Vacant spots in 2008

[Medstudentquest]

So I was looking at the previous year's match, and I noticed that there were several programs that had open spots, even good programs and good spots, such as transitional year programs! Can anyone explain why a program would choose to leave those spots unfilled? Does that mean that those spots are unfilled even after the scramble?

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[dragonfly99]

Could you clarify your question? Where are you seeing that there were open spots? I'm assuming that this was after the Match...but that most of the programs would have filled any remaining empty spot(s) during the scramble. That is what they usually do.

As far as why programs don't fill, sometimes it is just because they don't interview enough people. For example, if you are a pulmonary fellowship with 5 spots/year and you only interview 25 people or something, and then think that will definitely be enough to fill, but for some reason a few of those applicants who interviewed don't rank your program, or they all rank you but they ranked other programs higher and got in to the ones they ranked higher, then a pretty good program could not fill. Sometimes it happens. A lot of times there is some issue like the program has a rough call schedule, etc. that applicants find out during the interview process...usually it's a combination of that and the program being overconfident and not interviewing enough candidates.

 

[Medstudentquest]

Could you clarify your question? Where are you seeing that there were open spots? I'm assuming that this was after the Match...but that most of the programs would have filled any remaining empty spot(s) during the scramble. That is what they usually do.

As far as why programs don't fill, sometimes it is just because they don't interview enough people. For example, if you are a pulmonary fellowship with 5 spots/year and you only interview 25 people or something, and then think that will definitely be enough to fill, but for some reason a few of those applicants who interviewed don't rank your program, or they all rank you but they ranked other programs higher and got in to the ones they ranked higher, then a pretty good program could not fill. Sometimes it happens. A lot of times there is some issue like the program has a rough call schedule, etc. that applicants find out during the interview process...usually it's a combination of that and the program being overconfident and not interviewing enough candidates.

Hi,

I was looking at the charting outcomes for the match last year. I saw that for example, there were a few TY programs that didn't fill. Stanford's psychiatry program I think also didn't fill. There were multiple FM spots that didn't fill, Prelim/Derm spot that didn't fill, etc. I assume that this is after the match and after the scramble. Do these programs just go unfilled for that year and then make up the difference the following year?

What would happen if an applicant didn't match anywhere, would they be allowed to match in one of those spots that didn't fill, even after the scramble? Also, can programs choose not to fill their spots even if they have students interested in the program?

 

[BlondeDocteur]

Those lists are comprised for the Match only. The scramble is by definition outside of the match and won't be represented in the Charting Outcomes stuff.

 

[Medstudentquest]

Those lists are comprised for the Match only. The scramble is by definition outside of the match and won't be represented in the Charting Outcomes stuff.

So that means that the number of unfilled spots could be lower than what's expressed there. But still! How can so many good programs go unfilled? I assume programs like TY's would not have any problem finding candidates. Maybe it is true what the other poster said that they may not rank enough applicants. Since we are on the topic though, I am curious to understand how the rank process works. Say I go on 10 interviews, and I rank all the programs. If I rank my top choice as #1, and say they rank me as #2 or something like that, does that mean then that that's a match? As long as both the applicant and the program match each other, is that a match?

 

[BlondeDocteur]

Dragonfly gave good insight into the reasons 'good' programs go unfilled. Sometimes it's hubris (programs have an incentive, understood only to them, to "not go far down on the list," so they rank too few candidates), sometimes an ugly rumor about a certain facet of the program comes to light and scares people off. The neurology match for 2008 was especially prone to this.

In the competitive specialities, the few unmatched open spots go in nanoseconds in the scramble. There are none left unfilled afterwards. In other less desirable specialties/locations, some spots might go truly unfilled, even after the scramble.

The Match Algorithm is very well explained on their website:
http://www.nrmp.org/res_match/about_res/algorithms.html

The bottom line for you as an applicant is that it always, always, always is in your interest to truly rank the programs you liked the most first. Don't say "WashU will never pick me, I can't rank it first." The algorithm goes through your preference list and preliminarily matches you to the program you ranked the highest that also wants you. If WashU ranked you, then to WashU you'll go. If they didn't-- no harm, no foul, the computer immediately tries to match you into your #2 program.

 

[Medstudentquest]

Dragonfly gave good insight into the reasons 'good' programs go unfilled. Sometimes it's hubris (programs have an incentive, understood only to them, to "not go far down on the list," so they rank too few candidates), sometimes an ugly rumor about a certain facet of the program comes to light and scares people off. The neurology match for 2008 was especially prone to this.

