MATCH QUESTION

Burrell College of Osteopathic Medicine
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MaliOMali said:
What is really scary, and this blew my socks off when I read it is that not only does the Dean of Cornell not understand the match algorithm, but the AAMC would post her misunderstanding of the match algorithm on their website. I mean how can people so important to this process not understand it?
I'm sure you guys will get a kick out of this... (read 6th paragraph in the article- "reasonable order"?! the only order to rank in that is reasonable is by preference, no amount of manipulation or strategy, as discussed above in detail, can cheat the algorithm).

https://www.aamc.org/newsroom/reporter/april2013/334068/match.html
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double-face-palm.jpg
 
MaliOMali said:
What is really scary, and this blew my socks off when I read it is that not only does the Dean of Cornell not understand the match algorithm, but the AAMC would post her misunderstanding of the match algorithm on their website. I mean how can people so important to this process not understand it?
I'm sure you guys will get a kick out of this... (read 6th paragraph in the article- "reasonable order"?! the only order to rank in that is reasonable is by preference, no amount of manipulation or strategy, as discussed above in detail, can cheat the algorithm).

https://www.aamc.org/newsroom/reporter/april2013/334068/match.html
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Based on that, I get the feeling that the AAMC doesn't really understand the Match. Another example is how the AAMC keeps saying how the Match is getting terribly competitive, which they want to be able to say in order to support their agenda for expanding residency slots (in spite of the recent IOM report on GME). But the NRMP is really skeptical of that claim, based on its own analysis of its own stats.
 
MaliOMali said:
What is really scary, and this blew my socks off when I read it is that not only does the Dean of Cornell not understand the match algorithm, but the AAMC would post her misunderstanding of the match algorithm on their website. I mean how can people so important to this process not understand it?
I'm sure you guys will get a kick out of this... (read 6th paragraph in the article- "reasonable order"?! the only order to rank in that is reasonable is by preference, no amount of manipulation or strategy, as discussed above in detail, can cheat the algorithm).

https://www.aamc.org/newsroom/reporter/april2013/334068/match.html
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damn she is dumb as bricks
if you didn't match it's because no one put you high enough on their list, has nothing to do with how you ordered your list
 
PL198 said:
lol details for how they explained how to game it
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They talked about using all your safeties and shoo ins above all else, esp for couples and dual applicants. Dumb.
 
On the subject of bad advice on the match, I found this kind of disturbing:

"From an individual student’s perspective, applying to more programs makes sense and increases his or her chance of a desired outcome. However, as career advisors we have a responsibility to consider the opportunities for all of our advisees when we make recommendations to individuals."

Whoa. So there are advisors out there who see it as their job to *not* maximally increase a student's chance of matching ("desired outcome"), because of a perceived conflict with other priorities. I wonder how many of this author's advisees are aware of this divided loyalty. Buyer beware.
 
falsestart123 said:
On the subject of bad advice on the match, I found this kind of disturbing:

"From an individual student’s perspective, applying to more programs makes sense and increases his or her chance of a desired outcome. However, as career advisors we have a responsibility to consider the opportunities for all of our advisees when we make recommendations to individuals."

Whoa. So there are advisors out there who see it as their job to *not* maximally increase a student's chance of matching ("desired outcome"), because of a perceived conflict with other priorities. I wonder how many of this author's advisees are aware of this divided loyalty. Buyer beware.
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It actually makes sense to an extent though. For students in the bottom 50% (below average) applying to more programs is helpful. For student who are above average likely don't need to apply to the same number to get the same "desired" outcome. I think that is reasonable, especially for less competitive fields.
 
My issue isn't the about the number of programs an individual should apply to--competitive applicants probably need to apply to less. The problem I see, expressed directly in that quotation, is that these career advisors appear to give applicants advice that they know will not maximize the individual applicant's chances of desired outcome because the advisors have some other agenda (concerning, we are told, the greater good). That isn't the sort of advisor I want for my career. And I doubt this agenda is ever discussed with the individual student.
 
SouthernSurgeon said:
There are a lot of people out there, including students/applicants who have argued there should be a cap on # of programs people can apply to/interview at.

