What the heck happened with the urology match this year? Match rates of competitive specialties are scaring me and deterring me from them.

[DOVinciRobot]

It is not beneficial at all to the medical system to have students take a year off to get one of these competitive fields

I do think that it highlights the problem of med school class expansion and the fact that primary care fields are becoming less desirable.

Arguments from emotion rarely work. It doesn't impact the system at all to have students taking a year off as the number of physicians produced every year is wholly unchanged. Also, US student representation in primary care spots has only increased as the applicant numbers increase. Not sure there is any data showing they are becoming less desirable...

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[jstwannagraduaaate!!!]

Arguments from emotion rarely work. It doesn't impact the system at all to have students taking a year off as the number of physicians produced every year is wholly unchanged. Also, US student representation in primary care spots has only increased as the applicant numbers increase. Not sure there is any data showing they are becoming less desirable...

The doc is floating around here somewhere but theres an increase in apps to radiology and surgical subs, yet a decrease in apps to FM and EM; that should show that there are fields deemed less desirable. Just listen to how med students talk about certain fields

 

[NegativeMargin]

primary care fields are becoming less desirable.

People love to focus on competitive specialties when it comes to overflows, but this is even true for specialties like Family Care and IM. Overall 2-300 more people applying than there are spots seems par for the course.. and really that seems to be the take-home message overall. It's a nasty trend that is continuing, but it's only really nasty for the med students.

While I personally don't want to take an additional year to do research as someone who's going to turn 30 this year, it seems like the "medical system" is going to have no problem filling all it's slots even if a few hundred US Seniors did research years. While I'll certainly grow to dislike the fact that I'm paying hundreds of thousands of dollars to only have a small chance at doing what I ultimately want to do, what's the alternative?

Above all else, comparing data from then to now shows how variable things are from year to year. As an example, for US MD seniors in 2014 the match-rate for derm was 76%, in 2020 it was 85%. What I think we're seeing are people educating themselves more on what specialties have better lifestyles, and the people for whom that factor is a priority are willing to shift their application to fit with that. Urology was a perfect storm, and we will have more of them. It's certainly easy to be on the other side of this as say that we should enforce caps on things, let me be the first to say whether or not they start enforcing caps I'm going to give myself the best shot at doing what I want to do with my career, as will most people who are 8 years into a 10-15 year journey.

 

[DOVinciRobot]

The doc is floating around here somewhere but theres an increase in apps to radiology and surgical subs, yet a decrease in apps to FM and EM; that should show that there are fields deemed less desirable. Just listen to how med students talk about certain fields

EM is a dumpster fire of a field right now so apps absolutely should decrease as med students would be wise to choose a specialty that would lead to an actual job. FM has always been viewed as "less desirable" so I fail to see how that proves your point, particularly when more US grads are filling FM spots than before.

What med students say about certain fields is irrelevant honestly, as those opinions fluctuate constantly.

 

[mrbreakfast]

The doc is floating around here somewhere but theres an increase in apps to radiology and surgical subs, yet a decrease in apps to FM and EM; that should show that there are fields deemed less desirable.

What?

Per official NRMP releases, 2020 vs 2014:
-The increase in FM applicants, in terms of percentage, was greater than the increase for dermatology, neurosurgery, ortho, ENT, and radiology.
-Ortho and ENT are now less competitive than they were in 2014. Applicants/spot dropped by 2% for ENT and 3% for ortho.
-Dermatology is actually much less competitive in 2020 than it was in 2014 - the applicants/spot dropped 10%.
-FIVE more people applied for radiology in 2020 than 2014; the percentage of medical students applying to radiology decreased by 14% (from 3.5% to 3%). Radiology actually did get more competitive (applicants/spot increased 3%), though that's due to the decrease in the number of radiology spots by 3%. As a reminder, while the "med student talk" is that diagnostic radiology is competitive, there is no actual statistical evidence that this is the case.
-EM and FM both dropped in competitiveness, but that's because the number of spots for both of those specialties increased 50% over those 6 years, even though applications increased 48% for EM. For specialties with >100 spots, no single specialty grew more than EM; the percentage of medical students applying to EM increased by 26% (from 6% to 7.8%) over that time.
-As a whole, accounting for increase in applicants, the percentage of med students applying to any surgical subspecialty increased by 4% over 6 years.
-The biggest overall riser in terms of competitiveness was vascular surgery (which barely counts, as <100 people applied to vascular surgery in 2014). After that, the biggest riser I saw (didn't look at every specialty) was anesthesia.

