6% of USMD students, 20% of USDO students, and 46% of USIMGs went UN-matched

[sozme]

Highlights from the Match 2016

• It was the largest Match in history (42,370 applicants for 30,750 positions)
• ~18,000 US allopathic students and 17,000 “other applicants” (American D.O. and FMG/IMGs).
• The number of PGY-1 positions increased by 567 from last year (the number of US allopathic seniors also increased by 221).
• 18,187 US allopathic seniors submitted program choices for the Match. 17,057 matched to a first-year position (match rate of 93.8%). Of these, ~79% got one of their top 3 choices.
• 2,982 US osteopathic seniors submitted program choices. 80.3% of these matched to a first-year position.
• 5,323 US-IMGs submitted program choices for the Match. ~54% matched to a first-year position.
• 7,460 Non-US IMGs submitted program choices. 50.5% matched to a first-year position.

Source: http://www.nrmp.org/match-data/main-residency-match-data/

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[cbrons]

Obviously doesn't include SOAP, but what is apparent from this is that going to a Carrib school is still a huge gamble.

 

[Mad Jack]

Doesn't include SOAP, doesn't include AOA, etc.

We had 100% placement last year- the idea that 20% of DO students are going without a residency is ridiculous. We have to play a very different game because of the split match, so numbers look worse than the reality of the situation.

 

[DrBowtie]

Doesn't include SOAP, doesn't include AOA, etc.

We had 100% placement last year- the idea that 20% of DO students are going without a residency is ridiculous. We have to play a very different game because of the split match, so numbers look worse than the reality of the situation.

But the AOA matched people would be pulled out and not included. It doesn't include the SOAP or scrambling into unfilled AOA spots. I'll be curious to see how the numbers change with the merger.

 

[Mad Jack]

But the AOA matched people would be pulled out and not included. It doesn't include the SOAP or scrambling into unfilled AOA spots. I'll be curious to see how the numbers change with the merger.

People are using different strategies than they will post-merger. A lot of people overshoot AOA, get bumped to ACGME, overshoot (because why not, they've got a buffer) and don't match, then scramble ACGME as hard as they can before loosening up and scrambling light in AOA. We know we've got four levels to fall through so we play it that way- in the future, I think DO match rates will end up similar to MDs, but with much lower tier specialties and programs.

 

[AlbinoHawk DO]

I think it's good time to start the 2 tier match system where first you match US graduates MD/DO, then those that graduate international.

 

[Animalcules]

I think it's good time to start the 2 tier match system where first you match US graduates MD/DO, then those that graduate international.

or we could just stick to academic merit? otherwise programs may get confused and match all MDs first, and then those that graduate DO.

 

[AlbinoHawk DO]

or we could just stick to academic merit? otherwise programs may get confused and match all MDs first, and then those that graduate DO.

Yeah, I totally see that.

"durr, i'm a doctor, but i get seriously confused with this md and do thingy. guess match md first."

 

[235009]

People are using different strategies than they will post-merger. A lot of people overshoot AOA, get bumped to ACGME, overshoot (because why not, they've got a buffer) and don't match, then scramble ACGME as hard as they can before loosening up and scrambling light in AOA. We know we've got four levels to fall through so we play it that way- in the future, I think DO match rates will end up similar to MDs, but with much lower tier specialties and programs.

It's ridiculous that you are implying that this is a "strategy" let alone a viable one. Not matching at all is the worst possible outcome for a med student and that is what has happened with those 20% of DO students. In the SOAP/scramble you find programs where every person who interviewed there said "no thanks" and went elsewhere. Spots in malignant programs or undesirable locations. Scrambling is NOT a desirable outcome and should not be a part of your strategy as you are picking from the scraps in a hectic process where you are completely stripped of choice and essentially are forced to take whatever is offered. This extremely undesirable outcome happens over 3 times more often among DOs than US MDs.

Don't let the high placement rates the DO schools try and quote fool you. A match is still the goal and anyone who didn't match (over a fifth of DO students) did not get what they wanted.


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[Animalcules]

Yeah, I totally see that.

"durr, i'm a doctor, but i get seriously confused with this md and do thingy. guess match md first."

You clearly got my point.


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[Mad Jack]

It's ridiculous that you are implying that this is a "strategy" let alone a viable one. Not matching at all is the worst possible outcome for a med student and that is what has happened with those 20% of DO students. In the SOAP/scramble you find programs where every person who interviewed there said "no thanks" and went elsewhere. Spots in malignant programs or undesirable locations. Scrambling is NOT a desirable outcome and should not be a part of your strategy as you are picking from the scraps in a hectic process where you are completely stripped of choice and essentially are forced to take whatever is offered. This extremely undesirable outcome happens over 3 times more often among DOs than US MDs.

Don't let the high placement rates the DO schools try and quote fool you. A match is still the goal and anyone who didn't match (over a fifth of DO students) did not get what they wanted.


