What are the alternatives to the Match? What do you think would happen if it were abolished?

[Lawpy]

Doing your own research and getting advice can only take someone so far. Getting through med school and into residency is such a convoluted process, and we shouldn’t all be expected to just wing it on our own. The whole purpose of admin is to guide us through the process that we’ve never been through and counsel us when we’re going to make a ******* decision that can affect our employability for the rest of our lives.

I’m not on the “med schools should refund tuition for those who don’t match” side of this. I’m talking about accountability to the ACGME and COCA when a school has a pattern of poorly matching students.

If a US MD school is poorly matching students, the LCME will likely crack down on the senior administration officials and a lot of heads will roll. Some top schools like Hopkins apparently have garbage advising but their students still match ridiculously well unless we're talking something insane like a super competitive surgical subspecialty.

I think the issue lies with bad advising for matching a competitive specialty as opposed to bad advising in general. People seeking IM, FM, peds etc don't seem to have an issue.

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[Lawpy]

Maybe it only applies to DO schools like mine then. Cause not only do we have bad advising but little to no name recognition as opposed to John’s Hopkins.

Don’t get me wrong, I’m not a “get rid of the match” Truther or something thinking that the worlds falling around us, I only posted to the thread because I was seeing insanity posted, but at the same time there are schools with consistently poor match rates.

But poor match rates in what? If a school is poorly matching in IM/FM/peds, that's a very bad problem and the school should absolutely be condemned. But if MS4s can't match into a competitive specialty... this isn't the school's fault.

 

[Lawpy]

The focus of every med school should ensure that their students should be competent enough to practice as a PCP. That's the baseline. A surgery or derm or another competitive specialty match shouldn't be a guarantee.

 

[efle]

Prelim surgery programs have started being held accountable for placements of their interns and I think that overall it has been a net benefit. I don’t know why you think that concept is insane.

Fighting dead-end surgery prelims makes sense. It's morally messed up to use and abuse someone for a year if you're not going to help them continue along their training. Same thing for Caribbean med schools, it's messed up to enroll people with poor GPAs and MCATs that predict failing along the way.

A US MD school being told they're financially responsible for bottom-of-class students who insist on applying to ENT, Ortho, etc? That's insane.

 

[DokterMom]

What about requiring that schools submit a "Post-Graduate Placement Plan" for each student who fails to match/SOAP into a position? Total administrative PITA of the sort that might incentivize schools to pay a bit more attention to their students' ERAS applications.

 

[7331poas]

We need to stop treating med students like kids and force them to be like adults for once and accept responsibility for their actions and choices.

Big talk from the M1.

 

[7331poas]

If a US MD school is poorly matching students, the LCME will likely crack down on the senior administration officials and a lot of heads will roll.

Not a chance. The LCME exists to protect medical schools, not students.

If you want to argue that students should take charge of their own education, we should at least be providing applicants the tools to make those decisions. In my view, every school should be required to publish the percentage of graduates who had to SOAP into a position or went unmatched.

 

[Lawpy]

Big talk from the M1.

Not a chance. The LCME exists to protect medical schools, not students.

If you want to argue that students should take charge of their own education, we should at least be providing applicants the tools to make those decisions. In my view, every school should be required to publish the percentage of graduates who had to SOAP into a position or went unmatched.

I agree and they should be transparent with their match/SOAP/unmatch profile. The Charting Outcomes are also available. I also think tuition should be cut by over half, and clinical years should have way more independence for med students.

 

[efle]

I do like that idea a lot. US News annually publishes data on "2018 graduates who left school with a full-time job that lasted at least a year and required bar passage" for law schools. It would be amazing to have a similar tool for medical schools showing match rates by specialty

 

[wondervisions]

I'm curious how people think a regular job search would be better than the match?

 

[efle]

I'm curious how people think a regular job search would be better than the match?

The problem is it wouldnt be a regular job search. It would be a job search with exploding offers and recruitment starting before weve even had a chance to rotate through all our interests

 

[Med Ed]

If a US MD school is poorly matching students, the LCME will likely crack down on the senior administration officials and a lot of heads will roll. Some top schools like Hopkins apparently have garbage advising but their students still match ridiculously well unless we're talking something insane like a super competitive surgical subspecialty.