Just listen to how med students talk about certain fields

Anything med students - particularly preclinical students - say about certain fields is irrelevant, because more often than not these statements are misinformed, or downright incorrect.

 

[NotAProgDirector]

You'd know more than me,

... actually, I'm not convinced that's true... I get dumber every day ...

but wasn't the point to attempt to objectify an inherently subjective thing? And if it's all bunk anyway because everyone is "exceptional" then why use it all?

Wouldn't these same issues present in interviews?

Yes. That's my point. Most evaluation systems are inherently biased. We can try to minimize those biases -- for interviews by screening all sorts of data. Our interviewers, for example, don't get access to your MSPE, transcript, or USMLE scores. We want them to interview you based upon whom you are. But that then moves bias from "high scores" to potentially something else, like "being extraverted". We can further minimize with multiple interviews, some sort of holistic scoring system, etc. But my experience with all of that is a regression to the mean -- once you start giving people "points" for research, volunteer work, grades, community service, leadership, etc, you end up with everyone getting the same score (or clustering tightly).

I don't have a solution. Measuring who is a "better" medical student than someone else is difficult. My sense is that there often are "bins": Superstars, middle of the road (will do fine with minimal issues), those that will do OK but will need extra support, and those with problems. Students could probably be evaluated on clinical skills, people skills, and administrative skills. With that, I expect most programs could make some decent decisions. But schools have moved to Pass Fail for everything, all of our students are great nonsense. And when you create bins, there are always edge cases -- someone who is 1 point away from the next bin. An 80 is a B- and a 79 is a C+ in most grading scales, but is there really any difference? Probably not, but the cut point needs to be somewhere.

 

[Lawpy]

No one has said it’s not extremely competitive to match one of these specialties. Many (most?) of us just don’t see it as a problem. Med school is only a guarantee to becoming a doctor, it’s not a guarantee to which type. That’s completely on you.

Again, none of those things would be expected of applicants if there wasn’t an ever increasing pool of applicants from med school seat inflation.

App caps. They tackle the problem directly.

 

[qwerty89]

What?

Per official NRMP releases, 2020 vs 2014:
-The increase in FM applicants, in terms of percentage, was greater than the increase for dermatology, neurosurgery, ortho, ENT, and radiology.
-Ortho and ENT are now less competitive than they were in 2014. Applicants/spot dropped by 2% for ENT and 3% for ortho.
-Dermatology is actually much less competitive in 2020 than it was in 2014 - the applicants/spot dropped 10%.
-FIVE more people applied for radiology in 2020 than 2014; the percentage of medical students applying to radiology decreased by 14% (from 3.5% to 3%). Radiology actually did get more competitive (applicants/spot increased 3%), though that's due to the decrease in the number of radiology spots by 3%. As a reminder, while the "med student talk" is that diagnostic radiology is competitive, there is no actual statistical evidence that this is the case.
-EM and FM both dropped in competitiveness, but that's because the number of spots for both of those specialties increased 50% over those 6 years, even though applications increased 48% for EM. For specialties with >100 spots, no single specialty grew more than EM; the percentage of medical students applying to EM increased by 26% (from 6% to 7.8%) over that time.
-As a whole, accounting for increase in applicants, the percentage of med students applying to any surgical subspecialty increased by 4% over 6 years.
-The biggest overall riser in terms of competitiveness was vascular surgery (which barely counts, as <100 people applied to vascular surgery in 2014). After that, the biggest riser I saw (didn't look at every specialty) was anesthesia.



Anything med students - particularly preclinical students - say about certain fields is irrelevant, because more often than not these statements are misinformed, or downright incorrect.

If you are referring to the match data you have to compare apples to apples. There was a decrease in the number of DR positions because IR has a separate pathway now. The total number of DR+IR PGY1 & PGY2 spots today is more than the total number of DR PGY1 and PGY2 spots in 2014.

 

[Mad Jack]

More people apply to these fields than would otherwise because they aren't part of the main match process. Applying and failing only hurts your ego, while you still have a chance to match general surgery, radiology, or any number of other competitive backup fields in the main match. 35% may not match urology but I bet 90% of those still match in the NRMP and the 10% that don't are the ultracompetitive types that are doing a research year and almost certainly won't go unmatched next year.

