NRMP March 2021 Discussions & Results

[TrpIleAsnGluArg]

What do you guys think about a system like this:

Applicants rank programs they want to apply to. Each week, next top 5 from the applicant's list are sent to programs.

Programs then mark people they want to interview. At the end of the month, top 5 programs as ranked by applicants, send interviews to applicants. So if 15 programs out of the 20 that got applications want to interview you, you just get the top 5 programs you wanted to apply to. Interview invite queue would persist month-to-month.

This process continues until match day, where the match works as usual.


This has the effect of slowing down apps to PDs and prevents interview hoarding. It also shows PDs who is really serious about applying to their program, because they will be scheduled early.

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[Maimonides1]

The NRMP data so far showed:

The percentage of registrants matched to first-year positions declined from 80.8% to 78.5%, with a record number of 48,700 registering -- 8.3% higher than last year. The percentage of 4th-year U.S. allopathic medical school students matching to first-year positions declined from 93.7% to 92.8%; the percentage for U.S. osteopathic medicine degree earners declined from 90.7% to 89.1%.

Those submitting program preferences numbered 42,508, up 6% over last year.

Raw numbers regarding matching were also up, with some setting records. Of the 38,106 total positions available, 36,179 were filled -- a 2.6% increase over last year. Of the 35,194 first-year positions available, 33,535 were filled -- a 2.9% increase.

The percentage of all positions filled increased by 0.3%, to 94.9%, and the percentage of first-year positions filled increased by 0.2%, to 94.8%.

The rate of U.S. MD graduates matched to first-year positions increased from 45.6% to 48.2%, while U.S. DO graduates matching to first-year positions increased from 43.1% to 44.3%.

Specialties that filled all available positions (with at least 30 positions) included dermatology, emergency medicine, pediatrics, neurological surgery, otolaryngology, integrated plastic surgery, and vascular surgery.

Specialties that filled less than 50% of available positions with U.S. seniors included pathology (41.4%) and surgery (28%).

A record 5,915 programs participated, 88 more than last year, with the number of such programs increasing by 16.7% over the last 5 years. That surge has been "spurred in part by the completion of the transition to the single accreditation system," with DO and MD programs merging into a single matching system, according to the NRMP.

NRMP reported 1,927 spots unfilled this year, down 3.6% from last year; some unmatched residents were placed in those spots via the NRMP Match Week (SOAP), with final figures to be shared publicly in May.

These data follows reports that applications to medical school had soared 50% this year alone.
Medical schools cannot accommodate the surging demand, in part because residency program spots have not been increasing at the same rate as their applications. While the rate of residency positions per active applicant has increased slightly since 2010, that figure is still down over 2003, and well below the rates of the late 1980s and early 1990s.

"The AAMC is supporting bipartisan legislation that would gradually add 15,000 Medicare-supported residency positions over 5 years"

 

[ontiquicuo]

Specialties that filled less than 50% of available positions with U.S. seniors included pathology (41.4%) and surgery (28%).

Is that just prelim surgery or does it include categorical?

 

[AnatomyGrey12]

Is that just prelim surgery or does it include categorical?

Includes both I think

 

[nimbus]

It’s tragic. People have committed suicide over not matching. Taxpayers don’t care though about us, they care about the system we represent.

Tuition will never be free unless we all have mass philanthropic gestures like NYU had.

Taxpayers care about the product...ie doctors. Most IMGs who train in the the US stay in the US. From that perspective, IMGs are cheaper to the the US taxpayer since their taxes only subsidized their residency training and not their medical school. More than likely, another country foot the bill for their medical school educations since medical schools are heavily subsidized and inexpensive in most other countries.

 

[Maimonides1]

Taxpayers care about the product...ie doctors. Most IMGs who train in the the US stay in the US. From that perspective, IMGs are cheaper to the the US taxpayer since their taxes only subsidized their residency training and not their medical school. More than likely, another country foot the bill for their medical school educations since medical schools are heavily subsidized and inexpensive in most other countries.

