Advice for friend who didn't match

[zeppelinpage4]

Hey everyone, I'm posting this for a friend of mine.
She ranked 10 peds programs, and didn't match.
She got interviews at some really competitive places, and had some safeties, including her own home program. And I'm trying to understand how this could have happened. The only major blemish on her app is that she took Step 2 CS late and didn't have the score back for it before rank lists were submitted. But, it would seem ridiculous to not match just because of a late CS score.

By all standards, I believed an above average US MD student like her, ranking 9-10 pediatric programs would almost certainly match, especially if one of those was their own home program which would not want to see their own student go unmatched.

Those of us who know her are all perplexed right now and she's heartbroken. And I was just wondering if it's possible that this could have occurred due to an error/glitch in the system and she did actually match?

Also, how common are cases like this? I honestly thought 9-10 interviews for a US MD student almost guaranteed a match, especially in pediatrics which isn't super competitive like EM, ortho, or anesthesia.

Are her chances of matching pediatrics within the first or second round of SOAP good? Anyone been in this situation before and have useful advice or tips I can pass on to her?

*My apologies if i'ts a bit vague, I wanted to keep the details minimal to keep her anonymity.

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[Warderino92]

Did you cross post this on the peds subforum? I'd imagine the residents and attendings that frequent there would have the best advice for you.

 

[RogueBanana]

Never heard of anything like this happening. Honestly it's the worst case scenario for a lot of us!

Best of luck, hopefully one of the attendings here can offer some advice!

 

[zeppelinpage4]

^^ Thanks RogueBanana. *fingers crossed* it all works out for her.

Did you cross post this on the peds subforum? I'd imagine the residents and attendings that frequent there would have the best advice for you.

I didn't, is there any way for me to cross post this now? It's such a scary and unexpected situation to be in, I wanna be able to give her some helpful advice or at least an explanation for how this could have happened.

 

[IlDestriero]

Sometimes it's just bad luck. Her home program probably did rank her, however they filled up before they got to her number. Sometimes it all just goes sideways. Can't she soap into a peds spot somewhere? I would think that training somewhere is better than taking a year off, doing research etc. and reapplying.
If she is really above average she will likely rise to the top wherever she goes, with hard work, and can ultimately be successful.
Maybe this is an opportunity to try to soap into another specialty that she secretly desired?
I'd love to see her LORs.

--
Il Destriero

 

[wholeheartedly]

^^ Thanks RogueBanana. *fingers crossed* it all works out for her.


I didn't, is there any way for me to cross post this now? It's such a scary and unexpected situation to be in, I wanna be able to give her some helpful advice or at least an explanation for how this could have happened.

crossposting is against the TOS. Moderators can move threads if you feel there's a better place for it.

 

[Winged Scapula]

Hey everyone, I'm posting this for a friend of mine.
She ranked 10 peds programs, and didn't match.
She got interviews at some really competitive places, and had some safeties, including her own home program. And I'm trying to understand how this could have happened. The only major blemish on her app is that she took Step 2 CS late and didn't have the score back for it before rank lists were submitted. But, it would seem ridiculous to not match just because of a late CS score.

By all standards, I believed an above average US MD student like her, ranking 9-10 pediatric programs would almost certainly match, especially if one of those was their own home program which would not want to see their own student go unmatched.

Those of us who know her are all perplexed right now and she's heartbroken. And I was just wondering if it's possible that this could have occurred due to an error/glitch in the system and she did actually match?

Also, how common are cases like this? I honestly thought 9-10 interviews for a US MD student almost guaranteed a match, especially in pediatrics which isn't super competitive like EM, ortho, or anesthesia.

Are her chances of matching pediatrics within the first or second round of SOAP good? Anyone been in this situation before and have useful advice or tips I can pass on to her?

*My apologies if i'ts a bit vague, I wanted to keep the details minimal to keep her anonymity.

She may have overestimated her competitiveness or underestimated the competitiveness of Pediatrics.

Reviewing the 2016 NRMP Charting Outcomes for the Match, the mean number of programs ranked for matched US Seniors in Pediatrics is 12, not 9-10, although the probability of matching nears 1 with 9-10, it doesn't appear to become one until more than 12. The average Step 1 score for matched candidates was 230 and 244 for Step 2.

The fact that she didn't match at her home program tells us that they did not rank her very highly (assuming she ranked them). They obviously ranked other candidates higher, who also ranked them high.

What is her school telling her? She should be talking to them about why she didn't match especially why she didn't match at her home program.

Every year someone doesn't match that everyone around them expected to. The fact is that you don't know what the LORs said, what her real scores were (unless you've seen them, people tend to exaggerate these things), how she comes off on interview.

The reasons US students don't match:

- application flaws (poor USMLE scores, bad letters etc)
- poorly designed application (candidate overestimates their competitiveness, doesn't apply to enough programs, INCOMPLETE APPLICATION - if she applied to programs that REQUIRED USMLE Step 2 CS, she might as well have thrown her application in the trash)
- interview killer

It is extremely unlikely that there was an error and she really did match. She needs to put this possibility out of her head.

