E.g. instead of having the "match", why don't programs just accept or WL candidates and see who ends up taking their offer? that way, programs will still get who they want (accepted / WL candidates) while candidates will have more flexibility as well. am I missing something?
Why doesn't residency admissions work the same way as med school admissions?
- Thread starter glee123
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I think it used to be like that and it didn’t work well, people could drop positions for better offers later. The match just lets everyone do it at once and favors the students, it “simplifies“ the process
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deleted947265
The residency admissions process is actually quite a good system at what it does, and worked for a really long time. If you changed it to how it works in med school admissions you'd essentially be combining everything that's currently awful about med school admissions for both med schools and premeds with everything that's awful with the match for med students and PDs.
Every major problem that currently exists with the match could be resolved with a strict application cap in ERAS of 12. Get @ me.
Every major problem that currently exists with the match could be resolved with a strict application cap in ERAS of 12. Get @ me.
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Should check out Sheriff of Sodium's blog post about why we have a Match & its history
thesheriffofsodium.com
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. “…
thesheriffofsodium.com
Cap is nice but perhaps in addition it would also help to have all applicants to apply in specified waves on set dates should not have luck in the preceding wave. Gets rid of programs being overwhelmed with floods of applicants and they know whos really interested in them based on the wave.
Just thinking out loud.
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Yes, you are missing something. A friend of mine did competitive fellowship. This program didn't have a match. Friend did 4 interviews. Was rejected from two high-ranked uni programs, was accepted to a low-tier university program. He was awaiting an Ivy decision (best program in the country), so he called the Ivy to say he was accepted to the university program and was wondering about their timeline. Ivy said they're still interviewing, can't give an answer. Friend put off the university for weeks. Finally, university needed an answer because they wanted to make an offer to someone else if friend didn't want it. Friend called Ivy again, talked to two people. They said sorry no decision yet. Friend ended up signing with university. About a month later, Ivy contacted him to tell him they'd like to extend the offer. Friend was put in an impossible situation that would have been alleviated with a match.
The match favors the candidate.
Wouldn't the idea above (#5), being given the ability for everyone to apply to a limited number of programs in set waves, obfuscate this issue? So there'd be multiple rounds of applying and when a program fills up, it fills up. No waiting on a decision.
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No, it wouldn't. Waves is crazy. I can't imagine multiple matches with each round, demoralization sets in for both programs and candidates.
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AnatomyGrey12
You need a higher number. That's like putting a cap on medical school apps at 2.
No, not multiple matches. Applicant gets and interview then shortly after they are given a decision, they can accept or decline. Once you choose to accept the position or a program fills up, you're out and you forfeit the chance to interview more.
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Med school admissions and residency admissions are not analogous.
Med school admissions essentially has an unlimited amount of applicants for a limited amount of seats.
Residency admissions had a limited amount of applicants for a limited amount of seats.
Med school admissions essentially has an unlimited amount of applicants for a limited amount of seats.
Residency admissions had a limited amount of applicants for a limited amount of seats.
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Ah, okay and you think this will alleviate the problem I mentioned above? Sorry no, that's a horrible system. The Match, faults and all, is the (much) better plan.
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deleted947265
Meh, not really. It seems really low, but it's not. The average applicant sends like 60 applications, it's patently absurd. The only thing that would change under an application limit of 12 is your application to interview yield would be much higher. There would be problems at first, and maybe something slightly higher is needed, but 1 extra application would go a long way, longer than you would think. It doesn't work that way now because the vast majority of applications sent from a purely system point of view, are pointless. Any application that gets sent and doesn't lead to you ranking a program, and that program ranking you is pointless. That's why overapplication is such a problem, it's literally a waste of everyone's time, and because it costs 50$ to send JSON strings apparently(AAMC non-profit lul): money. Look at the PD pain points survey by the AAMC, almost half are the direct result of overapplication.
Large Volume of Applications? Overapplication.
Lack of information about which applicants were genuinely interested in my program? Overapplication.
Applicants cancelling interviews? Overapplication.
Interview season too long? Overapplication.
