the specialty, that pool can be slightly smaller or larger each year. What I can tell you is those applicants who are "qualified" using the program's particular metrics are highly sought after in academia. This is a zero sum game for the remaining non minority applicants. In addition, the classes are divided up by gender typically. Most top programs seek a diversified class per year but again, that depends on the pool of applicants available and where they choose to Match. This year it seems more chose Yale over Duke and Brigham.
I can assure you all those programs wanted to Match more minorities of color if possible.

The bottom line is if you are a male/female of non minority status then plan on applying to more middle tier programs even if your stats are top tier. This is the reality of all of medicine in 2024. Whether this is fair or not depends on your political viewpoint and view of the value of diversity/equity in our society. I for one am "old school" and wouldn't care if my class was 80% Asian male if they were the best candidates available. But, I doubt any academic program would allow such a viewpoint from a dinosaur such as myself to be a program director.

 

[BLADEMDA]

MGH Class of 2027- Very Diversified Class with a skew towards Asian (as expected at MGH)

Anesthesia Resident Profiles

The Massachusetts General Hospital anesthesia residency program recruits individuals from around the world who are committed to advancing anesthesia, critical care and pain medicine excellence.

www.massgeneral.org

 

[BLADEMDA]

Abandoned was just a word I chose and it may be too harsh. They certainly seem to favor a different demographic, in my experience and better test scores seem to be the main reason that drives this.

Better test scores simply means the metric that the program determines is satisfactory to Match the DEI applicant to their class. For example, we have discussed a Step 2 Score of 240-245 as a possible metric. An under represented minority who meets that metric would be preferred over a non minority candidate for the class. Thus, the non minority candidate with a much higher step 2 score would need to Match at a different program. Perhaps, since the pool of minority applicants is smaller this "inconvenience" to the non minority candidate isn't a big deal unless you are that person. This partially explains why the community programs are getting much more qualified applicants than the past. I concede other reasons include more applicants, more IMGs and DOs with higher scores, and gender balance in the programs.

 

[rowsdower88]

There is a limited pool of qualified minority applicants to Residency programs and depending on the specialty, that pool can be slightly smaller or larger each year. What I can tell you is those applicants who are "qualified" using the program's particular metrics are highly sought after in academia. This is a zero sum game for the remaining non minority applicants. In addition, the classes are divided up by gender typically. Most top programs seek a diversified class per year but again, that depends on the pool of applicants available and where they choose to Match. This year it seems more chose Yale over Duke and Brigham.
I can assure you all those programs wanted to Match more minorities of color if possible.

The bottom line is if you are a male/female of non minority status then plan on applying to more middle tier programs even if your stats are top tier. This is the reality of all of medicine in 2024. Whether this is fair or not depends on your political viewpoint and view of the value of diversity/equity in our society. I for one am "old school" and wouldn't care if my class was 80% Asian male if they were the best candidates available. But, I doubt any academic program would allow such a viewpoint from a dinosaur such as myself to be a program director.

Whenever I see these arguments crop up I'm reminded that above average white med school applicants are far more likely to "lose" a spot to a lower scoring white applicant than to a black applicant. The effects of black affirmative action policies were estimated to be equivalent to getting 1-2 questions wrong on the MCAT for the average white applicant.

I would suspect this holds true for residency applications as well, but I admit I don't have evidence for it.

Affirmative action doesn't hurt white medical school applicants

Quit whining that a black applicant "stole your spot" in medical school. She didn't.

www.statnews.com

Edit: It's hard to get riled up if we're just talking about 1-2 points. It's like someone could have a cold on the day of their test and that would impact their chances of acceptance more.

 

[gunnershow]

Whenever I see these arguments crop up I'm reminded that above average white med school applicants are far more likely to "lose" a spot to a lower scoring white applicant than to a black applicant. The effects of black affirmative action policies were estimated to be equivalent to getting 1-2 questions wrong on the MCAT for the average white applicant.

I would suspect this holds true for residency applications as well, but I admit I don't have evidence for it.

Affirmative action doesn't hurt white medical school applicants

Quit whining that a black applicant "stole your spot" in medical school. She didn't.

www.statnews.com

Edit: It's hard to get riled up if we're just talking about 1-2 points. It's like someone could have a cold on the day of their test and that would impact their chances of acceptance more.

It's way more than 1-2 questions. Just look at the raw data.

 

[rowsdower88]

It's way more than 1-2 questions. Just look at the raw data.

You either didn't read or didn't understand my post.

 

[Test Boy]

It's way more than 1-2 questions. Just look at the raw data.

Wow, I’m surprised the average MCAT for Asians and Hispanics is so much higher than for whites.

 

[Dr. Rude]

The World According to BLADE:

 

[Gern Blansten]

The World According to BLADE:

View attachment 384517

That seems like hyperbole. His posts simply pointed out issues that the AAMC charts shared just above show.

 

[Dr. Rude]

That seems like hyperbole. His posts simply pointed out issues that the AAMC charts shared just above show.

It is hyperbole. But, I couldn't resist.

