Why don't people match into residency?

[GOINGBALD42]

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A sort of friend of mine I thought he was a doctor already, but I thought it was weird how he does these research projects when supposedly he already graduated from medical school. He told me he didn't match into residency once and as I dig deeper he totally avoids the question. So how come people don't match into residencies? I am beginning to think he either flunked out, is lying that he is a doctor, etc... I am pretty sure its unlikely that you don't get a residency. I always got a weird vibe from him.

 

[LizzyM]

Did he graduate from a US medical school or an off-shore school? A doc is less likely to match if an alumnus of a an off-shore school.

Other possible reasons:
He has a red flag in his application such as unprofessional behavior, other institutional action in medical school (caught cheating, etc), he did very poorly on the Step 1 exam, he has had unrealistic hope for the match (the equivalent of applying only to UCLA and UCSF as an OOS applicant with a 3.00/499) and consequently receives no interviews. He interviews poorly and is ranked too low to be matched anywhere where he interviewed.

 

[Dr.J.D]

Did he graduate from a US medical school or an off-shore school? A doc is less likely to match if an alumnus of a an off-shore school.

Other possible reasons:
He has a red flag in his application such as unprofessional behavior, other institutional action in medical school (caught cheating, etc), he did very poorly on the Step 1 exam, he has had unrealistic hope for the match (the equivalent of applying only to UCLA and UCSF as an OOS applicant with a 3.00/499) and consequently receives no interviews. He interviews poorly and is ranked too low to be matched anywhere where he interviewed.

Come on now Lizzy babe.

 

[Goro]

Come on now Lizzy babe.

OP identified the person as "he".

 

[jm192]

Jesus. So eager to correct someone you can't even read.

 

[PreMedMissteps]

A sort of friend of mine I thought he was a doctor already, but I thought it was weird how he does these research projects when supposedly he already graduated from medical school. He told me he didn't match into residency once and as I dig deeper he totally avoids the question. So how come people don't match into residencies? I am beginning to think he either flunked out, is lying that he is a doctor, etc... I am pretty sure its unlikely that you don't get a residency. I always got a weird vibe from him.

Well, until you know for sure that he actually graduated, who knows.

As mentioned above, if he went offshore, matching is more difficult.

If he wanted a more competitive residency and didn't have the stats for it, then he wouldn't match, and wouldn't SOAP successfully.

If he is US educated and was going for a more difficult specialty, he may be doing research now to position himself for a less-competitive residency and he's entered the process this year or plans to do next year.

 

[Dr.J.D]

Jesus. So eager to correct someone you can't even read.

It was just a joke. But why couldn't you tell I was joking? That's the real question.

 

[Dr.J.D]

OK IM SORRY I DIDNT READ goro

 

[Dr.J.D]

SO politically correct

 

[mcloaf]

SO politically correct

Stop posting.

 

[Dr.J.D]

OP identified the person as "he".

Why are you so eager to assume people's genders? That person could be a non-binary androgyne genderfluid bisexual mutant ninja turtle.

 

[Dr.J.D]

Stop posting.

First amendment:
"Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances."

 

[PreMedMissteps]

First amendment:
"Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances."

Has congress weighed in here?

 

[Mad Jack]

JOKING OMG, GO GET READY TO REJECT PEOPLE FROM MED SCHOOL

3angry5me

 

[mcloaf]

First amendment:
"Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances."

You've posted 6 times in this thread, none of which are relevant to the OP. You clearly have nothing to contribute here.

 

[Dr.J.D]

Has congress weighed in here?

So your interpretation is that only congress is prohibited from making laws that restrict freedom of speech?

 

[jm192]

Can someone just ban this kid already? Holy god discussion hijacked.

Op:
FMG's have a bad time.
People aim too high with no backup plan--not sure what the statistics show--but we have plenty of unfiller IM and FM spots.

 

[Goro]

It was just a joke. But why couldn't you tell I was joking? That's the real question.

Humor doesn't travel well over the electrons.

