What if residency match process was applied to med school admissions

[Medwannabe123]

What would be pros and cons.

Pros:
One date it’s all over
Everyone gets one seat
Colleges still get to interview
Horseplay is avoided
Anxiety is reduced
More Humane treatment of some of the best

Cons:
May be students don’t get to go where they would if they had multiple A’s. Well yes they would loose a bit but they will still have matched their choice.

Thoughts?

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[klever]

isnt there too many potential premeds for this to work...?

 

[xakrinf]

That’s how the great state of Texas does it🤠

 

[Medwannabe123]

isnt there too many potential premeds for this to work...?

I think that may not be an issue. Just that match rate will be 40% instead of 90% for residency.

Even now about 40% get admitted when all the chaos settles down.

 

[Frigidcold]

I imagine there are greater financial considerations for medical school than residency. What happens if you match at a school, you get the financial aid package, and you can't pay for it? It's nice to be able to weigh options. I suppose you could shift everything before the match, but that might be an administrative nightmare.

 

[deleted1139416]

Medical school and residency are fundamentally different. Medical schools are looking for a diverse class of people. Residencies are looking for employees who are easy to work with and won’t give them grief for the next 3-7 years.

Also not all medical students in the same class have the same value, as evidenced by the fact that some get scholarships and some don’t. But every single resident gets the same salary. This changes the game quite a bit.

Not to mention that location is a much bigger driving factor in residency than med school. Med students on average are young and willing to move. Residents, on average, are more settled in life. This is why residencies take location preference significantly into account.

 

[Medwannabe123]

I imagine there are greater financial considerations for medical school than residency. What happens if you match at a school, you get the financial aid package, and you can't pay for it? It's nice to be able to weigh options. I suppose you could shift everything before the match, but that might be an administrative nightmare.

If you can’t pay and need a package should be part of the match algorithm. Like today for residents is their speciality and location choice and even partner co location.

The issue is that, is a one year horrendous process which breaks so many, and leaves all power in the hands of med schools any better.

 

[Medwannabe123]

Medical school and residency are fundamentally different. Medical schools are looking for a diverse class of people. Residencies are looking for employees who are easy to work with and won’t give them grief for the next 3-7 years.

Also not all medical students in the same class have the same value, as evidenced by the fact that some get scholarships and some don’t. But every single resident gets the same salary. This changes the game quite a bit.

Not to mention that location is a much bigger driving factor in residency than med school. Med students on average are young and willing to move. Residents, on average, are more settled in life. This is why residencies take location preference significantly into account.

Match process for med school admissions does not disqualify the option to build a diverse pool.

Residency match is okay by them bcos it’s a monopolistic process to ensure minimum wages. Not just non-grief !

Well all med school students don’t have the same value - true. Nor is residents value the same - but their value is flattened out for the hospitals economic benefits.

 

[Medwannabe123]

Medical school and residency are fundamentally different. Medical schools are looking for a diverse class of people. Residencies are looking for employees who are easy to work with and won’t give them grief for the next 3-7 years.

Also not all medical students in the same class have the same value, as evidenced by the fact that some get scholarships and some don’t. But every single resident gets the same salary. This changes the game quite a bit.

Not to mention that location is a much bigger driving factor in residency than med school. Med students on average are young and willing to move. Residents, on average, are more settled in life. This is why residencies take location preference significantly into account.

Actually most residents get thrown around all over the place, which even negates the premise of serving in the communities where they were admitted to med schools based on ‘we like candidates who will serve here’

 

[Fluidity of Movement]

I feel like yield protection is a thing that could be overcome easily. There is a certain cutoff where someone is not competitive enough for top schools, but too competitive for bottom schools, and middle schools are being pressured from both ends.

I would also like to see waitlists be guaranteed admissions for next cycle, with financial aid disbursed and payment made the year before to avoid schools getting screwed over.

This is one reason why I want to self-select into DO because they just don't give a **** about the above and just want people who want to be doctors.

No, I promise I'm not pandering to @Goro ok maybe a little.

 

[Goro]

Actually most residents get thrown around all over the place, which even negates the premise of serving in the communities where they were admitted to med schools based on ‘we like candidates who will serve here’

Where residents go is mostly by choice, as most, at least at my school, get their 1st to 3rd choices.

And if the app process "breaks people", we'll, they'd never survive med school or residency.

 

[Med Ed]

Thoughts?

Not feeling it.

 

[Medwannabe123]

Where residents go is mostly by choice, as most, at least at my school, get their 1st to 3rd choices.

And if the app process "breaks people", we'll, they'd never survive med school or residency.

I think it’s a myth that if the process was simpler and not drain emotionally some of the best we have, they won’t survive later.