People feel the need to send so many applications is because everyone else is sending so many applications. But if everyone sent less applications, everyone else wouldn't need to send so many applications and the match rate would be the same. Bryan Carmody has a pretty good breakdown of this. It seems counter-intuitive, but it works.
An application limit makes the match and the people behave much more predictably. Students are always going to send the maximum number of applications, and spend most of their applications applying programs they perceive as having the highest possible chances of getting an interview at and therefore ranking. Program directors have a much easier time deciding who to interview because they will receive far fewer applications than they used to. It makes it easier for programs at lower-tier programs, because they don't have to do anywhere near as much guesswork about who wants to come to their program. If PD's aren't getting enough applications, they can take pizza to the nearest medical school: it's not brain surgery.
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AnatomyGrey12
Yes but it needs to be a reasonable number and 12 is not that number. With such a low limit you are literally boxing people into applying to residencies they KNOW they'll get interviews at. There will be no reaching for programs in the next tier or in geographic locations on the other side of the country. Where you go to medical school will be even more paramount because your only chance to land a top residency would be to go to a top medical school, only chance to go back to your home state for residency will be to go to school in that state, etc. The number will need to be a decent amount, like 50, and then also be adjusted depending on the field. Like vascular surgery for example, it has only 59 programs and the vast majority of programs only take 1 or 2 residents, you honestly need to apply to just about all of them to maximize your chances.
You are greatly oversimplifying a complex process. Yes there needs to be a residency application cap, but much more nuance is required than what you are spouting.
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Because medical schools can accept hundreds of students each year, while some residencies accept 1-2 residents a year.
Capping to 12 residency applications is a ridiculous idea. Approximately 10% of residents in the current system don’t match general surgery when ranking 12 programs. Furthermore, there are two ways of applying general surgery, through prelim and categorical positions. If limiting to 12, this would have a disproportionally negative effect on prelim applicants, who due to having less competitive applications, have to rank many programs.
Why change a system that earned its creators the Nobel prize in mathematics?
Capping to 12 residency applications is a ridiculous idea. Approximately 10% of residents in the current system don’t match general surgery when ranking 12 programs. Furthermore, there are two ways of applying general surgery, through prelim and categorical positions. If limiting to 12, this would have a disproportionally negative effect on prelim applicants, who due to having less competitive applications, have to rank many programs.
Why change a system that earned its creators the Nobel prize in mathematics?
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The problem with this is you need transparency on the Program side in terms of what their step medians and ranges are , what their research productivity ranges are, what percent of people are from top nih funded schools, what percent of people did aways there , etc. Without that there is a very large liklihood that unmatched rate goes through the roof.
Its like limiting number of medical school applications without providing an MSAR.
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deleted947265
50? That's more than the average number of applications for most fields. 12 isn't necessarily the number, it could be slightly more or slightly less, but it's awful close and you can get a movement going under a cute catch phrase like "Doctors Dozen" so it's a good starting point. The problem is that there's an inverse relationship between number of applications, and probability of getting an interview. The actual number of applications doesn't matter as long as those applications lead to programs ranking those applicants and those applicants ranking the programs. The probability of going to an interview and appearing on that programs rank list are probably the same with or without application limits, and this is the only part that matters. Applications aren't a finite resource, and interviews are a finite resource.
On a related note would love to see data on average ROL length of matched/unmatched applicants/programs where rankings that are disjoint are removed.
If everyone applies to all 59 programs then you all have the same chances. Your odds are only improved compared to those who chose not to apply to all 59 programs. Under a capped system, your odds are better or worse depending on how and where you've chosen to apply. That's really it. If it caused a great number of unmatched applicants you could just run a second match cycle or just SOAP.
It's a really simple process. Could not be simpler.
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AnatomyGrey12
You are wrong. I don't know what else to tell you. You simply cannot cap residency apps at that small of a number without severely harming a lot of applicants. As it stands right now the match process favors the applicants.
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I actually agree with @Mythoclast here, even as somebody applying to a competitive surgical sub where people often apply to every single program. Capping the number of programs you apply to (I've proposed 15 in the past) will not change match results that drastically. Sure, we don't have great knowledge about how competitive programs are, but that might also be because residencies are less minutely stratified than medical schools, and connections matter a lot more. So maybe on paper one program has a higher step average, or higher research numbers for their matched students than another, but the second program is actually much better regarded in the field and happened to take people who were recommended to them by other famous people in the field. I don't think an MSAR would necessarily be that helpful because it can't capture those softer factors.