In the competitive specialities, the few unmatched open spots go in nanoseconds in the scramble. There are none left unfilled afterwards. In other less desirable specialties/locations, some spots might go truly unfilled, even after the scramble.

The Match Algorithm is very well explained on their website:
http://www.nrmp.org/res_match/about_res/algorithms.html

The bottom line for you as an applicant is that it always, always, always is in your interest to truly rank the programs you liked the most first. Don't say "WashU will never pick me, I can't rank it first." The algorithm goes through your preference list and preliminarily matches you to the program you ranked the highest that also wants you. If WashU ranked you, then to WashU you'll go. If they didn't-- no harm, no foul, the computer immediately tries to match you into your #2 program.

Ok, so if I ranked Wash U. #1, and they ranked me #15, then that's a match? If I ranked them, but they did not rank me, then no match. If they ranked me, but I didn't rank them, no match. Is that right?

Basically what I'm trying to understand is, the match is not an exact number by number process right? So in order to match, I don't have to rank my first program #1 and they have to rank me #1. As long as both myself and the program rank each other somewhere on the continuum, then it's a match. Is this right?

 

[BlondeDocteur]

If you rank WashU #1 and they rank you #15, it *could* be a match.

Let's say that you're applying for a program with 5 spots. From WashU's perspective, their rank list is this:

1. A
2. B
3. C
4. D
5. E
6. F
7. G
8. H
9. I
10. J
11. K
12. L
13. M
14. N
15. Medstudentquest

*IF* only 4 of the people ahead of you actually want to go to WashU-- say, persons A, F, G and N-- then you will match at WashU. If at least 5 of the others have ranked WashU highly, then you won't. Being *ranked* in and of itself will not guarantee a match there.

The computer starts with an applicant-- a randomly selected applicant, out of the 18,000+ in the Match-- and matches that person to their #1, temporarily. It then picks another random person and matches them to their #1, temporarily. Soon enough, after running through enough people, someone will get bumped. Let's keep using WashU's mythical 5-spot residency program. When the computer selects the random applicant in that huge pool who was ranked first, and who also ranked WashU first, that random applicant will be permanently matched to WashU. If the 5 slots were already filled with temporary matches, then the person lowest down on the list gets bumped.

That bumped guy is immediately thrown back into the pool, and is temporarily matched to his #2, if available.... and then, if not available or bumped, his #3... and so on.

So to answer your question there is no magic number on the rank list that guarantees you'll be matched to a particular program. Very, very competitive programs might fill in a 1:1 ratio (5 spots, first 5 on the rank list, all 5 ranked that program first, boom!-- done). Others might literally go all the way down. As you said, as long as you and the program both rank each other, and on your end none of the programs you ranked higher want you, and on the program end none of the candidates ranked higher than you prefer that program, it's a match.

 

[Medstudentquest]

If you rank WashU #1 and they rank you #15, it *could* be a match.

Let's say that you're applying for a program with 5 spots. From WashU's perspective, their rank list is this:

1. A
2. B
3. C
4. D
5. E
6. F
7. G
8. H
9. I
10. J
11. K
12. L
13. M
14. N
15. Medstudentquest

*IF* only 4 of the people ahead of you actually want to go to WashU-- say, persons A, F, G and N-- then you will match at WashU. If at least 5 of the others have ranked WashU highly, then you won't. Being *ranked* in and of itself will not guarantee a match there.

The computer starts with an applicant-- a randomly selected applicant, out of the 18,000+ in the Match-- and matches that person to their #1, temporarily. It then picks another random person and matches them to their #1, temporarily. Soon enough, after running through enough people, someone will get bumped. Let's keep using WashU's mythical 5-spot residency program. When the computer selects the random applicant in that huge pool who was ranked first, and who also ranked WashU first, that random applicant will be permanently matched to WashU. If the 5 slots were already filled with temporary matches, then the person lowest down on the list gets bumped.

That bumped guy is immediately thrown back into the pool, and is temporarily matched to his #2, if available.... and then, if not available or bumped, his #3... and so on.

So to answer your question there is no magic number on the rank list that guarantees you'll be matched to a particular program. Very, very competitive programs might fill in a 1:1 ratio (5 spots, first 5 on the rank list, all 5 ranked that program first, boom!-- done). Others might literally go all the way down. As you said, as long as you and the program both rank each other, and on your end none of the programs you ranked higher want you, and on the program end none of the candidates ranked higher than you prefer that program, it's a match.