 

[Medwannabe123]

I think it’s a myth that if the process was simpler and not drain emotionally some of the best we have, they won’t survive later.

You are right. 75% get 1-3 in Match.
That is 10,000 who don’t. But atleast it’s not a chaos

 

[jhmmd]

I think it’s a myth that if the process was simpler and not drain emotionally some of the best we have, they won’t survive later.

This is why God in his infinite wisdom invented organic chemistry

 

[wysdoc]

That’s how the great state of Texas does it🤠

True and I think the TMDSAS Match at least shortens the time somewhat to when applicants receive their results.
I liked it better when the TMDSAS application deadline was Oct 1 and Match Day was Feb 1.
Lately those deadlines are Nov 1 and early March, not sure why it is now extended.
But you know what? Even with a uniform match day some people complain, say it isn’t fair, and want to trade up to WL schools. Human nature.

 

[Medwannabe123]

Not feeling it.

Tell us more please what your views are

 

[Med Ed]

Tell us more please what your views are

I have mused over the idea myself, but ultimately it seems like a solution that's looking for a problem. Don't get me wrong, the existing system has plenty of problems, but the problems are largely known. You therefore need a very compelling reason to upend everything. The match was created to address a chaotic process where many people got suboptimal placements via exploding offers. Between AMCAS, the MSAR, and the AAMC traffic rules, UME admissions are a lot more orderly.

Currently schools are able to build most of their respective classes over time. I doubt many of them would want to relinquish that level of control, which includes the ability to recruit specific high-value candidates.

I'm also not sure how scholarships would work in a match unless everything converted to need-based.

Also, what unintended consequences could you foresee? Would schools start interviewing more to ensure they fill, and what would that mean? Would there be a SOAP-like process for unfilled seats? Would MD and DO schools be in the same match?

 

[TxMed55]

As a Texas resident the only thing that annoys me about the match system is that unless you prematch to schools you dont really know how many acceptances you would have had which can be annoying when trying to compare the schools pros, cons and financial aid.

 

[Medwannabe123]

I have mused over the idea myself, but ultimately it seems like a solution that's looking for a problem. Don't get me wrong, the existing system has plenty of problems, but the problems are largely known. You therefore need a very compelling reason to upend everything. The match was created to address a chaotic process where many people got suboptimal placements via exploding offers. Between AMCAS, the MSAR, and the AAMC traffic rules, UME admissions are a lot more orderly.

Currently schools are able to build most of their respective classes over time. I doubt many of them would want to relinquish that level of control, which includes the ability to recruit specific high-value candidates.

I'm also not sure how scholarships would work in a match unless everything converted to need-based.

Also, what unintended consequences could you foresee? Would schools start interviewing more to ensure they fill, and what would that mean? Would there be a SOAP-like process for unfilled seats? Would MD and DO schools be in the same match?

Thanks for a thoughtful response.

I agree applying Match to med school admissions will be different compared to now, much would change and will need to be resolved. Change is hard anyway.

It will solve the same chaos you call out for residents. A different context but chaos it is. Chaos which runs September to June, where some candidates have 7 admissions and some have 7 WL’s in say T50 schools. Remember a WL means they have been found fit for admission just that the particular school does not yet have a seat. May be the WL will turn to A. And may be all the T 150’s never interviewed this candidate and they go without an A at all. I don’t care of the T## list, just saying so for context.

I think we may actually get good choice match like we do for residents.
Texas folks seem to be fine with it.

If schools interview more so be it. I think resident match has DO and MD together. So that should be fine. SOAP yes.

I think the students will have a better and fair experience vs now. Ofcourse colleges will not like b’cos it will take some power away from them.

Thanks again. I appreciate your inputs and you have many good points.

 

[Snoozles]

As a Texas resident the only thing that annoys me about the match system is that unless you prematch to schools you dont really know how many acceptances you would have had which can be annoying when trying to compare the schools pros, cons and financial aid.

Agreed. The financial aid aspect is huge but we're expected to just kinda guess at what schools might give us some sort of scholarship or maybe we wouldn't have even gotten into those schools at all?
If, for example, I knew that my the med school at my alma mater would kick in a chunk of change, I would absolutely have bumped them on the priority list because none of my potential matches were significantly different in terms of prestige/residency match potential/etc. But by using the match system, they have taken away all of our negotiating ability. Cost should be a HUGE factor when ranking, but rarely do you have that info ahead of time.

 

[Fluidity of Movement]

I think it’s a myth that if the process was simpler and not drain emotionally some of the best we have, they won’t survive later.

I will take the rare (slight) disagreement with Goro and friends here to side with you.

The vast majority of premeds never make it to the app cycle. This entire process is hell. But ultimately it's good for us. I think since 2015 and even more recently though things shifting to a gap year being standard has helped.

