MSK Match

[fewa12]

Hi,

I'm a non-US resident who is interested in pursuing MSK in US. Now that MSK is in the Match, are there any advantages to submitting an application early? Am I more likely to get an interview if I submit my application early? Are the interview invites on a rolling basis?

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[colbgw02]

Early is good; too early is not. The match won't occur until 2019, and the SSR is recommending that programs don't accept applications before 1 October 2018. If you're just applying to programs in the match, then wait until then.

 

[fewa12]

Thanks!

 

[meister]

Didn’t realize MSK is in the match now. That sucks.

 

[808s&heartbreak]

Didn’t realize MSK is in the match now. That sucks.

Why does it suck to be in the match?

 

[radsisrad]

Why does it suck to be in the match?

Forces a number of applicants to wait until a Match Day to get their program - necessitating more interviews for many than would otherwise be necessary.

 

[meister]

More interviews, more money, more rules, delayed job offer/acceptance.

 

[808s&heartbreak]

True true. On the flip side, I've also heard of programs strong-arming fellowship applicants into accepting or denying an offer within a few days of interviewing, knowing that they aren't done interviewing. I'd much rather go on a few more interviews and rank them based on my actual preference than from playing mind games of "if I don't accept this current offer and my top choice rejects me then I"m screwed." To each their own, but I'm glad MSK is in the match and I hope all fellowships are in the match.

 

[colbgw02]

A big pro of the match is that it pushes back against the trend of starting the process earlier and earlier as programs race to be the first to offer applicants. It was already late summer/early fall of R3 in my day, which is already really early. In recent years, the whole process has practially been done before the applicants' R2 year, which is ridiculous. I saw a lot of people develop an interest in MSK only after doing their MR rotation as an R3, at which point it was too late. Of course, if you know you want to do MSK and, even more, know where you want to do it, then the match is going to be much more time-consuming and costly.

 

[scootad.]

.

 

[maxxor]

A big pro of the match is that it pushes back against the trend of starting the process earlier and earlier as programs race to be the first to offer applicants. It was already late summer/early fall of R3 in my day, which is already really early. In recent years, the whole process has practially been done before the applicants' R2 year, which is ridiculous. I saw a lot of people develop an interest in MSK only after doing their MR rotation as an R3, at which point it was too late. Of course, if you know you want to do MSK and, even more, know where you want to do it, then the match is going to be much more time-consuming and costly.

I’m doing an msk fellowship and applications were open in May of R2. Interviews were complete by June.

Something needed to be done. Maybe an embargo like what medical schools used when I applied (no offers until 4/1 with deposits due 5/1) would have been better, but in medical training, the match is always the automatic choice.

 

[radsisrad]

I’m doing an msk fellowship and applications were open in May of R2. Interviews were complete by June.

Something needed to be done. Maybe an embargo like what medical schools used when I applied (no offers until 4/1 with deposits due 5/1) would have been better, but in medical training, the match is always the automatic choice.

Whoa. Do MSK fellowships expect significant research? <2 years can't have been much time to work with.

 

[808s&heartbreak]

Whoa. Do MSK fellowships expect significant research? <2 years can't have been much time to work with.

No. It's a buyer's market for all fellowships except IR. You can pretty much go to any fellowship coming from any radiology residency (small community program to Harvard/Stanford).

 

[meister]

I guess if you don’t know which field you’d like to study then having it be so early is a problem. Personally as someone who always knew what I wanted to do I found it annoying to have to rank a bunch of programs and spend a bunch of money to find out where I was doing fellowship almost a year after some of my buddies already knew.

 

[TCOM12]

Even with the match, there will still be internal filling. Happens everywhere. So just like your home program and make sure they like you and you can avoid the dreaded match.

 

[Radology]

Dumb move.

Mamms went to a match. Overnight, they went from the second most competitive fellowship to half the programs going unfilled.

Unnecessary burden for one year of training

 

[Cognovi]

Dumb move.

Mamms went to a match. Overnight, they went from the second most competitive fellowship to half the programs going unfilled.

Unnecessary burden for one year of training

How do you know they were the second most competitive subspecialty?

 

[colbgw02]

I’m guessing the improvement in the job market had a lot more to do with the decline in mammo’s popularity than anything else.

