#s Discrepancy and Signing outside the match

[Amygdali-lama]

Hi. I was working on my ROL when I noticed something interesting. The quota provided on NRMP for this year's match is different (and always lesser) than what is provided on the ACGME website.

For example, there is a program that I am looking at which according to ACGME has 40 categorical spots for this coming year. When I looked at NRMP's quota for this year, they have listed it as having 35 categorical spots. So, just out of curiosity, I looked at how they matched last year (scutwork's pdf files) and it had listed 27/27 for categorical. I am very confused!!

What do you think this means? What are these variations from? Do you guys think that the lesser numbers offered for this year's quota is due to people who have already signed outside the match at these institutions, thereby reducing the numbers available for those who have not signed outside the match, like myself? If that is the case, then we already would know how many people a program has already signed. And if this is the case, then where is the discrepancy from LAST year's match stats coming from?

Confused!!!

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[Sivastraba]

Hi. I was working on my ROL when I noticed something interesting. The quota provided on NRMP for this year's match is different (and always lesser) than what is provided on the ACGME website.

For example, there is a program that I am looking at which according to ACGME has 40 categorical spots for this coming year. When I looked at NRMP's quota for this year, they have listed it as having 35 categorical spots. So, just out of curiosity, I looked at how they matched last year (scutwork's pdf files) and it had listed 27/27 for categorical. I am very confused!!

What do you think this means? What are these variations from? Do you guys think that the lesser numbers offered for this year's quota is due to people who have already signed outside the match at these institutions, thereby reducing the numbers available for those who have not signed outside the match, like myself? If that is the case, then we already would know how many people a program has already signed. And if this is the case, then where is the discrepancy from LAST year's match stats coming from?

Confused!!!

I also noticed the same problem when it came to matching my preliminary programs. The NRMP showed only 4 spots, but when I interviewed they told me they had around 10 spots through the match. I have no clue what this all means. I am guessing you shouldn't take the numbers stated in the NRMP website as the official..

 

[Solideliquid]

I also noticed the same problem when it came to matching my preliminary programs. The NRMP showed only 4 spots, but when I interviewed they told me they had around 10 spots through the match. I have no clue what this all means. I am guessing you shouldn't take the numbers stated in the NRMP website as the official..

Is it because a program may have given away a few spots outside the match (pre-match)?

 

[Amygdali-lama]

We need BKN!! Quick...someone signal the KN-KAM!

But seriously, I am very confused, so a little help from the PDs is requested!

 

[IM2006]

Hi. I was working on my ROL when I noticed something interesting. The quota provided on NRMP for this year's match is different (and always lesser) than what is provided on the ACGME website.

For example, there is a program that I am looking at which according to ACGME has 40 categorical spots for this coming year. When I looked at NRMP's quota for this year, they have listed it as having 35 categorical spots. So, just out of curiosity, I looked at how they matched last year (scutwork's pdf files) and it had listed 27/27 for categorical. I am very confused!!

What do you think this means? What are these variations from? Do you guys think that the lesser numbers offered for this year's quota is due to people who have already signed outside the match at these institutions, thereby reducing the numbers available for those who have not signed outside the match, like myself? If that is the case, then we already would know how many people a program has already signed. And if this is the case, then where is the discrepancy from LAST year's match stats coming from?

Confused!!!

I noticed the same thing, so I decided to call one of the places where I interviewed and asked them why the dicrepency. I talked to the program coordinator and she said that they indeed offered the spots outside the match ie. prematch. She also said that some programs take some spots out for the osteopathic match and if they dont match them in the osteopathic match, then they tag them onto they final list when the scramble comes out. Thats how I understand it anyway.

 

[penguins]

Interesting...
So I see the number on NRMP, when you are looking for a program but I am not seeing a number through ACGME. Somebody wanna give me a link or directions....? Please.
Interesting, I am curious to check up on some program and their claims of no-prematch vs prematch....

