THE SOAP 2013 Thread

[Y3M]

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i am just theorizing here..... but i think its worth a shot. the acgme.org website shows how many slots a program is approved for vs how many are filled. look after the website is updated factoring this year's new resident class. if the total residents in training equal the total approved positions, but they are unequally distributed across the years.... chances are that program as at least one off cycle resident. call and find out when the off cycle resident finishes and see if they will accept another one after they finish.

this may give you an early advantage into knowing when an opening is going to happen before they are published on the websites.

i dont see that list- where is it?

 

[Noegrus]

Thanks for the reply. Any thoughts on if it would be ok to reach out to the PDs where I interviewed and ask for feedback on how to improve for next cycle? I guess after Monday. . .

It would be a great idea. Be ready to be blown off/non-response from a certain percentage of PDs, but in general, PDs are very helpful. If I were you, I would write very brief, to the point emails asking for an appointment for advice, explain my background in some detail when I meet them in person (they wouldn't remember anything about you from the application season), and ask for critical feedback and advice. Negative feedback is the best feedback you can get. 'You were great', is never helpful.

 

[scott1981]

i dont see that list- where is it?

you are right. they updated their website. they no longer show how many residents are in each academic year. they only show how many a program is approved for and how many total are in the program.

you can still search here:

http://acgme.org/acgmeweb/tabid/172...reditedProgramsandSponsoringInstitutions.aspx

 

[Ogenki]

Good luck everyone. Someone's going to get the last positions, it could be you.

I realize everyone who didn't get an offer yet is beyond despondent right now but if a program calls right now, best to put on your most positive face. Might not do any good but better than coming off as someone who unravels under stress.

 

[molten]

Lost the post I just came across that said there were 800 unmatched AMGs. Where is that information/link? Interested in the IMG figure as well, matched and unmatched. Also, are similar figures going to be released for SOAP?

Edit to add Q: When is it going to be legit to call up programs?

 

[Noegrus]

Lost the post I just came across that said there were 800 unmatched AMGs. Where is that information/link? Interested in the IMG figure as well, matched and unmatched. Also, are similar figures going to be released for SOAP?

The ballpark figure would be close to 800 US med school seniors. In the 2012 match, there were 16,527 active US med school senior applicants. 4.8% went unmatched - 815 individuals (table 4 Charting outcomes). I expect this year's figure to be similar or slightly higher because of more seniors in the match.

 

[IamnotFreud]

Lost the post I just came across that said there were 800 unmatched AMGs. Where is that information/link? Interested in the IMG figure as well, matched and unmatched. Also, are similar figures going to be released for SOAP?

Edit to add Q: When is it going to be legit to call up programs?

There are ALWAYS unmatched AMGs due to a number of reasons. Some people apply to very competitive specialties (derm/rad onc) and don't get in, most of which do research fellowships for a year or so and match the next year, some people defer graduation/do other degrees, and I believe they are also included in the unmatched number, some people simply choose to forego residencies. About ~5% of AMGs don't match every year, I think that's pretty standard and has held statistically for years. I don't think the sky is falling. So if there are 800 unmatched AMGs, that figure would be 5% of about 16,000 graduating med students.

Unfortunately IMGs and FMGs will have increased unmatched applicants given that prematches are a thing of the past and so I think what we are seeing is the end result of this - less matched foreign grads. Right or not, that's a discussion for another day, but the figures are what this new match system is telling us.

 

[molten]

Unfortunately IMGs and FMGs will have increased unmatched applicants given that prematches are a thing of the past and so I think what we are seeing is the end result of this - less matched foreign grads.

Yes, of course. I was interested in the numbers and also the credentials of unmatched IMGs to compare them against mine.

 

[hola27]

Just to verify...programs can be contacted after 5pm right

 

[scott1981]

There are ALWAYS unmatched AMGs due to a number of reasons. Some people apply to very competitive specialties (derm/rad onc) and don't get in, most of which do research fellowships for a year or so and match the next year, some people defer graduation/do other degrees, and I believe they are also included in the unmatched number, some people simply choose to forego residencies. About ~5% of AMGs don't match every year, I think that's pretty standard and has held statistically for years. I don't think the sky is falling. So if there are 800 unmatched AMGs, that figure would be 5% of about 16,000 graduating med students.