Sent from my iPhone using SDN mobile app

I think you're missing that we have plenty of IM, FM, and psych programs available. So it is a strategy- you apply to strong DO programs in the AOA while skipping the weak ones, apply to programs you'd actually want to attend in the ACGME match and scramble, and if those don't work out, you've got a good selection of weaker AOA programs waiting for you that didn't fill. In a combined match, students wouldn't have three chances to reach before settling and would place their bets accordingly.

Let's say you've got a student from PA. He knows he doesn't stand a chance at ACGME ortho, derm, or yro, so he's set his sights on IM. There are a lot of AOA match programs in the area he wouldn't mind going to, but they never full so there is no incentive to apply. Instead, he does some reach applications in the AOA side- ortho, uro, etc- along with the stronger dual-accredited AOA programs in IM. He doesn't apply to anything uncompetitive as that would rob him his shot at the ACGME if he matched to a spot that won't fill anyway. Nothing competitive is left in the AOA scramble, so he skips it to enter the ACGME. He applies to the mud and low tier university programs that are geographically acceptable, as well as a few of the stronger university-affiliated community programs. He doesn't waste his time and money on ACGME community programs that aren't that stellar since he can just walk into any number of local AOA community programs in the area, and will have more geographic control if he just skips throwing them into his app and goes with calling unfilled AOA programs instead. He doesn't match, but then calls up a local community AOA program that is on the same level as whatever ACGME program he would have matched to and inquires about one of their for unfilled IM spots and signs up.

With less AOA match spots available, DOs will be forced to change the way they apply- broadly and more realistically. There has been no incentive to do this in the past, so there are a few ways we have historically gamed the multiple match setup.

 

[Seth Joo]

It's ridiculous that you are implying that this is a "strategy" let alone a viable one. Not matching at all is the worst possible outcome for a med student and that is what has happened with those 20% of DO students. In the SOAP/scramble you find programs where every person who interviewed there said "no thanks" and went elsewhere. Spots in malignant programs or undesirable locations. Scrambling is NOT a desirable outcome and should not be a part of your strategy as you are picking from the scraps in a hectic process where you are completely stripped of choice and essentially are forced to take whatever is offered. This extremely undesirable outcome happens over 3 times more often among DOs than US MDs.

Don't let the high placement rates the DO schools try and quote fool you. A match is still the goal and anyone who didn't match (over a fifth of DO students) did not get what they wanted.


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Its particularly painful when many DO students are now forking over close to $400k for their education, and in the not too distant future my guess that will be $500k, the reason I think so many people did not match is that many were aiming high and missed, most DOs are meant to be primary care physicians, but many people who get into DO schools have stats of MD matriculates 10 years ago, but have the same expectations of MD students. The ones who wind up not matching often wind up doing research for a year or wind up somewhere undesirable.

 

[ordersol7]

At my USMD school this year there were 3 graduating who had no residency position at all, about a dozen more who had a prelim spot with no advanced specialty lined up, and a smattering of people in middle-of-nowhere FM programs who I suspect SOAPed into those programs though to be fair I don't really know that. There was definitely a "whistling past the graveyard" vibe with the faculty giving speeches about what wonderful physicians and patient advocates we would all be knowing full well there was a not-insignificant number of students who would be reapplying the next year or only wound up in their residency program as a last resort, and many of the other graduating students looked absolutely grim. To be fair the majority of those unmatched students probably would have matched had they set their sights a little lower or applied more broadly. I had pretty terrible board scores and no clinical honors and extended my graduation to do more sub-i's after not matching EM and STILL matched into a decent IM program this year, though I was told I had strong LORs advocating for me. At the risk of sounding like I'm blaming the system my school's match advising was pretty terrible. All they gave me over the past year were vague words about knowing my competitiveness and assuring me that everything would work out without actual specific advice on good programs to apply to where to do rotations at. I suspect a lot of those unmatched students received similar poor guidance or overly rosy encouragement. If I could do it all over again, I'm not sure I'd bother asking my faculty for advice at all. Almost all my good advice this past year came from SDN or the attendings I worked with on away rotations. I really sympathize with anyone who goes through that experience of not matching.

 

[mimelim]

I think it's good time to start the 2 tier match system where first you match US graduates MD/DO, then those that graduate international.

Except that the FMGs are generally better candidates than the DOs.

 

[Mad Jack]

Except that the FMGs are generally better candidates than the DOs.

Really depends on the FMGs. There's a lot of FMGs that are better candidates than DOs, but there are a lot that are far, far worse. Medical education standards in many countries aren't exactly fantastic.

 

[mimelim]

Really depends on the FMGs. There's a lot of FMGs that are better candidates than DOs, but there are a lot that are far, far worse. Medical education standards in many countries aren't exactly fantastic.

I mispoke. I should have said that there are plenty of FMGs (not a majority) that beat the **** out of DOs and many AMG and excluding them is silly.