That was true in the middle of last century when the country needed able-bodies as IMGs/FMGs represented roughly 25% of working physicians in US..!

After the recent Caribbeans proliferation and the merger of MD/OD MATCH.., their matching numbers will be finally dwindling down according to the recent data:

International medical school graduates (IMGs) who are not U.S. citizens were especially affected -- their matching rate dropped from 61.1% to 54.8%.

The number of U.S. citizen international medical school graduates who submitted program lists increased 2.5%, to 5,295 -- the most in 6 years -- and 3,152 of them matched to first-year positions, down two spots over last year.

The number of non-U.S. citizen international medical school graduates who submitted lists increased by 15%, to 7,943; a record 4,356 of them matched to first-year positions -- up 3.2%.

 

[Redpancreas]

Taxpayers care about the product...ie doctors. Most IMGs who train in the the US stay in the US. From that perspective, IMGs are cheaper to the the US taxpayer since their taxes only subsidized their residency training and not their medical school. More than likely, another country foot the bill for their medical school educations since medical schools are heavily subsidized and inexpensive in most other countries.

I said the bolded twice on this thread in the past week in response to people asking AMGs to be prioritized so I don't know why this is a response to my post. The tragedy is the lack of awareness of struggles physicians here and abroad go through to match here. Agreed that they care about the product and it's not really different in medicine than many other fields in terms of tranparency to the taxpayer.

 

[WingZeroMD]

I have long argued that If students should not pay back the loans if they don't match. The loans were given with the hope that Students would secure the sorts of Jobs to pay the money back with interest. If the student loses (by not matching), how is it the school and the loan company want to set up a scheme whereby they win regardless of students outcome? Na man. If the Student Wins, They win. If the Student Loses, They Lose too. Seems logical to me. No? The biggest advocate of making sure Medical Students match IMO should be Loan Companies and Medical School. Time is coming when Legislators will write laws that compel schools and loan companies to do things they don't wanna do. Medicine better get its act together before we start seeing 10% unmatch rates with the Loan Burden of 300 or 400K per student. Its going to get ugly and nobody is going to win when that happens.

 

[TJRock]

I have long argued that If students should not pay back the loans if they don't match. The loans were given with the hope that Students would secure the sorts of Jobs to pay the money back with interest.

No, loans were given so that you can attend medical school. There are no guarantees in life, so if you sign your name on a loan application and accept the money, you should live up to your obligations.

 

[Med Ed]

I have long argued that If students should not pay back the loans if they don't match. The loans were given with the hope that Students would secure the sorts of Jobs to pay the money back with interest. If the student loses (by not matching), how is it the school and the loan company want to set up a scheme whereby they win regardless of students outcome? Na man. If the Student Wins, They win. If the Student Loses, They Lose too. Seems logical to me. No?

How to get your medical school loans discharged (according to this scheme):

1. Apply to every FM and/or prelim position in the country
2. Attend a single interview and completely bomb it
3. Fail to match at said program
4. You're off the hook!

I cannot imagine how this could possibly be abused or lead to unintended consequences.

 

[WingZeroMD]

No, loans were given so that you can attend medical school. There are no guarantees in life, so if you sign your name on a loan application and accept the money, you should live up to your obligations.

Right So there should be no guarantees that the Loan Company or Bank Gets their money back No?

Loans of this Magnitudes are given with the underlying/implicit understanding that one can command a salary to pay that money back..With Interest. Its an double sided business venture if you ask me. It was all fine and dandy when match rates were 100%. Loan Companies were getting their money back With interest and everybody was winning. But Now this is not the case. People are quarter milly in and banks still want their money.... with interest...uhhh I think Not

But As I said, I refuse to give credence to a scheme whereby regardless of student outcome, the bank/school/Lender still comes out on top. Bank/Lenders/School and Students are all in it together. "If We Win, then We Win, if We Lose We Lose." Life Continues. If the Student Loses, the Bank/School/Lender Should lose too. That is all I am saying.

