NRMP March 2021 Discussions & Results

[ohmanwaddup]

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American taxpayers don’t give a damn about US medical education or what’s happening to people who are SOAPing right now. They care about the quality of their doctor at the doctor’s office regardless of where they trained and IMGs readily contribute to that. One might find allies on the political right in this argument but it won’t be for the reasons you care about but to further their worldview that Americans are being left behind in lieu of foreigners.

as a general rule, I don’t think American grads should be have their lives ruined so an IMG can attend residency in the US, regardless of how qualified the IMG is.

there are obviously exceptions to this If the American student is woefully Inadequate.

Maybe a better option would be caps on IMGs, but this could easily be abused in a variety of racist snd sexist ways.

I think that having medical students go through all this debt and hard work and to pass numerous licensing boards, but Being unable to practice and pay off that debt is terrible and needs to change.

Maybe making medical school tuition free is the answer.

 

[ohmanwaddup]

I started out as a fan of interview caps, but after reading those two very interesting articles/studies, have become a convert of the ERAP Two-Step.

"The ERAP consists of a two-round residency application system in which the first round is capped at 5 applications (and 3 interviews). Applicants who do not match in the first round can apply to an unlimited number of programs in the second round."​

While it would definitely up the gamesmanship aspect of the residency application process, it also targets the specific problems of the current system -- over-application on the part of med students and over-reliance on 'convenience screens' by programs.

• The cream-skimming potential interview-hoarders would potentially be funneled off early
• Programs would be highly-motivated to favor ERAP applicants before opening the 'floodgates' to applicants of unknown interest
• The need for back-up specialties would be largely mitigated
• The proportion of applicants matching at their genuinely preferred programs would, I think, increase greatly.
• Yield-protection practices would be largely eliminated in the first round

I'm sure it would create its own set of trickle-down problems, so am very curious to see how well it works for the OB/GYN match this year --

This sounds like it would be great

 

[Redpancreas]

as a general rule, I don’t think American grads should be have their lives ruined so an IMG can attend residency in the US, regardless of how qualified the IMG is.

there are obviously exceptions to this If the American student is woefully Inadequate.

Maybe a better option would be caps on IMGs, but this could easily be abused in a variety of racist snd sexist ways.

I think that having medical students go through all this debt and hard work and to pass numerous licensing boards, but Being unable to practice and pay off that debt is terrible and needs to change.

Maybe making medical school tuition free is the answer.

It’s tragic. People have committed suicide over not matching. Taxpayers don’t care though about us, they care about the system we represent.

Tuition will never be free unless we all have mass philanthropic gestures like NYU had.

 

[sella.turcica]

I don’t think American grads should be have their lives ruined so an IMG can attend residency in the US

So, foreigners are to blame for our misery.

There was an Austrian guy who said the same thing around 100 years ago. But then he caused way more misery to way more people as a result of his simplistic mind. Can't remember his name though.

 

[Steve_Zissou]

So, foreigners are to blame for our misery.

There was an Austrian guy who said the same thing around 100 years ago. But then he caused way more misery to way more people as a result of his simplistic mind. Can't remember his name though.

Big jump from "we should prioritize American grads for spots being paid by American taxes" to being "literally Hitler."

 

[Chibucks15]

USMLE Steps true believer, are you not?

If you ask me these exams are rubbish (you'll do well if you're Anki-savvy); I actually think Step 2 CS is the best one (though far from perfect).

I'd agree with you if we had an unequivocal way of making sure any given US applicant would "meet all criteria set by the US to establish competent physicians".

We don't.

And bear in mind that being trained abroad does not mean being trained at lower standards. Don't fall into the overgeneralization trap.

1) steps aren’t end all be all
2) never said overseas was lesser
3) prioritizing American citizens to become doctors in America, given that they pass all required coursework and prove themselves competent is a long way away from the jumps made as a response to my points.

lots of words bein put in my mouth here.