I think the issue lies with bad advising for matching a competitive specialty as opposed to bad advising in general. People seeking IM, FM, peds etc don't seem to have an issue.

The most common "bad advising" is advice that the student will not accept. It's understandable. If your heart is set on ortho, derm, or ENT, then you don't want to apply to IM programs and feign interest. Even GS can be a stretch, especially when you consider that surgery PDs always hate feeling like they're not #1.

See LCME Accreditation Standard 11.2: Career Advising
A medical school has an effective career advising system in place that integrates the efforts of faculty members, clerkship directors, and student affairs staff to assist medical students in choosing elective courses, evaluating career options, and applying to residency programs.

The supporting data for this standard is pulled from the school's four most recent GQs, so it 100% reflects student opinion.

 

[wondervisions]

The problem is it wouldnt be a regular job search. It would be a job search with exploding offers and recruitment starting before weve even had a chance to rotate through all our interests

I agree. I strongly prefer a match system over a job search. I'm trying to understand why some people think the match is flawed.

 

[wondervisions]

I think people get caught up with the feeling of losing their freedom of choice in the match. The choice is still there, it just happens before you get an offer (by ranking programs).

 

[efle]

I think people get caught up with the feeling of losing their freedom of choice in the match. The choice is still there, it just happens before you get an offer (by ranking programs).

I think the red flag is more that we can't negotiate our pay, or really anything about our contracts, and there's no viable alternative route to get a residency. Job markets in the USA aren't supposed to look like this

In case you haven't read it before highly recommend the carmody blog posts about the lawsuit and legislation to protect the match from antitrust

This is the start Part 1:

The Match, Part 1: Why do we have a Match?

Not long ago, I interviewed an applicant for our residency program. She explained how, after each one of her interviews, her grandmother calls her and excidedly asks whether she got the job. &#8220…

thesheriffofsodium.com

Here's the Part 5 about the lawsuit: The Match, Part 5: The Lawsuit

 

[Lem0nz]

I think the red flag is more that we can't negotiate our pay, or really anything about our contracts, and there's no viable alternative route to get a residency. Job markets in the USA aren't supposed to look like this

In case you haven't read it before highly recommend the carmody blog posts about the lawsuit and legislation to protect the match from antitrust

This is the start Part 1:

The Match, Part 1: Why do we have a Match?

Not long ago, I interviewed an applicant for our residency program. She explained how, after each one of her interviews, her grandmother calls her and excidedly asks whether she got the job. &#8220…

thesheriffofsodium.com

Here's the Part 5 about the lawsuit: The Match, Part 5: The Lawsuit

Many people feel not being able to negotiate those things is a strength of the Match. I certainly am one of those people. If not constrained by the match competitive programs could lowball the **** out of you and you could be paying for residency instead of the other way around, as has been discussed in this thread and others earlier. The only counter argument I’ve seen to this is “no, the ACGME makes rules” to which I say - how is that any different than the match? Whether the rules are dictated to you by Congress, the ACGME, the match, or anyone else, you still can’t bargain. The only way to bargain a contract is to let employers bargain too, and there is absolutely no reason they can’t say “this is ortho, we’re worth more to you than you to us. You can pay me 50k to come train here or I’ll go hire an NP and SA who aren’t a revolving door.”

 

[Espressso]

The school shouldn't be held responsible for those who didn't match unless it fell into rare cases of bad advising and the unmatched MS4s who were truly competitive fell through the cracks. Which apparently is rare

You guys are right. I'll give you that. I just feel like it's not as rare as you think in the DO world.

 

[Lem0nz]

I think it’s worth saying that we as a country have found ourselves in a weird spot where medical students that don’t match are not acting like functional adults, but it isn’t entirely on them. Carib schools are a problem, IMG applications are a problem, DO mismatch to reality is a problem. MD seems like the problem is much smaller but non zero.

I guess I don’t see this as an all or none thing. Schools held accountable doesn’t have to be a free year of tuition or discharge the entire 4 years of Med school debt. It also doesn’t mean wash your hands. Maybe it’s a reduced tuition year. Or a match/remediation plan that is very organized, I thought that was a brilliant idea. There’s a lot of grey I think where we could make iterative improvement.