If you look at the NRMP data, people are going on a crapload of interviews and it gets worse every time they release a new charting outcomes.
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I'm sure some of this is due to the perception that applicants "must" apply to more programs in order to increase their chances at successfully matching, but another component to consider is people looking to move away from their med school. I know this was the case for me, and I applied to many more programs than I probably "needed to" because I knew very little about the programs and wanted to explore a few different places that I had never lived in before. I wasn't ever worried about matching, but I didn't like the idea of possibly missing out on a quality program in an area that I was interested in living in for no reason other than "that's too many programs to apply to."
 
eject said:
My issue isn't the about the number of programs an individual should apply to--competitive applicants probably need to apply to less. The problem I see, expressed directly in that quotation, is that these career advisors appear to give applicants advice that they know will not maximize the individual applicant's chances of desired outcome because the advisors have some other agenda (concerning, we are told, the greater good). That isn't the sort of advisor I want for my career. And I doubt this agenda is ever discussed with the individual student.
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I have a feeling some pre-med advisors do the same thing.
 
SouthernSurgeon said:
There are a lot of people out there, including students/applicants who have argued there should be a cap on # of programs people can apply to/interview at.

If you look at the NRMP data, people are going on a crapload of interviews and it gets worse every time they release a new charting outcomes.
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I think there absolutely should be, so you won't get the carpet bomb application from students who have zero desire to match in certain places.
 
eject said:
My issue isn't the about the number of programs an individual should apply to--competitive applicants probably need to apply to less. The problem I see, expressed directly in that quotation, is that these career advisors appear to give applicants advice that they know will not maximize the individual applicant's chances of desired outcome because the advisors have some other agenda (concerning, we are told, the greater good). That isn't the sort of advisor I want for my career. And I doubt this agenda is ever discussed with the individual student.
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Because maximizing an individual's chances of a desired outcome can result in a equilibrium that results not only in equilibrium worse for everyone, but for that individual as well (see Prisoner's dillema, Tragedy of the Commons, etc).

Certain specialties have people applying to close to 100 programs now. But if everyone applied to 10, the result would be essentially the same, except significantly more cheaper, people go to more places they are interested in. But, because of everyone attempting to maximizing individual results (if one applies to 100 programs when everyone else applies to 10), the end result is thousands of essentially unnecessary applications, clogged interview pipline, and money spent, and no way to reverse it without mandating strict limits (whose going to apply to only 30 when everyone else is applying to 60?).

Pretty much every field is undergoing this inflation now, with the solution being either a mass cooperation between the players with perfect information (unlikely, but the link is an attempt at that) or some strict regulation.
 
Slack3r said:
I think there absolutely should be, so you won't get the carpet bomb application from students who have zero desire to match in certain places.
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In some regard, though, this is minimized with the scaling fees that ERAS imposes which makes applying to more and more programs increasingly expensive (https://www.aamc.org/students/medstudents/eras/residency/344062/fees-info.html). Perhaps they could tinker with the fees to further incentivize not applying to tons of programs, but for the highly competitive fields (e.g., derm and plastics) applying to most if not all programs is simply a necessity.
 
I wonder how much, if it at all, an individual applicant actually benefits from applying broadly. On the surface, we assume there'd be at least some benefit, since more applications means more chances which should translate to higher overall odds of matching. But since this isn't secret advice, the percentage of applicants applying broadly keeps increasing (probably the majority by now?). So with more applicants per position per residency location, each applicant's odds of matching at each location individually will decrease. My question is, have the sum of decreasing odds at each individual position overcome the assumed increase in odds of matching altogether by applying broadly? No simple answer, obviously, but interesting to think about.
 
pd1112 said:
I wonder how much, if it at all, an individual applicant actually benefits from applying broadly. On the surface, we assume there'd be at least some benefit, since more applications means more chances which should translate to higher overall odds of matching. But since this isn't secret advice, the percentage of applicants applying broadly keeps increasing (probably the majority by now?). So with more applicants per position per residency location, each applicant's odds of matching at each location individually will decrease. My question is, have the sum of decreasing odds at each individual position overcome the assumed increase in odds of matching altogether by applying broadly? No simple answer, obviously, but interesting to think about.
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The point is not that an applicant does / does not benefit from applying broadly, it is that in the current climate he decidedly does NOT benefit from applying narrowly.
 