 

[penguins]

Interesting...
So I see the number on NRMP, when you are looking for a program but I am not seeing a number through ACGME. Somebody wanna give me a link or directions....? Please.
Interesting, I am curious to check up on some program and their claims of no-prematch vs prematch....

Okay, found it: http://www.acgme.org/adspublic/
So the program I was wondering about did tell the truth (maybe). Interesting that one program I interviewed at for prelim had 2 prelim spots and 6 cat spots. Now, on NRMP, there are only 2 cat spots and 1 prelim spot.
I didn't even notice the discrepency when I did my ROL. That seems so unfair. I know, I know it is the system... but wow!

 

[BKN]

We need BKN!! Quick...someone signal the KN-KAM!

But seriously, I am very confused, so a little help from the PDs is requested!

I think:

1. The RRC for the specialty sets a maximum or range for the number of residents that the program can train.

2. The institution funds a number of positions, which might be smaller than the maximum.

3. The program may prematch with DOs, DO students, USMGs and IMGs but not with allopathic MS4s.

4. The program may modify the number of slots to be offered through the match until a date certain. I think it was 1/31 this year.

 

[Amygdali-lama]

I think:

1. The RRC for the specialty sets a maximum or range for the number of residents that the program can train.

2. The institution funds a number of positions, which might be smaller than the maximum.

3. The program may prematch with DOs, DO students, USMGs and IMGs but not with allopathic MS4s.

4. The program may modify the number of slots to be offered through the match until a date certain. I think it was 1/31 this year.

Don't know about that. Still seems fishy to me. The program kept swearing up and down that they do not prematch and even made fun of prematching by calling it "archaic and something that community programs do....not us!"

Something just doesn't seem right. Hmmm....wonder what it can be...Oh yeah I forgot....could it be that same theme: NEVER TRUST THE WORDS THAT COME OUT OF A PD's MOUTH!!

What I still find confusing is the variations they have with respect to LAST year's filled positions: I believe it was approximately 30 out of 30. And this year its 35 as the quota while BOTH years is supposed to have 45 or so.

Does a program THAT IS NOT IN TROUBLE and doesn't have problems filling and such still have sch tremendous variations....

 

[usnavdoc]

Don't know about that. Still seems fishy to me. The program kept swearing up and down that they do not prematch and even made fun of prematching by calling it "archaic and something that community programs do....not us!"

Something just doesn't seem right. Hmmm....wonder what it can be...Oh yeah I forgot....could it be that same theme: NEVER TRUST THE WORDS THAT COME OUT OF A PD's MOUTH!!

What I still find confusing is the variations they have with respect to LAST year's filled positions: I believe it was approximately 30 out of 30. And this year its 35 as the quota while BOTH years is supposed to have 45 or so.

Does a program THAT IS NOT IN TROUBLE and doesn't have problems filling and such still have sch tremendous variations....

Its not really a pre-match. I cant speak to the program you are talking about. Those do seem like high numbers. But typically programs will hold out spots from the match to interview MDs changing from other fields, coming out of the military, coming from a research background, and the ones mentioned earlier(DOs and IMGs). Those individuals dont have to go by the rulse of the match. Which I find strange for DOs that are graduating and made the decision to go to an allopathic program. I think they should have to abide by the same rules as graduating MDs. But realistically I dont know if they are really benefitted by this.

I matched this way due to the military background. The program I am going to held two spots for outside matching. I dont know how many applicants they had for the two spots but I was chosen and a guy who had finished two years of gen surg then did a year of research in that field at that program were taken. The remainder were graduating MDs that matched through the normal pathway.

A school holding out 10 spots seems excessive enough to wonder. Do they have alot of IMGs in the class? I know some IM programs that have high numbers like that will take IMgs to round out the class. Those are programs that in the past had consistant year to year trouble filling.

 

[BKN]

: NEVER TRUST THE WORDS THAT COME OUT OF A PD's MOUTH!!