There is some predatory behavior, some ignorance, some failure to advise, and a healthy dose of unrealistic expectations on the student side. Maybe I’m going to get blasted for this, but I don’t know that you can just say “they’re adults, they should figure it out” for that last piece of unrealistic expectations. Medical education is a convoluted hot mess. A lot of medical students are delaying a lot of ‘adult things’ - buying a house, paying taxes, having children. I don’t know how to phrase this correctly and I’m doing a really bad job here but the adult maturing that most people go through is really delayed in our population and a lot of it is protracted and doesn’t happen until residency or even after. I really don’t know how to say it well, but medical school and DEFINITELY residency still felt like being in high school in a lot of ways. Anyone who is going through it or has been through it knows what I’m talking about, it’s hard to articulate.

I’m not saying we need to hold everyone’s hands like they aren’t adults. But there is something that is lost to us in the difficulty and rigor of medical training and residency that really does delay our maturation and development. So much of medicine is on rails - our living expenses, our insurance, our paychecks. It’s all very, very defined for us. There’s certainly a huge number of us that could use a slap in the face and for someone to say “grow the heck up, be realistic” but the driving forces and pressure in adult life are very muted in the 7-10 year block after undergrad.

idk. I’m rambling. Maybe someone else can say this better than I can. Someone posted before that it’s a good thing medical students generally don’t start school until 22 or later and I’m starting to really agree. It isn’t enough to say treat us like adults though. A great many of us haven’t been exposed to adult problems that make you have to reckon with reality. Everyone going into Med school thinks they’re going to be the AOA top ten percent and perfect grades and match into the top academic residency. 90% are shocked when they don’t - except, in my experience, the people who had careers and lives before medicine who are totally content.

does that make sense?

 

[Goro]

You guys are right. I'll give you that. I just feel like it's not as rare as you think in the DO world.

I can guarantee you that at least at my DO school, not a single competitive or even mediocre student went unmatched. Hell, even some of our all time worst students were able to match. Even the worst one ever! One's an anesthesiologist now, and probably killing patients somewhere in the Pac NW. If people aren't matching, it's for a reason.

 

[fldoctorgirl]

I like @NotAProgDirector 's idea of having a preliminary round. Kind of like early admission for colleges.

 

[Mad Jack]

the match algorithm and process is not the problem. The problem is the gamification of the residency selection process. Lots of people complain about program empty words, but the fix to that is incredibly simple: dont believe them. If your advisors arent telling you that, they are doing you a disservice.

There is *no reason* to believe any of it. The algorithm is applicant driven, so the applicant should *always* choose what they actually want first

 

[Lawpy]

I think it’s worth saying that we as a country have found ourselves in a weird spot where medical students that don’t match are not acting like functional adults, but it isn’t entirely on them. Carib schools are a problem, IMG applications are a problem, DO mismatch to reality is a problem. MD seems like the problem is much smaller but non zero.

I guess I don’t see this as an all or none thing. Schools held accountable doesn’t have to be a free year of tuition or discharge the entire 4 years of Med school debt. It also doesn’t mean wash your hands. Maybe it’s a reduced tuition year. Or a match/remediation plan that is very organized, I thought that was a brilliant idea. There’s a lot of grey I think where we could make iterative improvement.

There is some predatory behavior, some ignorance, some failure to advise, and a healthy dose of unrealistic expectations on the student side. Maybe I’m going to get blasted for this, but I don’t know that you can just say “they’re adults, they should figure it out” for that last piece of unrealistic expectations. Medical education is a convoluted hot mess. A lot of medical students are delaying a lot of ‘adult things’ - buying a house, paying taxes, having children. I don’t know how to phrase this correctly and I’m doing a really bad job here but the adult maturing that most people go through is really delayed in our population and a lot of it is protracted and doesn’t happen until residency or even after. I really don’t know how to say it well, but medical school and DEFINITELY residency still felt like being in high school in a lot of ways. Anyone who is going through it or has been through it knows what I’m talking about, it’s hard to articulate.