 

[triggermaster]

And here are actually random samples of “top programs”.

OMG with the pronouns. How can they teach medicine while denying obvious biological facts? They think it’s virtue signaling but it’s actually lack of conviction to stand up for truth.

 

[nimbus]

OMG with the pronouns. How can they teach medicine while denying obvious biological facts? They think it’s virtue signaling but it’s actually lack of conviction to stand up for truth.

Yes zir!

 

[Gern Blansten]

You either didn't read or didn't understand my post.

Can you explain it? I also saw that you said 1-2 questions is what the affirmative action impact was. Can you help me see what I missed or didn’t understand? I read it three times, so it isn’t that.

 

[rowsdower88]

Can you explain it? I also saw that you said 1-2 questions is what the affirmative action impact was. Can you help me see what I missed or didn’t understand? I read it three times, so it isn’t that.

Affirmative action doesn't hurt white medical school applicants

Quit whining that a black applicant "stole your spot" in medical school. She didn't.

www.statnews.com

"Figure 4 shows that it’s far more likely a white applicant “stole a spot” than a black applicant. For a white applicant with a 31 MCAT score and a 3.7 GPA, for every black applicant who scored lower and was accepted there are, on average, 4.11 white students who also scored lower and were accepted."

"The chance that a low-scoring white medical school applicant will “lose” a spot to a low-scoring black applicant is 0.5 percent. How unlikely is that? It’s even less likely as the applicant dying in a car accident.

White applicants with low scores should realize that their MCAT scores and GPAs are holding them back far more than their black colleagues."

Short answer: a lot of white students with poor MCATs still get in.

 

[mmag]

No matter the scores as long as URM finish training, they are going to provide better care to minority patients. If the goal is to improve population health, then color does matter because that's what patients see apparently. Per studies linked from below, Black patients are more satisfied and adherent to care when it is from a Black physician - doesn't matter if the Black physician is a West African immigrant or someone from the top 1%.

Do Black patients fare better with Black doctors?

Research shows that racial concordance can improve communication, trust, and adherence to medical advice. That has implications for health care providers.

www.aamc.org

 

[triggermaster]

Affirmative action doesn't hurt white medical school applicants

Quit whining that a black applicant "stole your spot" in medical school. She didn't.

www.statnews.com

"Figure 4 shows that it’s far more likely a white applicant “stole a spot” than a black applicant. For a white applicant with a 31 MCAT score and a 3.7 GPA, for every black applicant who scored lower and was accepted there are, on average, 4.11 white students who also scored lower and were accepted."

"The chance that a low-scoring white medical school applicant will “lose” a spot to a low-scoring black applicant is 0.5 percent. How unlikely is that? It’s even less likely as the applicant dying in a car accident.

White applicants with low scores should realize that their MCAT scores and GPAs are holding them back far more than their black colleagues."

Short answer: a lot of white students with poor MCATs still get in.

This is a ‘study’ with a predetermined conclusion. Why only consider MCATs under 26? What about white person with a 32 or 34 vs a black person with a 28 or 30? The answer doesn’t fit the narrative so it isn’t published.

 

[GassYous]

Congratulations to all those who matched
I just can't believe how competitive this field has become

 

[aneftp]

Affirmative action doesn't hurt white medical school applicants

Quit whining that a black applicant "stole your spot" in medical school. She didn't.

www.statnews.com

"Figure 4 shows that it’s far more likely a white applicant “stole a spot” than a black applicant. For a white applicant with a 31 MCAT score and a 3.7 GPA, for every black applicant who scored lower and was accepted there are, on average, 4.11 white students who also scored lower and were accepted."

"The chance that a low-scoring white medical school applicant will “lose” a spot to a low-scoring black applicant is 0.5 percent. How unlikely is that? It’s even less likely as the applicant dying in a car accident.

White applicants with low scores should realize that their MCAT scores and GPAs are holding them back far more than their black colleagues."

Short answer: a lot of white students with poor MCATs still get in.

Again. U fell hook line and sink for the percentage vs raw numbers.

The article purposely interchanges percentages vs raw numbers to booster take arguments

It’s like me says there are more white people on food stamps than black people . It’s true. Right?

But when I tell u whites makes up 70%? Of the USA population and make up 36% of food stamps people

Blacks make up 12% of population but 27% of food stamps participants

That’s how u fool people with data.

The aamc just fools most people with their propaganda. Except I like to tell people I’m usually the smartest person in the room when it comes to data interpretation. Complete mis use of real stats. Duh more white applications than blacks.

So aamc show me the percentage of black applicants to black acceptance rates.

I am so far from med school but I have a very good memory when aamc used to published real non DEI agenda.

Latino women in the early 90s had 50% chance of getting admitted to med school.

Than African American women were 45%

Native American women Indians were the same. Yet their mcat (the old scoring were than than 24/25 on average ). A score of 30 was consider above average out of 45.

White and Asians had a 33% acceptance rate with average score of 29/30. So whites and Asian had lower acceptance rate but higher scores even 30 plus years ago.

So how u need to interpret real data.