Unfortunately IMGs and FMGs will have increased unmatched applicants given that prematches are a thing of the past and so I think what we are seeing is the end result of this - less matched foreign grads. Right or not, that's a discussion for another day, but the figures are what this new match system is telling us.

i agree. unless there suddenly becomes more funding for new residencies....... the only accomplishment of opening all those new slots in med schools will be to make the match even more competitive.

now that the prematch was taken away, i personally believe that you will see less success in the match for IMG and FMG's. after they take the initial hit, it will then trickle over to the AMGs as well.

only my 2 cents for whatever it is worth.

 

[molten]

Just to verify...programs can be contacted after 5pm right

Would like to know as well.

 

[sazerac]

Hey Shadow, that sucks man, hope you try ur luck again next cycle. Have you considered FM or Psych as even more backups to EM?

EM is getting real competitive and most people I know have scores in the 230+

Why are so many AMGs with 220+ not getting matched anywhere? Anyone have an answer?

The common theme in this thread and in the allopathic forum is that these AMG's have Step 2 scores roughly 20 points below their Step 1 scores. I wonder if an average-to-good Step 1 causes the AMG applicant to aim average-to-high, but the downward trend in Step scores worries a PD more than we thought.

 

[IamnotFreud]

Would like to know as well.

Yes, after 5pm.

 

[CDI]

The common theme in this thread and in the allopathic forum is that these AMG's have Step 2 scores roughly 20 points below their Step 1 scores. I wonder if an average-to-good Step 1 causes the AMG applicant to aim average-to-high, but the downward trend in Step scores worries a PD more than we thought.

Possibly, since rather than weigh Step I like its the end-all exam, some seem to be looking at the average of the 2 scores as the filter. No idea if its true...or even an option. Never made much sense to me why Step I (pre-clinical yrs) was given so much weight to begin with.

 

[molten]

Possibly, since rather than weigh Step I like its the end-all exam, some seem to be looking at the average of the 2 scores as the filter. No idea if its true...or even an option. Never made much sense to me why Step I (pre-clinical yrs) was given so much weight to begin with.

From what I know, a lot of AMGs don't have their Step 2 scores early on in the season, so the step 1 score is the traditional filter.

 

[IamnotFreud]

Possibly, since rather than weigh Step I like its the end-all exam, some seem to be looking at the average of the 2 scores as the filter. No idea if its true...or even an option. Never made much sense to me why Step I (pre-clinical yrs) was given so much weight to begin with.

Not everyone has step 2 by the time they interview/rank, and except for competitive specialties, many programs don't require it/care about it. further many people score lower on step 2 than step 1 because many people simply don't care about it.

It's very difficult to gauge "why" someone did not match based on bits and pieces of information. We may not know the whole story. The reality is that most AMGs with average applications will match if they apply broadly and to specialties to which they are competitive.

 

[molten]

.

 

[hola27]

Yes, after 5pm.

Thanks

 

[gutonc]

The common theme in this thread and in the allopathic forum is that these AMG's have Step 2 scores roughly 20 points below their Step 1 scores. I wonder if an average-to-good Step 1 causes the AMG applicant to aim average-to-high, but the downward trend in Step scores worries a PD more than we thought.

QFT. During fellowship interviews this year, every single applicant that we reviewed who had a real downward trend in their Step scores (>10 points, not a 2-3 point difference) was dinged for it. Especially if it continued into Step 3 (not an issue for most residency applicants).

 

[CDI]

From what I know, a lot of AMGs don't have their Step 2 scores early on in the season, so the step 1 score is the traditional filter.

Ah, completely forgot about that. Makes sense now. Maybe there will be a push to take CK as well before applying?

 

[CDI]

QFT. During fellowship interviews this year, every single applicant that we reviewed who had a real downward trend in their Step scores (>10 points, not a 2-3 point difference) was dinged for it. Especially if it continued into Step 3 (not an issue for most residency applicants).

Wow, good to know! Thank you. Had no idea this was a factor.

 

[gutonc]

From what I know, a lot of AMGs don't have their Step 2 scores early on in the season, so the step 1 score is the traditional filter.