 

[Dr.J.D]

You've posted 6 times in this thread, none of which are relevant to the OP. You clearly have nothing to contribute here.

Well I was just lurking in the shadows of the thread, when I pointed out a mistake ( I thought to be at the time) , I realized then realized I was wrong and got roasted like a pig on a spit by all of you intellectuals. But what you all fail to realize is that I am fricking trolllling u. Gosh

 

[21Rush12]

@Dr.J.D go back to hSDN and let the adults have some peace and quiet.

OP it sounds to me like he graduated and didn't match, but there's probably more to the story. Some people choose not to go on to residency, and for others the choice isn't their own. It's probably a sensitive issue, but it isn't very common for US MD grads to not match anywhere at all.




Sent from my iPad using SDN mobile

 

[jm192]

Humor doesn't travel well over the electrons.

Especially the non-funny kind

 

[CherryRedDracul]

Well I was just lurking in the shadows of the thread, when I pointed out a mistake ( I thought to be at the time) , I realized then realized I was wrong and got roasted like a pig on a spit by all of you intellectuals. But what you all fail to realize is that I am fricking trolllling u. Gosh

Don't quit your day job.

Anyway, back to the OP, to further expound on what LizzyM meant by "unrealistic hope for the match", some people aim to match into very competitive specialties (e.g. dermatology, orthopedic surgery) but, unfortunately for them, fail to do so because they lose out against the competition. They may decide to do, for example, a dedicated research to make themselves competitive for the next matching cycle. I've had friends who did not match into competitive specialties, take a full research year, and match in the subsequent year.

 

[AnatomyGrey12]

People tend to not match for one of two reasons:

1. Have red flags, i.e. Board failures, class failures, bad clinical grades, repeating a year, LOAs, coming from a foreign school, etc. Generally it's a combination of more than one.

2. Applied to a field or to programs for which they were either not competitive or were borderline. This comes from over estimating how good your application really is. Applying smart is important for residency too, like it is for medical school.

*the caveat to 2 is that sometimes you can be a great candidate but are aiming for something like Derm or ENT and just miss. Those people tend to just take a research year and find a residency the following year in a less competitive field (like instead of ENT they do Gen surg) or sometimes in their original field of choice.

 

[GoCubsGo20]

Well I was just lurking in the shadows of the thread, when I pointed out a mistake ( I thought to be at the time) , I realized then realized I was wrong and got roasted like a pig on a spit by all of you intellectuals. But what you all fail to realize is that I am fricking trolllling u. Gosh

Shut up, Knicks are garbage too

 

[infectiousdisease101]

Don't pay Dr. JD any attention. He'll just respond and the cycle will continue.

Back to the issue at hand, US medical schools have a 96% match rate. Offshore medical schools, apart from the Big 4 Carribean ones (St George, American University of Carribean School of Medicine, Saba University, and Ross University) are typically 50%-60% or so.

Not wanting to talk about it means your friend really messed up in medical school. The one thing I'll always be grateful for is the fact my school's pre-med advisor is also like a mentor to me and keeps an eye on the things I say in social media, interviews and paper applications to help me hone my interpersonal skills and to stay out of trouble I did not mean to cause.

 

[Goro]

People tend to not match for one of two reasons:

1. Have red flags, i.e. Board failures, class failures, bad clinical grades, repeating a year, LOAs, Generally it's a combination of more than one.

2. Applied to a field or to programs for which they were either not competitive or were borderline. This comes from over estimating how good your application really is. Applying smart is important for residency too, like it is for medical school.

The bolded is exactly the case for the handful of my students who failed to match. And in general, mental health issues were at the bottom of their woes.

For item 2, I've had plenty of students who had to scramble, but they were able to eventually match. Upon autopsy, they all aimed too high, and had too few sites on their list. This has been far less of a problem lately as over time, our Clinical Education Deans got a LOT better, and hence, the advising got better.

 

[drmantistobbogan]

Why are you so eager to assume people's genders? That person could be a non-binary androgyne genderfluid bisexual mutant ninja turtle.

