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MacGyver

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If the plaintiffs were simply seeking an injunction and not monetary damages, I might support their cause.

Instead, they want to collect "damages" for lost wages as a result of the NRMP system.

This is a total joke:

http://www.residentcase.com/01_about/

So these guys want hundreds of millions in damages as part of a class action status. Of course, they dont mention that the lawyers would take a 40% cut of the proceeds.

Another "gem" of this lawsuit is they are playing the race card, claiming that the NRMP is a racist system that discriminates against minorities. I guess if you dont have the facts on your side, you can always make up BS racial claims to give your suit more "merit."

These 3 doctors and their shark lawyers should be ashamed of themselves. They might have some credibility if this wasnt just a blatant money grab and they were pushing for injunctive relief with no monetary damages. As it stands though, they give all of us a bad name.
 

southerndoc

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The crap the AAMC feeds us about what things would function like without the NRMP is BS.

How does the med school admission process work? Individuals apply through a centralized application service (AMCAS), interview, and get their acceptances individually. By a certain date, they have to decide which acceptance they wish to hold and which to relinquish.

The resident application process could work in a similar way. Instead of a computer matching you, you could apply through a centralized application service (ERAS), interview, and get your acceptances individually.

I really have mixed feelings about the match. I think it's better than applying to each program individually, but I'm not so sure it's better than what it would be if resident application was similar to med school applications.

Luckily the match worked for me. I'm going where I wanted to go. For some though, it didn't work in their favor.
 

ortho2003

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greek, how would your system work any more in the applicants favor. If a program only has four spots it will only offer four acceptances and then "waitlist" their next group. If someone denies the spot, then the top candidate from the waitlist will be offered a spot. This will continue until every spot is full. Candidates are still going to end up at the highest place on there list that wants them.

The only thing your system will do is drag the process out and hurt applicants. Programs, in order to prevent the process from dragging out into June will have to put strict deadlines on their offers, which would lead to applicants having to accept or turn down an offer before they have had the opportunity to interview at all their programs. The current set-up allows applicants to interview at every program they are offered interviews and then rank them according to desirability. If the system you propose is implemented, programs would have all the power. They would be able to offer a handful or interviews and offer spots to only the elite canidates, rather than interviewing everyone they think are qualified and ranking all of them. They would then offer the elite group spots and make them decide over the course of a few weeks. Then they would hand out the second batch of interviews and offers and continue down the line until they have their class full. The average candidate would end up waiting for the scraps for interviews. I think the match is by far the the most fair way for the applicants.
 
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prwunecom

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with the previous poster.....I think that geek's system would work better in some ways. I matched at my #5 choice, but I have been told by the program that I ranked #4 that I was ranked higher by them than two candidates who matched there. This would seem to me to be proof that the current match system is flawed.
 

southerndoc

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I don't see a problem in potential residents being waitlisted. Should we change the medical school admission process to one of a match system? People are waitlisted for medical school admission, and there is a deadline for acceptance into a program through AMCAS.

So you could have people apply early August, bump the interviews up a month, start offering acceptances on a rolling acceptance basis, and set a deadline of something like March 1st for everyone to only hold one acceptance.

Yes, the match does make it easier, but it also eliminates competition. Without a match system, I think resident salaries might be higher than what they are today, programs would offer better benefits, etc.

Having said that, I must reiterate that I am *very* happy with my match results. However, I still have mixed feelings about the NRMP match program.
 

neilc

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Originally posted by Geek Medic
Yes, the match does make it easier, but it also eliminates competition.
how does it eliminate competition?
 

neilc

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Originally posted by Geek Medic
It eliminates competition by programs to attract applicants... not eliminating competition by applicants. Sorry, I wasn't clear on that.
i don't really see how it does that....programs are free to offer better salary, benefits, etc...to attract applicants, and this is certainly something that is considered when making a rank list.

what exactly is anti-competitive about the match? i just have never really been convinced that this exists at all, i have yet to hear a good argument as to why the match is bad for applicants.
 

southerndoc

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Originally posted by neilc
what exactly is anti-competitive about the match? i just have never really been convinced that this exists at all, i have yet to hear a good argument as to why the match is bad for applicants.
How does residency selection occur in Prague? Do you guys have a similar match system? Out of curiosity, does any other nation have a similar match system?
 

beriberi

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Remember with the match there is a not insignificant number of people who locate a position through the scramble. It is a ridiculous system which makes professionals secure their training through last-minute deal brokering, with pressure to sign in minutes and no option of seeing the program/city. (And, at my excellent school, there were a number of students scrambling--myself included--all of us in the middle third or higher.)