 

[Gern Blansten]

Affirmative action doesn't hurt white medical school applicants

Quit whining that a black applicant "stole your spot" in medical school. She didn't.

www.statnews.com

"Figure 4 shows that it’s far more likely a white applicant “stole a spot” than a black applicant. For a white applicant with a 31 MCAT score and a 3.7 GPA, for every black applicant who scored lower and was accepted there are, on average, 4.11 white students who also scored lower and were accepted."

"The chance that a low-scoring white medical school applicant will “lose” a spot to a low-scoring black applicant is 0.5 percent. How unlikely is that? It’s even less likely as the applicant dying in a car accident.

White applicants with low scores should realize that their MCAT scores and GPAs are holding them back far more than their black colleagues."

Short answer: a lot of white students with poor MCATs still get in.

I see what you’re saying, but I would think the real reason that four white students were accepted with lower scores for every black student is strictly a numbers game. The vast majority of applicants seem to be white, as the overall average seems to mirror what the average acceptance rate for white students is at most points on the chart, with the marked exception of the two far left columns with low GPA/low MCAT and mid range GPA/low MCAT. At those two points, the black student still has about 56% chance and 67% chance respectively of being admitted. A white candidate with those low scores has an 8% and 14% chance of admission. The overall population of applicants is far greater for whites because the overall acceptance rate is not very far off from the overall white acceptance rate and nowhere near the elevated black acceptance rate, so it stands to reason that there would be far greater white people accepted who got a lower score than there would be black people. Strictly by sheer numbers of applicants.
However, I’m not sure I follow the leap of faith to state that missing 1-2 questions is the equivalent of the overall impact of these AA/DEI policies. The low GPA/low MCAT (22-24) section for blacks is a 56% acceptance rate. To approach that rate for whites, they have to have mid range GPA and a high MCAT (30-32) and then their acceptance rate jumps to 48%. The only group that is higher acceptance rate for whites is the high GPA/high MCAT group, which rises to an acceptance rate of 63%. An acceptance rate just slightly higher (but in the same ballpark) than the acceptance rate of the black student with low GPA and low MCAT.
To me, there is no way having a cold and missing an additional 1-2 questions is the equivalent of those stats. I’m just not sure I draw the same conclusions from that data chart that you do. I’m open to hearing if you are able to help me understand your point of view better.

 

[aneftp]

I see what you’re saying, but I would think the real reason that four white students were accepted with lower scores for every black student is strictly a numbers game. The vast majority of applicants seem to be white, as the overall average seems to mirror what the average acceptance rate for white students is at most points on the chart, with the marked exception of the two far left columns with low GPA/low MCAT and mid range GPA/low MCAT. At those two points, the black student still has about 56% chance and 67% chance respectively of being admitted. A white candidate with those low scores has an 8% and 14% chance of admission. The overall population of applicants is far greater for whites because the overall acceptance rate is not very far off from the overall white acceptance rate and nowhere near the elevated black acceptance rate, so it stands to reason that there would be far greater white people accepted who got a lower score than there would be black people. Strictly by sheer numbers of applicants.
However, I’m not sure I follow the leap of faith to state that missing 1-2 questions is the equivalent of the overall impact of these AA/DEI policies. The low GPA/low MCAT (22-24) section for blacks is a 56% acceptance rate. To approach that rate for whites, they have to have mid range GPA and a high MCAT (30-32) and then their acceptance rate jumps to 48%. The only group that is higher acceptance rate for whites is the high GPA/high MCAT group, which rises to an acceptance rate of 63%. An acceptance rate just slightly higher (but in the same ballpark) than the acceptance rate of the black student with low GPA and low MCAT.
To me, there is no way having a cold and missing an additional 1-2 questions is the equivalent of those stats. I’m just not sure I draw the same conclusions from that data chart that you do. I’m open to hearing if you are able to help me understand your point of view better.

100% facts.

I don’t know why people keep defending DEI and affirmative action.

A poor white kid with single mother with better grades and test score vs a rich black kid with all the means to succeed with below average scores and grades

Guess who will more likely get accepted? The answer is obvious

 

[triggermaster]

It's way more than 1-2 questions. Just look at the raw data.

It’s no longer ‘new’ but

New Chart Illustrates Graphically the Racial Preferences for Blacks, Hispanics Being Admitted to US Medical Schools

The bar chart above is based on selected data from the table below the chart and shows the acceptance rates for US medical schools based on three different combinations of MCAT scores and GPA by ethnic/race group during the 2013-2016 period. As I explained in previous CD post that featured the...

www.aei.org

 

[mmag]

100% facts.

I don’t know why people keep defending DEI and affirmative action.

A poor white kid with single mother with better grades and test score vs a rich black kid with all the means to succeed with below average scores and grades

Guess who will more likely get accepted? The answer is obvious

Because proportionately there are fewer Black doctors compared to white doctors and research suggests black patients have better outcomes with Black doctors. Medicine is not about opportunity for the physician it's about what is better for patients. The Black patient sees a white doctor and it doesn't matter that the white doctor got better grades and test scores despite overcoming adversity.