If you're going to attempt to be an edgelord, at least try to make it funny

 

[sliceofbread136]

Did he graduate from a US medical school or an off-shore school? A doc is less likely to match if an alumnus of a an off-shore school.

Other possible reasons:
He has a red flag in his application such as unprofessional behavior, other institutional action in medical school (caught cheating, etc), he did very poorly on the Step 1 exam, he has had unrealistic hope for the match (the equivalent of applying only to UCLA and UCSF as an OOS applicant with a 3.00/499) and consequently receives no interviews. He interviews poorly and is ranked too low to be matched anywhere where he interviewed.

Even with all of those possibilities as a us Med student he should have been able to scramble somewhere. Guessing he went offshore

 

[LizzyM]

Even with all of those possibilities as a us Med student he should have been able to scramble somewhere.

But ~5% don't...

 

[sliceofbread136]

But ~5% don't...

Pretty certain that 5% is pre-SOAP. I've actually never heard of a us md not even being able to get something like a pre-lim surgery year through soap

 

[gonnif]

But ~5% don't...

Pretty certain that 5% is pre-SOAP. I've actually never heard of a us md not even being able to get something like a pre-lim surgery year through soap

I ran some crude numbers on this a while back

Residency Match
Back of envelope calculation
in NRMP 2017 US Seniors
19030 initially applied for match
__431 withdrew application
___61 didnt get ranked at any program
18539 active applications
17480 matched
_1059 didnt match
__610 SOAP (post match) placement
__440 didnt match or SOAP
(some likely got individual contracts spots)
(some withdraws maybe not have graduated, not passed STEP 2, other issues for withdraw)

930 (approx) of 19030 who initially applied, didnt get a slot

Previous Graduates (ie someone other than senior)
_1500 (approx) (would include those in a slot who want another program or specialty)
--750 (approx) either match or SOAP
--750 (approx) dont get a new slot (would include some already in a slot)

It would seem of the 930 US seniors who dont get a slot, at least 500, likely closer or over 600 eventually do.

Ultimately, perhaps at most 400, likely under 300 of the 19,000 plus who graduate a year do not ultimately get a residency slot at some point or under 2% at most.

 

[gonnif]

Humor doesn't travel well over the electrons.

Two atoms are walking down the street
when one says to the other: "I think I've lost an electron!"
"Are you sure?" replies the second
"I'm Positive!!"

 

[mimelim]

Even with all of those possibilities as a us Med student he should have been able to scramble somewhere. Guessing he went offshore

Even pre-lim surgery positions have standards. While you can typically always use more bodies, someone that is going to be a distraction to the staff or other residents can hurt more than help. Someone that is so grossly unreliable that their work has to be double checked every step of the way or even redone isn't worth taking on.

Pretty certain that 5% is pre-SOAP. I've actually never heard of a us md not even being able to get something like a pre-lim surgery year through soap

And then what? A pre-lim surgery position is a dead end 50-55k single year contract. Matching a pre-lim position without an advanced position (ala Urology, radiology, etc) is no different than going into the lab.

 

[el_duderino]

How does the military match figure into those numbers? Could that account for a lot of the ones that don't place?

 

[deleted827260]

of course he isn't going to let some stranger dig into his personal life. What does "sort of friend" even mean...

 

[gonnif]

How does the military match figure into those numbers? Could that account for a lot of the ones that don't place?

.

Unfortunately, I cannot make any clear conclusions on this as the data overlaps across NRMP, the former AOA match system, and the military match, which tracks numbers via each of the three service branches, except maybe one: Some of the withdraws from NRMP are undoubtedly from the earlier Military Match. Therefore, my estimated maximum number of 400 MD seniors or previous grads never getting a slot is likely below 200 individuals. I am sure somewhere in the literature there must be someone who has looked at the actual data (following all AMCAS and AACOMAS grads thru the 3 matches) and come up with actual stats. My estimate shows that at max 2%, more likely 1% of those US MD/DO seniors or previous grads who want a PGY1 slot, ultimately do not get one. This number is so small (200 individuals from MD alone) that programs who are not of the NRMP "all in" policy, opt out open slots in SOAP, fill slots as contracts as they open, or get "informal" year (as to just get licensed), that it is likely under 100 individuals from MD school who want a residency, never get one.