The ultimate lesson is simply: you may not get the subspecialty that you want, but more often than not you can match to something else.

 

[DOVinciRobot]

App caps. They tackle the problem directly.

And create new problems for many applicants.

Everything is a give and take. These specialties will always be competitive regardless of app caps

 

[Lawpy]

And create new problems for many applicants.

Everything is a give and take. These specialties will always be competitive regardless of app caps

Applicants are not going to come out fine in any scenario. App caps comparatively do the least amount of damage.

 

[DOVinciRobot]

Applicants are not going to come out fine in any scenario. App caps comparatively do the least amount of damage.

Depends on which applicants you ask. I wouldn’t be at my current program with app caps.

But this is a convo for another thread.

 

[Lawpy]

Depends on which applicants you ask. I wouldn’t be at my current program with app caps.

But this is a convo for another thread.

I brought this up to directly answer your point on the increased number of applications. The overapplication problem is what’s aggravating the competitiveness issue and forcing med students to waste time churning out garbage research and fighting desperately to get straight honors and great letters. App caps directly stop overapplication problem and can significantly reduce the mania surrounding research, grades, activities, letters etc. Yes there will be people affected negatively by app caps but comparatively they are far superior to the current system

The aggressive expansion of medical schools can be stopped by holding LCME/COCA responsible (mainly COCA because the DO expansion is happening at an alarming rate).

The other thing to address is making ERAS a centralized and primary system for all residency application/interview related matters and driving Thalamus and other systems out of business.

There are solutions that can be worked out to resolve the many problems plaguing medical education and there will always be people affected by this because it’s impossible to satisfy everyone. But having the will to work on those solutions is the crucial step.

 

[GoSpursGo]

I brought this up to directly answer your point on the increased number of applications. The overapplication problem is what’s aggravating the competitiveness issue and forcing med students to waste time churning out garbage research and fighting desperately to get straight honors and great letters. App caps directly stop overapplication problem and can significantly reduce the mania surrounding research, grades, activities, letters etc. Yes there will be people affected negatively by app caps but comparatively they are far superior to the current system

I'm not fundamentally opposed to an app cap because I think it would reduce the cost of residency applications significantly. But I fail to see how an app cap would affect the research/activities/grades rat race. It just means you have to be REALLY SURE you're at the top of the bell curve to apply to a highly competitive field since you won't be able to have a backup specialty. I agree that it's dumb that there should be a research requirement to get into a highly competitive field, but I don't see an incentive for either residency programs to take a candidate with less research or for individual applicants to not maximize their competitiveness.

The aggressive expansion of medical schools can be stopped by holding LCME/COCA responsible (mainly COCA because the DO expansion is happening at an alarming rate).

I'm also not fundamentally opposed to this idea. But it's not clear to me "who" should be holding LCME/COCA responsible for anything.

 

[Lawpy]

I'm not fundamentally opposed to an app cap because I think it would reduce the cost of residency applications significantly. But I fail to see how an app cap would affect the research/activities/grades rat race. It just means you have to be REALLY SURE you're at the top of the bell curve to apply to a highly competitive field since you won't be able to have a backup specialty. I agree that it's dumb that there should be a research requirement to get into a highly competitive field, but I don't see an incentive for either residency programs to take a candidate with less research or for individual applicants to not maximize their competitiveness.

I'm also not fundamentally opposed to this idea. But it's not clear to me "who" should be holding LCME/COCA responsible for anything.

I’m under the impression that the only reason why programs are requiring research, grades, letters etc is because they have too many apps to read and need quick shortcuts to filter the apps to review. App caps would probably allow for much more holistic review and a less emphasis on the activities since programs will know the applicants applying to them are usually serious

I think research for competitive specialties would be a lot less emphasized in a capped world but i need to look into historical trends from the 1990s and earlier when people were sending apps by mail and thus virtually capped

Agreed there’s no one to force LCME/COCA but i’m just hoping for aggressive, focused lobbying from leading physician groups… honestly it’s probably just a pipe dream

Edit: oh a related point is a return to scored Step 1 in a capped world since the more objective metrics PDs have, the better/fairer evaluations can be. That could also reduce the weight of ECs/research even in competitive specialties

 

[efle]

I just want to add that caps are meant to streamline the matchmaker, they don't add any seats. If 400 people apply for 250 spots there will still be a terrible match rate, even if the process is perfect. People have to make peace with applying to a backup specialty, or be ready ahead of time to start a short notice research year and reapply.