 

[cbrons]

At my USMD school this year there were 3 graduating who had no residency position at all, about a dozen more who had a prelim spot with no advanced specialty lined up, and a smattering of people in middle-of-nowhere FM programs who I suspect SOAPed into those programs though to be fair I don't really know that. There was definitely a "whistling past the graveyard" vibe with the faculty giving speeches about what wonderful physicians and patient advocates we would all be knowing full well there was a not-insignificant number of students who would be reapplying the next year or only wound up in their residency program as a last resort, and many of the other graduating students looked absolutely grim. To be fair the majority of those unmatched students probably would have matched had they set their sights a little lower or applied more broadly. I had pretty terrible board scores and no clinical honors and extended my graduation to do more sub-i's after not matching EM and STILL matched into a decent IM program this year, though I was told I had strong LORs advocating for me. At the risk of sounding like I'm blaming the system my school's match advising was pretty terrible. All they gave me over the past year were vague words about knowing my competitiveness and assuring me that everything would work out without actual specific advice on good programs to apply to where to do rotations at. I suspect a lot of those unmatched students received similar poor guidance or overly rosy encouragement. If I could do it all over again, I'm not sure I'd bother asking my faculty for advice at all. Almost all my good advice this past year came from SDN or the attendings I worked with on away rotations. I really sympathize with anyone who goes through that experience of not matching.

I dont understand part of your story - you didnt match EM? So you had to wait a year and reapply for IM?

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[235009]

I think you're missing that we have plenty of IM, FM, and psych programs available. So it is a strategy- you apply to strong DO programs in the AOA while skipping the weak ones, apply to programs you'd actually want to attend in the ACGME match and scramble, and if those don't work out, you've got a good selection of weaker AOA programs waiting for you that didn't fill. In a combined match, students wouldn't have three chances to reach before settling and would place their bets accordingly.

Let's say you've got a student from PA. He knows he doesn't stand a chance at ACGME ortho, derm, or yro, so he's set his sights on IM. There are a lot of AOA match programs in the area he wouldn't mind going to, but they never full so there is no incentive to apply. Instead, he does some reach applications in the AOA side- ortho, uro, etc- along with the stronger dual-accredited AOA programs in IM. He doesn't apply to anything uncompetitive as that would rob him his shot at the ACGME if he matched to a spot that won't fill anyway. Nothing competitive is left in the AOA scramble, so he skips it to enter the ACGME. He applies to the mud and low tier university programs that are geographically acceptable, as well as a few of the stronger university-affiliated community programs. He doesn't waste his time and money on ACGME community programs that aren't that stellar since he can just walk into any number of local AOA community programs in the area, and will have more geographic control if he just skips throwing them into his app and goes with calling unfilled AOA programs instead. He doesn't match, but then calls up a local community AOA program that is on the same level as whatever ACGME program he would have matched to and inquires about one of their for unfilled IM spots and signs up.

With less AOA match spots available, DOs will be forced to change the way they apply- broadly and more realistically. There has been no incentive to do this in the past, so there are a few ways we have historically gamed the multiple match setup.

I'm not "missing" anything. I understand how the match works as I've been through it twice. It seems that you don't however. To suggest that someone is applying to multiple surgical sub-specialties in the AOA match, then applying IM programs in the ACGME match (let alone exclusively to university programs as a DO) and then settling for an unmatched (i.e. bottom of the barrel) AOA IM spot is laughable. No one in their right mind would do this let alone be able to create multiple strong applications for all these specialties. You very clearly have no clue what you're talking about. Having to scramble is not a strategy or gaming the system and is almost always a disaster/worst case scenario. I get that you're trying to polish this turd but your lack of experience and naivete are on full display with this absurd post.

 

[ordersol7]

I dont understand part of your story - you didnt match EM? So you had to wait a year and reapply for IM?

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Actually I applied to EM initially, got very few interviews, attempted to switch to IM and ultimately didn't match. When I called around to the IM programs the most common point against me was that they thought I wasn't serious about IM and was just applying as a back-up (Which to be fair was more or less true at the time) Tried for the remaining categorical IM spots in the SOAP and didn't get one. Didn't try for FM or prelim surgery in the SOAP as my deans offered an extension until december to reapply as a US student. I took the time to do additional audition sub-i's at IM programs in the region I was interested in staying in with the hopes of doing well enough to get strong LORs and match. Ultimately was successful and I start residency in a month. Hope that clears it up.

 

[GUH]

I'm not "missing" anything. I understand how the match works as I've been through it twice. It seems that you don't however. To suggest that someone is applying to multiple surgical sub-specialties in the AOA match, then applying IM programs in the ACGME match (let alone exclusively to university programs as a DO) and then settling for an unmatched (i.e. bottom of the barrel) AOA IM spot is laughable. No one in their right mind would do this let alone be able to create multiple strong applications for all these specialties. You very clearly have no clue what you're talking about. Having to scramble is not a strategy or gaming the system and is almost always a disaster/worst case scenario. I get that you're trying to polish this turd but your lack of experience and naivete are on full display with this absurd post.