What it will require is slightly more strategic applications. If you're a borderline candidate, maybe you shouldn't waste any of your precious spots on top tier institutions. Talk to your mentors and find out where you're competitive for. In the current system, you weren't going to get interviews there anyways.
For middle of the pack applicants, it actually improves their chances at at least getting interviews at top tier institutions. Saving ~3 spots for your dream, reach programs would still make sense, and because those programs have to go through less applications, yours is able to stand out more. You're going to be much more likely to get an interview then.
For the top tier of applicants, it will help as well. Maybe they don't get to brag about getting 40+ dermatology interview offers. But you get a much better shot at actually determining where you want to go. This would also prevent yield protection from lower tier programs, because if you're sending them one of your limited applications, then it's clear that you're actually serious about wanting to go there.
The one situation that I'm not sure how it would impact would be people dual applying. Should it be 15 apps total, or 15 apps per specialty? I'm not sure.
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AnatomyGrey12
Perhaps it's because I'm a DO applicant applying to a surgical field but I strongly disagree. If you capped me at 15 applications I would be forced to limit my application to former DO programs I know would consider me. There would be no room for reach programs on my list, even though people with my app typically match solid community or low tier (sometimes even mid-tier) university programs with a broad strategy, it would be too much of a gamble to send them apps with them limited that much.
Again, I am pro application cap, but not at such a small number. A small cap like that puts applicants in the serious bind of actually applying where they want to go vs. where they think they will have the highest yield.
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I would literally not have any reach programs on my list. The average number of interviews for a successful match in the sub specialty i am interested in is somewhere around 18. It would be insane for me to have reaches if i was limited to 12 interviews.
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I think you're underestimating how much better your yield of mid-tier programs would be if you weren't competing with literally everybody else applying to that specialty. It might be even better as a DO, because that's one of the filters PDs currently use to reduce apps. Applying to around 3 university programs may give you as good a yield as applying to 20 now.
You're basing that on data from the current system. Obviously people will have a higher high end of interviews when even super competitive applicants apply to 80 places. That gives the data a long tail.
If everybody is limited, then the average interview numbers of matched applicants will obviously look a lot different.
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AnatomyGrey12
I disagree. I think you are greatly underestimating the negative impact such a small number would have on each applicant. Even a number like 40 is so much more reasonable than 15.
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Capping residency apps is dumb. This happens nowhere else in life.
Can you imagine if you’re only allowed to apply for 2-3 jobs as an attending?
The reason you need the match is because residency programs are limited and highly time sensitive. Everyone needs a job on July 1st.
Can you imagine if you’re only allowed to apply for 2-3 jobs as an attending?
The reason you need the match is because residency programs are limited and highly time sensitive. Everyone needs a job on July 1st.
Incorrect. An application cap hurts students at low tier schools and DO applicants who need to apply broadly in order to match. It also negatively affects dual applicants.
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deleted731525
An application cap would have definitely screwed me. Every problem with the match is a consequence of there being too many applicants and not enough positions, when you factor in IMGs/FMGs. Its a high stakes game of musical chairs without enough seats and everyone looking for every advantage they can get to make sure they are sitting when the music stops.
I'll be damned:
Reforming the Match: A Proposal for a New 3-Phase System
E: link should work, can't fix label.
Reforming the Match: A Proposal for a New 3-Phase System
E: link should work, can't fix label.
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AnatomyGrey12
I'll be damned:
Reforming the Match: A Proposal for a New 3-Phase System
E: link should work, can't fix label.
That's essentially an opinion piece by a resident.
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Yes I am basing this on the current system , but how many people are matching in my field at their 12th -18th ranks on the list?
I think that limiting applications may be a useful way in reducing the burden that PDs face, however you need transparency on behalf the individuals programs, which is a bit problematic both in terms of manpower and egos of PDs. And you need a much larger limit like 25-30, not 14.
This system will still result in less overall initial matches and ultimately more soaping.