 

[Crayola227]

no, it is basically never a glitch in the system, if only it were

not to be mean, milk is spilt, but we need to kill the myth that interviewing at your home program means you will match there as a safety

I don't now how many programs "pity rank" their students so they don't go unmatched

My school's home program decided they were "too good" for their own graduates and wouldn't offer interviews - even if they did, they took a tiny number of them. They didn't want to appear inbred by taking too many of their own graduates - this makes it look like the program can't attract prestigious strangers, and the med school can't produce graduates in demand elsewhere: solution, don't take too many of your own. At least my school warned us, but it did make us look bad on the trail when other programs asked about our home program interviews we didn't have (not allowed interview question that happens all the time)

unless you're getting serious assurances from the entire DEPARTMENT how loved you are, because you've been spending 4 years becoming part of it, I would actually write off the idea that I was matching to my home program, as "safety", I would rank it where I ranted it, but the rest of my entire app and interview strategy would treat it as a hopeful Hail Mary if anything

The fact we are regarding the home program as a safety, makes me question what people regard as safeties

were there a few community programs in your region AND the middle of the country on the list? no? then there weren't really safeties

for general fields with numerous positions, even good graduates mathematically speaking can't all end up at a university program, even if they are above average! Someone's going to have to take the "chance" on a community program - the chance being that you know nothing about it to look at its name, unlike most state instituitions of higher education. Most of the community program names aren't household ones, but that doesn't mean anything for training.

https://forums.studentdoctor.net/search/61970810/?q=community+programs&o=relevance&c[user][0]=576613

SDN search for my posts, "community programs"

This pulls up a lot of my posts on what my strategy was. It's a different field and a few years back - but a lot of it is true time immemorial - how to answer "tell me about yourself" and "why this program" in a compelling way that sells you, put the program at ease that you're serious despite the weather, etc

My thoughts on the strategy of "applying down," which I touched on above. If you are a told that you are a good fit for low tier university, than community programs are your safeties!

Lastly, you need some data that SDN likely can't give you. You need to figure out where other ped students like you from YOUR SCHOOL with your numbers went - that's basically a function of your school advising. If that's crap, then you have to find other ways to figure that out. There's "common wisdom" like you'll read in my back posts - geography, certain schools/programs just unintentionally (hell sometimes it's intentionally, a graduate of U Minn goes to be a PD at community program in Orlando, and is still friends with the Dept Head back home, now you keep seeing U Minn students matched to Orlando) develop a pipeline. There's strategies like looking at your schools' match lists, and looking at the current residents at a given program. You can even email some of your school's Peds alumni to gather data (and maybe network?)

There is just sooooo much to consider, and you can spend a lot of time being sure you match "safely", but given everything I had to say without really knowing a damn thing about Peds except it's not that competitive, you can see why no one can answer this FOR your friend.

If you make enough love to SDN, you will find the answers. I made a point not long after my own interviews essentially documenting what I had consolidated of SDN, applied, and what my feedback analysis was on the whole caboodle.

TLDR:
home program is NEVER a given!
always consider your list - did you really add safeties? where are all the community programs??
did you apply to enough? did you go on enough interviews?
of those interviews, were enough really safeties? even in not that competitive of fields, at community programs, they'll interview 10:1
"apply down"
interview strategies

it's a numbers game and unless you're going for a fellowship, prestigious or high up admin job (Dean of a school somewhere), and are constrained by hubby's career and a baby, one should swallow all pride, be ruthless with themselves and the numbers game, and apply and fly as hard and wide as they can

 

[ProfMD]

There are a couple of things that could have happened:

1) She is a good candidate, but had bad luck. May have been just one or two spots out of matching for each program.

2) There is something about her application that did her in. Numbers do not tell the whole story. USMLE score is an important consideration, but letters are more important.

3) Interview - Not knowing her (obviously) but having experience on both sides of the interview table, this happens more often than you think. A poor interview can knock an application from the top of the pile to the bottom, easily.

She can SOAP. If she decides to take a year off and reapply, she must do some soul searching and talk to her mentors. She may even call places she interviewed. Basically, she needs to figure out why she did not match and do what she can to address that. This will maximize her chances of matching next year. In addition, I can assure you that as a reapplicant she will be asked why she did not match the first time and what she has done to correct any deficiencies.

 

[MrChance2]

Wouldn't Program's look at letters before interview invites?

 

[calvinhobbes]

Many people underestimate just how increasingly competitive Peds has become. Last year, and especially this year, Peds has seen a large influx of applicants. Don't forget, there are many more schools that have opened in the U.S. in the past several years, with more opening in the near future. People still say "Oh you'll match Peds, don't worry, its not-competitive." That just isn't the case anymore. More students means more applicants, and Pediatrics has become a very popular career choice. It has the same fellowship opportunities as IM, and for people who like working with kids and young adults, it's a truly rewarding profession.

Without knowing any specifics about your friend, long story short: this year there were just too many applicants for Peds positions.
I wish your friend much luck in the SOAP.