 

[deleted645092]

1) steps aren’t end all be all
2) never said overseas was lesser
3) prioritizing American citizens to become doctors in America, given that they pass all required coursework and prove themselves competent is a long way away from the jumps made as a response to my points.

lots of words bein put in my mouth here.

I think folks have gone a bit far comparing anyone to Hitler 🤦‍♂️. But that being said, I think the point they’re trying to make (poorly in execution) is that just like it’s ridiculous when people say “immigrants be taking our jobs” in all the other fields, it’s equally ridiculous in ours.

People aren’t not matching because of IMGs, plain and simple. There are still a ****load of unfilled spots even WITH IMGs. It’s just that American grads don’t want those spots. I might even go so far as to say they feel entitled to better programs, fields, and locations and think of themselves as too good for primary care or middle America. I applied EM this year, and the numbers I’ve seen were that there were >4,000 people applying for ~3,000 spots. Even assuming 1/4 of those are backups to ortho/ neurosurg/ whatever, that’s still a surplus of a few hundred applicants. To think that any substantial number of IMGs took spots from US grads at programs we would actually attend is dumb.

 

[Neopolymath]

1) steps aren’t end all be all
2) never said overseas was lesser
3) prioritizing American citizens to become doctors in America, given that they pass all required coursework and prove themselves competent is a long way away from the jumps made as a response to my points.

lots of words bein put in my mouth here.

Not to mention that other countries don't just let us walk into their field like it's nothing. Go try to be a physician somewhere else nice to live. You will be told no lol.

 

[SurfingDoctor]

Just speaking from experience, if someone wasn’t put on our rank list, it wasn’t because an there was some IMG snatching it up, it was usually because that applicant just kinda sucked.

While I get what people are saying, and I don’t have any specific issues with it, some programs would rather not fill than have an applicant match who is gonna be a massive headache for the next X years. We’ve have this discussion every year during rank list time, irrespective of if we offered interviews to IMGs or not and often come to the conclusion for certain applicants, we would rather go unfilled than match a potential disaster. In fact, that happened and someone scrambled in to our program several years ago. They ended up leaving anyway after 6 months, but whatever. Thus, the issue with IMGs taking spots is being a bit over exaggerated.

 

[Redpancreas]

So, foreigners are to blame for our misery.

There was an Austrian guy who said the same thing around 100 years ago. But then he caused way more misery to way more people as a result of his simplistic mind. Can't remember his name though.

I don’t think he was trying to be xenophobic.

 

[NotAProgDirector]

I started out as a fan of interview caps, but after reading those two very interesting articles/studies, have become a convert of the ERAP Two-Step.

"The ERAP consists of a two-round residency application system in which the first round is capped at 5 applications (and 3 interviews). Applicants who do not match in the first round can apply to an unlimited number of programs in the second round."​

While it would definitely up the gamesmanship aspect of the residency application process, it also targets the specific problems of the current system -- over-application on the part of med students and over-reliance on 'convenience screens' by programs.

• The cream-skimming potential interview-hoarders would potentially be funneled off early
• Programs would be highly-motivated to favor ERAP applicants before opening the 'floodgates' to applicants of unknown interest
• The need for back-up specialties would be largely mitigated
• The proportion of applicants matching at their genuinely preferred programs would, I think, increase greatly.
• Yield-protection practices would be largely eliminated in the first round

I'm sure it would create its own set of trickle-down problems, so am very curious to see how well it works for the OB/GYN match this year --

Although (so far) I favor an early round, I worry it won't be smooth sailing.

It is certainly true that top candidates whom might hoard interviews should match in the early round.

It is almost certainly true that not getting a spot in the early round will be a horrible experience. We can all say it's no big deal, most of the spots will be in the full match, etc. But I bet people who don't match in the early round will be here panicking, and might over-apply to the main match.

This works best if the early round is done before the main round starts. That's critical if you want to save people application fees. That means the early round needs to happen July - Sept. I don't see that as a problem, but it is early enough that doing SubI's might be impossible.

If we allow 5 apps in the early round, there may be some programs that never look at later apps -- they only interview from the initial 5. I think that's what you mean by your second bullet point. Whether that's a feature or a bug depends on your perspective.

