I'm way behind on this thread, so excuse the quotes from the last page.
So are applicants inherently pretty screwed? I've heard of multiple cases where students have been actively recruited by program directors/chairmen to rank their programs very highly, and even to send them "love letters" on one hand, while not being offered positions on the other.
At the same time, students can only send love letters to one school because apparently program directors talk, and know where you're applying because they ask you even though they're not supposed to. For the students we pretty much just have to rank the programs how we see fit and pray?
As has already been mentioned, students are not really "screwed". In fact, the whole point of the match is to help students. I think you're overweighting the impact of a "love letter" in most cases.
Why are pds allowed to talk to each other about candidates and ranking?
This is often mentioned on SDN, and the truth is that in most fields, there's no discussion at all. Perhaps in very small / very competitive fields, it's a thing. But in IM, FP, EM, etc -- there's just too many programs. And I doubt we'd trust each other, anyway. So this is mostly not an issue, despite the talk here.
Actually you'd be surprised at how variable the match range can be!
Most people seem to have an unrealistic sense of how far down the list programs go. The average for IM is 8/match. To fill a program of 10 interns, the average IM program will go down 80 ranks.
I think being a PD is somewhat of a thankless job. Of all the attendings I know personally who have become chairmen recently, not one of them was a PD first. It doesn't seem to be a sure-fire route to bigger and better things. It probably does come with a modest salary bump to compensate for the additional workload, but I would wager it's peanuts compared to what any academic attending could pull in private practice and probably not even near enough to compensate for all the BS they have to deal with. Whenever I read about a problem resident, my heart goes out to the poor PD whose work life is being consumed by some a--hole who can't be a normal human being and play well in the sandbox with other kids. No, I think most of those people do it because they honestly care about educating residents and enjoy that aspect of academic medicine.
It's the best job in the world!
However, can we address the elephant in this forum: the discriminatory selection (race, sex, religion, geography) of candidates accepted into any program.
Just because it commonly happens doesn't mean it's not illegal. It's possible people turned a blind eye to bias. There's just not enough people to protest a common trend.
On paper it sounds great, but on closer inspection of resident lists, it's clear discrimination is going on some level or another.
As for the OP (sorry this thread got so derailed) -- I would beware reading too much in to the makeup of the class as indicative of anything other than the people who ranked it highly. It's actually a problem that's been discussed in the academic medical literature, especially around programs that inadvertently end up skewing all male or all female; it becomes incredibly difficult to get the opposite sex applicants to rank the program high enough. I've heard faculty at other programs saying pre-match they thought they would get their first all-female/male resident class based on how the rank list ended up, only to match the exact opposite. People tend to go where they feel they fit in, so if the program already has a fairly homogenous makeup, it's not unreasonable that similar people will continue to match there of their own accord.
This. I can tell you that my rank list distribution of age, race, sex, etc looks just like the distribution of my applications. But I've had years where the sex ratio of my interns is very imbalanced. We always try to "debug" it and see if we could have done something different, but oftentimes it's luck. Also, certain types of applicants may be attracted to certain types of programs (or certain geographic locations).
Can programs discriminate illegally using the match? Sure, it's possible. It could be done because the people making the rank list are truly biased against some class of people. It could be because they think that those people "just won't fit in around here". For a program that takes a lot of IMG's, it could be because the program leadership wants to support one specific country / nationality -- or it could be that they just have good experiences with some schools (and bad experiences with others). But it's impossible to be certain just looking at final match lists, as any skewed distribution might be driven by applicant ranking preferences.
On the topic of programs preferring applicants with local links, part of that is that we might want to encourage graduates to settle locally, and that's more likely if the applicant has a history of living locally. It's not illegal to do this -- it's not illegal discrimination.