Just to add, with ultimately 97% of MD students earning their degree and 2% or less never getting a residency, there is a 95% "success" rate for allopathic students and likely similar for DO students

PS: I happen to be on a subway this week sitting across from an SGU medical school advertisement stating that 93% of students get a residency. I wanted to get up and scream
"What about attrition, withdraws, no ranks, where is the data on that SGU!?!" Of course on an NYC subway, no one would have taken notice.

 

[Lucca]

I wish we could also see how competitive all these students were. It could be that Vanderbilt students out performed other schools at the same LizzyM level but with rates this low they probably didn't.

 

[LizzyM]

.



Just to add, with ultimately 97% of MD students earning their degree and 2% or less never getting a residency, there is a 95% "success" rate for allopathic students and likely similar for DO students

But that 2% includes those who have an involuntary gap year after med school graduation.

PS: I happen to be on a subway this week sitting across from an SGU medical school advertisement stating that 93% of students get a residency. I wanted to get up and scream
"What about attrition, withdraws, no ranks, where is the data on that SGU!?!" Of course on an NYC subway, no one would have taken notice.

Yes! So true, both the observation about SGU and the comment about the NYC subway. 😉

 

[gonnif]

But that 2% includes those who have an involuntary gap year after med school graduation.

Yes! So true, both the observation about SGU and the comment about the NYC subway. 😉

I was trying to account for involuntary gap by including previous grads in the estimate. Since this number is relatively consistent and comes out of the withdraws, it is somewhere in the mix.

 

[usernamesaredumb]

Come on now Lizzy babe.

OP said he was a he you dolt

 

[infectiousdisease101]

I forgot. When I shadowed, there was one other MD that was shadowing with me. She took 3 years off because she had 2 or 3 kids she wanted to take care of. She was shadowing to show she was doing something while she applied to residency when I met her.

So some could have been something related to that as well.

 

[GOINGBALD42]

so you can still get residency years later?

 

[infectiousdisease101]

so you can still get residency years later?

Why not? The requirement is you have an MD. Unless the program requires you graduate within a certain amount of time, you're eligible to apply to residency. Although, the main difference between starting residency immediately and later is the added stress of the Step 3 exam because once you're in residency, the step 3 (since it's taken after medical school, typically in residency for those who started right away) exam score won't matter as long as you pass which is like the 2nd percentile so I am fairly certain you can BS that exam and still pass, assuming you paid attention in medical school. However, if you wait a while, you will probably need a good score because it will probably be factored into your residency application.

 

[gonnif]

so you can still get residency years later?

Why not? The requirement is you have an MD. Unless the program requires you graduate within a certain amount of time, you're eligible to apply to residency. Although, the main difference between starting residency immediately and later is the added stress of the Step 3 exam because once you're in residency, the step 3 (since it's taken after medical school, typically in residency for those who started right away) exam score won't matter as long as you pass which is like the 2nd percentile so I am fairly certain you can BS that exam and still pass, assuming you paid attention in medical school. However, if you wait a while, you will probably need a good score because it will probably be factored into your residency application.

Previous US MD grads get residency placement via Match and SOAP at about a 50% fill rate, which is similar to off-shore grads

 

[infectiousdisease101]

Previous US MD grads get residency placement via Match and SOAP at about a 50% fill rate, which is similar to off-shore grads

Higher if you go into primary care, which the previous MD was. I dare say if you do PC, it's almost guaranteed. The number of unfilled seats is pretty high.

 

[smq123]

so you can still get residency years later?

Theoretically you can. Realistically - no. Many programs (including primary care ones) will filter out applications from people who graduated more than 3-5 years before. Unless you did something very heavily clinical during those 3-5 years (i.e. another residency, medical missions, volunteering in a free clinic), the belief is that you are too far removed from clinical medicine to successfully re-adjust to internship.