I'll add that you really, really don't want to end up scrambling into AOA IM or FM if you can at all avoid it. I haven't gone through the match but have rotated through a hospital that fills up its resident slots during the AOA post-match and the residents gave us very clear warnings not to end up in their shoes. Better to match into a program that fills up during the match, even if it is low-tier.

 

[Mad Jack]

I mispoke. I should have said that there are plenty of FMGs (not a majority) that beat the **** out of DOs and many AMG and excluding them is silly.

Totally agree.

 

[deleted564680]

I mispoke. I should have said that there are plenty of FMGs (not a majority) that beat the **** out of DOs and many AMG and excluding them is silly.

I don't think we should exclude them because I think they have a unique perspective to bring to the table but it's not "silly." This is the United States of America and if the governing body of our medical education system decided to give preference to its own citizens, especially given the financial cost those citizens incur, it would be far from "silly."

I haven't looked into this but I don't think any other country in the world would give a US citizen the same chances if he/she was applying for residency in said country.

 

[Mad Jack]

I'm not "missing" anything. I understand how the match works as I've been through it twice. It seems that you don't however. To suggest that someone is applying to multiple surgical sub-specialties in the AOA match, then applying IM programs in the ACGME match (let alone exclusively to university programs as a DO) and then settling for an unmatched (i.e. bottom of the barrel) AOA IM spot is laughable. No one in their right mind would do this let alone be able to create multiple strong applications for all these specialties. You very clearly have no clue what you're talking about. Having to scramble is not a strategy or gaming the system and is almost always a disaster/worst case scenario. I get that you're trying to polish this turd but your lack of experience and naivete are on full display with this absurd post.

I'm just going by how the people that just matched in our class largely played the game. You're implying that they're trying to match in the ACGME scramble- that's not the case. We've got nearly a thousand programs that go unfilled, most of which are also unfilled post-scramble that we can literally just make some calls and start at should the ACGME match not pan out. Once you're down to lower-tier community ACGME programs, they're not all that different than community AOA programs (most of which are up for ACGME accreditation within the next year or two), so it comes down to "why bother interviewing at a dozen community ACGME programs when I can save the time and money and just go to an AOA program that has similar quality without much trouble?" A lot of DOs don't exactly have lofty goals- they just want a place to train, they're not looking to get into MGH.

As to people applying to competitive positions only in the AOA match, that's actually an incredibly common thing to do, since you really only need just north of average scores to match AOA ortho, the sorts of scores that would net you a decent community or low-tier ACGME IM program. So why not throw your name in the hat? You literally have nothing to lose since the AOA match happens first and you lose nothing by trying.

 

[AlbinoHawk DO]

Except that the FMGs are generally better candidates than the DOs.

LOL okay genius. Probably better candidates than you. We can make an exception and have you match the second tier with them.

 

[the argus]

I think it's good time to start the 2 tier match system where first you match US graduates MD/DO, then those that graduate international.

I don't think we should exclude them because I think they have a unique perspective to bring to the table but it's not "silly." This is the United States of America and if the governing body of our medical education system decided to give preference to its own citizens, especially given the financial cost those citizens incur, it would be far from "silly."

I haven't looked into this but I don't think any other country in the world would give a US citizen the same chances if he/she was applying for residency in said country.

It is kinda silly. 2 points.

1. Yes, this is the United States of America, a country built almost exclusively by immigrants in the not so distant past. It would be completely un-American to not give people from other countries the same chances (at least in theory). The most basic American ideal is that it doesn't matter where you come from, what matters is how hard you are willing to work (even though we all know where you come from still makes a big difference).

2. We basically already have a tiered system. USMDs get the pick of the litter, even if they are on paper weaker applicants. Then DOs get next choice, and finally foreign-IMGs take what is left. US-IMGs fit in somewhere among DOs and foreign-IMGs depending on the applicant and the program. The number of foreign citizens taking spots from USMDs/DOs is minimal, and those that do are clearly stronger applicants than the US grads.

There's this idea among some medical students that because you've paid a lot for medical school in the US, then you should officially be guaranteed a spot in the next level of training. This always seemed kind of whiny and infantile to me. You already are basically guaranteed a spot if you are willing to be realistic about your competitiveness and apply broadly enough. And no one forced you to go to medical school. Life comes with risk, and just because you managed to convince an admissions officer at an osteopathic medical school that they should accept you, doesn't mean that you should automatically get to work as a physician in the US.

 

[kbeitz]

Note: 5,314 osteopathic graduates in 2015 if all osteopathic graduates were to apply to the match they would consist of 18.2% of applicants ; this year, 4,278 total osteopathic students applied to the match (70% of whom were committed).

The number of active osteopathic students/graduates continued to grow in 2016. Of the 2,982 who submitted rank order lists of programs, 2,396 matched to PGY-1 positions, making their match rate of 80.3 percent the highest in over thirty years.