 

[DOVinciRobot]

The overapplication problem is what’s aggravating the competitiveness issue and forcing med students to waste time churning out garbage research and fighting desperately to get straight honors and great letters. App caps directly stop overapplication problem and can significantly reduce the mania surrounding research, grades, activities, letters etc. Yes there will be people affected negatively by app caps but comparatively they are far superior to the current system

I’m under the impression that the only reason why programs are requiring research, grades, letters etc is because they have too many apps to read and need quick shortcuts to filter the apps to review. App caps would probably allow for much more holistic review and a less emphasis on the activities since programs will know the applicants applying to them are usually serious

think research for competitive specialties would be a lot less emphasized in a capped world but i need to look into historical trends from the 1990s and earlier when people were sending apps by mail and thus virtually capped

I just want to add that caps are meant to streamline the matchmaker, they don't add any seats. If 400 people apply for 250 spots there will still be a terrible match rate, even if the process is perfect. People have to make peace with applying to a backup specialty, or be ready ahead of time to start a short notice research year and reapply.

This. The match rate to competitive specialties won’t be changed with app caps as the number of seats won’t change and these specialties won’t be any less competitive. If anything it will make the research/grades/activities rat race worse because people will do anything they can to ensure they are to the right of the applicant bell curve.

There is always a give and take and there are valid arguments for app caps. Competitive specialties being competitive isn’t one of them.

 

[Lawpy]

I just want to add that caps are meant to streamline the matchmaker, they don't add any seats. If 400 people apply for 250 spots there will still be a terrible match rate, even if the process is perfect. People have to make peace with applying to a backup specialty, or be ready ahead of time to start a short notice research year and reapply.

This. The match rate to competitive specialties won’t be changed with app caps as the number of seats won’t change and these specialties won’t be any less competitive. If anything it will make the research/grades/activities rat race worse because people will do anything they can to ensure they are to the right of the applicant bell curve.

There is always a give and take and there are valid arguments for app caps. Competitive specialties being competitive isn’t one of them.

400 apps for 250 spots in a capped world is better than thousands of apps for 250 spots in an uncapped world though. The best way is to look at how the residency process was like in the 1980s and 1990s in surgical subs/derm and compare that with now

 

[DOVinciRobot]

400 apps for 250 spots in a capped world is better than thousands of apps for 250 spots in an uncapped world though. The best way is to look at how the residency process was like in the 1980s and 1990s in surgical subs/derm and compare that with now

You seem to not understand the actual numbers. No specialty has thousands of applicants for 250 spots… 400/250 is a good example of what we currently have…

You can’t compare the days of then to now, there are too many fundamental factors that have changed.

 

[NotAProgDirector]

Both arguments are correct, to some extent. Let's consider a situation where 100 people are applying for 60 spots in 10 programs. Assuming all the spots fill, the match rate will be 60%. App caps won't change that. Chance of not getting a spot would be 40%.

Without app caps, everyone would apply to all programs. So each program would have 100 applications to review. If they feel like that's too much work, they might set a filter for # of research projects > 10, etc. This narrows down the number of apps to review, less work for programs, etc. People with less research don't get as many interviews, and match less.

Let's say we institute an app cap of 3. Let's also assume that the apps spread evenly. Now, each program will get 100 people * 3 apps each / 10 programs = 30 applications. So now, there's no reason to filter on anything -- programs can just review all 30 apps. In this case, programs MIGHT decide to weight things other than research in whom to invite. If so, then the overall match rate will stay 60%, but the types of people who get a spot might be different -- people will less research (in this example) might get a fuller review and other aspects of their applications may get them an interview and a higher rank. So the match rate stays the same, but the people who fall into that 60% match change.

Of course, if programs don't change their criteria and reviewing those 30 apps use research as a major deciding factor, then nothing may change at all -- except applicants save on ERAS fees and programs have less apps to grind through.

That's the theoretical win from app caps. For sure, people save on application fees. Not so sure but hopeful, the lower number of applications to review results in programs doing a better job of reviewing them, relying less on scores or other metrics. But ultimately all spots fill, and the number of people who benefit from a holistic review will equal the number that might have gotten a "better" spot based on numerical filters.

