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if an IMG got accepted to the program you wanted instead of you, and you were both invited for interviews, they literally may have taken your spot because without them, you would be 1 spot higher on their rank list and may have matched otherwise.
No, the program decided the IMG was a better fit for their program.
AMGs have a residency placement rate of like 99%. The only AMGs that don't eventually get a residency spot either messed up somehow and have MAJOR red flags, or they insist on applying to a specialty they are not competitive for.
And how many IMG's match neurosurgery every year?
Pretty much this. I don't think we should guarantee that every medical student matches 100% just because they went to a US school, but there should be, and there is, a significant preference for US graduates.
unless the FMG/IMG are the Werner Von Braun or the J. Robert Openheimer of medicine.
I agree. I just don’t think we’re to the point of “IMGs stealing our spots.” Not with US placement rates still essentially 100%.
Again, there are >7000 more first year residency positions than AMGs (MD + DO) on a yearly basis.
We know this is not true. I know of at least 3 people who did not match into "competitive" specialties with above median scores. Do you really think that 40% of ENT applicants "were not competitive" for seats?
This is the whole point, AMGs are already prioritized, heavily!
Board scores are not everything. And yes, if you don't match into a specialty (assuming you applied broadly, etc) then by definition you were not competitive enough for that specialty. Baseball players in AAA are amazing at baseball, but they are not amazing enough to be major leaguers.
If those above median applicants applied to IM/FM as backup, that's likely exactly what would happen.
Very true. It wouldn't surprise me at all if that were the case. DO student's in particular are very prone to being in denial about how uncompetitive for X specialty their app is.
The problem with your logic is that we do not know the "competitiveness" of a specialty ahead of time, especially in small fields like ENT. One year the match rate could be high, another it could be 70%. We can only postulate. Additionally, programs purposefully do not publish their individual class profiles in order to drive up application revenue and create uncertainty within the applicant population.
What you're hearing is cognitive dissonance from physicians who haven't participated in the match in a decade. Anyone arguing for the status quo just isn't seeing the big picture here.
That's a nice strawman you've constructed. Unfortunately for you, I never said anything like that.
Funny you should say that, the US MD match rate has been essentially unchanged since 2006 (I went through this in 2010). The DOs in the NRMP match did way worse in that time, but a) DOs still had their own match and b) they were much more of an unknown back then to many.
People know what the competitive specialties are and are not. Sure there is some variation from year to year, but look at the "positions per USMD senior" from the NRMP reports over the past few years and you will see that these wild swings of competitiveness for a given specialty don't actually exist.
I have participated in the match in the past decade, twice actually if you include fellowship. The big picture here is that you guys seem to be suggesting that just by completing medical school in the US you feel entitled to not only a guaranteed residency position, but also the ability to apply to a competitive specialty in a risk-free manner where you still get your pick of the "noncompetitive" positions if you fail to obtain a spot in the competitive field. Just seems bonkers to me...
This isn't true though. Canada has protectionism for the match due to limited spots, whereas we have literally 7,000 more spots than we can fill with AMGs. Same with Australia, they have protectionism but also have specialist saturation in cities and saturation in residencies. UK has a metric **** ton of IMG's. That leaves the EU which only has protectionism in SOME countries for applicants outside the EU/EEA/Switzerland...but there are 27 countries within the EU plus the 3 EEA countries and Switzerland, so it is not like they are keeping out every nationality but their own. And the EU protectionism exists in every single profession due to EU law, it is not specific to medicine which you seem to be implying is the case in "first world countries." In countries with physician shortages like Germany and Eastern Europe, the EU protections don't even apply and there is no real downside to being an IMG as long as you speak the local language well. In other countries like Portugal, France, Spain, and Italy, the residency match is as pure of a meritocracy as you can imagine: a single exam decides where you rank in the match system. They do have restrictions on non-EU spots, but like I said, that is EU law, not something specific to medicine. Jobs have to be filled by equally qualified EU citizens before being opened up to non-EU workers, but a more qualified non-EU worker can beat an EU-worker just like in the US (more qualified IMG beats AMG). The reason we give J1 and H1B visa to residents is that medical residency is a high skilled and specialized job that cannot be filled by American citizens alone.