....

Perhaps they don't have funding for 45 positions even though they are approved for that many. That is a huge program.

Suggestion, do not stress. A program with 45 approved positions is unlikely to be in trouble. Rank them as you want them.

p.s. Is that quote the right thing to say to a PD as you're asking him for info? I'm not offended. I just think you're a little over the top, even for an anonymous forum. I say this because: "The program kept swearing up and down that they do not prematch and even made fun of prematching by calling it "archaic and something that community programs do....not us!" " sounds like you may have put them on the grill enough that they may not be all that enthused about spending 3+ years with you.

 

[DistantMets]

A couple of my friends have been offered spot outside the match as DO MS4s and it only really benefits them if the program is actually their top choice. Otherwise, it puts pressure on them to make a decision and when they turned them down, they wondered if it affected how they were going to be ranked. It tipped the program off as to where they stood with the applicant. It also made them wonder just how desparate the program was.

Its not really a pre-match. I cant speak to the program you are talking about. Those do seem like high numbers. But typically programs will hold out spots from the match to interview MDs changing from other fields, coming out of the military, coming from a research background, and the ones mentioned earlier(DOs and IMGs). Those individuals dont have to go by the rulse of the match. Which I find strange for DOs that are graduating and made the decision to go to an allopathic program. I think they should have to abide by the same rules as graduating MDs. But realistically I dont know if they are really benefitted by this.

I matched this way due to the military background. The program I am going to held two spots for outside matching. I dont know how many applicants they had for the two spots but I was chosen and a guy who had finished two years of gen surg then did a year of research in that field at that program were taken. The remainder were graduating MDs that matched through the normal pathway.

A school holding out 10 spots seems excessive enough to wonder. Do they have alot of IMGs in the class? I know some IM programs that have high numbers like that will take IMgs to round out the class. Those are programs that in the past had consistant year to year trouble filling.

 

[usnavdoc]

A couple of my friends have been offered spot outside the match as DO MS4s and it only really benefits them if the program is actually their top choice. Otherwise, it puts pressure on them to make a decision and when they turned them down, they wondered if it affected how they were going to be ranked. It tipped the program off as to where they stood with the applicant. It also made them wonder just how desparate the program was.

I can see what you are saying. I think that if a DO goes through the allopathic match as allopathic students do then they should adhear to the same rules.. Better for them and the programs.

But as for programs being desparate. Im sure some are that offer outside match spots. Others arent at all. Its just a way they use to create diversity and attract people that have a somewhat different background.

You just need to look at a programs history(didactics and clinical, stability, and financial), reputation, and current residents.

 

[APACHE3]

To OP. The difference in the numbers is generally due to prematches offered to IMG's or DO's. I'm an IMG, living in Europe, who will move to the states with my family. I accepted a prematch at a nice community, University affiliated, VA-affiliated program. I could have waited until March to do "The Match", but for me, I needed this extra time for moving, etc. For me it was an easy decision. I'm not into bench research and dont want to attend noon conferences to listen about knockout mice. I want to be good clinician. Anyway, its funny how the USMG look down on prematches, but it is they, who are the cause in the first place!! USMG's will not go to small communities, nor will they take a chance at a place with few fellowship spots. SO dont blame the community hosp. for doing what they have to do. USMG's created the problem and it wont be corrected anytime soon. oh well, start flaming...

 

[mmmmdonuts]

I just think you're a little over the top, even for an anonymous forum. I say this because: "The program kept swearing up and down that they do not prematch and even made fun of prematching by calling it "archaic and something that community programs do....not us!" " sounds like you may have put them on the grill enough that they may not be all that enthused about spending 3+ years with you.

see this is the problem with pds -- they think theyre kings sitting on their little thrones and ruling over the land. if the pd has a question about anything at all about any applicant then its fair game and good for them to do whatever it takes to ferret out that information and if you aren't completely open then thats grounds for elimination and its on you because youre a liar. but if you demand information in return then it can and probably will be incomplete or just an outright lie if the truth will paint the program in a bad light and thats good and fair, too. who are you to "put us on the grill"? youre nothing. youre just someone who is on their hands and knees begging to work for me, peon. get back in your place. i just decided i don't want to work with you (haha, more like you work for me) because you questioned me. see how now the situation is back to 'you did something bad and i have to punish you for it'? yeah. good pd, right? good boy.