 

[ThoracicGuy]

There are a couple of things that could have happened:

1) She is a good candidate, but had bad luck. May have been just one or two spots out of matching for each program.

2) There is something about her application that did her in. Numbers do not tell the whole story. USMLE score is an important consideration, but letters are more important.

3) Interview - Not knowing her (obviously) but having experience on both sides of the interview table, this happens more often than you think. A poor interview can knock an application from the top of the pile to the bottom, easily.

She can SOAP. If she decides to take a year off and reapply, she must do some soul searching and talk to her mentors. She may even call places she interviewed. Basically, she needs to figure out why she did not match and do what she can to address that. This will maximize her chances of matching next year. In addition, I can assure you that as a reapplicant she will be asked why she did not match the first time and what she has done to correct any deficiencies.

Or she could delay graduation to still apply as a graduating senior if unable to SOAP.

 

[xffan624]

Have nothing to contribute except tremendous sympathy towards your friend. I had a similar app in number of programs and mix of programs. Only difference was I had all my scores in prior to ROL submission. Hopefully she can have some success in the SOAP.

 

[67552931811]

Many people underestimate just how increasingly competitive Peds has become. Last year, and especially this year, Peds has seen a large influx of applicants. Don't forget, there are many more schools that have opened in the U.S. in the past several years, with more opening in the near future. People still say "Oh you'll match Peds, don't worry, its not-competitive." That just isn't the case anymore. More students means more applicants, and Pediatrics has become a very popular career choice. It has the same fellowship opportunities as IM, and for people who like working with kids and young adults, it's a truly rewarding profession.

Without knowing any specifics about your friend, long story short: this year there were just too many applicants for Peds positions.
I wish your friend much luck in the SOAP.

? The total number of peds applicants decreased last year when compared to years past, in this example 2014: 3,234 applicants in 2016 and 3,248 applicants in 2014, all while the number of positions have increased (2,715 positions in 2014 and 2,768 positions in 2016).

http://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-US-Allopathic-Seniors-2016.pdf

http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014-Final.pdf

 

[Winged Scapula]

Some additional words of advice for your friend:

she must take whatever reasons are given as to why she didn't match to heart.

No excuses, no defensive tactics.

Hopefully its something simple as she needed the CS score in before applying. But if its something she may find hurtful - a bad LOR, or she doesn't interview well, she should take these HONEST truths from PDs and faculty as evidence that they are willing to help and make a plan to correct those deficiencies, whatever they may be.

 

[Winged Scapula]

? The total number of peds applicants decreased last year when compared to years past, in this example 2014: 3,234 applicants in 2016 and 3,248 applicants in 2014, all while the number of positions have increased (2,715 positions in 2014 and 2,768 positions in 2016).

http://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-US-Allopathic-Seniors-2016.pdf

http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014-Final.pdf

You have forgotten: EVERY program and specialty is competitive and its ALWAYS getting harder to find a position.

Conventional, if inaccurate, wisdom.

 

[ProfMD]

Wouldn't Program's look at letters before interview invites?

They may or may not - this will be program specific. Ideally they would, though.

However, you have to remember that the rank decisions are not based solely on interview, but rather on the whole package. So, if board scores, grades, letters got her an interview that then went mediocre, and she had mediocre letters, then that may not be enough to rank. On the other hand, if she had a great interview, that could make up for mediocre letters and vice-versa.

In the end, ever program will be a bit different with regards to what factors they consider most important and how they evaluate applicants.

 

[calvinhobbes]

? The total number of peds applicants decreased last year when compared to years past, in this example 2014: 3,234 applicants in 2016 and 3,248 applicants in 2014, all while the number of positions have increased (2,715 positions in 2014 and 2,768 positions in 2016).

http://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-US-Allopathic-Seniors-2016.pdf

http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014-Final.pdf

Thanks for posting that. I was actually referring to ALL US seniors combined, osteopathic schools included, which thus increases the number of students that applied t0 (and matched) in ACGME Peds positions.

 

[Winged Scapula]

Programs that receive hundreds of applications may not look at the letters before interview invite except maybe to scan the writer's name for someone of interest/well known in the field especially if she was otherwise an acceptable candidate. Once it comes down to ranking, the letters may be looked at more closely for hidden meanings, or outright non-support.

So simply getting an interview doesn't necessarily mean her letters were OK, especially since every program will have their own method of assessing whom to interview.

 

[Winged Scapula]

Let's move this to ERAS/NRMP forum where more of the match talk is going on.

 

[67552931811]

Thanks for posting that. I was actually referring to ALL US seniors combined, osteopathic schools included, which thus increases the number of students that applied t0 (and matched) in ACGME Peds positions.

Those numbers presented via the official links are for all applicants, which includes DOs and IMGs.

 

[calvinhobbes]

Thanks for the clarification.
Either way, whatever the numbers are, the general rule is that there are more overall applicants than positions available, and to always apply broadly and rank as many programs as possible/desired, to match.

 

[67552931811]

Thanks for the clarification.
Either way, whatever the numbers are, the general rule is that there are more overall applicants than positions available, and to always apply broadly and rank as many programs as possible/desired, to match.