What alternate reality are you living in that you think ENT should have enough spots for most of its applicants? ENT is wildly competitive. People saying there are plenty of spots for AMGs and that AMGs are wildly unrealistic are talking about YOU dude, and people who think like you. You are WILDLY unrealistic with this thinking. If AMGs, even who were competitive, failed to match ENT and didn't apply to and have a thorough backup plan, those medical school applicants were idiots. I'm sorry, someone has to say it. They were stupid future doctors who were overly confident. Everyone should have a backup plan. And the backup plan should be in a specialty and path that you over OVERLY qualified for and should be able to fall into as a safety net. I guarantee you that if those 40% of unmatched ENT docs applied to general surgery, or prelim years, or *insert any medical specialty here*, they would match.
Exactly. 99.9% of ENT unmatched applicants can match into FM or IM their second cycle, and that is if they can't SOAP into IM, FM, or a prelim surgery spot. I mean...come on, the match rate for US MD Senior with a Step 1 of 194-200 (lowest passing to 8th percentile) is 92% and that is including people who failed Step 1 one or more times and/or failed a year of medical school which is very likely amongst that cohort who are barely passing. If you control for a Step 2 above 9th percentile among the cohort and ranking more than 2 spots, it goes up to 98% matched into FM.
My assertion is not that those unmatched applicants should get into ENT. My assertion is that we should have a better option for US Seniors who do not match than the SOAP.
Ah, ok that's not at all unreasonable. But you do need to keep 2 things in mind. First, the SOAP is still pretty new. I can't remember exactly when it started, but it wasn't a thing when I (2010) and my wife (2011) went through the Match. Rather than come up with a brand new system, I'd bet they could tweak SOAP itself.
I never said it was specific to medicine, so that’s a straw man. I said they have protections for their own citizens. Which they do.
We do. Apply more realistically. Or hell, even apply to multiple specialties and rank first ENT and then anything else less competitive.
It seemed pretty implied to me since you replied to someone who was talking about residency specifically and you said other countries don’t work like that. Even if we get rid of that strawman and simplify things: what first world country with an excess of residency spots compared to domestic graduates restricts their residency spots from IMGs? The spoiler is that a country like that doesn’t exist.
This. There is only one person in my class who I was actually shocked didn't match (true fell through the cracks of the system story) and they grabbed a good categorical spot in the SOAP. The other all were apply to over competitive specialties and/or had red flags. In fact, there were many many more people who I was shocked that actually matched (people with red flags, board failures, really awkward/abrasive personalities etc) than shocked they didn't match
This 1000%. There are a non-zero number of posts on SDN and Reddit of DO students with 220s Step 1 and 230s Step 2 asking what they can do to match ortho, derm, etc. Normally with little to no research and no home program. It’s totally their decision to shoot their shot at those specialities, but no equitable system can or should guarantee a spot to someone who is taking that gamble. That person deserves an IM residency over a more qualified IMG? because that is who will be “taking their spot” if they don’t match to a backup. Give me a break.
Gotcha. I thought you were arguing that we should match all AMGs before any IMG matches and/or have a max number of IMGs who can match and/or have a first match for AMGs and a second match for IMGs, which are all “solutions” I have seen in this thread/similar threads. And I was saying that no country with a surplus of residency spots does that.
I agree but I bolded that sentence because I have heard that for fields like ENT, if you dual apply it makes you look less committed to the field which then makes it more difficult to match into ENT
Will they though? CT surgery is a fellowship of GS unlike ENT, ortho, or urology which I could see GS being salty about. Maybe some uneducated PD that doesn’t know I6 CT has a match rate of like <50% but even that seems unlikely since basically every GS program has CT surgeons involved that will know about the I6 programs at least vaguely.
No I'm saying if you are applying to ENT as your top choice and you apply to lets say IM as a back up the ENT folks will question your dedication to the field and IM will think you are using them as a backup. Seems like a lose lose
