New>NRMP SEEKING COMMENTS ON "ALL-IN" POLICY

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New>NRMP SEEKING COMMENTS ON "ALL-IN" POLICY

The National Resident Matching Program (NRMP) Board of Directors is considering a change to the policies governing the Main Residency Match. Under the new policy, the rules of participation for all registered applicants would be standardized by requiring institutions participating in the Main Residency Match to place all of their core residency positions in the Main Residency Match or another national matching program. Read about the Board's deliberations to date and learn how to submit comments on the proposed policy

 

[DrBowtie]

So no more prematching?

 

[ShyRem]

I like it.

 

[WingedOx]

So no more prematching?

umm, yeah... is that all that this changes does? I'm kinda neutral on it.

 

[peppy]

I could see this being a good thing. Sometimes malignant programs try to pressure independent applicants into signing prematches early on because they know the foreign grads in particular are desperate to get in somewhere. It might help applicants end up in the place that's truly the best fit if all the spots were truly up for grabs in the match.
However, I'm wondering if this move might also have the consequence of reducing the number of foreign grads that programs in general take, since apparently one of the rationalizations for prematches is that it makes it easier for programs to get the visa paperwork done in time to start residency. That might lead to an even stronger preference for American grads than (most) programs have previously had. Since the number of American applicants is increasing each year and many of us have concerns about the number of residency spots not being adequate for the number of med school grads, I wonder if that's why this is being brought up now.

 

[McGillGrad]

Seems like it would be a good thing for American grads, but would be a big issue for D.O. schools. They would not like it, either.

 

[Doctor4Life1769]

Seems like it would be a good thing for American grads, but would be a big issue for D.O. schools. They would not like it, either.

Nah.

Most competitive specialties don't even prematch DOs, it's the lesser competitive specialties that do (i.e. FM, IM, psych).
DOs pursuing competitive specialties (or even those non-competitive specialties in competitive programs) don't get prematched. They go through the match like US MD students. Plus, the non-competitive specialties in non-competitive programs will likely end up taking DOs anyway since US MDs usually don't pursue them.
The following; however, will be hurt by this: FMGs/USIMGs, and US grads (MD and DO) who did an intern year and are trying to prematch their way into an advanced year program.

 

[Woot!]

Nah.

Most competitive specialties don't even prematch DOs, it's the lesser competitive specialties that do (i.e. FM, IM, psych).
DOs pursuing competitive specialties (or even those non-competitive specialties in competitive programs) don't get prematched. They go through the match like US MD students. Plus, the non-competitive specialties in non-competitive programs will likely end up taking DOs anyway since US MDs usually don't pursue them.
The following; however, will be hurt by this: FMGs/USIMGs, and US grads (MD and DO) who did an intern year and are trying to prematch their way into an advanced year program.

I think the programs that are less competitive will be severely affected. There are hospitals that prematch because otherwise they would have no possiblility of filling all their spots. Students would rather take "lesser spots" ensuring that they will indeed have a place to train.

 

[ShyRem]

I'm a DO and I support no pre-matching. Everyone on an even field.

 

[patch28]

I'm a DO and I support no pre-matching. Everyone on an even field.

You're also already in a residency...

It's getting a bit out of hand with students in many specialties already interviewing at 20+ programs to get a spot. I know it is more often the competitive programs, but, for FMGs/IMGs, the non-competitive programs are the only chance, and the students will still interview at as many as possible. If you suddenly force all of those positions into the match, the programs will feel obliged to interview more traditional US medical grads, grads who are most likely destined for a different program, leaving more positions unfilled, and more IMGs/FMGs floating in the water. The match isn't always about getting the best candidate or the best program, but rather one that both sides are happy with and can progress with. The early matched, visa cleared, decent FMG is better than the un-matched spot or the FMG who suddenly can't get a visa and leaves the program floating in the water.

In the interest of full disclosure, I am biased as I am one of those who did an intern year and relied upon pre-matching outside of the match for my spot; I am very happy with my program and it is happy with me.

 

[Doctor4Life1769]

I'm a DO and I support no pre-matching. Everyone on an even field.

🙄

Please. You didn't even participate in the MD match. You matched via the DO match, you have no room to speak. Most DO IM programs never fill anyways, and your "dually-accredited" program is loaded up with FMGs ... most of whom likely pre-matched, anyway. Your program would be in trouble if not for the FMGs, and it would be forced to take more DOs and may not even fill even by the scramble if it only took DOs.

 

[ShyRem]

Amazing how med students have such opinions of things they have not yet attained and are not a part of. You have no idea of anything going on in the residency program and make opinions based on your own prejudices and very small viewpoint.

I went through med school, graduated, and went through a match process that I was happy with. I do not support pre-matches for DO or MD or IMG. But then I also support opening up DO residencies to MDs who take an OMT course.

 

[Doctor4Life1769]

I like it!
Belittle a med student for "not being a part of the process."
I've seen your program and the residents, most are FMGs.
You went through the DO match, which unless you're doing a specialty, isn't hard to match.

Do I think MDs should be able to participate in the DO match? Yes and No. If they want a primary care slot, sure. If they want a specialty slot, no.

However, you still can't deny the fact that your program would suffer if they were not allowed to prematch FMGs. It would be a different story if your program had matched several US MDs, but it's not the case. You're just an intern, so your experience is likely as limited.

PS: went back and looked, lots of Carib graduates, so the program may not need to prematch them, but there are still a fair number of foreign graduates who were never from the US.

 

[ShyRem]

You have no idea of how many my program prematched or did not, how many were interviewed, where they went to school. And you certainly seem to have opinions that are totally unsubstantiated and undeserved about people based on their credentials and citizenship.