Indeed, very true.

@zeppelinpage4 very sorry to hear about your friend. I can't imagine the sadness she feels at this moment. Hopefully things work out for her, be it SOAP or whatever she decides to do.

 

[zeppelinpage4]

Thanks so much for the kind words and advice everyone. Everything you guys posted definitely helped clarify the situation a bit more, and hopefully she can focus on identifying what happened and come back from this. I just spoke to her and now that some of the dust has settled, she seems to be taking this head on with the SOAP.

I'll absolutely suggest the idea of delaying graduation in case the SOAP doesn't work out though. Hopefully all goes well for her, I can't imagine the stress and uncertainty that comes with not matching.

Sometimes it's just bad luck. Her home program probably did rank her, however they filled up before they got to her number. Sometimes it all just goes sideways. Can't she soap into a peds spot somewhere? I would think that training somewhere is better than taking a year off, doing research etc. and reapplying.
If she is really above average she will likely rise to the top wherever she goes, with hard work, and can ultimately be successful.
Maybe this is an opportunity to try to soap into another specialty that she secretly desired?
I'd love to see her LORs.

--
Il Destriero

I'm hoping she can, she's applied to 30 programs through the SOAP so far.

And I appreciate the kind words. Yes, I honestly think she'll rise to the top wherever she goes. She's adapted to and been through a lot of tough situations in the past, and still come out on top.

She may have overestimated her competitiveness or underestimated the competitiveness of Pediatrics.

Reviewing the 2016 NRMP Charting Outcomes for the Match, the mean number of programs ranked for matched US Seniors in Pediatrics is 12, not 9-10, although the probability of matching nears 1 with 9-10, it doesn't appear to become one until more than 12. The average Step 1 score for matched candidates was 230 and 244 for Step 2.

The fact that she didn't match at her home program tells us that they did not rank her very highly (assuming she ranked them). They obviously ranked other candidates higher, who also ranked them high.

What is her school telling her? She should be talking to them about why she didn't match especially why she didn't match at her home program.

Every year someone doesn't match that everyone around them expected to. The fact is that you don't know what the LORs said, what her real scores were (unless you've seen them, people tend to exaggerate these things), how she comes off on interview.

The reasons US students don't match:

- application flaws (poor USMLE scores, bad letters etc)
- poorly designed application (candidate overestimates their competitiveness, doesn't apply to enough programs, INCOMPLETE APPLICATION - if she applied to programs that REQUIRED USMLE Step 2 CS, she might as well have thrown her application in the trash)
- interview killer

It is extremely unlikely that there was an error and she really did match. She needs to put this possibility out of her head.

Thanks Winged Scapula, this actually clarified ALOT. I hadn't realized the average Step scores were that high, she scored well, but wasn't far off from those averages.

I'm curious to hear what the school tells her as well. She seemed to have had a good relationship with the clerkship director in the department and most of the faculty. Even if they ranked her high, she might have just missed a spot too.

But you're definitely right. Interview and LORs are factors that none of us know. I just always assumed most people did okay on those. She's calmed down and taking this head on now though and working the her administration to do well with the SOAP she gets some good news.

no, it is basically never a glitch in the system, if only it were

not to be mean, milk is spilt, but we need to kill the myth that interviewing at your home program means you will match there as a safety

I don't now how many programs "pity rank" their students so they don't go unmatched

My school's home program decided they were "too good" for their own graduates and wouldn't offer interviews - even if they did, they took a tiny number of them. They didn't want to appear inbred by taking too many of their own graduates - this makes it look like the program can't attract prestigious strangers, and the med school can't produce graduates in demand elsewhere: solution, don't take too many of your own. At least my school warned us, but it did make us look bad on the trail when other programs asked about our home program interviews we didn't have (not allowed interview question that happens all the time)

unless you're getting serious assurances from the entire DEPARTMENT how loved you are, because you've been spending 4 years becoming part of it, I would actually write off the idea that I was matching to my home program, as "safety", I would rank it where I ranted it, but the rest of my entire app and interview strategy would treat it as a hopeful Hail Mary if anything

The fact we are regarding the home program as a safety, makes me question what people regard as safeties

were there a few community programs in your region AND the middle of the country on the list? no? then there weren't really safeties

for general fields with numerous positions, even good graduates mathematically speaking can't all end up at a university program, even if they are above average! Someone's going to have to take the "chance" on a community program - the chance being that you know nothing about it to look at its name, unlike most state instituitions of higher education. Most of the community program names aren't household ones, but that doesn't mean anything for training.

https://forums.studentdoctor.net/search/61970810/?q=community+programs&o=relevance&c[user][0]=576613

SDN search for my posts, "community programs"

This pulls up a lot of my posts on what my strategy was. It's a different field and a few years back - but a lot of it is true time immemorial - how to answer "tell me about yourself" and "why this program" in a compelling way that sells you, put the program at ease that you're serious despite the weather, etc

My thoughts on the strategy of "applying down," which I touched on above. If you are a told that you are a good fit for low tier university, than community programs are your safeties!