 

[TJRock]

Right So there should be no guarantees that the Loan Company or Bank Gets their money back No?

Loans of this Magnitudes are given with the underlying/implicit understanding that one can command a salary to pay that money back..With Interest. Its an double sided business venture if you ask me. It was all fine and dandy when match rates were 100%. Loan Companies were getting their money back With interest and everybody was winning. But Now this is not the case. People are quarter milly in and banks still want their money.... with interest...uhhh I think Not

But As I said, I refuse to give credence to a scheme whereby regardless of student outcome, the bank/school/Lender still comes out on top. Bank/Lenders/School and Students are all in it together. WE Played and WE Lost. Life Continues. If the Student Loses, the Bank/School/Lender Should lose too. That is all I am saying.

Did you know that before you signed? If so, you got what you asked for and that was funding to attend medical school along with an obligation to pay back the loan along with the interest that was disclosed at the time you accepted the money.

If that information wasn't disclosed, and you can prove that the lenders did not provide you with that information, contact an attorney. Otherwise, be an adult and deal with your debt.

 

[WingZeroMD]

If that information wasn't disclosed, and you can prove that the lenders did not provide you with that information, contact an attorney. Otherwise, be an adult and deal with your deb

I think you instinctively know the paradigm i have set up is logically and morally clear. Your basis argument is rooted in law but laws can change. This is why we don't have Debtors prisons and Slavery any more. We left those concepts in the 1800's. and just like you were arguing "what about the law," people like me said "nah eff that" and had the law changed.

Yes I know they willing signed to contract. There are times that I have argued on your side. I can easily be a "contract truther" all day. But students are 300K, 400K and some 500K in. At what point does society do away with the law and rightfully adopt the stance that we as society will not continue to tolerate squeezing the little guy only over a Mutual Deal that went south. This is the origin of cancel the Student Debt. Is it bad policy? It might be? But is it rooted in a strongly established sense of morality and justice. Yes 1,000% it is.

I will type this over and over until I ram it into people's head: If the Student Loses. The Bank/Lender/School MUST LOSE TOO.

 

[TJRock]

I think you instinctively know the paradigm i have set up is logically and morally clear.

Nope. Nothing morally clear to borrowing money with a promise (obligation) to pay it back and then deciding not to. It is neither the school nor the lenders fault that you can't get a residency.

 

[WingZeroMD]

Nope. Nothing morally clear to borrowing money with a promise (obligation) to pay it back and then deciding not to. It is neither the school nor the lenders fault that you can't get a residency.

Ok I have said.. (Over and Over might I add), That If the Student Loses, the Banks/Schools/Lender Should Lose too. What do yo say about that? No arguments from you about this paradigm when the Student is Winning correct? I

 

[Maimonides1]

Right So there should be no guarantees that the Loan Company or Bank Gets their money back No?

Loans of this Magnitudes are given with the underlying/implicit understanding that one can command a salary to pay that money back..With Interest. Its an double sided business venture if you ask me. It was all fine and dandy when match rates were 100%. Loan Companies were getting their money back With interest and everybody was winning. But Now this is not the case. People are quarter milly in and banks still want their money.... with interest...uhhh I think Not

But As I said, I refuse to give credence to a scheme whereby regardless of student outcome, the bank/school/Lender still comes out on top. Bank/Lenders/School and Students are all in it together. "If We Win, then We Win, if We Lose We Lose." Life Continues. If the Student Loses, the Bank/School/Lender Should lose too. That is all I am saying.

Shylock the Merchant of Venice..!!

 

[WingZeroMD]

When I come and Say:
If the Student WINS, the Banks/Lender/Schools must WIN too..

Not a SINGLE SOUL has but an argument or objection....

The Moment I remove "WIN" and insert "LOSE" the huffing and puffing start and people start losing their minds LOL.. am I missing something here?