But seeing as how you are so absolutely certain of your position and opinion, I have better things to do with my time than battle someone who is so ensconced in their own opinion and isn't interested in learning any other viewpoint or facts other than their own.

I hope you get what you want and deserve from your education. And I hope you learn something along the way.

Good luck to you.

 

[Doctor4Life1769]

Wasn't belittling. Prematches are a good thing, is my point. I'd love to have prematched, but I understand it doesnt always happen.
I'm just saying that doing away with prematches, in my opinion, is not totally beneficial. You didn't go through that process, and you are currently a resident, so none of this affects you. It helped an above poster who did an intern year, and if I end up having to do an intern year (and not match into the specialty of my choice), I'd hope that I could land a spot via a prematch in the same way rather than going through the treachery of the match .... again.

About your residents and where they attended school, it's posted on your program's website. FYI.

 

[ShyRem]

I was referring to the interviewees, not current residents.

 

[SouthernSurgeon]

It's getting a bit out of hand with students in many specialties already interviewing at 20+ programs to get a spot. I know it is more often the competitive programs, but, for FMGs/IMGs, the non-competitive programs are the only chance, and the students will still interview at as many as possible. If you suddenly force all of those positions into the match, the programs will feel obliged to interview more traditional US medical grads, grads who are most likely destined for a different program, leaving more positions unfilled, and more IMGs/FMGs floating in the water. The match isn't always about getting the best candidate or the best program, but rather one that both sides are happy with and can progress with. The early matched, visa cleared, decent FMG is better than the un-matched spot or the FMG who suddenly can't get a visa and leaves the program floating in the water.

If your hypothesis is correct (which I doubt), then it really wouldn't matter...the positions would go unfilled, and would simply get filled with IMGs/FMGs on the back end (scramble) rather than the front end (prematch)

 

[PlutoBoy]

Only programs win by prematching. It should not be allowed.

 

[QofQuimica]

My feeling about prematching is that either everyone should be allowed to do it (including sponsored allo candidates) or no one should be. Since the whole point of setting up the match in the first place was to prevent applicants from being pressured into choosing a residency quickly, I'm in favor of the option to eliminate prematching altogether.

Concerning the argument that it would hurt FMGs, I would say that if anything, FMGs probably need *more* protection from abusive practices, not less, especially if they aren't US citizens.

 

[Neuronix]

My feeling about prematching is that either everyone should be allowed to do it (including sponsored allo candidates) or no one should be. Since the whole point of setting up the match in the first place was to prevent applicants from being pressured into choosing a residency quickly, I'm in favor of the option to eliminate prematching altogether.

I second this.

(going through match now)

 

[peppy]

Another angle of things: this guy's experience with being permanently banned from the match.
I think that guy's story does put the idea of eliminating prematches in a different light. Do we want the NRMP to have so much control over someone's career?

 

[hakim100]

I think the this would give the NRMP way to much control over a medical grads career.

Think about it. If the ONLY way to get residency is through the match, what happens if you are banned from the match. Or flagged as a violator?


I think programs should be able to match as many spots as they want, and offer spots outside the match as often as they want.

If programs are punished for giving spots outside the match, and students are banned for taking spots outside the match, the NRMP basically gets to play god with your career.

Do your self a favor, go read the NRMP's contract and violation policy. It is very easy to get banned from the match. They hold all the cards. Applicants have no rights what so ever.

If this does happen, the permament ban should be removed from the violation punishment options

 

[KaiserSven]

Only programs win by prematching. It should not be allowed.

That is not accurate. If you are a non-traditional student, you are far better off being allowed to obtain a position out of the match.

I think it is a terrible idea to not allow pre-matching. It is very rare that it occurs, and when it does, it is usually for a good reason.

The NRMP monopoly is a complete disaster though. I know first hand from trying to scramble. It was impossible. I was locked out of their system because I applied to 20 programs. That is NOTHING when you are scrambling.

Matching outside the match allows people to get positions that wouldn't otherwise.

 

[NotAProgDirector]

I think it is a terrible idea to not allow pre-matching. It is very rare that it occurs, and when it does, it is usually for a good reason.

Depends on your definition of rare. Per the NRMP's position paper, about 1 in 7 spots overall are filled outside the match. In some fields, it will be much lower than this, in others much higher. Overall, about 6000 out of 28,000 spots were filled outside the match. Personally, I don't find those statistics rare.

The NRMP monopoly is a complete disaster though. I know first hand from trying to scramble. It was impossible. I was locked out of their system because I applied to 20 programs. That is NOTHING when you are scrambling.

I am not certain I understand what you're saying here. The scramble is not the match. I have no idea why you didn't match.

Matching outside the match allows people to get positions that wouldn't otherwise.

Since there are more people looking for spots than spots, everytime someone gets a position that "wouldn't otherwise", someone else DOESN'T get a spot that they "would have otherwise". Whether that's a win or lose depends on who the people are, and which you think is more deserving.

 

[patch28]

I know that the NRMP would withdraw this push if they saw the winds going against them, but I would just love it if, say, a third of the programs out there simply fully withdrew from the NRMP in response to this latests power grab by the NRMP.

FYI, from the bottom of their propaganda pdf:

Questions and comments should be sent to NRMP Executive Director Mona M. Signer by email at
[email protected], by fax to 202-828-4797, or by U.S. mail c/o the National Resident Matching Program,
2450 N Street, NW, Washington, DC 20037.

Perhaps they would pay ever so slightly more attention to comments sent directly to them than they would to an online forum. Write to your senat...I mean, Write to your Dictator!