Lastly, you need some data that SDN likely can't give you. You need to figure out where other ped students like you from YOUR SCHOOL with your numbers went - that's basically a function of your school advising. If that's crap, then you have to find other ways to figure that out. There's "common wisdom" like you'll read in my back posts - geography, certain schools/programs just unintentionally (hell sometimes it's intentionally, a graduate of U Minn goes to be a PD at community program in Orlando, and is still friends with the Dept Head back home, now you keep seeing U Minn students matched to Orlando) develop a pipeline. There's strategies like looking at your schools' match lists, and looking at the current residents at a given program. You can even email some of your school's Peds alumni to gather data (and maybe network?)

There is just sooooo much to consider, and you can spend a lot of time being sure you match "safely", but given everything I had to say without really knowing a damn thing about Peds except it's not that competitive, you can see why no one can answer this FOR your friend.

If you make enough love to SDN, you will find the answers. I made a point not long after my own interviews essentially documenting what I had consolidated of SDN, applied, and what my feedback analysis was on the whole caboodle.

TLDR:
home program is NEVER a given!
always consider your list - did you really add safeties? where are all the community programs??
did you apply to enough? did you go on enough interviews?
of those interviews, were enough really safeties? even in not that competitive of fields, at community programs, they'll interview 10:1
"apply down"
interview strategies

it's a numbers game and unless you're going for a fellowship, prestigious or high up admin job (Dean of a school somewhere), and are constrained by hubby's career and a baby, one should swallow all pride, be ruthless with themselves and the numbers game, and apply and fly as hard and wide as they can

Thanks! I never even realized this. I think this might be what got her. Most of the places she interviewed at were academic programs. Should I tell her to look at community programs in the SOAP?

There are a couple of things that could have happened:

1) She is a good candidate, but had bad luck. May have been just one or two spots out of matching for each program.

2) There is something about her application that did her in. Numbers do not tell the whole story. USMLE score is an important consideration, but letters are more important.

3) Interview - Not knowing her (obviously) but having experience on both sides of the interview table, this happens more often than you think. A poor interview can knock an application from the top of the pile to the bottom, easily.

She can SOAP. If she decides to take a year off and reapply, she must do some soul searching and talk to her mentors. She may even call places she interviewed. Basically, she needs to figure out why she did not match and do what she can to address that. This will maximize her chances of matching next year. In addition, I can assure you that as a reapplicant she will be asked why she did not match the first time and what she has done to correct any deficiencies.

Thank you, that's fantastic advice I will definitely pass this on to her. I'm hoping she gets a spot through the SOAP, but if not, this is very helpful to know before doing interviews again next year. I wonder if the SOAP phone interviews ask applicants the same question about why they are SOAPing.

 

[Winged Scapula]

Quick question:

why has she only applied to 30 programs? She can apply up to 45 and she is in no position to look down on community programs. I think we have one of our issues here - she didn't apply to a variety of programs.

Her goal is to be a physician; she may not get an academic Peds position.

 

[gyngyn]

Quick question:

why has she only applied to 30 programs? She can apply up to 45 and she is in no position to look down on community programs. I think we have one of our issues here - she didn't apply to a variety of programs.

Her goal is to be a physician; she may not get an academic Peds position.

I don't think there were even a dozen unfilled peds categorical programs today...

 

[zeppelinpage4]

Quick question:

why has she only applied to 30 programs? She can apply up to 45 and she is in no position to look down on community programs. I think we have one of our issues here - she didn't apply to a variety of programs.

Her goal is to be a physician; she may not get an academic Peds position.

I think her academic adviser recommended applying to 30. My other guess is that there weren't enough pediatric programs available in the SOAP. I just told her to apply to more programs, including community, hopefully they'll be available.

And definitely agree, though she wants to do academic peds, at this point matching and becoming any kind of pediatrician is the goal.

 

[Winged Scapula]

I think her academic adviser recommended applying to 30. My other guess is that there weren't enough pediatric programs available in the SOAP. I just told her to apply to more programs, including community, hopefully they'll be available.

And definitely agree, though she wants to do academic peds, at this point matching and becoming any kind of pediatrician is the goal.

Hmmm....the advisor who told her to only rank 9-10 programs, only apply academic and to apply without Step 2?

Color me dubious.

 

[zeppelinpage4]

Hmmm....the advisor who told her to only rank 9-10 programs, only apply academic and to apply without Step 2?

Color me dubious.

Yeah...I have no idea how this happened, or if it was the same adviser, but it's unfortunate. Just ranking 2 or 3 more programs, or having more community programs ranked might have prevented this. If only someone had told her in February.

I appreciate all your help now though. I passed on the info. to her, so hopefully she'll add more programs, including community ones and fare better in the SOAP.

Lesson learned, never underestimate how competitive this process can be, nothing is guaranteed.

 

[Ismet]

Does she have her CS score now? Many programs actually require CS in order to rank.

