Scramble?

[ayfucius]

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I just looked at the unmatched/scramble positions for the last three years for anesthesia. Some of the names that jumped out Hopkins and MGH (for advanced positions) with Iowa and Rush being on there frequently as well.

How hard is it to scramble into these advanced spots if I match at a prelim medicine year? Because if I match into categorical medicine instead I won't have the options of trying to scramble.

I know that MGH and Hopkins have a great reputation but for the most part is there something malignant about the other programs on the list?

 

[chocomorsel]

So are you trying to match into medicine? Are you hoping not to match into it, then have the chance to scramble into anesthesia? Well in any case, from what I've read and heard, you do not want to scramble, period. It's apparently a pain in the ass, and the people who successfully scramble from what our dean says, are a not that large a percentage. You should make up your mind though what it is you want. If you want anesthesia, then don't rank the categoricals assuming you have enough prelims. You can try next year for an outside the match CA1 position.

 

[Gern Blansten]

The list of positions available through the scramble can sometimes be misleading. From what I have heard, many of those spots are spoken for immediately and never truly "available" through the scramble because of local candidates that the program knows(medicine or surgery converts etc).
Even though there may be 50 or so spots "available," the ones that are really available are much fewer. Scrambling is not a good place to be, for either side.

 

[Canrenone]

I just looked at the unmatched/scramble positions for the last three years for anesthesia. Some of the names that jumped out Hopkins and MGH (for advanced positions) with Iowa and Rush being on there frequently as well.

How hard is it to scramble into these advanced spots if I match at a prelim medicine year? Because if I match into categorical medicine instead I won't have the options of trying to scramble.

I know that MGH and Hopkins have a great reputation but for the most part is there something malignant about the other programs on the list?

could you link me to where you got that info please?

 

[ayfucius]

could you link me to where you got that info please?

I got a copy from my dean's office. I don't know if there is an online source.

To answer the other posts. I want to do anesthesia, but it's basically too late for this match. I have been advised by some people to do categorical medicine and quit if I get an anesthesia spot as CA1. Others have told me to just do prelim year and apply for CA1. I was just wondering if I go the prelim route, I might be able to scramble into advanced anesthesia spots and I didn't know how tough that would be. Because if I match into categorical medicine, scrambling won't be an option at all.

 

[jennyboo]

I just looked at the unmatched/scramble positions for the last three years for anesthesia. Some of the names that jumped out Hopkins and MGH (for advanced positions) with Iowa and Rush being on there frequently as well.

How hard is it to scramble into these advanced spots if I match at a prelim medicine year? Because if I match into categorical medicine instead I won't have the options of trying to scramble.

I know that MGH and Hopkins have a great reputation but for the most part is there something malignant about the other programs on the list?

You can very easily land a CA1 position doing either of these routes.

It is much easier to get a CA1 position at an elite program (like MGH or Hopkins) by going through the match than by scrambling or applying outside the match. So if that's what your aim is, then you probably should take a year off, do research or other related CV-expanding work, and apply new for the match (interviewing for both prelim and residency). I agree that there are fewer positions in the scramble than are listed in the "unfilled programs" list. I work in a program that did not fill a couple of spots one year and absolutely none of the spots were offered in the scramble -- the spots were quietly offered to candidates who applied outside the match with research backgrounds or who'd completed another residency elsewhere.

However, if your priority is to not lose a year and to get a residency no matter what, then you can definitely match a prelim and try to scramble a CA1 year, or if unsuccessful in the scramble apply for outside-the-match spots as an intern. You should definitely get something one way or the other and there are a lot of outside-the-match spots available even if a good position doesn't come up in the scramble. However, your chances of a "top 10" or "top 20" residency are much smaller. You can definitely get an average spot which will prepare you just fine for clinical practice, but your shot at elite programs is much smaller because their spots are already filled.

The program's reputation will make very little difference to your quality of life, so if your priority is to move on and make your living, then I wouldn't go to enormous effort to take a year off. Scramble (lower chance of successful match but still a good option) or apply outside the match as an intern (back-up to unsuccessful scramble which will almost definitely land you a job). Either way works.

 

[WhoopDeeDoo]

I have seen that book in my dean's office -- the one that talks about the open spots in a field. If I remember correctly, there aren't a WHOLE LOT in anesthesia. When I told my Dean I was looking mostly on the West Coast she told me there were very few scramble spot available and told me to cast my net wider.

Anyway, I can see pros and cons to doing either of your options, here are my two cents worth:

1. If you only do a preliminary position, don't the programs that you interviewed at have to rank you for their preliminary list and thus you should contact them ASAP and let them know? Also, some programs have completely different interviews and program directors for the prelim medicine year, e.g. UC-Irvine.