I’m not saying we need to hold everyone’s hands like they aren’t adults. But there is something that is lost to us in the difficulty and rigor of medical training and residency that really does delay our maturation and development. So much of medicine is on rails - our living expenses, our insurance, our paychecks. It’s all very, very defined for us. There’s certainly a huge number of us that could use a slap in the face and for someone to say “grow the heck up, be realistic” but the driving forces and pressure in adult life are very muted in the 7-10 year block after undergrad.

idk. I’m rambling. Maybe someone else can say this better than I can. Someone posted before that it’s a good thing medical students generally don’t start school until 22 or later and I’m starting to really agree. It isn’t enough to say treat us like adults though. A great many of us haven’t been exposed to adult problems that make you have to reckon with reality. Everyone going into Med school thinks they’re going to be the AOA top ten percent and perfect grades and match into the top academic residency. 90% are shocked when they don’t - except, in my experience, the people who had careers and lives before medicine who are totally content.

does that make sense?

Honestly, i'm not seeing the issue with bad advising or matching problems in most fields but i admit i'm talking strictly in US MD perspective. I have no idea about IMGs and Carib issues other than Carib schools are predatory. And i still think the unmatch issues for MD apply for DO as well but maybe somewhat worse due to persistent anti DO bias.

Like i said before, i think the issue lies with difficulty in matching to a competitive specialty (and not matching in general) and schools getting slammed for bad advising on matching into competitive specialties. I think it's a problem that should be sorted out by admins and senior faculty but matching a competitive specialty shouldn't be a guarantee.

 

[Lawpy]

There is *no reason* to believe any of it. The algorithm is applicant driven, so the applicant should *always* choose what they actually want first

I feel people who are complaining about the Match are really just complaining about the crappy parts of residency app process which have little to nothing to do with the Match itself

 

[FindersFee5]

Honestly, i'm not seeing the issue with bad advising or matching problems in most fields but i admit i'm talking strictly in US MD perspective. I have no idea about IMGs and Carib issues other than Carib schools are predatory. And i still think the unmatch issues for MD apply for DO as well but maybe somewhat worse due to persistent anti DO bias.

Like i said before, i think the issue lies with difficulty in matching to a competitive specialty (and not matching in general) and schools getting slammed for bad advising on matching into competitive specialties. I think it's a problem that should be sorted out by admins and senior faculty but matching a competitive specialty shouldn't be a guarantee.

I'll add that the competitive specialty game is really different from general advising, and it has become even more wild in the last 10 years so many of the general residency advisors don't understand it anymore. It ends up in a situation where advising is dependent on intra-specialty advisors, which is a lot more heterogeneous. At my school, our ENT applicants got good, conservative advising, many of them dual applied, and they all matched. In ortho and plastics the specialty advisors did not understand the current situation as well: a few people went unmatched because they were told they would be fine without dual applying.

 

[PandaBaer]

Just spitballing here, but could some of this be alleviated by the way residencies are set up? It seems many of the issues stems from overapplication to integrated competitive (sub) specialities, i.e. ortho, plastics, derm, rads, vascular, CT, etc. This is also exacerbated by the fact that these specialties are not even experienced till MS4, therefore many students are applying "blind".
Would shifting residency structure so that any non-core specialty requires a prelim year in medicine or surgery be beneficial? This allows students to explore more sub-specialties in MS4 and would funnel all prospective applicants to prelim years where they can then further apply with having MS4 subI grades, possibly step 3?/in services scores, and more tailored research/experience? Furthermore, if PGY-2 applicants are unsuccessful they can still pursue the more generalized specialty.
Looking at the match data can be very disorienting given so many possible choices, especially with the combined residencies. Narrowing the choices down to the core rotations in MS3 and gating the sub specialties behind a general intern year might allow students to self-select better and truly identify with a chosen specialty.

 

[Lem0nz]

Just spitballing here, but could some of this be alleviated by the way residencies are set up? It seems many of the issues stems from overapplication to integrated competitive (sub) specialities, i.e. ortho, plastics, derm, rads, vascular, CT, etc. This is also exacerbated by the fact that these specialties are not even experienced till MS4, therefore many students are applying "blind".
Would shifting residency structure so that any non-core specialty requires a prelim year in medicine or surgery be beneficial? This allows students to explore more sub-specialties in MS4 and would funnel all prospective applicants to prelim years where they can then further apply with having MS4 subI grades, possibly step 3?/in services scores, and more tailored research/experience? Furthermore, if PGY-2 applicants are unsuccessful they can still pursue the more generalized specialty.
Looking at the match data can be very disorienting given so many possible choices, especially with the combined residencies. Narrowing the choices down to the core rotations in MS3 and gating the sub specialties behind a general intern year might allow students to self-select better and truly identify with a chosen specialty.