 

[sazerac]

? The total number of peds applicants decreased last year when compared to years past, in this example 2014: 3,234 applicants in 2016 and 3,248 applicants in 2014, all while the number of positions have increased (2,715 positions in 2014 and 2,768 positions in 2016).

http://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-US-Allopathic-Seniors-2016.pdf

http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014-Final.pdf

I wonder if the same thing already happening in psych is happening also to peds... in psych, fewer people are applying every year, but when you look behind the numbers, for every two IMGs that drop out of applying to psych, another high scoring AMG applies. The Step 1 scores go up and up.

The specialties that used to be "easy" to get into are getting fewer, but much higher quality applicants.

 

[67552931811]

I wonder if the same thing already happening in psych is happening also to peds... in psych, fewer people are applying every year, but when you look behind the numbers, for every two IMGs that drop out of applying to psych, another high scoring AMG applies. The Step 1 scores go up and up.

The specialties that used to be "easy" to get into are getting fewer, but much higher quality applicants.

I mean I suppose that's possible but it still has one of the highest match rates while psych match rates have been going down over the past few years (both were at 96% in 2014 and last year peds increased to 97% and psych went down to 90%). I mean really who knows why the young woman didn't match. There are crappy outcomes every year . Still, she is a USMD with average board scores so either she is an oddball/ bad interviewer or she didn't apply broad enough.

Edited: cause I can't spell.

 

[zeppelinpage4]

Does she have her CS score now? Many programs actually require CS in order to rank.

Unfortunately no, she's still waiting on her score.
This was probably a factor as well then. Having to take CS is already such a headache, it's unfortunate that it could possibly affect ones match this severely too.

 

[Bru]

Yikes. No CS score back even now? Something was very wrong with exam timing/planning and unfortunately they are now paying the price.

 

[Winged Scapula]

Yikes. No CS score back even now? Something was very wrong with exam timing/planning and unfortunately they are now paying the price.

agreed.

It sounds like she was an average candidate and got some bad advice including the timing of this exam. With so many more applicants in the pipeline I can see why a program director might not rank someone without the score when there are numerous equally qualified candidates with all their licensing exams except step three done and in.

 

[icd22]

To be honest, I think she failed CS and now she just retook it. Otherwise why delay the test for this long? It might also explain why she didn't match. I for one didn't tell ANY of my friends when I failed step 1, just my family.

 

[Mad Jack]

To be honest, I think she failed CS and now she just retook it. Otherwise why delay the test for this long? It might also explain why she didn't match. I for one didn't tell ANY of my friends when I failed step 1, just my family.

This is entirely possible. No program would rank a person with a CS failure unless they had a successful retake already in the bank before ROLs were submitted.

 

[zeppelinpage4]

Hmm...that's certainly a possibility. I don't know if this was her first attempt at CS or not. But if it was a retake, I can see how it would be another knock on her app.

I had thought programs would be a bit more lenient about CS, especially since more students are failing now. Normally 1-2 students fail a year at my school, but this year it was 7. But as Winged Scapula said, being an average candidate unfortunately doesn't leave much room for error.

Being a bottom barrel applicant like myself, who also failed and had to retake CS (thankfully passed), this just makes me appreciate my match even more.

Hopefully folks can see this thread in the future, it might prevent someone from having the same outcome.

 

[Crayola227]

She shouldn't feel bad if she didn't know about SDN or thought to come here for this.

From what I have read on SDN and talked to fellow residents, my school did a truly outstanding job of advising - for my field alone. I'm hearing horror stories for some other departments.

Keeping in mind I lucked out with my school & field - SDN was still like 90% of what I think is essential match/interview advice. I still felt lost as I made my list! But the rest I found answers.

I don't think a match strategy is sound if it doesn't include many many hours reading how to match on SDN. There's no better place for the info even if it isn't consolidated and you must weigh each bit of advice for yourself.

 

[Crayola227]

Hmm...that's certainly a possibility. I don't know if this was her first attempt at CS or not. But if it was a retake, I can see how it would be another knock on her app.

I had thought programs would be a bit more lenient about CS, especially since more students are failing now. Normally 1-2 students fail a year at my school, but this year it was 7. But as Winged Scapula said, being an average candidate unfortunately doesn't leave much room for error.

Being a bottom barrel applicant like myself, who also failed and had to retake CS (thankfully passed), this just makes me appreciate my match even more.

Hopefully folks can see this thread in the future, it might prevent someone from having the same outcome.

I think programs were more lenient not having CS in back in my day, when the pass rate was 99.9%, especially if you interviewed well.

Programs are never going to be "lenient" about a fail, especially not with a test like CS. With more students failing (thank you USMLE) I can see them just being stricter.

She may well have been ranked where she interviewed, but not high enough :-(

And also, yes, just about everyone should apply community!

Some high tier community programs can offer higher quality training (this depends on soooo many factors) than some low tier academic.

Keep in mind some community programs do well with fellowship placement, you just have to consider them carefully, look at their lists, opportunities with research, how closely they're tied to academic institutions if they're affiliated, and bust your butt. It depends on how competitive the fellowship as well.

As I always say, matching is the most important thing to do for your career, so no pride.