"Yield protection" would still be a thing in the first round. Evryone whom sends me an early app probably sent four other programs one also. They can only go to one program. I won't have infinite early interview slots -- I'm unlikely to be able to interview all of them. Hence, I'll need to decide whom I want to offer an early interview to. This means guessing how interested they really are. "Yield protection" would not be a thing in the main round for anyone whom applied in the early round and didn't get a spot -- they would likely be prioritized for an interview. But how will the applicants feel -- applying early, not getting an early interview, and then getting a main interview? Will they still be as excited? Or will they now be upset and less interested?

Still, I favor this, I think it might help.

I'm also coming around to the idea of a specialty app cap - a max number of applications for a specific specialty. If someone applies for two fields, they get the max in each. This would be really important for people applying to advanced and prelim spots. But it might also greatly increase the backup applications - if people are capped, they might decide to apply to a second field "just in case"

 

[Chibucks15]

Not to mention that other countries don't just let us walk into their field like it's nothing. Go try to be a physician somewhere else nice to live. You will be told no lol.

Exactly. Especially as a DO I can barely go anywhere.

I never said IMGs taking our jobs or that they were stealing spots. I’m just saying AMGs should be given preference after are deemed competent by the American medical education system. There is just no legal right or standing to demand to be able to waltz in another country and demand to be able to practice

 

[Ho0v-man]

Omg guys IMGs aren’t takin’ yer jerbs. If you can’t outcompete a foreign grad with all the crap they have to overcome and the discrimination they face in the match, you were just a crappy candidate.

 

[deleted645092]

Exactly. Especially as a DO I can barely go anywhere.

I never said IMGs taking our jobs or that they were stealing spots. I’m just saying AMGs should be given preference after are deemed competent by the American medical education system. There is just no legal right or standing to demand to be able to waltz in another country and demand to be able to practice

You keep saying “IMGs are taking our jobs” without actually saying it.

 

[ohmanwaddup]

Well apparently Im the same as hitler, but to be clear I have no issue with IMGs. All I’ve stated it given the massive amount of debt and requirements of passing several board exams, I would be open to more protections for American grads. I’m aware they already have a big advantage. I’m aware IMGs are not taking AMG jobs.

a AMG only first round would still allow IMGs to match since there’s more spots than AMGs, and as others have said would still stop the AMG from matching that shouldn’t. It would also give AMGs a second chance to match if they didn’t the first round.

this doesn’t mean I think the worst of the worst of AMG should get spots over competent IMG, but given the consequences for not matching, something needs to be done.

 

[deleted645092]

Well apparently Im the same as hitler, but to be clear I have no issue with IMG. All I’ve stated it given the massive amount of debt and requirements of passing several board exams, I would be open to more protections for American grads. I’m aware they already have a big advantage. I’m aware IMGs are not taking AMG jobs.

this doesn’t mean I think the worst of the worst of AMG should get spots over competent IMG, but given the consequences for not matching, something needs to be done.

Did you not read my response above? There are more spots than applicants. Not everyone can go into radiology, anesthesia, ortho, and neurosurgery. We have more people interested than can they can take. It has zero to do with protections needed for American grads...

 

[Banco]

Omg guys IMGs aren’t takin’ yer jerbs. If you can’t outcompete a foreign grad with all the crap they have to overcome and the discrimination they face in the match, you were just a crappy candidate.

Yeah I kind of more or less agree with this. It's a huge challenge and accomplishment for IMGs to make it. Furthermore, the really well-qualified USMD candidates that fall through the cracks are not fighting for the same spots as IMGs usually are anyway. IMGs at this point take the spots that prevent our system from collapsing to some extent.

 

[ohmanwaddup]

Did you not read my response above? There are more spots than applicants. Not everyone can go into radiology, anesthesia, ortho, and neurosurgery. We have more people interested than can they can take. It has zero to do with protections needed for American grads...