 

[trkd]

see this is the problem with pds -- they think theyre kings sitting on their little thrones and ruling over the land. if the pd has a question about anything at all about any applicant then its fair game and good for them to do whatever it takes to ferret out that information and if you aren't completely open then thats grounds for elimination and its on you because youre a liar. but if you demand information in return then it can and probably will be incomplete or just an outright lie if the truth will paint the program in a bad light and thats good and fair, too. who are you to "put us on the grill"? youre nothing. youre just someone who is on their hands and knees begging to work for me, peon. get back in your place. i just decided i don't want to work with you (haha, more like you work for me) because you questioned me. see how now the situation is back to 'you did something bad and i have to punish you for it'? yeah. good pd, right? good boy.

Wow, that sounds pretty angry! In all honesty, applicants can lie just as much as PDs (and as residents at a program, and as the next guy on the street). Such is life. I don't know if this needs to be such a fired up issue. PDs lying will more likely get revealed in the end by a programs residents and get a bad rep. This is their punishment. I think this matching issue is all taken a bit personally. This is not some battle between the PDs and us (especially not the ones who are on this forum helping answer questions).

I think some folks just need to relaxxxx.

 

[mmmmdonuts]

youre free to think what you wish.

 

[medlaw06]

Perhaps they don't have funding for 45 positions even though they are approved for that many. That is a huge program.

Suggestion, do not stress. A program with 45 approved positions is unlikely to be in trouble. Rank them as you want them.

p.s. Is that quote the right thing to say to a PD as you're asking him for info? I'm not offended. I just think you're a little over the top, even for an anonymous forum. I say this because: "The program kept swearing up and down that they do not prematch and even made fun of prematching by calling it "archaic and something that community programs do....not us!" " sounds like you may have put them on the grill enough that they may not be all that enthused about spending 3+ years with you.

Hey BKN...actually, I have noticed the same thing too while I was doing the ROL.

For example, Jacobi's (NYC) program quota for their IM categorical is 10 even though when I was looking over their handouts, they had like 25 residents listed. And as per the OP's suggestion, I looked over the scutwork past match list as well. While they have 10 this year, they had 15 last year, 17 the year before that, and 22 the year before that!!

So, would it be resonable to assume that over the last 3 or so years, they have been offerring more and more pre-matches since the numbers available for their "quota" seems to keep dwindling....and if that IS the case, then could that be an indirect way of deducing that the program is going down the crapper over the last few years....

I have NO IDEA what to make of this!!!

Any other ideas/suggestions!!

BTW...to the OP, you didn't REALLY make the statement about the "archaic" crap, did you?

 

[APACHE3]

many program will list their COMBINED prelim/categorical numbers. So thats why you see strange numbers in the PGY-2 year. At least I think...

 

[BKN]

:

So, would it be resonable to assume that over the last 3 or so years, they have been offerring more and more pre-matches since the numbers available for their "quota" seems to keep dwindling....[\QUOTE]

Perhaps.

and if that IS the case, then could that be an indirect way of deducing that the program is going down the crapper over the last few years....

[\QUOTE]

The problem with making that jump is an implicit assumption that traditional candidates are more desirable than nontraditional. In fact, I prefer a 30 year old who has had time to figure out what they want to do with life, had experiences outside of the academic arena, and hopefully had at least one job where "customer service" is essential. It doesn't have to be other medical experiences, a trained engineer, social worker, business person, exmilitary etc. often is more mature and less self-centered as well.