 

[rokshana]

Hey everyone, I'm posting this for a friend of mine.
She ranked 10 peds programs, and didn't match.
She got interviews at some really competitive places, and had some safeties, including her own home program. And I'm trying to understand how this could have happened. The only major blemish on her app is that she took Step 2 CS late and didn't have the score back for it before rank lists were submitted. But, it would seem ridiculous to not match just because of a late CS score.

By all standards, I believed an above average US MD student like her, ranking 9-10 pediatric programs would almost certainly match, especially if one of those was their own home program which would not want to see their own student go unmatched.

Those of us who know her are all perplexed right now and she's heartbroken. And I was just wondering if it's possible that this could have occurred due to an error/glitch in the system and she did actually match?

Also, how common are cases like this? I honestly thought 9-10 interviews for a US MD student almost guaranteed a match, especially in pediatrics which isn't super competitive like EM, ortho, or anesthesia.

Are her chances of matching pediatrics within the first or second round of SOAP good? Anyone been in this situation before and have useful advice or tips I can pass on to her?

*My apologies if i'ts a bit vague, I wanted to keep the details minimal to keep her anonymity.

I think you are overestimating what her level is...ok, most people in med school will try to project themselves as being a little better than they really are but it sounds like she had a combination of overestimating her competitiveness and receiving poor advice...

at this point, all her efforts should go into the SOAP...and use all her applications now as opposed to holding some out (if there are less than 45 programs that were unfilled, then at least she apply to all the unfilled places)...her goal is to get something...she does not have the luxury to be picky, however the fact that she STILL does not have her CS scores is going to hurt her and so m/l will not get anything in the SOAP.

after all the hullabaloo has calmed down, she needs to make an appointment to sit down with the PD of her peds program and ask for a realistic assessment of what was weak with her application (and there was something weak...generally if a med student from the home school voices that they want to stay with the home program, they will be ranked in the upper end of the list...but then she may not have voiced that to the program if she was thinking it was a "safety" spot) and what she can do to improve her application...

did she rank all the programs that she interviewed with...or did she think 9-10 was "enough"...gone are the days that USMDs can think they can be selective and rank only a few places...the adage that you should rank all the programs that you would rather be at then have to SOAP is true now for everyone, not just IMGs.

 

[Ismet]

Hmm...that's certainly a possibility. I don't know if this was her first attempt at CS or not. But if it was a retake, I can see how it would be another knock on her app.

I had thought programs would be a bit more lenient about CS, especially since more students are failing now. Normally 1-2 students fail a year at my school, but this year it was 7. But as Winged Scapula said, being an average candidate unfortunately doesn't leave much room for error.

Being a bottom barrel applicant like myself, who also failed and had to retake CS (thankfully passed), this just makes me appreciate my match even more.

Hopefully folks can see this thread in the future, it might prevent someone from having the same outcome.

Pediatrics is one of the least lenient in terms of CS failure, it's a massive red flag. An IM PD said the same about her program. Obviously with a subsequent pass that improves chances, but certainly the better programs can afford to be picky.

This is why I don't understand why people brush this test off. I'm not talking about you or your friend, and I know that even the most prepared people can end up failing because of how subjective the test is, I'm just talking in general. Half the group that tested with me had zero clue about how the test was done, they showed up with things they weren't permitted to take in the room and a couple people without some of the few things that we had to bring (i.e. stethoscope), people didn't know how many stations there were, how much time they had in the room, how much time they had to write the note...I can't fathom dropping $1300 on a test and having no understanding of it, especially with one that's so subjective. You should try to control everything that's in your power to control. For future test takers reading this thread - this is not a joke test. You certainly don't need the amount of preparation that Step 1 or CK requires, but you still need to prepare for it and take it seriously.

 

[Crayola227]

Pediatrics is one of the least lenient in terms of CS failure, it's a massive red flag. An IM PD said the same about her program. Obviously with a subsequent pass that improves chances, but certainly the better programs can afford to be picky.

This is why I don't understand why people brush this test off. I'm not talking about you or your friend, and I know that even the most prepared people can end up failing because of how subjective the test is, I'm just talking in general. Half the group that tested with me had zero clue about how the test was done, they showed up with things they weren't permitted to take in the room and a couple people without some of the few things that we had to bring (i.e. stethoscope), people didn't know how many stations there were, how much time they had in the room, how much time they had to write the note...I can't fathom dropping $1300 on a test and having no understanding of it, especially with one that's so subjective. You should try to control everything that's in your power to control. For future test takers reading this thread - this is not a joke test. You certainly don't need the amount of preparation that Step 1 or CK requires, but you still need to prepare for it and take it seriously.

Especially since there's quite a few very simple "immediate fail on this station" type thing.

I got the FA for CS. I didn't read it cover to cover, but it covers all the things you said.

I knew someone who did scoring for these, here's an example. If you have a young person that does exercise and faints, if one of your ddx's doesn't include hypertrophic cardiomyopathy, that's an immediate fail.

So you want to be sure you're up on all of your "most dangerous/emergency" dx's for the various scenarios. The rest of ddx could be sorta off, but you can't miss the can't miss stuff.