I edited my comment and addressed this. I think two rounds will allow those who don’t match their desired speciality a better option for choosing a new one rather than waiting another year, or going through the nightmare Of SOAP.

 

[deleted645092]

I edited my comment and addressed this. I think two rounds will allow those who don’t match their desired speciality a better option for choosing a new one rather than waiting another year, or going through the nightmare Of SOAP.

Is this what you’re getting at when you say “protections”? How is this a protection of spots for American grads?

 

[DrZoidbergDO]

Although (so far) I favor an early round, I worry it won't be smooth sailing.

It is certainly true that top candidates whom might hoard interviews should match in the early round.

It is almost certainly true that not getting a spot in the early round will be a horrible experience. We can all say it's no big deal, most of the spots will be in the full match, etc. But I bet people who don't match in the early round will be here panicking, and might over-apply to the main match.

This works best if the early round is done before the main round starts. That's critical if you want to save people application fees. That means the early round needs to happen July - Sept. I don't see that as a problem, but it is early enough that doing SubI's might be impossible.

If we allow 5 apps in the early round, there may be some programs that never look at later apps -- they only interview from the initial 5. I think that's what you mean by your second bullet point. Whether that's a feature or a bug depends on your perspective.

"Yield protection" would still be a thing in the first round. Evryone whom sends me an early app probably sent four other programs one also. They can only go to one program. I won't have infinite early interview slots -- I'm unlikely to be able to interview all of them. Hence, I'll need to decide whom I want to offer an early interview to. This means guessing how interested they really are. "Yield protection" would not be a thing in the main round for anyone whom applied in the early round and didn't get a spot -- they would likely be prioritized for an interview. But how will the applicants feel -- applying early, not getting an early interview, and then getting a main interview? Will they still be as excited? Or will they now be upset and less interested?

Still, I favor this, I think it might help.

I'm also coming around to the idea of a specialty app cap - a max number of applications for a specific specialty. If someone applies for two fields, they get the max in each. This would be really important for people applying to advanced and prelim spots. But it might also greatly increase the backup applications - if people are capped, they might decide to apply to a second field "just in case"

if there's ealry admission to get into med school, don't see why that shouldnt also be the case for residencies.

 

[ohmanwaddup]

Is this what you’re getting at when you say “protections”? How is this a protection of spots for American grads?

I’d hope a first round of AMG only interviews and match would help prevent the competent ones from slipping through cracks in the match, and a second round of interviews and match being being better than SOAP.

im not sure how this would be done without drastically lengthening the the application cycle though. Maybe I’m way off base, but after watching what happens to AMGs that don’t match I feel like something needs to be done.

 

[deleted645092]

I’d hope a first round of AMG only interviews and match would help prevent the competent ones from slipping through cracks in the match, and a second round of interviews and match being being better than SOAP.

im not sure how this would be done without drastically lengthening the the application cycle though. Maybe I’m way off base, but after watching what happens to AMGs that don’t match I feel like something needs to be done.

A majority of AMGs who go unmatched fall into one of these groups:

1) Applied to a specialty with few positions and a surplus of applicants.
2) Red flags and were high-risk of not matching anyways.
3) Personality issues that showed through during interviews.
4) People who are so picky they only applied to coastal cities (plus Chicago).
4) Fell through the cracks being in the middle of a lot of ranklists but not high enough to match. This is a very small percentage of unmatched applicants.

So I don’t see which of these problems outside of #4 all of these rounds would fix. You’re going to still have a group who are devastated because they didn’t get their specialty or coveted city, whether it’s through SOAP or a late-round of primary interviews.

 

[Lawpy]

We need reasonable app caps now!

 

[DrZoidbergDO]

We need reasonable app caps now!

One other thing i havent really seen mentioned too much is the financial aspect. I'm incredibly fortunate enough that i could financially apply to a lot of places and attend lots of interviews, with no effect on my financial status. That isn't true for a lot of people, and would give me an imo unfair advantage.

 

[7331poas]

My proposal would be a first round that only includes USMDs and DOs. Then a second round with IMGs and unmatched MDs.