For students and graduates of osteopathic medical schools (“Osteo”), the top five specialties/specialty tracks were:

• Internal Medicine (categorical) (498)
• Family Medicine (381)
• Pediatrics (categorical) (353)
• Emergency Medicine (224)
• Anesthesiology (categorical, advanced, and physician positions) (213)

Compared to 2012, the greatest increases were in Anesthesiology (+1%), Psychiatry (+0.8%), and Internal Medicine (+0.7%). Over the same period, the greatest declines were in Family Medicine (-2.5%) and Obstetrics Gynecology (-2.1%).

Osteopathic students/graduates accepted 132 (12.9%) SOAP positions with 817 eligible applicants. If we include these individuals as successful match applicants, the total successful comes out to 84.7%

 

[memory tcells]

I knew this was going to turn into a MD vs DO thread before even clicking on it. It provided a good 10 minutes of entertainment while I'm at work.

 

[Stagg737]

I mispoke. I should have said that there are plenty of FMGs (not a majority) that beat the **** out of DOs and many AMG and excluding them is silly.

There are quite a few FMGs that beat the **** out of US MDs on paper as well, but may have significant issues with where they did rotations, grade standards, or language barriers. I'm all for choosing applicants based on academic merit, but the quality of the academics have to be scrutinized as well.

I don't think we should exclude them because I think they have a unique perspective to bring to the table but it's not "silly." This is the United States of America and if the governing body of our medical education system decided to give preference to its own citizens, especially given the financial cost those citizens incur, it would be far from "silly."

I haven't looked into this but I don't think any other country in the world would give a US citizen the same chances if he/she was applying for residency in said country.

The problem is that there are several Carib schools where US-IMGs can take out Fed loans from the U.S. government. So do we still give those individuals preference based on their intent to return to the U.S. knowing they went to a sub-par school or do we say that because they went abroad they're not second (or 3rd if you're separating DOs) tier applicants?

 

[deleted731525]

I think it's good time to start the 2 tier match system where first you match US graduates MD/DO, then those that graduate international.

If that ever happens the first tier will include USIMGs. There is no way you are going to convince all of Congress to do something that will negatively effect US citizens. Keep in mind they dont give a single **** about whether its fair or not or anything to do with the merit of getting into a US school.

 

[235009]

I'm just going by how the people that just matched in our class largely played the game. You're implying that they're trying to match in the ACGME scramble- that's not the case. We've got nearly a thousand programs that go unfilled, most of which are also unfilled post-scramble that we can literally just make some calls and start at should the ACGME match not pan out. Once you're down to lower-tier community ACGME programs, they're not all that different than community AOA programs (most of which are up for ACGME accreditation within the next year or two), so it comes down to "why bother interviewing at a dozen community ACGME programs when I can save the time and money and just go to an AOA program that has similar quality without much trouble?" A lot of DOs don't exactly have lofty goals- they just want a place to train, they're not looking to get into MGH.

As to people applying to competitive positions only in the AOA match, that's actually an incredibly common thing to do, since you really only need just north of average scores to match AOA ortho, the sorts of scores that would net you a decent community or low-tier ACGME IM program. So why not throw your name in the hat? You literally have nothing to lose since the AOA match happens first and you lose nothing by trying.

Good job following up an uninformed post with one that makes even less sense.

If you know nothing else about the match you should make sure you understand one thing: it is in your best interest to be at a program you interviewed at. You do NOT want to go to a program blind, which is what happens during the scramble (whether it's AOA or ACGME). Especially since it is almost certainly a program that has red flags that deterred multiple applicants to the point that they did not fill in the match.

It's ridiculous that you're arguing it would be better to scramble into a leftover AOA IM program instead of applying to ACGME community programs. This isn't about "lofty goals" and "MGH". It's about knowing what you're getting yourself into for the next 3 years. Last thing anyone wants is to commit to work somewhere for 3 years without knowing anything about the place. If you are trying to save "time and money" during residency applications then you're doing it wrong and have your priorities completely out of wack.

Finally to reiterate: if you are applying to ACGME university IM programs as a DO having done two ortho away rotations you're not getting an interview. Your theoretical match "strategies" have no basis in reality because you don't actually know how the match works.

2. We basically already have a tiered system. USMDs get the pick of the litter, even if they are on paper weaker applicants. Then DOs get next choice, and finally foreign-IMGs take what is left. US-IMGs fit in somewhere among DOs and foreign-IMGs depending on the applicant and the program. The number of foreign citizens taking spots from USMDs/DOs is minimal, and those that do are clearly stronger applicants than the US grads.

It's not as simple and clear cut as you make it seem. US MDs certainly have the advantage but there are FMGs that beat out DOs and even US MDs at some programs. There are some very highly qualified ones out there from top med schools around the world (with tons of research, PhDs, etc) that match very well.