Would make those incredibly incredibly long residencies even longer with the only upside being maybe we have less applicants during the match. Condemning them to a year of prelim general surgery (assuming most would pick that because most of those specialties are surgical) seems... cruel.

 

[PandaBaer]

Would make those incredibly incredibly long residencies even longer with the only upside being maybe we have less applicants during the match. Condemning them to a year of prelim general surgery (assuming most would pick that because most of those specialties are surgical) seems... cruel.

I definitely agree there are many possible downsides such as having to move after prelim, another set of interviews and matching, but I don't see how total training time would increase. It would be similar to how rads and gas already operate.
The upside would be programs would have more info to sort applicants by, MS4 grades, Step 3, etc. Home programs would also get to evaluate applicants based on performance in a real clinical setting. Applicants can utilize MS4 to truly explore sub-specialties and tailor applications. More meaningful research may be conducted during school with a longer timeline to get published.
I am obviously aware this would probably never happen, but I would like to hear what all the possible pros and cons are, and I guess, what the benefit is for moving sub-specialities to integrated paths.

 

[DOVinciRobot]

I definitely agree there are many possible downsides such as having to move after prelim, another set of interviews and matching, but I don't see how total training time would increase. It would be similar to how rads and gas already operate.
The upside would be programs would have more info to sort applicants by, MS4 grades, Step 3, etc. Home programs would also get to evaluate applicants based on performance in a real clinical setting. Applicants can utilize MS4 to truly explore sub-specialties and tailor applications. More meaningful research may be conducted during school with a longer timeline to get published.
I am obviously aware this would probably never happen, but I would like to hear what all the possible pros and cons are, and I guess, what the benefit is for moving sub-specialities to integrated paths.

This would only work for the general surgery adjacent specialties in my opinion, I.e vascular and CT, and perhaps plastics (but their residency is still different enough it might not work for them either). Ortho, ENT, Neurosurgery would not have shortened residencies because the prelim surgery year is not similar enough to what they do in their own intern years to pick up the intern level skills they need in those specialties.

The uncomfortable answer I think, is that we as students need to accept that we are not owed a spot in a competitive specialty, regardless of how competitive we might be, and there will always be unmatched applicants. There isn’t anything wrong with the Match itself.

 

[Lawpy]

I'll still say related to the main point that if schools are poorly matching students to FM/IM/peds, there should be a severe financial penalty imposed on the schools.

Really what we need is the match rate categorized by each specialty for each year.

 

[Med Ed]

I'll still say related to the main point that if schools are poorly matching students to FM/IM/peds, there should be a severe financial penalty imposed on the schools.

By who and under what authority?

If 5% of our students didn't match each year then we'd just increase tuition by 5% and let the matching students subsidize the others. Sound fair?

 

[Lawpy]

By who and under what authority?

If 5% of our students didn't match each year then we'd just increase tuition by 5% and let the matching students subsidize the others. Sound fair?

I was thinking the LCME at the very least. Matching into a primary care field should be a guarantee and all schools should be required to have excellent, accurate advising for PCP fields. So i'm ok if this means someone who went unmatched in FM/IM/peds gets their debts completely forgiven.

This is different from going unmatched in general. Someone who went unmatched in a competitive specialty aren't going to get this support

 

[7331poas]

The uncomfortable answer I think, is that we as students need to accept that we are not owed a spot in a competitive specialty, regardless of how competitive we might be, and there will always be unmatched applicants. There isn’t anything wrong with the Match itself.

I dont think anyone thinks they are owed a spot in neurosurgery. My point is that the penalty for a 250, 8 pub applicant not matching neurosurg should not be the SOAP (or spending thousands of dollars on a dual application).

 

[Lawpy]

I dont think anyone thinks they are owed a spot in neurosurgery. My point is that the penalty for a 250, 8 pub applicant not matching neurosurg should not be the SOAP (or spending thousands of dollars on a dual application).

... what should it be other than reapplying?