2. If you do a prelim year, then the program knows that they will have you for only one year. If you know at this point that you do not want to be a categorical resident in IM...it's not very nice to take that spot from who actually want to be categorical. Then you will leave after a year and leave a spot unfilled for the program.

3. People switch into Anesthesia from different fields all the time. In my 9 anesthesia interviews this fall/winter, I met at least 6 or 7 people who were switching. They were looking for a CA-1 spot to start in 2009. I guess they were planning on taking time off in between. The advantage to actually going to the interviews (especially if you are a competitive candidate) is that you will have YOUR choice of the program you want to go to...instead of whatever is left over. However, if you go through the match again, you will be losing a year.

4. Looking outside the match for a CA-1 position starting in summer of 2009 during your intern year. I know that there are tons of programs across the country that leave some spots out of the match to make room for residents to switch into anesthesia (when they see the light). I was told at UCSF that even though they have 25 spots per year, they tend to leave 3 or 4 of them open for "out of the match." If you were able to get a spot out of the match, you could not have to take time off. However, it will be hard work to go through this all again during your intern year. You will have to leave vacation time to go to interviews.

5. Scrambling -- how easy is it to scramble into a field that you didn't have an intention of going into in the first place? I think it's fairly easy with things like Family Practice and Internal Medicine because there are so many open spots to scramble into. However, with anesthesia, it doesn't seem like there are that many spots and you make me competing with U.S. Senior who didn't match into Anesthesia and already have anesthesia personal statements, LORs, and connections to make calls for them.


...just my opinion. If I were you, I would probably just match into an intern year with internal medicine (but probably rank categorical too...so that you're not scrambling for something for even the first year!) Then I guess it would be worth a shot to try to scramble into an anesthesia program. I would have an anesthesia personal statement and a LOR handy for March 20th. If that didn't work, I would start sending emails to programs in the Fall of 2008 inquiring about open positions and try to interview during my intern year to procure a CA-1 position for 2009.

Good luck!

I got a copy from my dean's office. I don't know if there is an online source.

To answer the other posts. I want to do anesthesia, but it's basically too late for this match. I have been advised by some people to do categorical medicine and quit if I get an anesthesia spot as CA1. Others have told me to just do prelim year and apply for CA1. I was just wondering if I go the prelim route, I might be able to scramble into advanced anesthesia spots and I didn't know how tough that would be. Because if I match into categorical medicine, scrambling won't be an option at all.

 

[jennyboo]

Keep in mind that outside-the-match spots happen for one of two reasons:

1) One of their current residents quit. In which case, they're often willing to fill these spots with anyone.

2) The program always has outside-the-match spots in order to attract special candidates.

Who the permanent outside-match spots are offered to vary by the program. Keep in mind that strong academic programs like UCSF tend to offer these spots to particularly remarkable candidates, often previously trained (i.e. foreign) physicians with research backgrounds or physicians who are already boarded in another specialty (i.e. possibly smart). This means it can be hard for new grads to get these spots, since new US grads aren't particularly special and, sadly, rarely go on to an academic career. On the other hand, average clinical programs with permanent "outside-match" spots may have easily attainable spots, and they may be very happy to catch an average US grad with good references from their current job who wishes to switch specialties.

 

[Benzwiz]

You do not want to go through the scramble. Many programs in anesthesiology rather run their own mini-match in the scramble and/or hire ppl outside the match, both situations in which they have direct control over who enters their program, instead of "the computah". Many programs only rank a portion of the ppl they interview and rather have open positions and have direct authority over who they hire than leave it up to chance.
The scramble is a true mini-match, at least for anesthesia and other competitive specialties. Nobody gets offered a spot right away, rather the programs want you to send them your ERAS application, thru ERAS, and they will call you for an interview (these are often on the phone). The only ppl I now who have gotten a spot on scramble day are ppl that decided to go for family medicine - these programs are just happy to be getting ppl to cover their services.
My chairman recently told me that he had recently read some stats to the tune of about 1/3 to 1/2 of all anesthesia positions are filled/offered outside the match, making the match numbers useless to determine how competitive the field is.
Anesthesia programs love to scoop up ppl that were trying to get into ortho/ophto/surg/derm.. (insert competitive specialty here) who for some reason ro another (read, "the computah"/suicide matching/not being realistic of the # of places to rank) did not get in or from ppl who only saw the light later in their career due to lack of exposure to the field (such as moi)..

Your best bet if you don't get in the first time is to go through the scramble, and if that doesn't do anything for you, to sit down and get in touch with as many programs as you can during your transitional year to see which will be offering positions outside the match, as these are not typically advertised and often filled from within due to lack of candidates.

cheers.