 

[mrbreakfast]

Let's also assume that the apps spread evenly.

The issue with application caps is that there's no reason to assume this; we can't assume applicant ranking of programs is random, because we know it to not be. Mathematically it's not implausible to see situations where a less-desirable program interviews 30 applicants, and all 30 of them match elsewhere. After all, in the real world, do less-desirable programs not drop deep into their rank lists to fill? Even the weakest applicants might not apply to program #10 of 10. People are not realistic when estimating their own chances; this is demonstrable in the match rates that started this whole discussion. In the same vein, it's not implausible - and not even all that unlikely - that someone with only 3 interviews won't match anywhere.

It turns into a complex math problem, but the odds of someone not matching/a program not filling decrease the more applications there are. The benefit of no application cap is that it introduces a mathematical improbability of an applicant not matching/a program not filling. Programs will never accept an applicant cap, because the number of programs that wouldn't fill and would have to SOAP would skyrocket.

 

[NotAProgDirector]

Yes, I assumed even spread for simplicity.

Of course there won't be even spread. This is well demonstrated by the signal data in the ENT match. 50% of the signals went to 25% of the programs. Applications will likewise not be even.

Less desirable programs might not drop deeper into their rank lists. If they "interview smart", and pick people they think are more likely to come, then they may match at exactly the same number are more desirable programs.

Whether a cap is a "good" idea or not is highly subjective. Some people will benefit, and some will do worse.

Whether programs would support it is unclear. Infinite applications to programs isn't a benefit -- we can't interview infinite numbers of applicants, so ultimately we end up picking people from the pile. The more apps there are, the more likely we're to use something arbitrary to try to winnow the pile.

I think what you're getting at is that there's probably a "sweet spot" if there was to be an app cap. If the cap is too low, some programs may go unfilled because they get too few applications. If the cap is too high, programs may pre=screen applications with some filter. The question is whether there's a middle ground.

For the record, I'm not a fan of caps - unless we somehow publish some sort of guide / tool that tells applicants realistically which programs they are competitive for. Residency explorer is a start - but not good enough.

 

[Lawpy]

For the record, I'm not a fan of caps - unless we somehow publish some sort of guide / tool that tells applicants realistically which programs they are competitive for. Residency explorer is a start - but not good enough.

So basically we need a residency version of the MSAR

 

[mrbreakfast]

That's all well and good, but let's imagine an applicant who might benefit from this system: someone with bottom-10% metrics (step scores, class rank, whatever) for a specialty, but who has an amazing story. For example, someone ex-military who took several years off to establish and organize a free clinic for the homeless, and who collected data to demonstrate it made an appreciable difference in homeless health in a large metropolitan area. I think we could agree that this person is more "competitive" than their metrics, but how much more competitive? Should they apply to big-name, competitive programs, assuming their extracurricular experience will get more weight? Or should they apply to programs more "appropriate" for their metrics, unwilling to risk their match potential on someone actually reading their application? For someone who has precious few applications to send out, the decision can't be taken lightly, and every program will weigh those experiences differently.

My point is not to be contentious, but just to point out that limiting apps can raise new challenges. There likely is a "sweet spot" in terms of application numbers, but it's likely different for every specialty, and will likely require trial and error.

 

[Darrow O'Lykos]

That's all well and good, but let's imagine an applicant who might benefit from this system: someone with bottom-10% metrics (step scores, class rank, whatever) for a specialty, but who has an amazing story. For example, someone ex-military who took several years off to establish and organize a free clinic for the homeless, and who collected data to demonstrate it made an appreciable difference in homeless health in a large metropolitan area. I think we could agree that this person is more "competitive" than their metrics, but how much more competitive? Should they apply to big-name, competitive programs, assuming their extracurricular experience will get more weight? Or should they apply to programs more "appropriate" for their metrics, unwilling to risk their match potential on someone actually reading their application? For someone who has precious few applications to send out, the decision can't be taken lightly, and every program will weigh those experiences differently.

My point is not to be contentious, but just to point out that limiting apps can raise new challenges. There likely is a "sweet spot" in terms of application numbers, but it's likely different for every specialty, and will likely require trial and error.