But I will always err on the side of mental health and SI as it's extremely prevalent issue especially as of late. As that is one of my career and life missions the point you are making is valid but I think some pressure being relieved at the top end (med school dropping class ranks, going pass fail) does help a bit on our end as the bar of success seems less daunting.

That is my opinion at least.

 

[Med Ed]

It will solve the same chaos you call out for residents. A different context but chaos it is.

I disagree on this point.

If we really wanted to take things back to the age before the NRMP, we'd have to do the following:
1. Get rid of AMCAS. Every school goes back to a unique application.
2. Get rid of the MSAR and AAMC data tables. Everyone applies without knowledge of how competitive they are.
3. Get rid of the traffic rules. Allow schools to give legally-binding offers of admission that expire after 24 hours (aka exploding offers).

That, my friend, would be chaos. If the current system is guilty of anything it's the anxiety associated with waiting. The only moderately chaotic period is the mad rush through the waitlist in early May.

So we've go the NRMP match, which has about 5,000 programs and more seats than US grads, and the TMDSAS match, which operates in a confined single-state ecosystem and has both pre-match and rolling components. One could try to mentally extrapolate to a nationwide match involving almost 200 institutions, but I just don't see the utility of the exercise.

 

[cj_cregg]

I'm just not sure what a match system actually fixes for medical students. Matching doesn't mean "one day it's all over," the residency match process still takes months. Everybody already gets one seat...you can only go to one medical school. There is PLENTY of horseplay in the residency match and it is PLENTY anxiety-inducing, honestly I was more anxious about the residency match because I had so much less control over the process. I don't think the medical school application system as it currently stands is any less humane than the residency match. I personally was lucky to have multiple acceptances back in my day and I was grateful to have the opportunity to choose the school that made the most sense for ME with regards to cost, location, etc., instead of just having one choice. The people who just have one choice will still just have one choice. The people who don't get in still won't get in. I think the current traffic rules for medical school applications protect the students just fine AND give the students fortunate enough to garner multiple acceptances more freedom and control compared to the match system, where even the best applicants are still at the whim of a computer algorithm.

 

[Goro]

I think it’s a myth that if the process was simpler and not drain emotionally some of the best we have, they won’t survive later.

You've never taught medical students, I see.

Med school can break even healthy students.

 

[Medwannabe123]

I'm just not sure what a match system actually fixes for medical students. Matching doesn't mean "one day it's all over," the residency match process still takes months. Everybody already gets one seat...you can only go to one medical school. There is PLENTY of horseplay in the residency match and it is PLENTY anxiety-inducing, honestly I was more anxious about the residency match because I had so much less control over the process. I don't think the medical school application system as it currently stands is any less humane than the residency match. I personally was lucky to have multiple acceptances back in my day and I was grateful to have the opportunity to choose the school that made the most sense for ME with regards to cost, location, etc., instead of just having one choice. The people who just have one choice will still just have one choice. The people who don't get in still won't get in. I think the current traffic rules for medical school applications protect the students just fine AND give the students fortunate enough to garner multiple acceptances more freedom and control compared to the match system, where even the best applicants are still at the whim of a computer algorithm.

Thanks. Congratulations on multiple A’s.

 

[cj_cregg]

Thanks. Congratulations on multiple A’s.

That was about 10 years ago at this point lol but thank you

 

[Medwannabe123]

You've never taught medical students, I see.

Med school can break even healthy students.

Ofcourse it can. The percent drop out though is no different than premed drop outs.

 

[deleted1139416]

Ofcourse it can. The percent drop out though is no different than premed drop outs.

It’s a statistic that we will never know. Being a med student is an official title, unlike being a premed. But just anecdotally, I can tell you that the percent of premeds who don’t go into med school is vastly higher than the percent of med students dropping out.

 

[senecca]

In America, the college admissions is about the colleges, not the students. Goro once said “it is about what the colleges want, not the students “. Unless we shift the focus to the students as done in all other countries, things will get only worse.

I spent only three hours and came up with holistic + merit based medical school admissions process which could be over in 3-4 weeks.

1. Before submitting the application, the applicant should have all criteria evaluated just like GPA and MCAT. Let the applicants write around 3 essays under proctored environment just like mcat , AAMC can score those essays in an anonymous manner. Similarly, the applicants can sign up for an interview with aamc and have it scored by 5 members panel.
2. On may 1st, let applicants submit their applications and select top 2 schools for holistic round 1. Let the colleges take 10 days to review the applications (not evaluate them) and offer admissions and merit/need based scholarships. Give applicants accept or withdraw acceptances and move on to round 2.
3. For the second holistic round, the applicants can choose top 2 schools and colleges review the applications and offer admission and scholarships. Applicants can choose to accept or withdraw offers.
4. Round 3 will be merit based on gpa, mcat, essay and interview scores. A computer algorithm will assign the students colleges according to their preferences, just like residency match.