Outside of the issues posed by the scramble, I am opposed to the match because it is a process with no (honest) feedback given to the applicant. People constantly complain about being lied to and flaws in the algorithm. I would prefer a process that says "we like you and look forward to working with you AND are prepared to offer you a position." As a previous poster mentioned, it would be easy to institute a set of standards (similar to the med school application process) where students would be allowed to hold multiple acceptances until a certain date and then be required to only hold one offer.

This would be better and different than the match. Students who recieved offers early from a program they most want to attend could stop the process and not feel pressured to fly to 9 more interview "just in case." Schools who are certain they want to keep students (as we all know certain programs at our schools always plan on doing) could do that immeadiately, saving them the time and expense of interviewing 10 people for every one position.

Also, once students were holding multiple offers (much like college/medical school acceptances) they would be free to negotiate from a position of power. "School X has offered me 40K plus dental, I would prefer to be a part of your program School Y, but I will need dental benefits as part of the package." This is how other professionals find jobs and it is not unrealistic to expect this at our level of training.

We all spend a lot of time and money on this idealized match process that leaves some students unmatched, some students in programs they have never seen, many students satisfied and most probably in a worse position had they been able to negotiate a job contract on the open market.
 

mpp

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I still don't understand how it would be any different without the match. There would still be those less-qualified applicants that would have to scramble into empty spots at the last minute if they were not offered any positions after interviews (equivalent to not being high enough on any prorams' rank lists such as beri beri above). Guess who would be holding onto all the offers at the top programs, especially in a small competitive field such as radiation oncology or dermatology?

Programs that want to attract applicants can alter their salary, hours, and benefits now, with the match in place. There is no reason why not having a match would all of a sudden make the programs want to offer higher salaries and more benefits. You can still 'extort' programs in the match by telling them to give you good reasons to rank their program #1. If they are flexible in their salary and benfits (which I doubt they are since these are not corner gas stations but rather large hospital corporations and medical institutions), they can offer you something better than others programs you are interested in.

And anways, people in the real world cannot negotiate individual health benefits (by law, each employee must be offered the exact same health benefits package (or choice of health packages) as every single other employee). Even negotiating salary is quite difficult except in the case of rare supply-demand issues (such as the computer programming craze of the late-1990's...look where many of those people are now).

I don't see how getting rid of the match will change anything except make the entire process like the current scramble.
 

neilc

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Originally posted by Geek Medic
How does residency selection occur in Prague? Do you guys have a similar match system? Out of curiosity, does any other nation have a similar match system?
i hate to admit it, but i am not positive how to get a job here after graduation....from my limited understanding, it is kind of a network thing, you apply for posts in several hospitals and hope for the best. however, all grads to need to do a rotating internship (1-2 years, blocks in IM, surg, obs/gyn, peds) before you can apply for a specialty. lots of folks that want the additional training simply cannot get it, and wind up as GP's. and still others wind up out in the boonies.

it does seem like a big pain, and the hospitals cleary have the advantage here. more applicants than spots, the government pays interns/residents peanuts, the interns/residents work loooooong hours and basically live in the hospitals. i think the system here is similar to the very old days (like 1950's) in the states. from my admittedly VERY limited knowledge on the residency application procedures in other countries, the match seems by far the best. we should get the input of the UK docs, as they have to apply to each hospital for a post. those that i know don't really like the system, and it has it's own share of problems.

and, beri beri, you do make some good points. but, isn't the overall match rate around 90%? that is pretty good, and i would imagine that any system you can think of would have a "fail" rate in this range. and, your points can be seen as a reason for an alternative to the match, if enough people want it. but, i just don't see it holding up as the argument in an anti-competitive lawsuit.
 

ewing

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Originally posted by prwunecom
with the previous poster.....I think that geek's system would work better in some ways. I matched at my #5 choice, but I have been told by the program that I ranked #4 that I was ranked higher by them than two candidates who matched there. This would seem to me to be proof that the current match system is flawed.
That is very disturbing. If they're not just blowing smoke up your a$$ and you didn't make a mistake on your ROL and your #4 program didn't make a mistake on their rank list, then it would seem that we are actively being lied to. If this could be documented, then we could sue for punitive damages, too! :clap: :clap:

If you can get documentation from them showing where they ranked you, then you should definitely contact the legal team because this is hardcore evidence. Alternatively, the lawyers could subpoena this info. from NRMP...they probably have to keep records of everyone's rank list.
 

prwunecom

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I appreciate the support that I am getting here. I am not unhappy with where I ended up, as I put a lot of thought into all 10 places that I ranked. However, it would seem that something is amiss in the algorithm, eh? The program that I ranked #4 is checking on what happened, but I doubt very seriously whether anything will come of it.
 
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