Jabbed said:
The point is not that an applicant does / does not benefit from applying broadly, it is that in the current climate he decidedly does NOT benefit from applying narrowly.
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Absolutely, not questioning this, was just contemplating if the paradoxical drawback also exists.
 
Do we really need a match process? Why can't we just apply to residency the same way people apply for internships and jobs? We send out our applications, they interview us, and if they like us, they make an offer.

I feel like this is just a way for these organizations to make money.
 
SouthernSurgeon said:
Y ou can easily look to history to see what an unregulated match looks like. Particularly for desirable fields.

Programs have all the power, applicants very little. A centralized 3rd party helps ensure standardization if nothing else.
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I see. I'm actually curious- where could I read about that history?

I feel like programs still have most of the power. After all there are far more applicants than positions.
 
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chipwhitley said:
I see. I'm actually curious- where could I read about that history?

I feel like programs still have most of the power. After all there are far more applicants than positions.
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That's like that at most jobs. Welcome to the real world.
 
Brigade4Radiant said:
That's like that at most jobs. Welcome to the real world.
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I agree, I mean I personally don't have a problem with residency operating the same way pretty much everything else does. I'm not a huge fan of a centralized body deciding what happens.
 
The fundamental problem before the match era was mediocre programs would interview early and make binding offers that were only good for 24 hours. Students were forced to take huge chances that they might be turning down their last job offer. It was also inefficient for programs, because they wouldn't end up with their most desired candidates either.

The match is the most efficient method we've found for meeting the desires of the candidates and the programs.

The match is fundamentally different from the real world because it is so synchronized.
 
sazerac said:
The fundamental problem before the match era was mediocre programs would interview early and make binding offers that were only good for 24 hours. Students were forced to take huge chances that they might be turning down their last job offer. It was also inefficient for programs, because they wouldn't end up with their most desired candidates either.

The match is the most efficient method we've found for meeting the desires of the candidates and the programs.

The match is fundamentally different from the real world because it is so synchronized.
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I'd rather have the freedom of not having to rely on a centralized body and their rules and timeline. Sure, there are risks involved, but there are benefits too.
 
Siggy said:
Want to see what residency application would be without the Match? Just look at the scramble, except include everyone and start in July.
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I don't see what the big deal is. That's how the job application process for just about every other profession works...
 
chipwhitley said:
I don't see what the big deal is. That's how the job application process for just about every other profession works...
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the job application sucks for pretty much everyone. have you ever dealt with HR? absurd requirements which are completely unnecessary for the job. if our job applications worked like other professions, we would need a year of paid work as a resident before residency even started. also skills with c++ and microsoft office required
 
Psai said:
the job application sucks for pretty much everyone. have you ever dealt with HR? absurd requirements which are completely unnecessary for the job. if our job applications worked like other professions, we would need a year of paid work as a resident before residency even started. also skills with c++ and microsoft office required
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what does that have anything to do with the match process, lol.
 
chipwhitley said:
I don't see what the big deal is. That's how the job application process for just about every other profession works...
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Please define the following phrases: status quo bias, system justification, and appeal to tradition.
 
I just think it would be nice to have more freedom, competition and choice in this process. For example, it would be nice if a competitor was able to make a much more modern and user-friendly application system than ERAS, like one that has a mobile app, for instance.
 
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chipwhitley said:
I just think it would be nice to have more freedom, competition and choice in this process. For example, it would be nice if a competitor was able to make a much more modern and user-friendly application system than ERAS, like one that has a mobile app, for instance.
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Dear god. History and marketing are important here.

A competitor cannot join this market at this particular time. The NRMP has generated a significant amount of buy-in. The have also passed such sweeping reforms as the All-in policy, something most thought they could never do. As long as they maintain a high standard of providing optimal matches, there is no need for a competitor in the match market. A new competitor would create chaos as you would have to apply to multiple matches (meaning more money, because initial fees are always more expensive) in order to ensure coverage and programs would have no idea WTH was going on.

ERAS will eventually get their technology straight. It may seem as easy as just going electronic, but there are legacy issues and staffing issues involved with any upgrade. We saw that this year with the all electronic application and the site being overwhelmed. I would prefer to have to use some random browser on my iPhone or a PC to log into ERAS this year, then to have them mess up my application because they were busy trying to make the UI more user-friendly. Keep in mind you're not getting cream of the crop IT here. The best of the best go to Apple/Google, the next go to private companies that pay really well, etc.
 
dyeguy21 said:
Dear god. History and marketing are important here.