 

[deleted731525]

It's ridiculous that you are implying that this is a "strategy" let alone a viable one. Not matching at all is the worst possible outcome for a med student and that is what has happened with those 20% of DO students. In the SOAP/scramble you find programs where every person who interviewed there said "no thanks" and went elsewhere. Spots in malignant programs or undesirable locations. Scrambling is NOT a desirable outcome and should not be a part of your strategy as you are picking from the scraps in a hectic process where you are completely stripped of choice and essentially are forced to take whatever is offered. This extremely undesirable outcome happens over 3 times more often among DOs than US MDs.

Don't let the high placement rates the DO schools try and quote fool you. A match is still the goal and anyone who didn't match (over a fifth of DO students) did not get what they wanted.


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I agree with this. I dont see why anybody would intentionally do that. That being said I think the separate matches leads DO students to having to make a decision between playing it safe with the AOA math or attempting ACGME. Some students who "gamble" overestimate their competitiveness or just get screwed/have bad luck and end up having to scramble. With the combined match students will be able to shoot for higher tier programs without losing out on the lower tier former AOA programs and that can lead to higher match rates.

 

[235009]

I agree with this. I dont see why anybody would intentionally do that. That being said I think the separate matches leads DO students to having to make a decision between playing it safe with the AOA math or attempting ACGME. Some students who "gamble" overestimate their competitiveness or just get screwed/have bad luck and end up having to scramble. With the combined match students will be able to shoot for higher tier programs without losing out on the lower tier former AOA programs and that can lead to higher match rates.

The single match, in my view, the only positive thing DOs will gain from the ACGME takeover of GME (aka "the merger"). Those that waited for the ACGME match and went unmatched are probably the ones who get screwed the hardest. They typically had a reasonable shot at ACGME programs and have to settle for scraps in the SOAP or AOA scramble.

 

[deleted564680]

If that ever happens the first tier will include USIMGs. There is no way you are going to convince all of Congress to do something that will negatively effect US citizens. Keep in mind they dont give a single **** about whether its fair or not or anything to do with the merit of getting into a US school.

I agree. It would be US citizen (no matter what school/degree) vs. non-US citizen.

Again, I'm not in favor of changing the system we have. I just find it odd that people would think it's a silly notion to consider an alternative when pretty much no other country in the world would show "outsiders" similar treatment.

I suppose it's just like how we are expected to treat illegal immigrants here in the US like citizens and not expect them to show ID or whatnot whereas if a US citizen was caught in another country without ID you'd sure bet he/she would be in loads of trouble. Come to the US, we don't care about anything!

 

[235009]

If that ever happens the first tier will include USIMGs. There is no way you are going to convince all of Congress to do something that will negatively effect US citizens.

Yea, I'm not sure why DOs think they should have a law passed that gives them preference over US citizens at offshore med schools which congress has equally legitimized by providing their students with government subsidized student loans.

 

[AlbinoHawk DO]

If that ever happens the first tier will include USIMGs. There is no way you are going to convince all of Congress to do something that will negatively effect US citizens. Keep in mind they dont give a single **** about whether its fair or not or anything to do with the merit of getting into a US school.

You affected yourself yourself by going to another country for your education. You will not convince Congress to hurt institutions in the united states for people that decided to leave the country and now want to come back for a job. US MD/DO first match ensures doctors trained in the US have a US job as intended and many thousands of Americans working at those institutions have safe jobs. I don't think you understand that your citizenship doesn't entitle you too a job, much less a government sponsored one after you abandoned the US for your benefit.

 

[deleted731525]

You affected yourself yourself by going to another country for your education. You will not convince Congress to hurt institutions in the united states for people that decided to leave the country and now want to come back for a job. US MD/DO first match ensures doctors trained in the US have a US job as intended and many thousands of Americans working at those institutions have safe jobs. I don't think you understand that your citizenship doesn't entitle you too a job, much less a government sponsored one after you abandoned the US for your benefit.

Im not arguing whether it is right or wrong(not interested in that debate). It just isnt going to happen.

 

[ordersol7]

Good job following up an uninformed post with one that makes even less sense.


It's not as simple and clear cut as you make it seem. US MDs certainly have the advantage but there are FMGs that beat out DOs and even US MDs at some programs. There are some very highly qualified ones out there from top med schools around the world (with tons of research, PhDs, etc) that match very well.

I think it's true that there are some programs that specifically select for FMGs. Specifically service-heavy community programs that would rather hire residents that were already fully trained attendings rather than your standard recent allopathic or osteopathic graduate fresh out of school so they don't have to teach them as much. Anecdotally, I did apply to some of those IMG farm community programs this past year as an absolute last resort in case I did not match again and the majority of those programs did not interview me despite me getting interviews from significantly stronger university programs and university affiliates.

 

[ordersol7]

It is kinda silly. 2 points.

1. Yes, this is the United States of America, a country built almost exclusively by immigrants in the not so distant past. It would be completely un-American to not give people from other countries the same chances (at least in theory). The most basic American ideal is that it doesn't matter where you come from, what matters is how hard you are willing to work (even though we all know where you come from still makes a big difference).