The transparency may also lead to PDs number whoring like medical schools for ego reasons.
This system will probably hurt marginal students and programs.
This system will disproportionately negatively impact DO and IMGs.
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For anyone not aware (like I wasn't), the SOAP already operates using these rounds (three rounds total). What you guys are proposing basically already exists, with Round 1 being the major match that assigned 94% of MDs and the SOAP then consisting of Rounds 2-4.
I can absolutely see how this could be slightly modified into a multi-round Match.
I can absolutely see how this could be slightly modified into a multi-round Match.
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Unpopular idea, but I don’t think we’d have to cap applications if programs just tell us what they want.
I didn’t apply to top MD schools bc it was obviously going to be a waste.
Now I’m looking at residencies in a moderately competitive field and even some top programs are like “pass your boards on your first try. We do not screen by numeric score. Research is not necessary.”
Yeah right. Then you dig around and figure out that programs average is 240+ Step 1 and everyone there has a CV a mile long. But they’re banking on over-application to increase their chances of filling.
Once ERAS opens I won’t have time to do that with every program.
I didn’t apply to top MD schools bc it was obviously going to be a waste.
Now I’m looking at residencies in a moderately competitive field and even some top programs are like “pass your boards on your first try. We do not screen by numeric score. Research is not necessary.”
Yeah right. Then you dig around and figure out that programs average is 240+ Step 1 and everyone there has a CV a mile long. But they’re banking on over-application to increase their chances of filling.
Once ERAS opens I won’t have time to do that with every program.
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Which is why i just shot gunned to every program in my geographic region and look at that stuff after...
It is, but its explained with more effort there. I think the biggest issue is that everybody is caught up on the arbitrary number of 12.
Residency Explorer offers some level of transparency.
How can one spearhead pushing for transparency? As someone said, MSAR was great applying to medschool.
What difference does "less" initial matches matter if one matches the second round vs their match is revealed March 20th? You matched to a program you liked. No more interviews, crappy hotels, traveling, more money in your pocket. Less money that needs to be spent on applications.
Why should marginal students and marginal programs be entitled to anything?
Upper-tier programs already "degree" ***** MD's over more qualified DO's. Number transparency lets the most qualified, MD or DO, get the position. Maybe number whoring isn't that bad. If it's such an issue, one doesn't have to apply to them.
Exactly. There needs to be an MSAR. That way applicants stop wasting money applying to programs they have no chance at and programs get the candidates that they are looking for, by whatever metric they individually choose.
Besides, there's only so many people who score +250 on step 1 and only so many of them apply for a top program. These top programs will have to consider applicants with lower scores or they risk going unfilled.
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Residency explorer numbers are years old, and dont necessarily reflect the reality. They often have outdated or straight up wrong information.Residency Explorer offers some level of transparency.
How can one spearhead pushing for transparency? As someone said, MSAR was great applying to medschool.
What difference does "less" initial matches matter if one matches the second round vs their match is revealed March 20th? You matched to a program you liked. No more interviews, crappy hotels, traveling, more money in your pocket. Less money that needs to be spent on applications.
Why should marginal students and marginal programs be entitled to anything?
Upper-tier programs already "degree" ***** MD's over more qualified DO's. Number transparency lets the most qualified, MD or DO, get the position. Maybe number whoring isn't that bad. If it's such an issue, one doesn't have to apply to them.
Exactly. There needs to be an MSAR. That way applicants stop wasting money applying to programs they have no chance at and programs get the candidates that they are looking for, by whatever metric they individually choose.
Besides, there's only so many people who score +250 on step 1 and only so many of them apply for a top program. These top programs will have to consider applicants with lower scores or they risk going unfilled.
The initial match failure comes at a price. Atleast with match you have a semblance of control to what programs you will interview at and where you will rank. If you fail match everything is out the window and now you may end up in a different part of the country in a different field all together.
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Reforming the Match: A Proposal for a New 3-Phase System
An Error Occurred Setting Your User Cookie
I kind of like this approach -- Capped initial applications in Wave 1 with a Yes/No decision released. Then uncapped applications in Wave 2. Then SOAP. If all you get from Wave 1 is a Yes/No, you could still have the ritual Match Day celebrations.