Wow, that's complicated!! I am getting depressed about this whole process. I read on the statistics that for 08, there were about 28,000 people applying for 22,000 spots! What's the likelihood of non-US grads realistically matching? Are certain programs more likely to take non-Us grads over US grads? I have encountered a number of US grads who did not match last year, and have met non-Us grads who matched. Seems odd.

 

[Blade28]

What's the likelihood of non-US grads realistically matching? Are certain programs more likely to take non-Us grads over US grads?

(1) In which field?
(2) With all else being equal? Probably not.

 

[Medstudentquest]

(1) In which field?
(2) With all else being equal? Probably not.

Well I realize that certain fields are incredibly hard to get into (derm, optho, rads, etc). but I mean in less competitive fields such as peds, IM, etc., if a US grad had the bare minimum, let's say 185 USMLE (i think that was the old pass level?), and say all proficients in rotations, could they match into one of these fields? I ask because I recently applied to a prelim program and they rejected me! I was so surprised, yet when I went to look at their current residents, half of them were FMG and/or DO's! I was very surprised and that's what sparked my question.

 

[dragonfly99]

Sometimes prelim programs are more competitive than categorical programs.
Also, just because a residency has some DO's and FMG's, that doesn't mean it's totally noncompetitive. Perhaps they have had good experiences with students from those particular schools (i.e. particular DO school that they know produces good residents, or a particular Indian med school that they've found produces good residents).

I think all other things being equal, a lot of residency programs would take a US citizen IMG with 185 USMLE over say an Indian med student FMG with 185 USMLE. However, the reality is there is self-selection and a lot of the foreign doc FMG's who are applying in the US have above average USMLE's, many have publications, etc. I do think a US citizen IMG can match in fp or medicine if he/she applied to enough programs, and has decent LOR's and passed all the steps on the first try, but that is just my gestalt/impression. Peds doesn't have as many spots but should be possible in most cases, particularly if the step scores are OK.

 

[Medstudentquest]

Sometimes prelim programs are more competitive than categorical programs.
Also, just because a residency has some DO's and FMG's, that doesn't mean it's totally noncompetitive. Perhaps they have had good experiences with students from those particular schools (i.e. particular DO school that they know produces good residents, or a particular Indian med school that they've found produces good residents).

I think all other things being equal, a lot of residency programs would take a US citizen IMG with 185 USMLE over say an Indian med student FMG with 185 USMLE. However, the reality is there is self-selection and a lot of the foreign doc FMG's who are applying in the US have above average USMLE's, many have publications, etc. I do think a US citizen IMG can match in fp or medicine if he/she applied to enough programs, and has decent LOR's and passed all the steps on the first try, but that is just my gestalt/impression. Peds doesn't have as many spots but should be possible in most cases, particularly if the step scores are OK.

Why do you say that some prelim programs are more competitive than some categorical programs?

Also since you seem knowledgeable, I'll ask here. I have an interview tomorrow for a prelim program in my state (yay!!!) so I'm trying to have everything as perfect as possible that's in my control. I have read the website and the program info, getting my clothes ready, etc.

My questions are: what type of questions should I be prepared to answer? How many questions should I ask them? Should I bring my personal statement and CV? Anything else I should do?

 

[Law2Doc]

Sometimes prelim programs are more competitive than categorical programs.

Matching into a prelim medicine year at Mass General is going to be harder than matching categorically in medicine at some community hospital, absolutely. And certainly at some of the smaller hospitals, you see lots of categoricals being FMGs while the prelims are all folks going into gas, neuro, PM&R etc. so in this case too there might be more competition for the prelim spot.

 

[Law2Doc]

Why do you say that some prelim programs are more competitive than some categorical programs?

Also since you seem knowledgeable, I'll ask here. I have an interview tomorrow for a prelim program in my state (yay!!!) so I'm trying to have everything as perfect as possible that's in my control. I have read the website and the program info, getting my clothes ready, etc.

My questions are: what type of questions should I be prepared to answer? How many questions should I ask them? Should I bring my personal statement and CV? Anything else I should do?

You don't need to bring anything to an interview; thanks to ERAS they will have it all online or as printouts. Be prepared with enough questions that you can conduct your own 20 minute interview if you have to -- once in a while interviewers will simply start out with "what questions can I answer". Most won't, but you need to be prepared to fill the time.

 

[dragonfly99]

Agree with above.
The most important things to bring are a smile, firm handshake and plenty of questions that you can ask about their program. Show them that you have read up on their program and hospital system on their web site, etc.
They should/will have your personal statement and CV from ERAS, but if it makes you feel more secure you can bring a copy. Most of the interviewers are pretty organized and they have done this before.