True. But there's a difference between a filter and selection criteria. Programs use Step scores to get their applications down to a manageable number to review. But just because you make the Step X cutoff score doesn't mean you're going to get an interview, or even ranked.

 

[molten]

True. But there's a difference between a filter and selection criteria. Programs use Step scores to get their applications down to a manageable number to review. But just because you make the Step X cutoff score doesn't mean you're going to get an interview, or even ranked.

Yes, that's obvious. A filter is a screen.

 

[IamnotFreud]

True. But there's a difference between a filter and selection criteria. Programs use Step scores to get their applications down to a manageable number to review. But just because you make the Step X cutoff score doesn't mean you're going to get an interview, or even ranked.

That goes both ways though-you may not have "cut off" scores and still get an interview at that place. So I would take that with a grain of salt. Also I agree with you that many cut offs are to reduce apps to a manageable # especially in competitive residencies. If you have 1 or 2 spots and have 300 applicants, you gotta reduce that by about 250 or so and having a cut off is one of the easiest way to do so. But the excessive emphasis on scores is nauseating.

 

[Jessipeds]

Just want to wish Good Luck to everyone SOAPing.... hang in there, you can do it!!!

 

[gutonc]

That goes both ways though-you may not have "cut off" scores and still get an interview at that place. So I would take that with a grain of salt. Also I agree with you that many cut offs are to reduce apps to a manageable # especially in competitive residencies. If you have 1 or 2 spots and have 300 applicants, you gotta reduce that by about 250 or so and having a cut off is one of the easiest way to do so. But the excessive emphasis on scores is nauseating.

This is rare, but it certainly happens. Just one (small) concrete example, my IM subspecialty fellowship program this year.

We absolutely did not even review the apps of applicants who didn't meet our Step score screen (I don't remember the number as I wasn't involved in that, but it included any completed Step score <XXX and the number wasn't all that high...I saw some pretty crappy scores). That said, there were two applicants, one a resident at our institution, the a hospitalist here, who did not make those cuts but who were invited for interviews. Both courtesy, both ranked low (but ranked), neither matched.

I get that the obsession with numbers is frustrating, but you gotta do what you gotta do.

 

[IamnotFreud]

This is rare, but it certainly happens. Just one (small) concrete example, my IM subspecialty fellowship program this year.

We absolutely did not even review the apps of applicants who didn't meet our Step score screen (I don't remember the number as I wasn't involved in that, but it included any completed Step score <XXX and the number wasn't all that high...I saw some pretty crappy scores). That said, there were two applicants, one a resident at our institution, the a hospitalist here, who did not make those cuts but who were invited for interviews. Both courtesy, both ranked low (but ranked), neither matched.

I get that the obsession with numbers is frustrating, but you gotta do what you gotta do.

See the thing is this. Not everyone is a superstar at test taking, and I am a firm believer that standarized scores are not an indication of how good a doctor anyone will be. The fact that most if not all attendings would fail all steps is a clear indication of that. When I was doing IM one of our attendings told us how she was so embarrassed that she had failed the practice tests for her re-certification exam and what not, and I've heard numerous attendings say if I was taking the exams I would fail them. Clearly there are some superstar attendings out there.

So in your program's case, the doctors applying have completed undergrad, med school, internship, residency. Do steps taken maybe when they were M3's really attest to what kind of doctors/heme/oncs they would make? That's 4-5+ years in the past. As an M3 you don't really know much, and does knowing the Kreb's cycle or the heme pathway really make you a better doctor than someone who could remember it on test day? Not really.

If someone was an awful resident then I agree, it should be a no go. But the tests are really irrelevant.