Having said that, let's talk about IM since it's the example. Years ago, the guy who was IM PD at our instituition explained his penchant for non-trads this way: "Any third quartile American Grad can get into Southwestern or the like, why would he come here?" I'm not sure he wasn't exaggerating a little, but he would know better than I. If that's so, why wouldn't a program go for the best people that they can get, particularly when they are often better than the "average" traditional?

p.s. I trained in the show (baylor student, hopkins resident). There's lots of good things there. But many of the students and h.o.s were self-centered, self-pitying and not aware that their job was to help the patients.

p.p.s. I was a very traditional and arrogant student. I succeeded almost continually in the class room. I was stunned to read my evals from clinicals just before I graduated and to learn that the clinical faculty weren't all that impressed. The best thing that ever happened to me is being pyramided out after my surgical internship. I would have been a terrible surgeon and I got to see a glimpse of my future if I didn't staighten up. I got to be a flight surgeon at a smal air base in the desert taking care of the healthiest population in the world. Yuck.

The rest is silence.

 

[BKN]

see this is the problem with pds -- they think theyre kings sitting on their little thrones and ruling over the land. if the pd has a question about anything at all about any applicant then its fair game and good for them to do whatever it takes to ferret out that information and if you aren't completely open then thats grounds for elimination and its on you because youre a liar. but if you demand information in return then it can and probably will be incomplete or just an outright lie if the truth will paint the program in a bad light and thats good and fair, too. who are you to "put us on the grill"? youre nothing. youre just someone who is on their hands and knees begging to work for me, peon. get back in your place. i just decided i don't want to work with you (haha, more like you work for me) because you questioned me. see how now the situation is back to 'you did something bad and i have to punish you for it'? yeah. good pd, right? good boy.

Back in my student days, I read an article in a throwaway about the patient's viewpoint of the therapist while undergoing psychotherapy. The author compared it to Dorothy's view of the wizard. First he was a scary powerful wizard, then he was a fraud, finally he was seen as simply a helpful normal human (albeit a bit of a showman).

When I was an intern, I saw my PD as a scary, powerful and arbitrary person. Actually, now that I think about it, I still think he was. I resented being told to grow up, but he wasn't wrong about my weaknesses, my unsuitability for surgery nor for my need to change. Nor was he wrong to be irritated with me when I made his complicated life more so.

The Buddhists have a saying about the road to enlightenment: When the student is ready, the teacher will appear. I didn't find that to be true in EM in the 70's, mostly because there was noone trained to be the faculty. Around our place we say "Good judgement is generally the result of bad judgement, hopefully somebody else's". Read that as if you won't listen to other's bad experiences, you're condemned to repeat them.

My comments to Amygdali-lama had nothing to do with the truth or lack of it in the program's comments. I was trying to help him think it through. I was saying that if you give a program the impression that you are anxious, aggressive and/or argumentative, they are going to have the viewpoint that you are going to be PITA to work with. And make no mistake, the relations between you and your faculty in residency are going to be far closer and far longer than any you ever had in college or med school. Mostly, I think the residents and the faculty come away from the experience with deep affection and mutual admiration. There are exceptions.

Despite your comments, it works both ways. The employment decision is mutual. If you have the impression that a program's faculty and particularly the PD are dishonest, arrogant or unpleasant, you owe it to yourself to rank them low or not at all.

It's the end of the season, you'all have done endless trips, spent lots of money and ate a lot of not great food. I've reviewed hundreds of apps, done 80+ interviews with another 6 to go. Then I've got a lot of math to do, followed by negotiations with the faculty. We're all exhausted and we need to not flame.

P.S. I know a lot of PDs. I don't see us as you apparently do, although I once did. I see us as normal people trying to be helpful, but I'm at the other end of Dorothy's journey.

 

[mmmmdonuts]

actually, never mind its not worth it