One suggestion to avoid interview-hoarding would be to limit accepted interviews to one per day. For example, an applicant accepted an interview for November 30th at a 'good' program, then receives a 'better' offer for the 30th. They'd have 24 hours to release (or reschedule) the less-preferred option, thereby making more spots available to other applicants.
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Agree. There is not near enough transparency currently to put a cap on applications. FREIDA was super outdated too.
Well, it'd help if PD's stopped discriminating against DO's. If you're qualified, you're qualified. Anything less is immoral and shameful.
The number can be disputed, we should stop focusing on that.
By applying in 'waves,' programs will already let programs know your level of interest in them. If nothing else, if you applied to Harvard, in wave 1, you'd stand out even more than if everyone applied all at once as A) the PD can gauge your genuine interest since you applied wave 1 and B) They're not overwhelmed with applicants and you're more likely to be noticed. More importantly, with the application Cap and applying in waves, students can no longer hoard +40 interviews (interviews are limited) while everybody else is left with little to nothing and programs having to make last minute cancellations. You also won't have to wait 4 months to find out you're not getting an interview from them and you need to move on. Also it eliminates the possibility of disingenuous 'love letters' sent to programs to get an interview. Part of the reason people apply to +100 places is because so many people hoard and others are left with little opportunity.
What about 30? Or what number do you suggest? You can apply to all your reaches then. If you don't get lucky, wave 2 you can apply away. The average MD applies ~60, DO ~75, Canadian 78, IMG ~137. The numbers of applications keep going up, in part because theres a smaller minority that hoards all of the interviews forcing students with 'less prestigious' degrees to apply more to compensate.
I disagree. The cap prevents interview hoarding from applicants. This would benefit DO's since they don't (generally) receive as many II despite applying to more programs. An extreme example but I hope it gets the point across: Instead of Applicant A hoarding 40 II all for themself and leaving 10 for everyone else; Applicant A can only hoard 12, the other 38 are left remaining for the others.
I acknowledged the issue with RE, I said it offers some level of insight.
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The average MD is probably applying to 30ish programs.
There is no minority that hoards all the interviews. often times there are many overlaping interview dates for programs and it becomes difficult to hoard all the interviews. Furthermore the numbers dont work like that, people arent going to 100+ interviews, Even in the most competitive specialties people tap out around 20 interviews. Realistically people are going to 15~interviews . And if you look at the average and incorporate people dual applying it leads to 9 interviews per specialty application by US MDs as evidenced by this chart.
You have kinda glossed over the fact that the alternative system you are proposing would provide people with little control or input to locations where they might end up or specialties where they might end up.
The more I look at this problem, it seems like there are little to no benefits of capping applications considering the average applicant it attending 15 interviews and ranking as many programs. with the average applicant applying to 30ish programs that doesnt really seem excessive. Atleast that person has control over where that person would be willing to apply to and what programs that person is willing to apply to .
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There definitely is a minority that hoards interviews:
It's not just a maldistribution of applications, but also of who gets interviewed. A shocking fraction of interviews gets absorbed by a small handful of applicants. In the worst cases like Family Medicine and Internal Medicine, a full 50% of interviews are being taken by only 7-12% of applicants.
The opportunity cost of this inequity is huge. So, so many interviews are getting wasted on a handful of superstars that are all likely to land in their first few ranks.
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1. ENT match is hardly a blip in terms of average match.
2. This paper defines interview rich as 16+ interviews, all the while completely ignoring median interviews attended by a person in that specialty. ENT for example has the median number of programs ranked by an applicant as 15~ in the NRMP report that this paper utilized.
3. This paper doesnt really take into account real interview capacity. it is possible that people with lower ranks were offered more interviews and they never attended.
3. If you look at these fields that paper would have you believe that there are numerous programs that are unable to find a match considering people "hoard " interviews. It speaks nothing to the idea that perhaps those programs would not have extended interviews to less qualified people considering they are still able to fill .
4. Here is what the medians look like for US seniors.
Its a little hard justifying a complete change of the process if on edge cases.
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Their method is accurate for the other specialties too however. ~10% of IM applicants are taking 50% of invites. Idk what to call that if not hoarding.