As amazing as the hypothetical applicant's story is (which, being at the literal far left of the curve minimizes how amazing said story might be), it's trumped by the fact that it's well documented that humanitarian ECs are not very high on the list of what most PDs consider when reviewing applicants. If that person is hoping to achieve grand things, match to a competitive position, etc., then they have to show the foresight and wherewithal to get their **** together in order to make that happen. Allowing themselves to fall that far down the curve shows a lapse in judgement, or just plain absence of critical reasoning, both of which are fair game when deciding why not to consider someone to match into say, neurosurgery. Taking years off to establish a free clinic doesn't bestow upon the individual any right to a more competitive big-name program. Read up on programs to consider applying to and if it turns out that a desirable place seems to take a truly more holistic approach, then by all means apply there.

I think some major overhaul is needed, but at the end of the day you are what your ERAS application says you are. If someone is a bottom 10%er in the metrics, then they're not going to attain a position that directors believe requires top 10% intellect, regardless of what is done outside of classroom, research, etc.

(Also obviously none of that is directed towards you, just the hypothetical).

 

[Lawpy]

That's all well and good, but let's imagine an applicant who might benefit from this system: someone with bottom-10% metrics (step scores, class rank, whatever) for a specialty, but who has an amazing story. For example, someone ex-military who took several years off to establish and organize a free clinic for the homeless, and who collected data to demonstrate it made an appreciable difference in homeless health in a large metropolitan area. I think we could agree that this person is more "competitive" than their metrics, but how much more competitive? Should they apply to big-name, competitive programs, assuming their extracurricular experience will get more weight? Or should they apply to programs more "appropriate" for their metrics, unwilling to risk their match potential on someone actually reading their application? For someone who has precious few applications to send out, the decision can't be taken lightly, and every program will weigh those experiences differently.

My point is not to be contentious, but just to point out that limiting apps can raise new challenges. There likely is a "sweet spot" in terms of application numbers, but it's likely different for every specialty, and will likely require trial and error.

That type of applicant quite literally gets into T10 med schools. There’s no reason why programs have to follow completely different criteria.

 

[qwerty89]

App Caps don't do a damn thing. The number of residency spots remains the same.

It also creates new problems. Lets say you have a 20 program cap. Prior to even sending out invites faculty can reach out to other faculty that they know to see if they would be receptive to interviewing a particular student. The student is then either directly told or given a wink wink nudge nudge to apply to that program knowing that they will get an interview. This would again favor students from the top schools with better connected faculty. Yes these schools already have an advantage but this would heavily incentivize schools to encourage their faculty to do this. It increases their schools applicants interview yield rate (ratio of interviews invitations received to applications sent). Students at schools without a derm or ortho or optho home department might find themselves at an even worse disadvantage.

People in the couples match might be screwed since they are forced to prioritize programs that will take them vs geographic proximity early on in the process. Currently they can at least wait to see where they get interviews and then prioritize what is most important to them.

An individual with a lopsided resume i.e. MD/PhD with lower than average clinical scores/step 1 would be at a disadvantage since they don't know which types of programs would take them. Their grades/scores might turn off academic programs and their research background might turn off community programs who don't think the applicant will take their program seriously. They might get screwed if they happen to send their limited applications to the wrong program.

App caps just create a whole new type of gamesmanship. The advantage is purely for the programs. Just less applications to sift through. Does nothing, on the whole, for the applicants.

Another alternative with many of the same disadvantages would be to change the entire system to mirror the SOAP process. Have multiple rounds of matching early on in the process. Programs can invite a select number of students each round for a spot. Students have a limited number of time to accept. This also has most of the same problems but at least speeds up the whole process and gives students more time to adjust. As it currently stands students find out if they matched on Monday and by Friday they need to know if they are going to do a prelim and reapply, stay in med school 1 more year and reapply, or graduate and do a "research fellowship".

 

[Ho0v-man]

That's all well and good, but let's imagine an applicant who might benefit from this system: someone with bottom-10% metrics (step scores, class rank, whatever) for a specialty, but who has an amazing story. For example, someone ex-military who took several years off to establish and organize a free clinic for the homeless, and who collected data to demonstrate it made an appreciable difference in homeless health in a large metropolitan area. I think we could agree that this person is more "competitive" than their metrics, but how much more competitive? Should they apply to big-name, competitive programs, assuming their extracurricular experience will get more weight? Or should they apply to programs more "appropriate" for their metrics, unwilling to risk their match potential on someone actually reading their application? For someone who has precious few applications to send out, the decision can't be taken lightly, and every program will weigh those experiences differently.