 

[monkeyboy2888]

Thank you all in advance for any advice that may come my way. The thread has been up and down with getting down right nasty in some cases and though tensions run high and anger, sadness and being bitter is ok for the time being, please try to not get jaded. So here's my story;
Non traditional US senior in public state medical school; long story short, had to work EMS through medical school for financial reasons. Bad at managing both and ended up repeating 2nd year for a single course failure in which remediation was not an option. Tough coming back from it but I will finish my coursework with no other failures on my record. Passed all Steps first time with below average scores(1-221 2-208 CS - P). I was always passionate about EM, Honored all my EM aways, clerkships and continued to participate in research projects that will be submitted for publication this month and next. I applied early and widely on the eastern seaboard, knowing that EM is getting more and more competitive. My application was held up until late October for one letter of rec from an away program. I received 6 interviews, which I thought had gone well, and was counseled to apply to IM/prelim as a back-up. Only received one interview at my home institution and was told by the PD that my application was so EM heavy that it was no surprise that I did not receive more IV invites in my back ups.
NOW: No match, No SOAP and about 500k in debt and not sure about my future.
Plan: Try to scramble on Monday, keeping an eye out for any openings that might occur while in the meantime returning to work to live and try to participate in anypublishable research that might bolster my re application next cycle where I will try for EM even more widely and more IM programs as many as I can afford to apply to.
Any advice out there of anything more that I should do? Constructive comments would be greatly appreciated. Best of luck to all of you....

Keeping calm and carrying on...

you have several red flags in your application. first, you failed and had to remediate an entire year. second your step scores are below average, especially your step 2 (which EM looks more favorably on). step 2 is thought of as the much easier exam and you're below 1 SD on scoring. lastly not a red flag but you only applied to the eastern seaboard instead of broadly (south, midwest, etc.) with your application.

its true that EM tends to look past things like numbers in favor of the whole applicant and your research with EM and excellent SLOR/grades probably helped you out. EM is so competitive though that programs are starting to weed out applicants based on numbers.

there's nothing you can do now about your scores so i'd suggest doing a lot of EM related research and going to some of the national conferences (SAEM, ACEP) to meet PD's and residents so you can get your name out there. other than that pray and hope next year's match isn't that much more competitive. and also apply broadly for IM/FP because your scores are also below average for those specialties too.

 

[gutonc]

See the thing is this. Not everyone is a superstar at test taking, and I am a firm believer that standarized scores are not an indication of how good a doctor anyone will be. The fact that most if not all attendings would fail all steps is a clear indication of that. When I was doing IM one of our attendings told us how she was so embarrassed that she had failed the practice tests for her re-certification exam and what not, and I've heard numerous attendings say if I was taking the exams I would fail them. Clearly there are some superstar attendings out there.

So in your program's case, the doctors applying have completed undergrad, med school, internship, residency. Do steps taken maybe when they were M3's really attest to what kind of doctors/heme/oncs they would make? That's 4-5+ years in the past. As an M3 you don't really know much, and does knowing the Kreb's cycle or the heme pathway really make you a better doctor than someone who could remember it on test day? Not really.

If someone was an awful resident then I agree, it should be a no go. But the tests are really irrelevant.

I'm not arguing with you. I get that some people suck at taking standardized tests (but perhaps entering a career that requires a lifetime of taking those tests isn't the best idea in the first place) and that the Steps aren't designed to be used as screening tools for residency/fellowship. But this is the reality of the situation and the sooner that everyone accepts that (or becomes the head of the ACGME or NRMP and prohibits the use of Step scores in residency selection) the better.

I'm not saying it's not worth trying to change the situation. But that's not going to help you this year (or next, or the year after that, etc)...it might help the kids on hSDN right now who are thinking about where they're going to college so they can get into a good med school.

 

[molten]

Interviewers should consider pimping. I think it can be effectively used to assess clinical acumen- and can perhaps be a better teller than scores.

 

[IamnotFreud]

I'm not arguing with you. I get that some people suck at taking standardized tests (but perhaps entering a career that requires a lifetime of taking those tests isn't the best idea in the first place) and that the Steps aren't designed to be used as screening tools for residency/fellowship. But this is the reality of the situation and the sooner that everyone accepts that (or becomes the head of the ACGME or NRMP and prohibits the use of Step scores in residency selection) the better.

I'm not saying it's not worth trying to change the situation. But that's not going to help you this year (or next, or the year after that, etc)...it might help the kids on hSDN right now who are thinking about where they're going to college so they can get into a good med school.

Yes I agree that "that's the way it is," and also agree with your second statement about the head of the ACGME/NRMP, lol. Who is the head of the ACGME/NRMP btw? I guess I'm someone who sees more than just scores/grades as being important. I have vowed for a long time that if I ever become a PD, I will look at people beyond their scores. As someone told me in one of my interviews, I want to learn more about the person and look beyond scores and stats. Right on! At the end of the day we are people not just numbers. If I ever do become anything or head up a serious medical entity, I'll be sure to change certain things.