Agree that many times the invites are much higher than actual ranks, though. We had an ortho applicant that got >40 interviews and ended up home matching. But they don't have any way to control for that in the public NRMP data.
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Also the chart is saying that 12% were offered 50% of interviews, but acutally 25% ended up attending 50% of interviews. Once again, not sure I would consider that hoarding, rather just a difference in competitiveness. Also if you look at the the data it says that the median number of IM interviews was close to 15 or their limit of Interview rich applicants.
And the paper doesnt really differentiate between turning down interviews by people who ranked even fewer places.
Edit difference in competitiveness or risk tolerance.
There are the averages from ERAS themselves. Its broken down by type of applicant as well. So your premise is based on faulty numbers. Anyone can look for themselves, you are mistaken in this instance.
People hold onto interviews and cancel interviews last minute all of the time. Interviews are limited. You hold onto interviews, it costs other people. As an example, in late December, another applicant said they were going to cancel 6 or 7 interviews because they already attending 16 and didn't feel like attending more (you need ~8 to have >90% chance of matching in that specialty). Another applicant had nearly 30 interviews and they finished attending nearly all of them by that date. I'm not sure where they got the money to apply and attend all of those interviews, but thats a separate issue. Others I met routinely had +20. invites.
You are not distinguishing between hoarding an II and actually attending the interview. An applicant can hold onto as many II as they want, preventing others from receiving it, irrespective of whether the they cancel last minute or attend as excess of interviews.
Where did you get that 9 interviews from?
https://mk0nrmp3oyqui6wqfm.kinstacdn.com/wp-content/uploads/2019/06/Applicant-Survey-Report-2019.pdf
You do realize US Seniors applies only to MD's, right? The reason these numbers differ from ERAS is because ERAS uses an average, this uses a median. Either way, your '30' is wrong. A MD can apply to half the number of programs, yet receive significantly greater numbers of interviews. It's a zero sum game...so one party is getting all of the interviews again? It's not DO's, they're applying to more programs to make up for the lack of invites and getting filtered out at many programs.
At the very least, whether an applicant is 'strong' or not, most parties are discriminated against except US MD's and thus they receive the vast majority of invites. This isn't meant to be a MD vs DO vs IMG argument, but that alone should hopefully have you agree that at least some part of the population is receiving the majority of interviews (again, its zero sum). That is further stratified with strong applicants receiving the most attention and invites.
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I should have said 30~ is the median. That chart literally says
The median is 35.
The match was designed for USMDs in mind. I literally could care less what IMGs do or do not do.
The median MD applies to 35 programs and attends 12 interviews . That is not unreasonable. Forcing people to limit applications to 30 is not going to change the number of interviews extended to IMGS or DOs.
Have you ever considered that programs would just interview fewer people, but still itnerview US MDs more often?
The DO data is before the DO merger took place. There is a still a DO bias, But you cant attribute all the difference between DO match and USMD match to bias, considering the lack of research in DO schools and on average lower step 1 pass rates.
When you consider the median of 35 and the average being 60~ the reality of the people applying to many programs is either they are applying to a very competitive field, or they are a weak applicant.
The more i look at this it seems like the over-application thing is overblown.
You said: "The average MD is probably applying to 30ish programs." You didn't say median and we were speaking of averages at the time. That one is on you.
And why are you using old data. The 2019 report is out. The current MD receives a median of 17 interviews and attends only 13. The more competitive MD's likely receive far more interviews than "just" 17. So the median MD then holds onto 4 interviews. Remember, this is the median, essentially a measure of frequency. The strong applicants are a minority who receive an excess of interviews, likely far above 17, therefore will not be represented in a median. I'd like to give you the benefit of the doubt that you were not intentionally partaking in sophistry nor that I have to go further in explaining the difference between median and average.