 

[deleted645092]

My proposal would be a first round that only includes USMDs and DOs. Then a second round with IMGs and unmatched MDs.

Why is separating US MDs and DOs from IMGs supposed to be a magic fix so all US grads can match? I’ve said it before and will say it til the end of time, IMGs are not stealing spots from us.

 

[7331poas]

Why is separating US MDs and DOs from IMGs supposed to be a magic fix so all US grads can match? I’ve said it before and will say it til the end of time, IMGs are not stealing spots from us.

Great, then it should be no problem putting them in a second round so that US students do not feel pressure to dual apply.

 

[MDFUTURE123]

Exactly. Especially as a DO I can barely go anywhere.

I never said IMGs taking our jobs or that they were stealing spots. I’m just saying AMGs should be given preference after are deemed competent by the American medical education system. There is just no legal right or standing to demand to be able to waltz in another country and demand to be able to practice

What do you mean by can barely go anywhere? like for residency?

 

[Neopolymath]

What do you mean by can barely go anywhere? like for residency?

He means going to another country to practice medicine (specifically as a DO)

 

[MDFUTURE123]

Does anyone have any statistics on how many MD's unmatched this year vs how many DOs unmatched? Im curious, because I am a first year DO student interested in surgery and wondering if this is just a pipe dream now...

 

[deleted645092]

Great, then it should be no problem putting them in a second round so that US students do not feel pressure to dual apply.

This logic makes zero sense.

Edit: Your logic is “change one of the parts of the match process that plays zero role in US grad placement”

 

[Ho0v-man]

Does anyone have any statistics on how many MD's unmatched this year vs how many DOs unmatched? Im curious, because I am a first year DO student interested in surgery and wondering if this is just a pipe dream now...

I think you have to wait for the charting outcomes. But gen surg is definitely not a pipe dream.

 

[Maimonides1]

Does anyone have any statistics on how many MD's unmatched this year vs how many DOs unmatched? Im curious, because I am a first year DO student interested in surgery and wondering if this is just a pipe dream now...

It’s all anecdotal so far now..
We are awaiting on forthcoming reports to formulate sensible plans and make recommendations for a revamped NRMP going forward !

 

[AnatomyGrey12]

Does anyone have any statistics on how many MD's unmatched this year vs how many DOs unmatched? Im curious, because I am a first year DO student interested in surgery and wondering if this is just a pipe dream now...

It’s not a pipe dream. 5/6 of our GS applicants matched. The one that didn’t wasn’t a surprise.

 

[Dr.Bruh]

Does anyone have any statistics on how many MD's unmatched this year vs how many DOs unmatched? Im curious, because I am a first year DO student interested in surgery and wondering if this is just a pipe dream now...

Typically 4-5% of USMDs and 7-8% of USDOs go unmatched each year. But after SOAP 99%+ of both USMD/DOs are places in a spot somewhere.

 

[ohmanwaddup]

A majority of AMGs who go unmatched fall into one of these groups:

1) Applied to a specialty with few positions and a surplus of applicants.
2) Red flags and were high-risk of not matching anyways.
3) Personality issues that showed through during interviews.
4) People who are so picky they only applied to coastal cities (plus Chicago).
4) Fell through the cracks being in the middle of a lot of ranklists but not high enough to match. This is a very small percentage of unmatched applicants.

So I don’t see which of these problems outside of #4 all of these rounds would fix. You’re going to still have a group who are devastated because they didn’t get their specialty or coveted city, whether it’s through SOAP or a late-round of primary interviews.

You're probably right.

 

[valuat]

I started out as a fan of interview caps, but after reading those two very interesting articles/studies, have become a convert of the ERAP Two-Step.

"The ERAP consists of a two-round residency application system in which the first round is capped at 5 applications (and 3 interviews). Applicants who do not match in the first round can apply to an unlimited number of programs in the second round."​

While it would definitely up the gamesmanship aspect of the residency application process, it also targets the specific problems of the current system -- over-application on the part of med students and over-reliance on 'convenience screens' by programs.