A competitor cannot join this market at this particular time. The NRMP has generated a significant amount of buy-in. The have also passed such sweeping reforms as the All-in policy, something most thought they could never do. As long as they maintain a high standard of providing optimal matches, there is no need for a competitor in the match market. A new competitor would create chaos as you would have to apply to multiple matches (meaning more money, because initial fees are always more expensive) in order to ensure coverage and programs would have no idea WTH was going on.

ERAS will eventually get their technology straight. It may seem as easy as just going electronic, but there are legacy issues and staffing issues involved with any upgrade. We saw that this year with the all electronic application and the site being overwhelmed. I would prefer to have to use some random browser on my iPhone or a PC to log into ERAS this year, then to have them mess up my application because they were busy trying to make the UI more user-friendly. Keep in mind you're not getting cream of the crop IT here. The best of the best go to Apple/Google, the next go to private companies that pay really well, etc.
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I feel like given the fact that we pay through our nose for ERAS already (keep in mind most websites we use every day are free or very cheap compared to ERAS), and the fact that they can increase their prices all the they want and we can do nothing about it, they certainly could hire far better technical talent and easily afford to improve their system. The problem is they have no incentive to because there is no competition. Even if we absolutely hate it, we have no choice but to use it and they know that. So they can be as sloppy as they want, and take as much time as they want. If we complain enough, they'll fix it eventually, probably. Other companies can't because they know if their system goes down or sucks, customers will start switching over to a line of competitors waiting for their business
 
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chipwhitley said:
what does that have anything to do with the match process, lol.
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That's how the job application works for many other professions which you mentioned in your post

There is plenty of freedom and choice with more than enough competition to go around
 
Psai said:
That's how the job application works for many other professions which you mentioned in your post
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requirements for the job have nothing to do with the actual application process itself. NRMP does not define what residency programs require from their applicants, they all have different expectations, just like every job offer comes with its own expectation. no connection between the two.
 
chipwhitley said:
requirements for the job have nothing to do with the actual application process itself. NRMP does not define what residency programs require from their applicants, they all have different expectations, just like every job offer comes with its own expectation. no connection between the two.
Click to expand...

Med Students and residencies are pretty unique, however. You're technically still in school and can't just leave at the drop of a hat and still meet the requirements to graduate, which you need to do in order to accept the job.

Plus you would be forcing not only yourself to go to a bunch of interviews maybe even as early as February of your 3rd year, you would also be forced to commit on the spot to a particular offer if given the choice.

The match process allows for the time you need to go on interviews, for programs to get a feel for the types of applicants in the pool, and allows you to shop around for programs as well. It takes a whole lot of power out of the hands of the programs and gives it back to you

chipwhitley said:
I feel like given the fact that we pay through our nose for ERAS already (keep in mind most websites we use every day are free or very cheap compared to ERAS), and the fact that they can increase their prices all the they want and we can do nothing about it, they certainly could hire far better technical talent and easily afford to improve their system. The problem is they have no incentive to because there is no competition. Even if we absolutely hate it, we have no choice but to use it and they know that. So they can be as sloppy as they want, and take as much time as they want. If we complain enough, they'll fix it eventually, probably. Other companies can't because they know if their system goes down or sucks, customers will start switching over to a line of competitors waiting for their business
Click to expand...

Yes, that's how it would work in a perfect market. This is not that. It is similar to a regulated monopoly, which is the best system we can come up with at this moment. Competitors, like I stated before, would mess up the process for a lot of years and we don't have the time right now, given the increasing cost of medical care and the impending shortage of physicians, to screw up a process that has worked for quite some time.

The websites you use everyday pay for it with advertising, donations, and subscriptions. I don't want my official process to be offering me "One weird trick to get into residency" in the sidebar. Donations wouldn't happen. And a one-time fee makes more sense.