My point is not to be contentious, but just to point out that limiting apps can raise new challenges. There likely is a "sweet spot" in terms of application numbers, but it's likely different for every specialty, and will likely require trial and error.

I think if we start interviewing/ranking students based on their “story”, it still just benefits the wealthiest students. You really think just anyone can afford to take several years off to elaborately volunteer? This would just make people go from taking research years to “make-me-more-interesting” years.

I’ve gotta be honest, I’ve never really understood the whole “holistic review” thing anyway. Once you ignore academic performance and things that show interest like research etc, the majority of medical students look exactly the same and programs are just trying to make sure they don’t rank a douche.

 

[NotAProgDirector]

So basically we need a residency version of the MSAR

That would probably help. But there's no such thing as "GPA" in medical school, so I don't know that this is really feasible.

My point is not to be contentious, but just to point out that limiting apps can raise new challenges. There likely is a "sweet spot" in terms of application numbers, but it's likely different for every specialty, and will likely require trial and error.

You're not being "contentious" at all IMHO, and I agree that app caps create all sorts of new problems.

Signals being tested this year are a compromise -- no cap, but limited number of signals.

There are whole other threads discussing possible changes to the match or app process where this has been discussed.

I'm not a fan of a "multiple rounds of SOAP". That's going to be miserable for everyone, and creates a "take an offer or hope for something better" issue.

Early application / match option is a another possible solution -- very limited number of applications, programs can fill only a portion of their positions in an early process. That could be "SOAP-like" rather than a true match.

Any change creates winners and losers. Most spots fill in the current match (especially in competitive fields), any change is going to leave the match rate the same, can only change whom gets a spot -- again, different winners and losers. Might make the whole process "feel better" and less churn, by getting 25% of the applicants settled in an early round.

 

[Ganon]

Once you ignore academic performance and things that show interest like research etc, the majority of medical students look exactly the same and programs are just trying to make sure they don’t rank a douche.

They differ quite a bit on gender and racial background, among other things. Those things are weighted heavily in this realm.

 

[Ho0v-man]

They differ quite a bit on gender and racial background, among other things. Those things are weighted heavily in this realm.

Talking about things you have control over in your app.

 

[Ganon]

Talking about things you have control over in your app.

So things you have control over, but you wanted to exclude academic performance and research, as well as what I mentioned?

What exactly are you talking about, then?

 

[Ho0v-man]

So things you have control over, but you wanted to exclude academic performance and research, as well as what I mentioned?

What exactly are you talking about, then?

Please consider reading the post to which I was responding. Your current interpretation is incorrect.

 

[Ganon]

Please consider reading the post to which I was responding. Your current interpretation is incorrect.

Your sequence of comments makes no sense at all.

Once you ignore academic performance and things that show interest like research etc, the majority of medical students look exactly the same and programs are just trying to make sure they don’t rank a douche.

This statement is false. There are a lot of things that differentiate applicants aside from these things, which I pointed out.

Talking about things you have control over in your app.

But you had established in your original comment that you wanted to exclude those things?

Your statement is basically, "If you ignore all the things you can control, and ignore all the things you can't control, all the apps look alike!"

I have no clue what you're getting at

 

[Ho0v-man]

Your sequence of comments makes no sense at all.



This statement is false. There are a lot of things that differentiate applicants aside from these things, which I pointed out.



But you had established in your original comment that you wanted to exclude those things?

Your statement is basically, "If you ignore all the things you can control, and ignore all the things you can't control, all the apps look alike!"

I have no clue what you're getting at

I think if we start interviewing/ranking students based on their “story”, it still just benefits the wealthiest students. You really think just anyone can afford to take several years off to elaborately volunteer? This would just make people go from taking research years to “make-me-more-interesting” years.

I’ve gotta be honest, I’ve never really understood the whole “holistic review” thing anyway. Once you ignore academic performance and things that show interest like research etc, the majority of medical students look exactly the same and programs are just trying to make sure they don’t rank a douche.

Of the things you can control like ECs, conferences, etc; 99% of med students have these experiences. They do not set anyone apart from the rest and most people reviewing apps don’t care much about them anyway.

Please read the entire post that I’ve quoted here for your convenience. I am arguing against ignoring academic performance and research because I do think that those things hold merit in resident selection.

If for some reason you still don’t understand what I’m saying, then you would likely benefit from academic performance being withheld in the resident selection process.