 

[IamnotFreud]

Interviewers should consider pimping. I think it can be effectively used to assess clinical acumen- and can perhaps be a better teller than scores.

that's probably one of the worst ideas ever. I don't think I would never rank a program that pimped me. And since a medical student applying to residency has not started residency they don't know much of anything so how are they going to have clinical acumen? That's absurd, not to mention completely non-objective.

 

[Ogenki]

What do you tell the attendings who passed their boards years ago but got screened out of fellowships this way? "I'm sorry, we'd consider your application but according to statistical research, your step 1 and 2 scores indicate you might not pass step 3?"

I can understand step 3 for primary care fellowships, many applicants haven't taken boards yet and it is the last test with something besides pass/fail (although I have a feeling PDs will put in high RISE scores in their LORs for applicants from their program.) But I imagine any fellowship program that decided to screen with step 1-2 scores that long ago was simply getting too many applicants, and not in a good way (there's some med schools that ended up labeled as "backups" who ask for SAT scores for example). Its basically giving up on finding the best candidate and simply looking for acceptable ones.

 

[molten]

that's probably one of the worst ideas ever. I don't think I would never rank a program that pimped me. And since a medical student applying to residency has not started residency they don't know much of anything so how are they going to have clinical acumen? That's absurd, not to mention completely non-objective.

-The entire aim of the interview is to have a subjective assessment.
-Besides, I was not suggesting pimping as a substitute for scores that are the most objective part of the application.
-A med student should have some clinical acumen after the clinical rotations.

Anyway.

 

[rgnysp0333]

8 Rounds and nothing. FML

 

[CDI]

Interviewers should consider pimping. I think it can be effectively used to assess clinical acumen- and can perhaps be a better teller than scores.

IMGs do get pimped on interviews. Nothing new here.

AMGs might be getting the cakewalk.

 

[hola27]

okay guys...it seems the SOAP is over....good luck guys...

 

[Knicks]

Those who got spots through SOAP, did you get an EMAIL that you received an offer (in addition to the NRMP site)?

 

[gutonc]

I have vowed for a long time that if I ever become a PD, I will look at people beyond their scores.

Everybody looks beyond scores. But you have to start somewhere. Again, one small example. We had 3 fellowship spots this year. We got over 500 applications. We were only planning to invite 40 people (we interviewed around 50). There's just no way that one person can wade through all those apps. Forget about a 50-person/class IM program that gets 5K apps...it's just not happening.

Step scores are easy to filter by and have a (very) rough correlation with later success (at least as far as board exams go...again, not the be all, end all of being a physician). It would be just as easy to filter by AMG/IMG/DO status...would that be more fair?

There are no simple answers to this problem. One that has been proposed in the past is limiting the number of apps you can put out. That way you have to be more realistic/selective about your prospects and can't just spam as many apps out there as you have room on your credit card to pay for and PDs won't have to read as many apps (theoretically). Is that a more fair way to approach this? I don't know (and I don't really think so).

TL;DR - The process as it is works for the majority of applicants (and the vast majority of AMGs). It is unlikely to change all that much in the foreseeable future.

 

[b-real]

that's pretty harsh that you'd have to repeat a whole year for only one course, no? I would suggest to apply to IM and possibly transfer later on. There are still some positions open and I'm pretty sure will be positions open after today and that pop up. Needless to say being an AMG gives you an advantage. Also while you have repeated a year, I find it surprising that you did not match. I've had colleagues with lower scores than you who did match. I myself only went to a handful of interviews that I can count on my hand and matched in my specialty so maybe get some feedback if possible about what might have gone wrong. Lastly, any way that you can talk ot your school and ask if they could give you a prelim spot? Most EM programs require internship anways so that might help. Also ask your EM PD for help, if they like you, you are far more likely to get in next year. Re: your debt, you will likely never pay it off and you'll have to go on the income based repayment plan, which is forgiven after like 10 years now I think if you've made monthly payments until then.