This is a complex system of verifying applicant information and presenting it all in a way that maintains the integrity of your data and the process of offers. The algorithm in use won a Nobel prize and they have updated it to requests for couples matches and advanced matching. It requires a lot of people to maintain all the infrastructure surrounding the process and a tiny fee (you can apply up to 10 programs for a mere $95 and a transcript fee...hardly through the nose) is all you pay. That might seem like a lot of money, but it's due to the fact that disseminating the information is a lot more complex than just sending an email and hosting a letter.
 
dyeguy21 said:
Med Students and residencies are pretty unique, however. You're technically still in school and can't just leave at the drop of a hat and still meet the requirements to graduate, which you need to do in order to accept the job.

Plus you would be forcing not only yourself to go to a bunch of interviews maybe even as early as February of your 3rd year, you would also be forced to commit on the spot to a particular offer if given the choice.

The match process allows for the time you need to go on interviews, for programs to get a feel for the types of applicants in the pool, and allows you to shop around for programs as well. It takes a whole lot of power out of the hands of the programs and gives it back to you



Yes, that's how it would work in a perfect market. This is not that. It is similar to a regulated monopoly, which is the best system we can come up with at this moment. Competitors, like I stated before, would mess up the process for a lot of years and we don't have the time right now, given the increasing cost of medical care and the impending shortage of physicians, to screw up a process that has worked for quite some time.

The websites you use everyday pay for it with advertising, donations, and subscriptions. I don't want my official process to be offering me "One weird trick to get into residency" in the sidebar. Donations wouldn't happen. And a one-time fee makes more sense.

This is a complex system of verifying applicant information and presenting it all in a way that maintains the integrity of your data and the process of offers. The algorithm in use won a Nobel prize and they have updated it to requests for couples matches and advanced matching. It requires a lot of people to maintain all the infrastructure surrounding the process and a tiny fee (you can apply up to 10 programs for a mere $95 and a transcript fee...hardly through the nose) is all you pay. That might seem like a lot of money, but it's due to the fact that disseminating the information is a lot more complex than just sending an email and hosting a letter.
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I see your points, and they are valid, but I'm still not completely convinced that this is the best arrangement. I also don't think we need to justify how much it costs them. That's their problem to figure out. We just need to demand better service and incentivize them to improve. Isn't that what is being done to physicians everyday? No one is justifying our costs.

By the way, unless you're a superstar applicant, you're probably going to be applying to a bit more than 10 programs, and the price gets pretty steep pretty quickly.
 
Another way of thinking about life without the Match. Remember applying to medical school? Remember how long that process was and hoping for an acceptance. Now imagine if your first offer came with a time limit, and if you accepted it, you were contractually obligated to go to that school. Your number 1 just offered you an interview? Too bad, you already signed.
 
Siggy said:
Another way of thinking about life without the Match. Remember applying to medical school? Remember how long that process was and hoping for an acceptance. Now imagine if your first offer came with a time limit, and if you accepted it, you were contractually obligated to go to that school. Your number 1 just offered you an interview? Too bad, you already signed.
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Why are we assuming that there would be time limits?
 
Beacopp665 said:
Because that's how it used to be. Middle to low tier programs would interview early and then offer spots that expired after 24-48 hours
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That might have been how it used to be, but I'm sure they would have realized over time that was just as bad a strategy as the car dealer who says the sale price expires if you don't buy today, and lo and behold it's still the same price next month...
 
chipwhitley said:
That might have been how it used to be, but I'm sure they would have realized over time that was just as bad a strategy as the car dealer who says the sale price expires if you don't buy today, and lo and behold it's still the same price next month...
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You give some programs more credit than I would my friend haha. I think the way the match is currently, while not perfect by any means, does optimize the match for both programs and applicants better than anything that used to happen previously
 
Beacopp665 said:
You give some programs more credit than I would my friend haha. I think the way the match is currently, while not perfect by any means, does optimize the match for both programs and applicants better than anything that used to happen previously
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I'm not saying it isn't doing it's job, or that it isn't better than what we used to have, I'm just thinking of how it could be better than it is today.
 
chipwhitley said:
I'm not saying it isn't doing it's job, or that it isn't better than what we used to have, I'm just thinking of how it could be better than it is today.
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" the enemy of a good plan is a perfect one"

we don't change things for the hell of it, especially important things. unless there was a likely substantial benefit to be gained from changing the system, such a change wouldn't occur.
 
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