The entire cycle will be over in one month. Mission based programs can use legal agreements to enforce compliance.

 

[cj_cregg]

In America, the college admissions is about the colleges, not the students. Goro once said “it is about what the colleges want, not the students “. Unless we shift the focus to the students as done in all other countries, things will get only worse.

I spent only three hours and came up with holistic + merit based medical school admissions process which could be over in 3-4 weeks.

1. Before submitting the application, the applicant should have all criteria evaluated just like GPA and MCAT. Let the applicants write around 3 essays under proctored environment just like mcat , AAMC can score those essays in an anonymous manner. Similarly, the applicants can sign up for an interview with aamc and have it scored by 5 members panel.
2. On may 1st, let applicants submit their applications and select top 2 schools for holistic round 1. Let the colleges take 10 days to review the applications (not evaluate them) and offer admissions and merit/need based scholarships. Give applicants accept or withdraw acceptances and move on to round 2.
3. For the second holistic round, the applicants can choose top 2 schools and colleges review the applications and offer admission and scholarships. Applicants can choose to accept or withdraw offers.
4. Round 3 will be merit based on gpa, mcat, essay and interview scores. A computer algorithm will assign the students colleges according to their preferences, just like residency match.

The entire cycle will be over in one month. Mission based programs can use legal agreements to enforce compliance.

I think you have a very optimistic view of how long this whole process would take. I cannot imagine that schools would be able to review literally thousands of applications in 10 days. Students don't get to visit/talk to schools at all to determine the right fit for them? I don't see how a computer algorithm assigning students a single option is any better than the current system. This system still doesn't benefit anyone who would have gotten no acceptances or 1 acceptance anyway, and just hurts the students who may have had the opportunity to have multiple. "Mission based programs can use legal agreements to enforce compliance" - why would any student want to do that, especially if they could have had the opportunity to go somewhere else anyway?

 

[senecca]

I think you have a very optimistic view of how long this whole process would take. I cannot imagine that schools would be able to review literally thousands of applications in 10 days. Students don't get to visit/talk to schools at all to determine the right fit for them? I don't see how a computer algorithm assigning students a single option is any better than the current system. This system still doesn't benefit anyone who would have gotten no acceptances or 1 acceptance anyway, and just hurts the students who may have had the opportunity to have multiple. "Mission based programs can use legal agreements to enforce compliance" - why would any student want to do that, especially if they could have had the opportunity to go somewhere else anyway?

Since the proposal is to limit the students to pick utmost 2 schools for the holistic rounds, schools will not receive thousands of applications. All the criteria are pre scored, so reviewing shouldn’t take much time, it can be automated. The computer algorithm is not going to randomly select a college for you , it will pick from order of preference of the applicant according to his merit, he has two holistic rounds as well.

The advantages are, the cycle will be very short, less stressful, everyone will get interviewed, every qualifying applicant will have a seat in one month, the process will have some openness and predictability. Highly qualified applicants won’t fall through the cracks.

 

[Medwannabe123]

I think you have a very optimistic view of how long this whole process would take. I cannot imagine that schools would be able to review literally thousands of applications in 10 days. Students don't get to visit/talk to schools at all to determine the right fit for them? I don't see how a computer algorithm assigning students a single option is any better than the current system. This system still doesn't benefit anyone who would have gotten no acceptances or 1 acceptance anyway, and just hurts the students who may have had the opportunity to have multiple. "Mission based programs can use legal agreements to enforce compliance" - why would any student want to do that, especially if they could have had the opportunity to go somewhere else anyway?

Not commenting on sanecca proposal.

But cj_cregg - why does the algorithm seem okay for residents? Don’t they expect choice, multiple offers, higher salary. They do. But atleast the process is better. Even NRMP is there bcos Hospitals have joined hands to keep wages low.

For students - they don’t do match YET - since it is for grants, alumni funds, denying state students over non-state etc.

Thanks cj, all for joining the discussion. We are all learning a lot.

 

[Medwannabe123]

In America, the college admissions is about the colleges, not the students. Goro once said “it is about what the colleges want, not the students “. Unless we shift the focus to the students as done in all other countries, things will get only worse.

I spent only three hours and came up with holistic + merit based medical school admissions process which could be over in 3-4 weeks.