Just to clarify, there are no advanced (PGY-2) EM programs. You would have to start as an intern if you want to transfer.

 

[halekulani]

so let me get this straight. you feel that an AMG with a very subpar application, possibly with basic science failures or lousy usmle scores should get matched over a caribbean student who worked very hard to get a competitive application regardless of merit?

why dont you go back in time. the roles were reversed. back in undergrad, the caribbean student may have had a subpar GPA or MCAT, but there were repercussions to that........ im doubtful that you shed a tear for them getting marooned to the caribbean. you, as a US grad, have a sense of entitlement here. two US citizens should not be held to different standards. unfortunately they already are at a disadvantage....... but you want everything....... only when the time is right for you.

it sounds like you want have your cake and to eat it too.

no
i want an AMG to have an opportunity to match with a priority in the soap

if he is a sub par student and has red flags, institutions have the right to deny him a position. people with red flags aren't entitled to be accepted by any institution.

i don't know why people assume XYZ scenario is going to happen just because you institute a 'priority' rule. bad applicants are bad applicants, period.

you do realize plenty of qualified, zero red flag people are scrambling, right? i wouldn't be so quick to assume that everyone who didn't match has red flags with previous failures.
there are also people who matched advanced who have trouble securing prelims and risk losing their advanced position. these are struggles that should be relieved.

not everyone who is scrambling is a terrible student. i hate how people constantly bring up the loser who skated by in med school. couples matching problems, other personal reasons for regional restraints, and highly competitive specialties are just a few of the many reasons why some people don't match.

you think i'm entitled? fine. but at least my opinion comes with experience, reasoning, and an open mind rather than limiting my entire argument to a single slacker american triumphing over a hard working IMG. because let me tell you, that single example you proposed is the exception, NOT the rule.

 

[VenusinFurs]

Yeah, I already mentioned my friend who had no real red flags in her app, just an unlucky match.

 

[molten]

.

 

[Knightmd]

Where's the list of unfilled spots???

 

[scott1981]

no
i want an AMG to have an opportunity to match with a priority in the soap

if he is a sub par student and has red flags, institutions have the right to deny him a position. people with red flags aren't entitled to be accepted by any institution.

i don't know why people assume XYZ scenario is going to happen just because you institute a 'priority' rule. bad applicants are bad applicants, period.

you do realize plenty of qualified, zero red flag people are scrambling, right? i wouldn't be so quick to assume that everyone who didn't match has red flags with previous failures.
there are also people who matched advanced who have trouble securing prelims and risk losing their advanced position. these are struggles that should be relieved.

not everyone who is scrambling is a terrible student. i hate how people constantly bring up the loser who skated by in med school. couples matching problems, other personal reasons for regional restraints, and highly competitive specialties are just a few of the many reasons why some people don't match.

you think i'm entitled? fine. but at least my opinion comes with experience, reasoning, and an open mind rather than limiting my entire argument to a single slacker american triumphing over a hard working IMG. because let me tell you, that single example you proposed is the exception, NOT the rule.

fully aware of all the reasons. it is unfortunate. reality is that the doctor shortage is not going to be alleviated anytime soon with a residency bottleneck.

a simple way to save problems for AMG's is to actually do what IMG's have had to do for quite some time. apply broadly. dont assume anything. the reality is, program directors already give preference to AMGs. i can tell you from experience. we didnt even consider IMG's unless they were superstars....literally. however, we did interview quite a bit of average/above average AMG's. hence year after year our classes consist of mostly average / above average AMG's (majority) and a minority of superstar IMG's.

not everyone who is scrambling is a terrible student. i hate how people constantly bring up the loser who skated by in med school. couples matching problems, other personal reasons for regional restraints, and highly competitive specialties are just a few of the many reasons why some people don't match.

unfortunately, when one talks about making AMGs get a priority in the match or soap....try to insert a pre-med applying to medical school in your description...... because that is really all that separated a lot of caribbean students from going to a US school.

if you give institutions the right to deny a bad AMG applicant, then I am confused at how it will be any different then how it is.

once again, the real issue is that there are not enough residency positions.... period. in 3-4 years with the increase in enrollment sizes of schools, most of the successful caribbean students the past 10 years would have gained admission to the US schools. they will take a chunk of the otherwise very well qualified students that normally would have resorted to the caribbean. the quality of the caribbean applicant will decrease and caribbean schools will be a non-factor.

what can be done to expand residency positions especially in the sequester governmental environment? i dont see an answer and i think we are in this for the long term. unfortunately...... we will be stuck with a doctor shortage for some time.