Didn't do hand hygeine where the standardized patient could see? = immediate fail.

Fail enough and you fail the test.

 

[Ismet]

Especially since there's quite a few very simple "immediate fail on this station" type thing.

I got the FA for CS. I didn't read it cover to cover, but it covers all the things you said.

I knew someone who did scoring for these, here's an example. If you have a young person that does exercise and faints, if one of your ddx's doesn't include hypertrophic cardiomyopathy, that's an immediate fail.

So you want to be sure you're up on all of your "most dangerous/emergency" dx's for the various scenarios. The rest of ddx could be sorta off, but you can't miss the can't miss stuff.

Didn't do hand hygeine where the standardized patient could see? = immediate fail.

Fail enough and you fail the test.

I think the most important part of FA is the first half where it explains the test. I would have lost major points on CIS if I hadn't read the first half, because it walks you through what they expect for counseling. And it's a lot of stuff that you honestly don't do in day to day real life practice. I maybe did 15-20 cases and practiced writing a couple notes, but I read through the entirety of the book prior to the cases. That first half is where the money is.

 

[ThoracicGuy]

I'm just glad that I missed having to do that CS crap.

 

[gutonc]

I'm just glad that I missed having to do that CS crap.

I was the first class of AMGs that had to do it. It was not a smooth process at all, but as long as you checked all the boxes, it wasn't that hard.

Ironically, I was also the first class to take Step 1 electronically (I did a PhD in the middle there...and I'm old). That was much easier than the CS nonsense.

 

[ThoracicGuy]

I was the first class of AMGs that had to do it. It was not a smooth process at all, but as long as you checked all the boxes, it wasn't that hard.

Ironically, I was also the first class to take Step 1 electronically (I did a PhD in the middle there...and I'm old). That was much easier than the CS nonsense.

I don't remember how I took Step 1 or 2 for that matter. I do remember the MCAT being pencil and paper, though.

 

[zeppelinpage4]

Pediatrics is one of the least lenient in terms of CS failure, it's a massive red flag. An IM PD said the same about her program. Obviously with a subsequent pass that improves chances, but certainly the better programs can afford to be picky.

This is why I don't understand why people brush this test off. I'm not talking about you or your friend, and I know that even the most prepared people can end up failing because of how subjective the test is, I'm just talking in general. Half the group that tested with me had zero clue about how the test was done, they showed up with things they weren't permitted to take in the room and a couple people without some of the few things that we had to bring (i.e. stethoscope), people didn't know how many stations there were, how much time they had in the room, how much time they had to write the note...I can't fathom dropping $1300 on a test and having no understanding of it, especially with one that's so subjective. You should try to control everything that's in your power to control. For future test takers reading this thread - this is not a joke test. You certainly don't need the amount of preparation that Step 1 or CK requires, but you still need to prepare for it and take it seriously.

I think the most important part of FA is the first half where it explains the test. I would have lost major points on CIS if I hadn't read the first half, because it walks you through what they expect for counseling. And it's a lot of stuff that you honestly don't do in day to day real life practice. I maybe did 15-20 cases and practiced writing a couple notes, but I read through the entirety of the book prior to the cases. That first half is where the money is.

Absolutely agree with you Ismet, and they are grading the test a lot more stringently now than they used to.

And yeah I had scheduling factors that got in the way, my situation was a bit complicated. I reserved time to study for it in my 4th year but finished third year later than I had expected and lost what was going to be that study time for CS. But once I realized this, I couldn't re-schedule the exam to a period where I would have time to adequately study, with all the rest of the dates being booked, so I had to suck it up and just take it without studying as much as I felt I needed and hoping for the best. I was also given a false sense of security from residents, and fellow classmates who said you could pretty much wing it, so I thought I might still be okay. But I def wasn't.

Totally agree, the first half of that First Aid CS book is gold. For my re-take, I took lots of notes from the first half of that book and felt it helped a lot. Also recommend reading the Step 2 CS pdf guide on their website which outlines the specifics of scoring and other important details.

I also suggest practicing with another person, or even an empty chair and really trying to simulate the experience timed to get used to it beforehand. It's not as hard of an exam like Step 1 or CK in terms of the time needed to prep or the difficulty, but you gotta know the checklist stuff and how the exam is graded so you know what to focus on.

 

[sazerac]

The other important thing about CS is that you take it in August or early September so that you get the results AFTER the September 15th deadline. That way you can submit ERAS with a CS score still pending and can retake it a couple more times (and get results before ranking time) in case you fail, without revealing a fail to the programs.

 

[IM2GI]

She may have overestimated her competitiveness or underestimated the competitiveness of Pediatrics.

Reviewing the 2016 NRMP Charting Outcomes for the Match, the mean number of programs ranked for matched US Seniors in Pediatrics is 12, not 9-10, although the probability of matching nears 1 with 9-10, it doesn't appear to become one until more than 12. The average Step 1 score for matched candidates was 230 and 244 for Step 2.

....

There must be some serious step 1 inflation going on these days. Is 240 the new 230?