1. Before submitting the application, the applicant should have all criteria evaluated just like GPA and MCAT. Let the applicants write around 3 essays under proctored environment just like mcat , AAMC can score those essays in an anonymous manner. Similarly, the applicants can sign up for an interview with aamc and have it scored by 5 members panel.
2. On may 1st, let applicants submit their applications and select top 2 schools for holistic round 1. Let the colleges take 10 days to review the applications (not evaluate them) and offer admissions and merit/need based scholarships. Give applicants accept or withdraw acceptances and move on to round 2.
3. For the second holistic round, the applicants can choose top 2 schools and colleges review the applications and offer admission and scholarships. Applicants can choose to accept or withdraw offers.
4. Round 3 will be merit based on gpa, mcat, essay and interview scores. A computer algorithm will assign the students colleges according to their preferences, just like residency match.

The entire cycle will be over in one month. Mission based programs can use legal agreements to enforce compliance.

Amazing ! You mean students first. Wow.

What about the myth of mission fit
Read everyone’s mission it’s generically the same.

That the student is looking forward to 10 years of debt and minimum wages is not enough to show they are here bcos they want to.

And how much the mission applies for patients is very debatable anyway.

 

[cj_cregg]

Since the proposal is to limit the students to pick utmost 2 schools for the holistic rounds, schools will not receive thousands of applications. All the criteria are pre scored, so reviewing shouldn’t take much time, it can be automated. The computer algorithm is not going to randomly select a college for you , it will pick from order of preference of the applicant according to his merit, he has two holistic rounds as well.

The advantages are, the cycle will be very short, less stressful, everyone will get interviewed, every qualifying applicant will have a seat in one month, the process will have some openness and predictability. Highly qualified applicants won’t fall through the cracks.

There are like 50,000 medical school applicants every year. If most of them make their first picks top 50s, with 2 choices each, that's 2,000 applicants per school under your system that are apparently going to be reviewed in 1 week. And how many people do you think are going to preference places like Harvard, Yale, NYU, etc. in their top 2? I don't think the modern medical school application system that places increasing emphasis on extracurriculars, service, communication skills, professionalism, fit/mission, etc. lends itself to an automated review process.

How is the applicant supposed to know their preference without having an opportunity to learn more about the school beyond what's on the website?

I don't think there can realistically BE a short admissions cycle that also gives a fair and full consideration to each applicant. I think the idea that 50,000 applicants can be placed in one month is ridiculous, it doesn't even happen that quickly for the residency match which is about half that size. Faster is not inherently better. I don't think a computer algorithm determining your fate is any less stressful. And not every applicant SHOULD be interviewed, so now you're adding in a bunch more interviews and work for admissions offices as well, prolonging the process even further.

Not commenting on sanecca proposal.

But cj_cregg - why does the algorithm seem okay for residents? Don’t they expect choice, multiple offers, higher salary. They do. But atleast the process is better. Even NRMP is there bcos Hospitals have joined hands to keep wages low.

For students - they don’t do match YET - since it is for grants, alumni funds, denying state students over non-state etc.

Thanks cj, all for joining the discussion. We are all learning a lot.

I don't think the match algorithm is okay for residents, is the underlying argument here. In fact I think residents would be happier if there were "traffic rules" similar to medical school applications, which would prevent residency programs from manipulating residents with exploding offers (which was the reason the match was created in the first place) and also allow some additional measure of choice and control for many applicants.

 

[Medwannabe123]

There are like 50,000 medical school applicants every year. If most of them make their first picks top 50s, with 2 choices each, that's 2,000 applicants per school under your system that are apparently going to be reviewed in 1 week. And how many people do you think are going to preference places like Harvard, Yale, NYU, etc. in their top 2? I don't think the modern medical school application system that places increasing emphasis on extracurriculars, service, communication skills, professionalism, fit/mission, etc. lends itself to an automated review process.

How is the applicant supposed to know their preference without having an opportunity to learn more about the school beyond what's on the website?

I don't think there can realistically BE a short admissions cycle that also gives a fair and full consideration to each applicant. I think the idea that 50,000 applicants can be placed in one month is ridiculous, it doesn't even happen that quickly for the residency match which is about half that size. Faster is not inherently better. I don't think a computer algorithm determining your fate is any less stressful. And not every applicant SHOULD be interviewed, so now you're adding in a bunch more interviews and work for admissions offices as well, prolonging the process even further.


I don't think the match algorithm is okay for residents, is the underlying argument here. In fact I think residents would be happier if there were "traffic rules" similar to medical school applications, which would prevent residency programs from manipulating residents with exploding offers (which was the reason the match was created in the first place) and also allow some additional measure of choice and control for many applicants.

I agree with you.

NRMP helps the hospitals so they have it. Reduces competitive placement and salary for residents. It was not designed for residents. Thousands of institutions agreed to it bcos it was good for them. The algo got a Nobel.