Why not? The requirement is you have an MD. Unless the program requires you graduate within a certain amount of time, you're eligible to apply to residency. Although, the main difference between starting residency immediately and later is the added stress of the Step 3 exam because once you're in residency, the step 3 (since it's taken after medical school, typically in residency for those who started right away) exam score won't matter as long as you pass which is like the 2nd percentile so I am fairly certain you can BS that exam and still pass, assuming you paid attention in medical school. However, if you wait a while, you will probably need a good score because it will probably be factored into your residency application.

- Sure, you're eligible to apply. The chances that you will match, though, are pretty low. Fair or not, there is a bias against people who could not match, and the generally accepted advice is that your chances drop precipitously the farther out from school you are.

- Step 3 is exceptionally easy IF you're doing general clinical medicine everyday.

Higher if you go into primary care, which the previous MD was. I dare say if you do PC, it's almost guaranteed. The number of unfilled seats is pretty high.

The number of unfilled seats is getting lower, though, and will likely continue to get lower as the number of people in the residency match increases.

 

[infectiousdisease101]

Theoretically you can. Realistically - no. Many programs (including primary care ones) will filter out applications from people who graduated more than 3-5 years before. Unless you did something very heavily clinical during those 3-5 years (i.e. another residency, medical missions, volunteering in a free clinic), the belief is that you are too far removed from clinical medicine to successfully re-adjust to internship.



- Sure, you're eligible to apply. The chances that you will match, though, are pretty low. Fair or not, there is a bias against people who could not match, and the generally accepted advice is that your chances drop precipitously the farther out from school you are.

- Step 3 is exceptionally easy IF you're doing general clinical medicine everyday.



The number of unfilled seats is getting lower, though, and will likely continue to get lower as the number of people in the residency match increases.

I figured it was the case for previous MDs, that's why she was shadowing with me.

In addition, your statement about matches is a very deceptive statistic. You did not account for the increase in positions. For the past 3+ years, the number of residency positions has been increasing for internal medicine, but the number of available positions has been increasing at a higher rate. That means the number of unfilled positions for internal medicine has been increasing for the past 3 cycles. I got this data from the residency match data from 2015-2017. Can't post the link because I'm a relatively new member.

 

[gonnif]

Link to 2017 data

http://www.nrmp.org/wp-content/uploads/2017/06/Main-Match-Results-and-Data-
2017.pdf

I figured it was the case for previous MDs, that's why she was shadowing with me.

In addition, your statement about matches is a very deceptive statistic. You did not account for the increase in positions. For the past 3+ years, the number of residency positions has been increasing for internal medicine, but the number of available positions has been increasing at a higher rate. That means the number of unfilled positions for internal medicine has been increasing for the past 3 cycles. I got this data from the residency match data from 2015-2017. Can't post the link because I'm a relatively new member.

 

[PreMedMissteps]

Even pre-lim surgery positions have standards. While you can typically always use more bodies, someone that is going to be a distraction to the staff or other residents can hurt more than help. Someone that is so grossly unreliable that their work has to be double checked every step of the way or even redone isn't worth taking on.



And then what? A pre-lim surgery position is a dead end 50-55k single year contract. Matching a pre-lim position without an advanced position (ala Urology, radiology, etc) is no different than going into the lab.

True. A US MD resident recently told me that a Caribb grad only got a pre-lim surg position, which ended several months ago...and now that student has nothing.

I often wonder when the Caribbs report their match successes if they're counting single-year prelim/trans matches when that's all their students get when they were going for an advanced residency.

 

[begoood95]

True. A US MD resident recently told me that a Caribb grad only got a pre-lim surg position, which ended several months ago...and now that student has nothing.

I often wonder when the Caribb's report their match successes if they're counting single-year prelim/trans matches when that's all their students get when they were going for an advanced residency.

Knowing their other misleading practices, I wouldn't doubt that this is the case.