 

[DOVinciRobot]

I dont think anyone thinks they are owed a spot in neurosurgery. My point is that the penalty for a 250, 8 pub applicant not matching neurosurg should not be the SOAP (or spending thousands of dollars on a dual application).

These statements are not congruent. Such an applicant is not owed a neurosurgery spot. They are free to dual apply to a less competitive specialty if they wish, nothing is stopping them.

 

[7331poas]

... what should it be other than reapplying?

In my opinion, I liked the earlier suggestions of having a early match for the "competitive" specialities and then a second match for "everyone else". That way nsg applicants are not forced to dual apply upfront.

 

[7331poas]

These statements are not congruent. Such an applicant is not owed a neurosurgery spot. They are free to dual apply to a less competitive specialty if they wish, nothing is stopping them.

...yes. I specifically stated that in the following 5 words that you did not highlight.

 

[Lawpy]

In my opinion, I liked the earlier suggestions of having a early match for the "competitive" specialities and then a second match for "everyone else". That way nsg applicants are not forced to dual apply upfront.

Is the early match system something like that of ophtho/uro?

 

[DOVinciRobot]

...yes. I specifically stated that in the following 5 words that you did not highlight.

No.... you said you didn’t think that was a good option.

An earlier round for competitive specialties could work, but it would blow up the couples match and likely have other significant unforeseen consequences.

Competitive specialties are.... competitive. The chance of not matching is significant regardless of how good you are as an applicant, and not having a plan in place in case that happens simply isn’t very smart. I’m not sure we need to design a new system just to benefit applicants to these specialties.

Unmatched applicants to these specialties almost always land on their feet somewhere within a year or two, even if it’s not in their desired specialty. A prelim surgery year or ending up in a different specialty is simply the risk we run when we shoot for specialties with more good applicants than spots.

 

[Lawpy]

No.... you said you didn’t think that was a good option.

An earlier round for competitive specialties could work, but it would blow up the couples match and likely have other significant unforeseen consequences.

Competitive specialties are.... competitive. The chance of not matching is significant regardless of how good you are as an applicant, and not having a plan in place in case that happens simply isn’t very smart. I’m not sure we need to design a new system just to benefit applicants to these specialties.

Unmatched applicants to these specialties almost always land on their feet somewhere within a year or two, even if it’s not in their desired specialty. A prelim surgery year or ending up in a different specialty is simply the risk we run when we shoot for specialties with more good applicants than spots.

How does the couples match work for ophtho/uro?

 

[DOVinciRobot]

How does the couples match work for ophtho/uro?

It doesn’t. From my understanding the partner just tries to rank programs higher that are in the geographic area of the other partners earlier match. The partner has to apply very broadly and hope they land some where nearby.

This is how it has been explained to me. I’d love to be corrected if that’s not how it works.

 

[DokterMom]

In my opinion, I liked the earlier suggestions of having a early match for the "competitive" specialities and then a second match for "everyone else". That way nsg applicants are not forced to dual apply upfront.

No.... you said you didn’t think that was a good option.

An earlier round for competitive specialties could work, but it would blow up the couples match and likely have other significant unforeseen consequences.

Competitive specialties are.... competitive. The chance of not matching is significant regardless of how good you are as an applicant, and not having a plan in place in case that happens simply isn’t very smart. I’m not sure we need to design a new system just to benefit applicants to these specialties.

Unmatched applicants to these specialties almost always land on their feet somewhere within a year or two, even if it’s not in their desired specialty. A prelim surgery year or ending up in a different specialty is simply the risk we run when we shoot for specialties with more good applicants than spots.

I'd suspect this would have the unintended consequence of greatly increasing the number of applications for the most competitive fields. After all, what's the downside if a 'failed' integrated plastics applicant gets to apply to GS as if they'd never applied to plastics first?

For couples, there would need to be a couples match in the hyper-competitive round (if both applying hyper-competitive) and results would need to be released early enough for the other applicants so a primary-care partner could apply within a specified geographic area.

Not impossible, but a major re-working of the process and two compressed time frames.

 

[NotAProgDirector]

It doesn’t. From my understanding the partner just tries to rank programs higher that are in the geographic area of the other partners earlier match. The partner has to apply very broadly and hope they land some where nearby.

This is how it has been explained to me. I’d love to be corrected if that’s not how it works.