 

[halekulani]

if you give institutions the right to deny a bad AMG applicant, then I am confused at how it will be any different then how it is.

the goal would be to reduce the number of applications each institution must review before giving a final offer thus prioritizing a qualified AMG. is that so unfair?

a priority filter would maximize the number of qualified/zero red flag AMGs to secure spots. that alone would relieve a lot of stress. if you don't agree with it, you have to have a damn good reason. i know multiple sub surg specialty applicants who didn't even find a prelim.

 

[secondtimearoun]

I think it's important that at this point we all sit back and think about the fact that at this point in our careers, we have more in-school training, more hands-on training, and higher testing standards than either PAs or NPs, yet we have less ability to practice and even less flexibility to practice despite this.

Please note that I am not in any way bashing PAs or NPs. I've worked with them, I've been educated by them, I've educated them (former resident). Like physicians, the dedicated ones are amazing at what they do and increase patient care and health quality which is something that cannot be denied.

All I am pointing out is the hypocrisy of the situation in which despite the fact that most of us would make perfectly decent limited-scope GPs (which lets face it, is what the country needs more than anything), we are prevented from doing so for no obvious or clear reason.

Again, I'm not saying that primary care residencies don't produce benefits and that people so trained aren't more equipped at all. Rather, I'm simply pointing out that we have a substantial amount of training and should AT LEAST have the degree of flexibility and freedom to practice that NPs and PAs do.

 

[Print1]

I think it's important that at this point we all sit back and think about the fact that at this point in our careers, we have more in-school training, more hands-on training, and higher testing standards than either PAs or NPs, yet we have less ability to practice and even less flexibility to practice despite this.

Please note that I am not in any way bashing PAs or NPs. I've worked with them, I've been educated by them, I've educated them (former resident). Like physicians, the dedicated ones are amazing at what they do and increase patient care and health quality which is something that cannot be denied.

All I am pointing out is the hypocrisy of the situation in which despite the fact that most of us would make perfectly decent limited-scope GPs (which lets face it, is what the country needs more than anything), we are prevented from doing so for no obvious or clear reason.

Again, I'm not saying that primary care residencies don't produce benefits and that people so trained aren't more equipped at all. Rather, I'm simply pointing out that we have a substantial amount of training and should AT LEAST have the degree of flexibility and freedom to practice that NPs and PAs do.

You've made a lot of good points here. You know, another solution might be to redesign medical school, or reconstruct accreditation and licensing, so that people are actually qualified to do something when they graduate, instead of having to do some type of extra training. Of course, most graduates would still choose to do a residency, but at least there would be another option, if necessary.

 

[survivordo]

I hope it turned out alright for most of you, looks like this year was the toughest yet and will continue to be. I do agree with the above that there should be some avenue for those with an MD/DO that wish to pursue a career as a "supervised" physician, much in the same way NP/PA's practice. After so many years of apprenticeship perhaps one could take a set of boards/oral exams. This is essentially residency but if it could somehow be arranged on a case by case basis where a primary care doc could take you under their wing but not necessary meet all the requirements of a formal program. Food for thought.

Survivor DO

 

[Ogenki]

Yea, I'm not sure why a doctor who didn't match is prevented from taking the PA or NP licensing exams if he/she wanted to other than legal headache from IMGs that want to do the same. I do think they should take the licensing exams though if they want to do a PA/NP's job. I mean it seems like a real waste that after 4 years, if we don't get a residency spot, we can't do anything else with our degree.

I do think some people are vastly underestimating PA exams and what they need to go through though (don't know about NP). There aren't many schools out there and the average GPA in college is about the same as DOs. They might have had 'less training' in terms of years but most of the fourth year is spent interviewing or sleepwallking and the first two years had alot of science fluff most of us forget that isn't in their ciriculuum while alot of the other scientific fluff is just glossed over. Once you've done residency, its a different story (or it should be unless the residency isn't training.)