• The cream-skimming potential interview-hoarders would potentially be funneled off early
• Programs would be highly-motivated to favor ERAP applicants before opening the 'floodgates' to applicants of unknown interest
• The need for back-up specialties would be largely mitigated
• The proportion of applicants matching at their genuinely preferred programs would, I think, increase greatly.
• Yield-protection practices would be largely eliminated in the first round

I'm sure it would create its own set of trickle-down problems, so am very curious to see how well it works for the OB/GYN match this year --

This is not a bad idea. As always, the problem would be fine-tuning the main parameters: <5> applications and <3> interviews.

AAMC/NRMP/ERAS whoever it may be, they should run massive simulation studies with real data to try and come up with a better system. We can argue all we want with all the good intentions in the world but without real data it is very hard to propose anything...

 

[valuat]

No, I think that when there is this much debt involved those American tax dollars are best spent on American graduates, so as to not waste the massive investment taxpayers have been funding throughout that students medical education, and as to not ruin the lives of American graduates.

Wait, are my tax dollars funding medical students? Or any higher education students for that matter? Don't they have to pay it all back?

I'm completely fine helping fund primary and secondary education but higher education should be optional and people should pay for it.

 

[frenchyn]

This is not a bad idea. As always, the problem would be fine-tuning the main parameters: <5> applications and <3> interviews.

AAMC/NRMP/ERAS whoever it may be, they should run massive simulation studies with real data to try and come up with a better system. We can argue all we want with all the good intentions in the world but without real data it is very hard to propose anything...

But the question is: will they come up with a solution based on that data to benefit the most for medical students OR for themselves?

 

[valuat]

But the question is: will they come up with a solution based on that data to benefit the most for medical students OR for themselves?

You've probably heard of @jbcarmody. I don't agree with everything he says but he makes some excellent points about this whole circus.

This is one I found particularly intriguing:

 

[valuat]

Not that AMGs may care, they should, another one about the ECFMG:

https://thesheriffofsodium.com/2020/08/28/ecfmg-finances-part-i-on-purell-and-profiteering/

 

[Redpancreas]

Wait, are my tax dollars funding medical students? Or any higher education students for that matter? Don't they have to pay it all back?

I'm completely fine helping fund primary and secondary education but higher education should be optional and people should pay for it.

Your state tax dollars are subsidizing the tuition of instate medical students of your state and your federal tax dollars are contributing to medicare which funds US residency salaries. My thought is that while tons of IMGs are doing US residency, they are just as likely to practice in the US and contribute to US medical care as US AMGs hence not making US AMGs more entitled to that tax money. IMGs are already highly selected against in the recruitment process across all fields of medicine. 100s of FM/IM positions remain open after the match, but US grads don't want these spots hence IMGs take them. The world's a competitive place and embracing that only makes us better.

 

[ohmanwaddup]

Wait, are my tax dollars funding medical students? Or any higher education students for that matter? Don't they have to pay it all back?

I'm completely fine helping fund primary and secondary education but higher education should be optional and people should pay for it.

Your tax dollars are funding student loans, subsidizing the schools, etc.

when people can’t pay those loans back or have to spend so much of their income on payback and interest that they can’t stimulate the economy, that negatively affects you.

 

[valuat]

Your state tax dollars are subsidizing the tuition of instate medical students of your state and your federal tax dollars are contributing to medicare which funds US residency salaries. My thought is that while tons of IMGs are doing US residency, they are just as likely to practice in the US and contribute to US medical care as US AMGs hence not making US AMGs more entitled to that tax money. IMGs are already highly selected against in the recruitment process across all fields of medicine. 100s of FM/IM positions remain open after the match, but US grads don't want these spots hence IMGs take them. The world's a competitive place and embracing that only makes us better.

Thanks for clarifying. This could go on and on and on so let's get back to the main topic of the thread.

Less than 24 hours to go!!!!

Any PD here to share their impression of the residents they ended up matching with?

 

[Redpancreas]

Thanks for clarifying. This could go on and on and on so let's get back to the main topic of the thread.