 

[Radology]

You could guess that.

Or you could talk to residents choosing fellowships last year who were pushed off the fence from considering mammo.

Our current junior residents are taking the same mentality about msk.

 

[tco]

A big pro of the match is that it pushes back against the trend of starting the process earlier and earlier as programs race to be the first to offer applicants. It was already late summer/early fall of R3 in my day, which is already really early. In recent years, the whole process has practially been done before the applicants' R2 year, which is ridiculous. I saw a lot of people develop an interest in MSK only after doing their MR rotation as an R3, at which point it was too late. Of course, if you know you want to do MSK and, even more, know where you want to do it, then the match is going to be much more time-consuming and costly.

I don't understand why the match is done during R3. We do the match in MS4 and it works out fine. R3 is already stressful enough with boards. As someone who just went through this process and couldn't really start studying for boards until about 6 weeks ago, it needs changed (one or the other).

 

[maxxor]

I don't understand why the match is done during R3. We do the match in MS4 and it works out fine. R3 is already stressful enough with boards. As someone who just went through this process and couldn't really start studying for boards until about 6 weeks ago, it needs changed (one or the other).

Boards should move back to end of residency.

 

[colbgw02]

You could guess that.

Or you could talk to residents choosing fellowships last year who were pushed off the fence from considering mammo.

Our current junior residents are taking the same mentality about msk.

So what are all of these match-wary residents choosing for fellowship? Peds? Chest? Nucs?

 

[maxxor]

So what are all of these match-wary residents choosing for fellowship? Peds? Chest? Nucs?

Abdomen/Body seems popular this year

 

[thatsrad]

So what are all of these match-wary residents choosing for fellowship? Peds? Chest? Nucs?

I was on the fence between MSK and Body. This made it easy. Definitely doing Body. I’m not wasting valuable time and money doing a match when my top 6-8 choices are essentially equivalent.

I’m an R1, about to be R2. I don’t see why you need more than 2 years to decide. May/June of R2 for applications is fine. Get it out of the way.

 

[colbgw02]

I was on the fence between MSK and Body. This made it easy. Definitely doing Body. I’m not wasting valuable time and money doing a match when my top 6-8 choices are essentially equivalent.

If you truly are on the fence between a match/non-match subspecialty, then I can see how that could push you toward, in this case, body. I just don't think that there are enough people just like you to significantly move the needle. The only fellowships left that don't have a match are body/MR, chest, peds, and nucs. Three of those aren't popular, and I just don't see a huge swell of chest radiologists in the near future just because people want to avoid a match process.

I’m an R1, about to be R2. I don’t see why you need more than 2 years to decide. May/June of R2 for applications is fine. Get it out of the way.

It's really not. As mentioned earlier, many (most?) residencies don't expose residents to cross-sectional MSK in their first two years. I recruited multiple people to fellowship who just happened to have their MSK MR rotation early in their R3 year. Had their schedules been different, then they would have discovered their interest in MSK too late. I get the criticism of the match, which is why it's a shame they couldn't get programs simply to not accept applications before a certain date, rather than go all-in with a match.

 

[thatsrad]

If you truly are on the fence between a match/non-match subspecialty, then I can see how that could push you toward, in this case, body. I just don't think that there are enough people just like you to significantly move the needle. The only fellowships left that don't have a match are body/MR, chest, peds, and nucs. Three of those aren't popular, and I just don't see a huge swell of chest radiologists in the near future just because people want to avoid a match process.



It's really not. As mentioned earlier, many (most?) residencies don't expose residents to cross-sectional MSK in their first two years. I recruited multiple people to fellowship who just happened to have their MSK MR rotation early in their R3 year. Had their schedules been different, then they would have discovered their interest in MSK too late. I get the criticism of the match, which is why it's a shame they couldn't get programs simply to not accept applications before a certain date, rather than go all-in with a match.

You make some good points. There must be a wide variation as to what residents are exposed to during R1/R2.

At my program, we do everything R1 except body MR and mamms. My R1 rotation, I read 60+ MSK MR, performed 20 or so arthrograms including a few wrists and elbows, and assisted in several CT/US guided tumor biopsies. We have no MSK fellows and half the time there is only one resident on service so we get first dibs on any MR or procedure. I just assumed this was the norm. It was more than adequate to get a good feel for the breadth of the specialty and spark a strong interest. We also do IR during R1, so really the only specialty I have no feeling for is mamms.