The match can be looked at as separately from applying (ERAS) and who receives most of the interview invites. Eitherway, the process was created to facilitate the training of doctors, not by degree. If that were the case, DO's and others would otherwise be barred from applying entirely. Regardless, are you suggesting it is okay for so called moral physicians to discriminate based on a persons degree, where they came from, or creed? That is shameful for anybody to endorse. The most qualified should win it out, regardless of degree, they worked hard, they earned it. The only argument that can be made against is against IMG's in which there is far more grey area and nuance. Depending on where they come from, they often have their education paid for by their government and tax payers, then come here and get subsidized training over the US grad (paid for by US tax payers), and simultaneously results in the 'brain draining or poaching' of a country that may need their best and brightest. I can see both sides of that argument and I don't have a dog in that fight. But at bear minimum, you nor anybody with anything that can be considered a moral compass should be for the discrimination against DO's who are qualified (ironically, something that seems to be more prevalent in higher academia, which in practice, generally consists of individuals who should be opposed to any discriminatory practices. period. But that's beside the point and just an observation that I cannot back with any data).
If we are talking about pass rates, in recent years, the difference in pass rates is 1-2% between MD and DO...big deal. In 2017 & 2018, the most recently released data, DO's had a higher overall pass rate on step one by 1% and repeat pass rate of 6-9% higher than MD's (still...who cares!). That's not bad considering DO's are taught to the COMLEX (granted, it has more overlap with the USMLE than the reverse) but if an MD crossed over to take the COMLEX, they most likely would borderline fail. Besides, in a field like Psychiatry where "scores don't matter," MD's still send ~half the applications and receive far more interviews. I was hoping this wouldn't devolve into MD vs DO, but discrimination is wrong in any form, especially when its concerning US tax paying applicants.
"When you consider the median of 35 and the average being 60~ the reality of the people applying to many programs is either they are applying to a very competitive field, or they are a weak applicant."
I guess those MD's just have really weak applications compared to DO's 😉
Derm: https://www.aamc.org/system/files/2020-01/R-Dermatology (080).pdf
Ortho: https://www.aamc.org/system/files/2020-01/R-Orthopaedic Surgery (260).pdf
Neuro Surg: https://www.aamc.org/system/files/2020-01/R-Neurological Surgery (160).pdf
ENT: https://www.aamc.org/system/files/2020-01/R-Otolaryngology (280).pdf
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I corrected myself, Median is a much better measure of what most of the people are doing considering the extreme outliers of competitive specialties where people apply to every specialty.
You have ZERO evidence that the median applicant recieving 17 interviews is parking 4 that they dont attned. It is completely possible they turn down the interviews that are available to other.
You are laying it on quite thick here. IMMORAL to "discriminate" based on degree. lol get a grip. Pedigree of school is one aspect of merit.
IMGs and FMGs are gambles with we dont know what their programs are really like, if they know culturally what this country is like and what care is expected , and lastly they have higher rates of first time step failure and lower step 1 scores.
Not all DO's sit for Step1 , and out of those that do a higher percent of them fail step 1 on first sitting, this was true until last year where first time takes had equivilant pass rates, but still does not mean all DO students were taking step 1, and on average tend to have lower scores. Furthermore they do not have as much research , nor do they have home programs to get appropriate letters. So not all DO bias is because of the degree there is some aspect that resume based.
Also, dont be surprised if the match rate for those specialties for DO candidates was particularly low. The smart ones were probably applying to previous DO programs. It seems like many of those candidates did not even get an interview considering they are not on the chart above. It is likely that they did not have the resume to match into those fields and were just throwing their hat in the ring.
Top 20 people have different career and residency prospects in comparing to other MD programs. And DO's have different career prospects compared to the average MD .This doesnt mean exceptional candidates cant overcome this. This board is littered with this information. Unsure why you expected reality to be any different.
1.Your argument that people people are hoarding interviews and harming IMG/FMG and DO 1. doesnt make sense since the programs that would not be extending interviews to those other candidates would have difficulty matching. They are not.
The match forces programs to extend interviews and invite people that they would want. If applicants were hoarding interviews to the detriment of other applicants programs would have a difficult time filling. this is simlpy not true , in many competitive matches .
2. You still havent considered that if a limit on applications was placed the same programs would just interview USMDs more often but have overall lower amount of interviews. Still excluding IMG/FMG and DOs.
3, You still havent acknowledged that there are large differences in resumes because of the way schools are set up, research home program etc. How many DO programs have home programs in Ortho or Neurosurg or have labs for research?