Med school admission may be a reasonable use case for a match process / modified match. Texas has it. Worldwide many countries have it. But the 200 odd schools will not let it since it reduces their control.

The modern extreme focus on EC’s and mission fit is driving mediocrity. Now that is a separate debate. May be one day MCAT will meet the SAT fate. That will be pretty scary

 

[cj_cregg]

I agree with you.

NRMP helps the hospitals so they have it. Reduces competitive placement and salary for residents. It was not designed for residents. Thousands of institutions agreed to it bcos it was good for them. The algo got a Nobel.

Med school admission may be a reasonable use case for a match process / modified match. Texas has it. Worldwide many countries have it. But the 200 odd schools will not let it since it reduces their control.

The modern extreme focus on EC’s and mission fit is driving mediocrity. Now that is a separate debate. May be one day MCAT will meet the SAT fate. That will be pretty scary

I don't think a match system reduces schools' control at all, quite the opposite. I think it reduces applicants' control. And I don't agree that the focus on ECs/mission "drives mediocrity," also quite the opposite. But as you said...separate debate.

 

[jhmmd]

Computers can't possibly pick med students, or residents. Y'all are simplifyng the process WAY too much. HUMANS write LoRs, humans take standardized tests, humans interview and are ranked by humans, etc.

If there was something wrong with the process, then why do most med students graduate and go on to finish residency (and become successful doctors)?

 

[Goro]

Computers can't possibly pick med students, or residents. Y'all are simplifyng the process WAY too much. HUMANS write LoRs, humans take standardized tests, humans interview and are ranked by humans, etc.

If there was something wrong with the process, then why do most med students graduate and go on to finish residency (and become successful doctors)?

So true. Yet some people here can't seem to understand the difference between a process that is essentially a job application process, and a process of applying to professional school.

I'm reminded of the people who come here every now and then seeking affirmation if their notions, rather than actual answers from people in the know.

Then I remember that people get dismissed from residency for being unteachable.

 

[Med Ed]

Even NRMP is there bcos Hospitals have joined hands to keep wages low.

Residents are called "residents" because they weren't paid enough to afford independent housing, and therefore resided in housing provided by the hospitals. The current system came into being when the federal government decided to fund GME. The large majority of residency and fellowship positions are funded by Medicare, and are stipulated to include salary, benefits, and malpractice coverage. This also explains the relative uniformity of residency salaries across the country.

In theory the federal government could decide to stop funding GME altogether, and send it back to the free-for-all it was in the old days, but I don't think such a scenario would necessarily play out in the favor of the trainees.

 

[Med Ed]

Amazing ! You mean students first. Wow.

Institutions of higher education exist to serve society, not applicants.

What about the myth of mission fit
Read everyone’s mission it’s generically the same.

Dell Medical School:

Revolutionize how people get and stay healthy by:​

• Improving health in our community as a model for the nation;
• Evolving new models of person-centered, multidisciplinary care that reward value;
• Accelerating innovation and research to improve health;
• Educating leaders who transform health care; and
• Redesigning the academic health environment to better serve society.

Carle Illinois College of Medicine:

We educate exceptional physician-innovators to deliver high-value, compassionate health care through transformative solutions developed at the intersection of engineering, science, and medicine.

Brody School of Medicine (ECU):

• To increase the supply of primary care physicians serving the state
• To improve the health status of eastern North Carolina’s citizens
• To enhance access of minority and disadvantaged students to a medical education

 

[Medwannabe123]

So true. Yet some people here can't seem to understand the difference between a process that is essentially a job application process, and a process of applying to professional school.

I'm reminded of the people who come here every now and then seeking affirmation if their notions, rather than actual answers from people in the know.

Then I remember that people get dismissed from residency for being unteachable.

You certainly have more experience. Respect. But I think it’s okay to discuss and get more understanding.

NRMP started 1952. Residents might get better opportunities now without it.

AMCAS started 1970. Students might deserve a better system. Thousands are starting their apps again, while still not sure of the cycle that started last year. And schools even now don’t know who is coming and who is not !This perhaps is not an optimized way.

Change is very hard.

 

[jhmmd]

You certainly have more experience. Respect. But I think it’s okay to discuss and get more understanding.

NRMP started 1952. Residents might get better opportunities now without it.

AMCAS started 1970. Students might deserve a better system. Thousands are starting their apps again, while still not sure of the cycle that started last year. And schools even now don’t know who is coming and who is not !This perhaps is not an optimized way.

Change is very hard.

Why?

 

[Medwannabe123]

Institutions of higher education exist to serve society, not applicants.


Dell Medical School:

Revolutionize how people get and stay healthy by:​

• Improving health in our community as a model for the nation;
• Evolving new models of person-centered, multidisciplinary care that reward value;
• Accelerating innovation and research to improve health;
• Educating leaders who transform health care; and
• Redesigning the academic health environment to better serve society.