2. We basically already have a tiered system. USMDs get the pick of the litter, even if they are on paper weaker applicants. Then DOs get next choice, and finally foreign-IMGs take what is left. US-IMGs fit in somewhere among DOs and foreign-IMGs depending on the applicant and the program. The number of foreign citizens taking spots from USMDs/DOs is minimal, and those that do are clearly stronger applicants than the US grads.

There's this idea among some medical students that because you've paid a lot for medical school in the US, then you should officially be guaranteed a spot in the next level of training. This always seemed kind of whiny and infantile to me. You already are basically guaranteed a spot if you are willing to be realistic about your competitiveness and apply broadly enough. And no one forced you to go to medical school. Life comes with risk, and just because you managed to convince an admissions officer at an osteopathic medical school that they should accept you, doesn't mean that you should automatically get to work as a physician in the US.

I'm inclined to agree with this. FMGs by and large are not "taking" spots from USMDs because the programs they typically match into are programs most US seniors won't consider anyway. The majority of US students, even borderline ones with board failures or professionalism problems, can still match. Probably won't be Derm in Chicago but IM/FM/Peds/Psych is doable in pretty much any region. Even an academic program with fellowships if you are REALLY not picky about where you live.

 

[AlbinoHawk DO]

Im not arguing whether it is right or wrong(not interested in that debate). It just isnt going to happen.

Because you say so? Oh okay, thanks for letting us know.

 

[Mad Jack]

Good job following up an uninformed post with one that makes even less sense.

If you know nothing else about the match you should make sure you understand one thing: it is in your best interest to be at a program you interviewed at. You do NOT want to go to a program blind, which is what happens during the scramble (whether it's AOA or ACGME). Especially since it is almost certainly a program that has red flags that deterred multiple applicants to the point that they did not fill in the match.

It's ridiculous that you're arguing it would be better to scramble into a leftover AOA IM program instead of applying to ACGME community programs. This isn't about "lofty goals" and "MGH". It's about knowing what you're getting yourself into for the next 3 years. Last thing anyone wants is to commit to work somewhere for 3 years without knowing anything about the place. If you are trying to save "time and money" during residency applications then you're doing it wrong and have your priorities completely out of wack.

Finally to reiterate: if you are applying to ACGME university IM programs as a DO having done two ortho away rotations you're not getting an interview. Your theoretical match "strategies" have no basis in reality because you don't actually know how the match works.



It's not as simple and clear cut as you make it seem. US MDs certainly have the advantage but there are FMGs that beat out DOs and even US MDs at some programs. There are some very highly qualified ones out there from top med schools around the world (with tons of research, PhDs, etc) that match very well.

Many of these AOA programs aren't places you're going into blind- they're the places we do our third year rotations, and they usually don't fill because they're in the middle of nowhere and only open to AOA candidates. Most of them aren't malignant, they just have a very limited applicant pool care of being closed off to only DOs, and much of that pool isn't interested because they aren't in fantastic areas. If you're stuck between ranking malignant ACGME programs or going to an AOA program you know is decent, it kind of makes sense to leave those ACGME spots unranked and just fail to match so that you can enter an AOA program.

As to applying to different specialties in the AOA and ACGME match- it sucks, but as DOs we have to be realistic. A lot of the time you weaken your application and split it amongst two specialties if you want any shot at something competitive- gearing an app for both EM and IM is a pretty common one at my school ever since EM started getting more competitive. And if you really want to do, say, AOA ortho, chances are you aren't going to match, so you have to build some padding into your app for another specialty. Most of the people that gun for the competitive AOA stuff and fail don't end up not matching- they end up in FM or IM, sometimes ACGME, sometimes AOA. Sometimes the really committed ones end up doing a year of research or whatever, but generally they end up matching into something less competitive.

Unification of the match will really change how people have to play the game- we'll lose our protected community spots as they open up to FMGs, so we'll have to apply for them outright (which would force us out of the ACGME match if we were to do so right now) instead of going into them post-match. That's a good thing, because that lets us actually rank things properly rather than having to split up our application (do I go ACGME only so that I don't risk missing out on good programs? Do I rank lower-ranked AOA programs that are decent if those programs will probably have extra spots but being accepted means I have no shot at the ACGME match? Do I apply to ACGME community programs that I'd rather not go to when I could just attend an AOA program that I know is okay?). All of that goes away. You can rank things the way people would today if they were able (Good ACGME>Good AOA>Okay ACGME>Okay AOA>malignant ACGME=malignant AOA) but currently can't care of the wonderful split match setup. People will be able to apply to specialties broadly that are actually realistic instead of splitting their apps apart to try and get a shot at something crazy with another specialty as a fallback plan.

I certainly don't think 20% of DOs will be starving on the streets care of no GME is my point, I guess.