IF you want DO's to have the same standing as MDs perhaps Increase the access to research and residency home programs would be the first step. Decrease the Resume gap between the median DO and MD. and Force every student to take USMLE step 1. This process was designed for USMDs, if you want outcomes like USMDs you should look like USMDs on paper.
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Limiting applications alone disproportionately favors the most competitive applicants and the most desirable programs, while hurting the rest because as others have stated, they'd be limited to "sure things" or would simply not match/not fill because they wouldn't even know which programs to apply to and programs wouldn't have enough people on their ROL. Many programs in the less competitive fields also drop below 10 or 12 on their ROL/spot.
Maybe if the goal is to match as many of the most competitive people and fill as many of the most competitive programs as possible, then it makes sense to only cap apps to a low number. But that's not the goal of the match. The goal is to match as many applicants as possible and fill as many programs as possible. I don't even think you would need to limit residency apps if criteria for interview were more transparent.
To blame everything on applicants overapplying, as if its reasonable to expect them to "act responsibly" and "trust in the system" when they literally have everything to lose if it doesn't work is ridiculous. It ignores the underlying problem of the whole process, which is the high stakes combined with lots of competition (i.e. applicants > spots) and uncertainty by programs with regards to their criteria for interviews. We're also missing a big part that is that some programs aren't transparent because they want to boost their applicant numbers to have a bigger pool to choose from.
Maybe if the goal is to match as many of the most competitive people and fill as many of the most competitive programs as possible, then it makes sense to only cap apps to a low number. But that's not the goal of the match. The goal is to match as many applicants as possible and fill as many programs as possible. I don't even think you would need to limit residency apps if criteria for interview were more transparent.
To blame everything on applicants overapplying, as if its reasonable to expect them to "act responsibly" and "trust in the system" when they literally have everything to lose if it doesn't work is ridiculous. It ignores the underlying problem of the whole process, which is the high stakes combined with lots of competition (i.e. applicants > spots) and uncertainty by programs with regards to their criteria for interviews. We're also missing a big part that is that some programs aren't transparent because they want to boost their applicant numbers to have a bigger pool to choose from.
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There's a prior thread I started about reforming the match, worth a read: NRMP Match: Good, bad or ugly?
Trying to decrease application numbers is very complicated. It's a classic example of the Prisoner's Dilemma. It's best if everyone decreased their applications to a reasonable number of programs they were actually interested in. But it's to everyone's advantage to defect -- if everyone else applies in a focused manner, and you apply broadly, you'll get many more interviews than everyone else. Game theory tends to show that if the same people repeat similar decisions in settings like this, they tend to learn to "cooperate". But in the short term, everyone defects. /MathNerd
Focusing on only US MD's isn't a good long term strategy. There are lots of programs that fill with only DO / IMG candidates, and plenty that fill with a mix. Any solution that ignores them is going to fail.
I'm not a fan of the 3 phase system as written. As I mentioned in the attached thread, I'd add an early app phase with a limit of how many spots can be filled in the early phase. The timeline of the early phase would need to be pushed forward so that they could avoid interview costs. It would be difficult to get the whole early phase done prior to main apps going out, but it might be possible.
Trying to decrease application numbers is very complicated. It's a classic example of the Prisoner's Dilemma. It's best if everyone decreased their applications to a reasonable number of programs they were actually interested in. But it's to everyone's advantage to defect -- if everyone else applies in a focused manner, and you apply broadly, you'll get many more interviews than everyone else. Game theory tends to show that if the same people repeat similar decisions in settings like this, they tend to learn to "cooperate". But in the short term, everyone defects. /MathNerd
Focusing on only US MD's isn't a good long term strategy. There are lots of programs that fill with only DO / IMG candidates, and plenty that fill with a mix. Any solution that ignores them is going to fail.
I'm not a fan of the 3 phase system as written. As I mentioned in the attached thread, I'd add an early app phase with a limit of how many spots can be filled in the early phase. The timeline of the early phase would need to be pushed forward so that they could avoid interview costs. It would be difficult to get the whole early phase done prior to main apps going out, but it might be possible.
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