That's exactly how it "works".

In order for an early round to work, it needs to be over before the next round starts. An early match for nsg won't be helpful if by the time the results are out, GS interview have been offered and all/most interview slots are full. This early match would need to be in July/Aug with results by September. Now that most medical schools have shortened preclinical training, this might work and still give students enough time to do their rotations and get letters, but it will shorten the timeline.

There would be no couples match, unless both were applying to competitive fields.

Whether or not this is a good idea at all depends upon what people who don't match into nsg/ortho/plastics/vascular want to do. If the answer is "a research year and apply again" an early match offers nothing. How many people just throw in the towel and apply for GS/gas/etc? I don't know.

No matter how you slice it, the same problem arises in the main match. After you carve out Nsg/Ortho/Plastics/Vascular/Derm, there will now be something else in the main match which is relatively the "most competitive". And people applying into that field will face the same problem -- although the magnitude of the problem might be much less.

I think you can only have one early match. Better to carve out the competitive fields, or better to allow an "early decision" option for all fields?

 

[Lem0nz]

That's exactly how it "works".

In order for an early round to work, it needs to be over before the next round starts. An early match for nsg won't be helpful if by the time the results are out, GS interview have been offered and all/most interview slots are full. This early match would need to be in July/Aug with results by September. Now that most medical schools have shortened preclinical training, this might work and still give students enough time to do their rotations and get letters, but it will shorten the timeline.

There would be no couples match, unless both were applying to competitive fields.

Whether or not this is a good idea at all depends upon what people who don't match into nsg/ortho/plastics/vascular want to do. If the answer is "a research year and apply again" an early match offers nothing. How many people just throw in the towel and apply for GS/gas/etc? I don't know.

No matter how you slice it, the same problem arises in the main match. After you carve out Nsg/Ortho/Plastics/Vascular/Derm, there will now be something else in the main match which is relatively the "most competitive". And people applying into that field will face the same problem -- although the magnitude of the problem might be much less.

I think you can only have one early match. Better to carve out the competitive fields, or better to allow an "early decision" option for all fields?

None of the above and preserve the couples match probably. =\ Not that I think we particularly owe it to have a couples match at all, but it seems the least evil. As has been said, many times, people who don't match competitive specialties almost always land on their feet.

 

[PandaBaer]

This would only work for the general surgery adjacent specialties in my opinion, I.e vascular and CT, and perhaps plastics (but their residency is still different enough it might not work for them either). Ortho, ENT, Neurosurgery would not have shortened residencies because the prelim surgery year is not similar enough to what they do in their own intern years to pick up the intern level skills they need in those specialties.

The uncomfortable answer I think, is that we as students need to accept that we are not owed a spot in a competitive specialty, regardless of how competitive we might be, and there will always be unmatched applicants. There isn’t anything wrong with the Match itself.

I see, so what you're saying is specialization happens as early as pgy 1 for many specialities and general specialties consisting of the core rotations in MS3 would end up delaying training. By core I mean IM, GS, Psych, OB, Peds, FM(?), EM(?).
Fair enough, this solution probably wouldn't solve over application directly anyways.

Throwing more crazy ideas out there, feel free to tear apart.

1. Set up a reject function in ERAS with a limited number of re-applies to show true interest. i.e. applicant is notified of programs that have rejected them for interview, they then have X amount of re-applies to send to rejected programs. If an applicant accepts an interview it counts against their re-apply bank. This would allow applicants to show interest, also puts a limit on those with a lot of interviews from using re-applies to hoard more interviews. This may also hedge high stat applicants against yield protection.

2. Have applicants rank order programs during initial application. This would be a soft application cap of sorts and probably doesn't resolve much congestion at top tier programs, many would still rank them high. This does not have to be a hard numerical rank, maybe group rank, i.e. top 10, next 10, etc. Downside is ranking, however roughly, programs without interview/visit. Though it would perhaps prompt deeper research into programs by applicants and incentivize programs to better advertise their strengths, ideally by becoming more transparent.

 

[Lawpy]

I realize i keep ignoring the IMG/FMGs which complicates the reforms a lot since factoring them in makes number of applicants way higher than number of spots. Unless IMG filter is used everywhere, overapplication is going to persist.