 

[Animalcules]

You affected yourself yourself by going to another country for your education. You will not convince Congress to hurt institutions in the united states for people that decided to leave the country and now want to come back for a job. US MD/DO first match ensures doctors trained in the US have a US job as intended and many thousands of Americans working at those institutions have safe jobs. I don't think you understand that your citizenship doesn't entitle you too a job, much less a government sponsored one after you abandoned the US for your benefit.

It is a common theme that people who are not competitive in an unregulated system call for protectionism. Yet, the odds are already heavily stacked against FMGs today. It may be better use of your time to evaluate how you can strengthen your application for your match cycle, rather than to ask for congress to eliminate your competition. You are entitled to nothing, sorry.


Sent from my iPhone using SDN mobile app

 

[Mad Jack]

Im not arguing whether it is right or wrong(not interested in that debate). It just isnt going to happen.

There's actually been some political discussion in this regard recently. I think that, given enough publicity, it could gain traction. Pretty much nothing looks worse than, "US-Trained Doctors Go Jobless While Taxpayers Fund Foreign Trainees," so I could really see such a policy getting some legs in our current political climate. I think it would be a bad thing, personally, but I think it is something that could very well happen if certain lobbies push the right buttons with legislators and the public.

 

[AlbinoHawk DO]

It is a common theme that people who are not competitive in an unregulated system call for protectionism. Yet, the odds are already heavily stacked against FMGs today. It may be better use of your time to evaluate how you can strengthen your application for your match cycle, rather than to ask for congress to eliminate your competition. You are entitled to nothing, sorry.


Sent from my iPhone using SDN mobile app

The issue is not that simple especially when we are dealing with government. Protectionism serves for the best interests of a country and it's population. For example, we have a minimum wage. China essentially doesn't. People become "non-competitive" as a result. It's in the best interest of the country to restrict that. The same is true for the US considering it's US tax money that goes into training doctors. No point in giving kids loans or subsidized education through public schools just to lose it to a foreign national or someone that left the US.

 

[WingedOx]

Edit: nevermind. @mimelim corrected his point.

 

[Mad Jack]

The issue is not that simple especially when we are dealing with government. Protectionism serves for the best interests of a country and it's population. For example, we have a minimum wage. China essentially doesn't. People become "non-competitive" as a result. It's in the best interest of the country to restrict that. The same is true for the US considering it's US tax money that goes into training doctors. No point in giving kids loans or subsidized education through public schools just to lose it to a foreign national or someone that left the US.

I disagree. We want the best and brightest in our medical system, regardless of where they went or where they came from. I don't want to lose some brilliant researcher from Oxford just so some DO that barely scraped by at LUCOM with multiple board failures can match "because we need to put US students first!"

We didn't become world leaders in innovation by only looking after our own. We did it by taking the best the world had to offer and giving them a place to do their thing. The price of that is that sometimes the weaker amongst us must suffer. But that is a price worth paying.

 

[WingedOx]

The issue is not that simple especially when we are dealing with government. Protectionism serves for the best interests of a country and it's population. For example, we have a minimum wage. China essentially doesn't. People become "non-competitive" as a result. It's in the best interest of the country to restrict that. The same is true for the US considering it's US tax money that goes into training doctors. No point in giving kids loans or subsidized education through public schools just to lose it to a foreign national or someone that left the US.

Sorry, but I'd much rather my tax dollars go to training someone from the top of his class AIIMS than a kid from the latest bumfark campus of LECOM or NYITCOM.

 

[Mad Jack]

Sorry, but I'd much rather my tax dollars go to training someone from the top of his class AIIMS than a kid from the latest bumfark campus of LECOM or NYITCOM.

Unfortunately the public is dumb enough to not share the opinions of those that are in the know. I really hope it doesn't become an issue that reaches critical mass politically.

 

[kbeitz]

Sorry, but I'd much rather my tax dollars go to training someone from the top of his class AIIMS than a kid from the latest bumfark campus of LECOM or NYITCOM.

I heard all the Presidents of the USMD schools were going to get the AOA to fund a wall between DO students and USMD residencies. Your tax dollars are unnecessary.

 

[AlbinoHawk DO]

I disagree. We want the best and brightest in our medical system, regardless of where they went or where they came from. I don't want to lose some brilliant researcher from Oxford just so some DO that barely scraped by at LUCOM with multiple board failures can match "because we need to put US students first!"

We didn't become world leaders in innovation by only looking after our own. We did it by taking the best the world had to offer and giving them a place to do their thing. The price of that is that sometimes the weaker amongst us must suffer. But that is a price worth paying.

Research is not closed because you went to another country. The number of genius like that are almost none. We can easily make a compromise to fix that. Say there are 1000 spots total for argument sake. We can make sure US graduates are limited to 950 leaving 50 spots always available for international people with talent. As of right now if all US MD and DO match, no Oxford genius will go without residency.

 

[deleted731525]

Because you say so? Oh okay, thanks for letting us know.

All the proposed plans being put into motion(which themselves probably have little chance of passing) determine the first tier by citizenship. Not to mention the lobbying power that Caribbean schools have.