 

[Radology]

If you truly are on the fence between a match/non-match subspecialty, then I can see how that could push you toward, in this case, body. I just don't think that there are enough people just like you to significantly move the needle. The only fellowships left that don't have a match are body/MR, chest, peds, and nucs. Three of those aren't popular, and I just don't see a huge swell of chest radiologists in the near future just because people want to avoid a match process.

.

Personally, I preferred neuro when I was choosing fellowships, but went with body to avoid the Match. It was awesome. I interviewed at two programs and picked one within a week. No games, no love letters, no uncertainty. Imagine that, I didn’t have to fly to California to blow smoke up the butts of some UCSF attending, pretending my life would not be complete without learning their way of diagnosing an IPMN as opposed to how the losers in flyover country do it.

MSK and body is a pretty natural fork point, don’t see how MSK doesn’t lose a big chunk of applicants to body for the near future. I think you’re really overestimating how committed People are to a certain fellowship. You think people really care that much? Most of us would not do a fellowship if we had a choice...

Other than IR and mammo, They’re all the same. We just want jobs in a certain place, and to just get through this painful ass process of medical training without drawing out every damn step to grueling detail.

 

[qxrt]

I liked that IR fellowship match was done through the match. It allowed me to interview and see what many different programs were like across the country. I would not have liked it if I could only interview at one or two places and had to decide then and there that I wanted to go to that one program.

Perhaps this matters less for non-IR fellowships, as most non-IR fellowships have relatively little variability and probably train you the same for the most extent.

 

[colbgw02]

Personally, I preferred neuro when I was choosing fellowships, but went with body to avoid the Match. It was awesome. I interviewed at two programs and picked one within a week. No games, no love letters, no uncertainty. Imagine that, I didn’t have to fly to California to blow smoke up the butts of some UCSF attending, pretending my life would not be complete without learning their way of diagnosing an IPMN as opposed to how the losers in flyover country do it.

MSK and body is a pretty natural fork point, don’t see how MSK doesn’t lose a big chunk of applicants to body for the near future. I think you’re really overestimating how committed People are to a certain fellowship. You think people really care that much? Most of us would not do a fellowship if we had a choice...

Other than IR and mammo, They’re all the same. We just want jobs in a certain place, and to just get through this painful ass process of medical training without drawing out every damn step to grueling detail.

I think residents care more than you think they do. More precisely, I think they care more about which fellowship they do than they do about putting up with a match. If people didn't care that much, then we would have already seen the wholesale abandonment of neuro when they implemented their match.

If anything, I think we'll see a small dip in MSK's attractiveness because some current junior residents have a pre-existing expectation of not having a match. Within a year or two, it will have evened out as the new residents won't have that expectation.

 

[thatsrad]

If people didn't care that much, then we would have already seen the wholesale abandonment of neuro when they implemented their match.

Actually neuro is awfully uncompetitive with 1/3 of their spots going unfilled this year. I hear it was one of the most competitive specialties before they went to a match, probably filling nearly all their spots. If that’s the case, then they lost ~1/3 of their applicants...

 

[colbgw02]

Actually neuro is awfully uncompetitive with 1/3 of their spots going unfilled this year. I hear it was one of the most competitive specialties before they went to a match, probably filling nearly all their spots. If that’s the case, then they lost ~1/3 of their applicants...

Link?

 

[Cognovi]

http://www.nrmp.org/wp-content/uploads/2018/02/Results-and-Data-SMS-2018.pdf page 7

 

[colbgw02]

Actually neuro is awfully uncompetitive with 1/3 of their spots going unfilled this year. I hear it was one of the most competitive specialties before they went to a match, probably filling nearly all their spots. If that’s the case, then they lost ~1/3 of their applicants...

So I decided to do some digging myself, and I found this article written upon conclusion of year 3 of the neuroradiology match. It states...

"Over the 3-year period, the fill rates increased from 45% of positions and 22% of programs in 2001 to 76% and 59%, respectively, in 2003."

