residency process

[idkoop]

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how does this work? what happens if a student lists every choice in a match for a competitive field, but doesn't get into any residency program for that field? does she just get placed in another program, but one that still maximizes the tradeoff between what she wants and what is available, or is she just sort of screwed and placed into one with the most slots available? what kind of filtering process goes on beforehand to make these match lists, i.e. i'm assuming a med school doesn't let students at the bottom of their class try to match for neurosurgery..

 

[Instatewaiter]

Then he or she has to scramble which occurs for around 24h after your find out if you matched or not. Then you are just trying to get into any program that still has open slots.

Before the match you have interviews. So if you dont get an interview then you probably wont get into that residency. Also your school will steer you in the right direction. If you have low numbers they will not allow you to try and match into a competitive specialty.

 

[Meatwad]

Then he or she has to scramble which occurs for around 24h after your find out if you matched or not. Then you are just trying to get into any program that still has open slots.

Before the match you have interviews. So if you dont get an interview then you probably wont get into that residency. Also your school will steer you in the right direction. If you have low numbers they will not allow you to try and match into a competitive specialty.

I always wondered about this kind of stuff as well. So, for example, if some kid was all set on applying to derm programs, but didn't have good scores/research/rank, etc. etc., and all he ranked was derm programs, what happens when they don't get in? I don't think anyone scrambles into derm (or other really competitive spots, derm just being a good example), so do they just try to get into something easier (like FP, IM, etc)?

Thanks.

 

[alwaysaangel]

My understanding is your medical school will steer you towards a realistic specialty. I mean, you get to pick, but if you sucked on your Step 1s and just barely passed your way through years 1 and 2 then your school won't even write you a recommendation to apply for derm or rad. Its just not going to happen. They steer you to something you like, but that is realistic.

So you're already self-selected to a realistic residency type.

Now you apply and interview to a specialty (I've kind of gotten the impression from the ERAS forum that its frowned upon to apply to more than specialty - especially at the same hospital since they would likely find out).

So now you apply and get interviews. When you're done interviewing you rank the programs you interviewed at in the order that you prefer them. And program directors rank you and all their other interviewees. Your list supercedes the programs list. This explains how that works (http://www.nrmp.org/fellow/algorithm.html)

So a week before the 15th (match day - when everyone finds out where they matched) everyone finds out IF they matched.

If you find out that you didn't match then you "scramble" and look around for programs that didn't fill all their slots. And you try to match into them at the last minute. Sometimes you scramble into a speciality than you originally intended.

 

[soeagerun2or]

I always wondered about this kind of stuff as well. So, for example, if some kid was all set on applying to derm programs, but didn't have good scores/research/rank, etc. etc., and all he ranked was derm programs, what happens when they don't get in? I don't think anyone scrambles into derm (or other really competitive spots, derm just being a good example), so do they just try to get into something easier (like FP, IM, etc)?

Thanks.

Once you have your step 1 score you'll know to which specialties you can apply.

In brief: there are 2 matches, to keep it simple we will only use the NRMP (doesn't include Derm, Ortho, Neuro, Plastics, Optho, or Uro).

If you really want to do General surgery but don't have > 200 on the boards you have a poor shot at matching and know it. Thus you a) apply to less selective residencies (internal medicine, pediatrics, family medicine) as a back-up or b) risk not matching.

If you don't match you go through the scramble wherein you get a list of programs with open spots and spend the day frantically calling program directors attempting to get a spot (this is not fun).

The rank list is setup such that you order the programs you would like to train at, the highest program you pick that also picks you is your match. You don't rank programs you don't want to go to and you don't get ranked at program you don't interview at. Once you're matched that's pretty much it.

 

[Meatwad]

Thanks for the answers. I've always wondered about what would happen if one really had their heart set on something uber-competitive but didn't match anywhere; then what? My question is pretty much answered now. Advisors build-in a mechanism to make sure this doesn't happen by discouraging applicants from reaching way too far.

I wonder, though, what happens if you believe you have a shot and so does your advisors/whoever tells you go for it/don't bother? A little bit of research, pretty decent scores, some honors, etc., but in the end you still didn't make it in. I guess that's a risk you take when you want something really competitive!

 

[excalibur]

The NRMP DOES include derm and ortho. Derm and Ortho hopefuls find out where they match in March just like most of the other hopefuls.

The main specialties not inluded in the NRMP are Neurosurgery, Ophtho, and urology. These guys find out in Jan and Feb.

As stated, if you are applying to a competitive specialty, most people will apply to a backup specialty simultaneously. You can rank all your backup specialty programs after say your derm programs on your rank list and submit that list to the match. This way the match algorithm will automatically attempt to match you in your backup if you don't match in your competitive specialty. This is better than just applying to the competitive and then going through the scramble if you don't match. If you just go to the scramble afterward, you're just dealing with the leftover spots across the nation. By submitting a list of your competitive programs followed by your backup specialty programs, you can compete with every match applicant for all the spots available in the programs you list in your backup specialty.

Also, some people opt to just apply to one specialty only, and if they don't get it, they will spend a year doing research and attempt again next year. Many applicants going into the surgical subspecialties exercise this option.

 

[deleted77919]

Basically all of this is correct, but since I went though the effort to trype this out in the allo forum (it got closed as I was trying to post) I feel the need to copy and paste it here . . .

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A lot of questions here, I'll bite and answer a few.

1) If a school does their job advising students properly they should manage a students expectations.

2) To apply for a residency you can send out a lot of applications, but programs must choose to interview you, you can only rank places where you interviewed on your rank order list. If you don't have any interviews by a certain point it might be time to apply to some prelim medicine spots.

3) Two days before the match everyone gets an e-mail saying "Congratulations you matched" (but doesn't tell you where) or "We're sorry you didn't match" If you did not match then the next day a list of programs with open spots is made available, this is called the scramble. You try very hard to get a spot in something you want (although most competitive fields will fill at nearly every program) or just try to settle for a prelim medicine or surgery. Hopefully you scrambled successfully and have a year in either medicine or surgery during which you can reapply, or apply to a specialty that you have a more realistic chance of matching in. Or take a year off and do research and reapply (again, if you didn't get many interviews the first time this will not help because nothing in your application has changed, this is a chance to broaden your horizons by applying to programs you didn't consider or applying to a specialty you didn't consider).

 

[Critical Mass]

The NRMP DOES include derm and ortho. Derm and Ortho hopefuls find out where they match in March just like most of the other hopefuls.

The main specialties not inluded in the NRMP are Neurosurgery, Ophtho, and urology. These guys find out in Jan and Feb.

Methinks Plastics is NRMP too, and Neurology just switched over (either this year or next). You can find the outcome stats in a booklet linked from my sig.

It's kind of like playing Survivor. There's more to it than ranking what you want. Ranking a program that wouldn't interview you, for instance, is either impossible or just plain stupid.

Just like applying to med school (though with some of the mdapps I see on pre-allo, I have to wonder), you can tell more or less what you'll be able to get before you apply.