Less than 24 hours to go!!!!

Any PD here to share their impression of the residents they ended up matching with?

Curious about this as well. I imagine it’s usually a let down. Oh god, I ended up with this guy.

 

[valuat]

Curious about this as well. I imagine it’s usually a let down. Oh god, I ended up with this guy.

Actually, I think MATCH results are disclosed to PDs at 3pm EDT.

@NotAProgDirector (sorry to tag you; you're the only one I know of around here) I must be pretty exciting to PDs as well, I presume.

 

[NotAProgDirector]

I'm very happy. Got some great people.

Ended up filling lower on my list than usual as an absolute number, but with more applicants / more interviews / less cancellations we ended up with a much longer list and relatively was better than usual.

One person told us they were ranking me #1, and didn't. Perhaps I call them tomorrow and congratualte them on matching with us, just to see what happens?

 

[deleted645092]

I'm very happy. Got some great people.

Ended up filling lower on my list than usual as an absolute number, but with more applicants / more interviews / less cancellations we ended up with a much longer list and relatively was better than usual.

One person told us they were ranking me #1, and didn't. Perhaps I call them tomorrow and congratualte them on matching with us, just to see what happens?

Is it more common for us to play y’all like that or for y’all to play us?

 

[Taco Time]

Is it more common for us to play y’all like that or for y’all to play us?

Reading that brought a smile to my face

 

[The Med-Peds Dude]

Are you one of those people who needs a peer reviewed paper before believing things like water is wet? What I think is a plausible and defendable reason experienced by other applicants in multiple specialties is just as likely as... Wait, you never offered an explanation besides saying you in your one program in your one specialty don't do it so it isn't the reason... Yeah, hard to argue with someone who isn't actually saying anything or making any points lol. Go ahead and explain why with some realistic reasons so we can all be educated by your perspective on the other side, seriously.

Occam's razor here: I am quite literally a spitting image of a couple program's residents year after year in everything but way better board scores. I am from the area and show a track record of staying in the area. They take MDs, DOs, IMGs. I fit the mission statement to a T based on the PDs' mouths in their program info/meet and greets and via knowledge from alum of the programs. I have no red flags and have branded my application to target this type of program specifically. This was illustrated effective by other very, very similar community programs in the same geographic area lauding my application as an excellent fit for that type of program and by some academic programs saying that I don't fit their typical mold but they were intrigued why I would apply there given my community program branding/aspirations/style.

I have a personal relationship with a few PDs in a couple specialties and they say they yield protect due to app numbers and geography. It's brought up on SDN and reddit every year. We know some people in programs still don't understand how the match works based on the dumb stuff they say repeated by applicants on the trail every year.

This scenario for DO students isn't exactly controversial. Solid DO students mention this every year.

@Chibucks15 can think what he wants but I want to make one thing clear. I feel that he is putting words in my mouth saying that I'm using this as some crutch for my ego. That's bull****. I'm specifically trying to go to these programs, even tried to interview at some terrible ones because I would rather be there than move to Minnesota or whatever. I'm committed and since I didn't get an interview no one can say it's because I had a bad attitude at the interview and thought I was too good for them blah blah blah. When I didn't get an interview at Duke (random example) I didn't cry because I'm a DO who doesn't fit their mold in my app or my actual goals.

So I'm comically the same (the homogenous nature of these programs was brought up multiple times each year on the spreadsheets causing URMs to not even apply) but 20+ points higher on boards... Or because that's not a rigorously tested theory we can go with proposed option two: I had the wrong neck angle on my headshot and the Pds decided to suddenly only interview black women in radiology to turn the program 180. I'm using hyperbole clearly but I think the dismissive posts are lazy bull**** and certainly not more supported despite that ironically being the main argument against my thoughts on the matter apparently.

Believe what you like. Program directors talk, within and between institutions. I've been through more matches than you ever will, and, based on historical trends, have probably been a program director considerably longer than the program director quoted above. Finally, the match algorithm does not penalize you for ranking your first choices first.