 

[colbgw02]

View attachment 235314
http://www.nrmp.org/wp-content/uploads/2018/02/Results-and-Data-SMS-2018.pdf page 7

Thanks, but that wasn't what I was getting at. I know that neuro doesn't fill and hasn't filled in a long time, if ever. I'm more interested in seeing evidence that 1) neuro was once the most popular fellowship and 2) it was its match that undid that popularity. My interpretation of the article I posted in my previous post is that the match, at worst, did nothing to hurt neuro's attractiveness when first implemented.

 

[maxxor]

Thanks, but that wasn't what I was getting at. I know that neuro doesn't fill and hasn't filled in a long time, if ever. I'm more interested in seeing evidence that 1) neuro was once the most popular fellowship and 2) it was its match that undid that popularity. My interpretation of the article I posted in my previous post is that the match, at worst, did nothing to hurt neuro's attractiveness when first implemented.

If anything, 2 years at a lot of heavy-hitter programs is hurting it's attractiveness the most...

 

[Cognovi]

Thanks, but that wasn't what I was getting at. I know that neuro doesn't fill and hasn't filled in a long time, if ever. I'm more interested in seeing evidence that 1) neuro was once the most popular fellowship and 2) it was its match that undid that popularity. My interpretation of the article I posted in my previous post is that the match, at worst, did nothing to hurt neuro's attractiveness when first implemented.

Neuroradiology does not subscribe to the "all-in policy", so not all available spots are put in the Match (typically internal candidates take the others). Thus, reading match statistics is fraught with error and the true fraction of accredited fellowship spots that go unfilled is less than 1/3. It's not clear that the Match undid the popularity back in 2001. It's not clear that it stayed the same. See series of papers describing the results of the first three years of the neuroradiology match: results neuroradiology fellowship yousem match - PubMed - NCBI Estimates depend upon survey results, which are also imperfect due to under-response.

 

[colbgw02]

Neuroradiology does not subscribe to the "all-in policy", so not all available spots are put in the Match (typically internal candidates take the others). Thus, reading match statistics is fraught with error and the true fraction of accredited fellowship spots that go unfilled is less than 1/3. It's not clear that the Match undid the popularity back in 2001. It's not clear that it stayed the same. See series of papers describing the results of the first three years of the neuroradiology match: results neuroradiology fellowship yousem match - PubMed - NCBI Estimates depend upon survey results, which are also imperfect due to under-response.

Good post. This type of "research" is highly flawed and the data are ultimately inconclusive. However, I, for one, am more confident that the match didn't cause the downfall of neuroradiology after reading these articles than I was before, which was the assertion that started this particular branch of the thread.

Perhaps the greater take-home point isn't the data, but rather that the neuroradiology leadership was obviously cognizant of the change they made, took steps to monitor it in its early years, and ultimately decided to stick with the match.

 

[Radology]

neuro going to match is probably irrelevant to this discussion because 2001 was a long time ago.

I stand by my assertation that msk will regret this. I think “combined” msk/neuro msk/body fellowships are about to become a lot more competitive.

 

[meister]

This is an interesting discussion. I doubt combined fellowships will see increasing interest, however, despite their obvious utility. I personally would have loved to do neuro/MSK.

 

[maxxor]

This is an interesting discussion. I doubt combined fellowships will see increasing interest, however, despite their obvious utility. I personally would have loved to do neuro/MSK.

Same but the CAQ screws with that. There’s one at Jefferson I know of. Not sure if you get CAQ from it though.

 

[qwerty89]

Given the trend for consolidation with larger and larger groups where people read a higher percentage of studies within their area of fellowship it seems like a bad idea to pick a fellowship based on whether or not its in a match.

 

[qwerty89]

Same but the CAQ screws with that. There’s one at Jefferson I know of. Not sure if you get CAQ from it though.

MCW as well.
MCW: Musculoskeletal-MRI & Neuroradiology | Hybrid Fellowship Program

 

[Radology]

It’s very very rare to do 100% MSK outside of academics. Even 50% is unheard of in most regions. Combo fellowships get a bad rap on forums for some reason, but it makes you pretty damn marketable to most groups.
Anyone whose done a fellowship knows that the last 6 months are diminishing returns anyways.