Carle Illinois College of Medicine:

We educate exceptional physician-innovators to deliver high-value, compassionate health care through transformative solutions developed at the intersection of engineering, science, and medicine.

Brody School of Medicine (ECU):

• To increase the supply of primary care physicians serving the state
• To improve the health status of eastern North Carolina’s citizens
• To enhance access of minority and disadvantaged students to a medical education

Serving society = patients at the other end. I am not sure the bills and insurance ecosystem is serving society. Another debate.

As far as mission goes. Yes they all read different. But innovation, evolution, technology, multi disciplinary, serve local area, underserved etc etc. or equivalent words are most commonly found items in the mission statements.
I don’t think any school or student does not align to all of these. So much focus and SDN content on how to map to mission. Do we really think A student can map to 30 college missions if those were too different. We make too much of a volunteer member reading the app !

I am learning a lot in this thread. Thank you. It’s not an easy situation. I do have appreciation for the differing inputs.

 

[Fluidity of Movement]

Do we really think A student can map to 30 college missions if those were too different. We make too much of a volunteer member reading the app !

Maybe at some point the student should actually take their own mission seriously, and only then when the student takes themselves seriously, can they see why the school wants to hear about that. You are looking at it through the lens of students bull****ting their way through 30 apps just to get accepted anywhere that will take them. This is meant to be yet another filter for people who aren't ready to be doctors. Each student should have their own strong, well-thought out mission statement, and should only apply to schools where that can fit.

Serving society = patients at the other end. I am not sure the bills and insurance ecosystem is serving society. Another debate.

Medical schools serve society by training effective doctors. What does that have to do with insurance? They are not related in any way.

That the student is looking forward to 10 years of debt and minimum wages is not enough to show they are here bcos they want to.

This might be true for social workers or other places that have pathetic wages even with advanced degrees. It wasn't long ago you could have 6 years + debt and other various training and be making 35 grand. That is some serious self-selection. Residents still end up making around the national average US salary, which is still way more than very large portions of the country. (Please dont every resident quote me with 100 things and downvotes, I'm aware of how ****ty residency and their finances are).

I am learning a lot in this thread. Thank you. It’s not an easy situation. I do have appreciation for the differing inputs.

I think the main thing you are not getting is that things don't operate ideally. There are constraints to everything. What is best cannot always be. Medical education is a privilege, not something owed to us, not something we can earn after a series of X hard work and Y time invested. And schools have just as many rights and ideals as we do.

 

[Fluidity of Movement]

In America, the college admissions is about the colleges, not the students. Goro once said “it is about what the colleges want, not the students “. Unless we shift the focus to the students as done in all other countries, things will get only worse.

I spent only three hours and came up with holistic + merit based medical school admissions process which could be over in 3-4 weeks:

1. Before submitting the application, the applicant should have all criteria evaluated just like GPA and MCAT. Let the applicants write around 3 essays under proctored environment just like mcat , AAMC can score those essays in an anonymous manner. Similarly, the applicants can sign up for an interview with aamc and have it scored by 5 members panel.
2. On may 1st, let applicants submit their applications and select top 2 schools for holistic round 1. Let the colleges take 10 days to review the applications (not evaluate them) and offer admissions and merit/need based scholarships. Give applicants accept or withdraw acceptances and move on to round 2.
3. For the second holistic round, the applicants can choose top 2 schools and colleges review the applications and offer admission and scholarships. Applicants can choose to accept or withdraw offers.
4. Round 3 will be merit based on gpa, mcat, essay and interview scores. A computer algorithm will assign the students colleges according to their preferences, just like residency match.

The entire cycle will be over in one month. Mission based programs can use legal agreements to enforce compliance.

I spent only three minutes and came up with this holistic + concise review of your system which could be over in 10-11 points:

1. Possible reduction in school choice: Limiting the number of schools that applicants can apply to in the first two rounds could limit their options and potentially force them to choose between schools they may not be as interested in attending.
2. Increased stress for applicants: The proctored essay writing and interview process could add to the stress and pressure of an already competitive application process, potentially disadvantaging applicants who perform well academically but struggle with standardized tests or public speaking / writing. (The writing portion of the MCAT was removed in 2015)
3. Reduced diversity: There is a risk that the proposed system could unintentionally disadvantage applicants from underrepresented groups who may not perform as well on standardized tests or interviews, leading to a less diverse applicant pool and student body.
4. Increased workload for admissions committees: With multiple rounds of applications and evaluations, the workload for admissions committees could increase significantly, potentially leading to longer wait times for applicants to hear back about their application status.
5. Lack of consideration for extracurricular activities: The proposed system does not explicitly consider an applicant's extracurricular activities, which can be an important factor in evaluating a candidate's potential for success in medical school.
6. Potential for gaming the system: Applicants may strategize to maximize their chances of being assigned to their top-choice schools in the final round, potentially leading to a less fair and equitable admissions process.
7. Need for infrastructure and resources: The proposed system would require significant infrastructure and resources to be put in place to manage the multiple rounds of evaluations, potentially leading to higher costs for both applicants and medical schools.
8. Limited opportunities for re-evaluation: With the proposed system, applicants may not have the opportunity to re-evaluate and improve their application materials between the first and second rounds of applications, potentially disadvantaging those who receive rejections in the first round.
9. Possible reduction in competitiveness: The system may lead to a reduction in competitiveness among applicants, as they may feel that their chances of being admitted to their preferred schools are higher with the multi-round system, leading to a potential decrease in the quality of applicants.
10. Delayed admissions process: The proposed system may lead to a longer admissions process overall, with multiple rounds of evaluations and waiting periods for applicants to hear back from schools, potentially delaying the start of medical school for successful applicants.
11. Limited impact on diversity: While the proposed system may aim to reduce bias and increase diversity, there is no guarantee that it will be successful in achieving these goals, particularly if the system still relies heavily on standardized test scores and interviews.

I ran out of witty things to say at the end here after my extensive copy and pasting of chatGPT

 

[Med Ed]

As far as mission goes. Yes they all read different. But innovation, evolution, technology, multi disciplinary, serve local area, underserved etc etc. or equivalent words are most commonly found items in the mission statements.
I don’t think any school or student does not align to all of these. So much focus and SDN content on how to map to mission. Do we really think A student can map to 30 college missions if those were too different. We make too much of a volunteer member reading the app !

Your original statement was that all missions are essentially the same. This is untrue. But it is true that while most schools do have interchangeable missions, a subset do not. I chose Dell, Carle, and Brody as examples of this. Dell is into health systems science, Carle is into engineering, Brody is into eastern North Carolina. If one of those things is your bag then congrats, you have a school to target.

All that said, most schools do have fairly generic missions, just as most applicants have fairly generic career goals.

 

[senecca]

Your original statement was that all missions are essentially the same. This is untrue. But it is true that while most schools do have interchangeable missions, a subset do not. I chose Dell, Carle, and Brody as examples of this. Dell is into health systems science, Carle is into engineering, Brody is into eastern North Carolina. If one of those things is your bag then congrats, you have a school to target.

All that said, most schools do have fairly generic missions, just as most applicants have fairly generic career goals.

Medical schools charge roughly $320k for each student for a medical degree. So, I don’t think they have any mission other than making money, it’s all bogus . If I claim to have a mission, I have to fund it to make it happen.

 

[Fluidity of Movement]

Medical schools charge roughly $320k for each student for a medical degree. So, I don’t think they have any mission other than making money, it’s all bogus . If I claim to have a mission, I have to fund it to make it happen.

where is the vote ban button ughhhhh

how much longer are you going to keep trolling us. that's what the reddit is for.

 

[throwawayftw]

As a current applicant, I'm in favor of a med school match. The process should be modelled off the NRMP (I think @senecca proposal is too complicated and gameable). Students would submit their AMCAS and secondaries by Labor Day (as is currently advised) and do interviews August-January. Applicants and schools would make match lists. Match Day would be in March and there could be a SOAP for unmatched slots.

Rebuttals to common criticisms:

Diversity - Don't see why a match should prevent a school from building a diverse class. Schools could also choose who to interview and rank based on their mission statements.

Financial aid - I think financial aid is the hardest issue to resolve. My solution is for price transparency instead of very high sticker price with varying levels of financial aid. The current system of financial aid / scholarships doesn't seem consistent or fair. Fin aid shouldn't be based on applicants with many A's playing schools against each other while students with 1 A settle for negligible aid. Schools should compete for the lowest sticker price (like NYU and Kaiser) to get higher on an applicant's rank list. Around 70% of med students are taking out loans so I would argue that lower sticker price is better than a system where some get full rides and some pay full price.

Applicant choice- @cj_cregg Applicants under a match system would be able to rank schools based on their preference. Keep in mind that a large majority of applicants get into 0-2 schools. Applicants would no longer be able to brag about having a ton of A's but could at least brag about a ton of IIs.

The real advantage of a med school match is all applicant will know if they got into med school and where they're going by mid-March. Students who formerly got fall A's would be worse off. However, no one would be stuck on the waitlist through June and rejected applicants could start their re-application earlier. Adcoms wouldn't be worrying about their yields and could go on vacation April-July.