 

[sunshinefl]

When I come and Say:
If the Student WINS, the Banks/Lender/Schools must WIN too..

Not a SINGLE SOUL has but an argument or objection....

The Moment I remove "WIN" and insert "LOSE" the huffing and puffing start and people start losing their minds LOL.. am I missing something here?

Yes you are missing that they aren’t your spouse that said they believe in you, your journey, and investing in you. They are a financial institution that lent you money that you agreed to pay back.

 

[the argus]

I think you instinctively know the paradigm i have set up is logically and morally clear. Your basis argument is rooted in law but laws can change. This is why we don't have Debtors prisons and Slavery any more. We left those concepts in the 1800's. and just like you were arguing "what about the law," people like me said "nah eff that" and had the law changed.

Yes I know they willing signed to contract. There are times that I have argued on your side. I can easily be a "contract truther" all day. But students are 300K, 400K and some 500K in. At what point does society do away with the law and rightfully adopt the stance that we as society will not continue to tolerate squeezing the little guy only over a Mutual Deal that went south. This is the origin of cancel the Student Debt. Is it bad policy? It might be? But is it rooted in a strongly established sense of morality and justice. Yes 1,000% it is.

I will type this over and over until I ram it into people's head: If the Student Loses. The Bank/Lender/School MUST LOSE TOO.

When I come and Say:
If the Student WINS, the Banks/Lender/Schools must WIN too..

Not a SINGLE SOUL has but an argument or objection....

The Moment I remove "WIN" and insert "LOSE" the huffing and puffing start and people start losing their minds LOL.. am I missing something here?

There are so many reasons why this narrative you are pushing is misguided, but I'll just discuss one as an example.

I assume in this grand Mutual Deal scenario, you are cool with the bank/lender/school also getting to determine which specialty, and programs within specialty, you apply to and rank? I mean, if this is a Mutual Deal and everyone is on the hook for your failure to match, then very logically they should be able to assure that you do everything possible not to fail.

So your idea is great as long as you are willing to give up the autonomy to choose your specialty and location of training...

 

[VA Hopeful Dr]

When I come and Say:
If the Student WINS, the Banks/Lender/Schools must WIN too..

Not a SINGLE SOUL has but an argument or objection....

The Moment I remove "WIN" and insert "LOSE" the huffing and puffing start and people start losing their minds LOL.. am I missing something here?

Very well...

I wouldn't say the banks/lenders/schools "win" so much as "they fulfilled their contractual obligation and they student fulfilled theirs".

Personally, I would have no objection to some amount of loan forgiveness but this wouldn't even be a big argument if the debt at the end was 160k-ish like it was 10 years ago compared to the 250-300k that it is now.

 

[TJRock]

Ok I have said.. (Over and Over might I add), That If the Student Loses, the Banks/Schools/Lender Should Lose too. What do yo say about that? No arguments from you about this paradigm when the Student is Winning correct? I

Then doctors must reimburse patients and insurance companies if the treatment that they prescribed doesn't cure the patient. I'm sure that you are ok with that, right?

The lender wins when they make the loan. That is their business and you chose to do business with them. Why should they care if you can't get a residency? You agreed, not with a gun to your head but willingly, to pay them back with interest. They shouldn't lose because they did their job and did it well.

 

[WingZeroMD]

See anybody saying otherwise is only saying that because they (presumably) have the Laws and the Guns on their side. If enough people get straddled with insurmountable debt, beating them over the head with "yOU siGNed tHE CoNtraCT!!" Will only work for so long. There will come a day where you will have neither the Law or the Guns on you side

Soon they rip those laws you lean on apart to shreds and they will point those guns right back at you. The Debt Truthers, for if anything self preservation need to show some also show some empathy and understanding of the other side. Squeezing the little guy for MUTUAL DEAL gone wrong is not going to work for very much longer and folks

At least VA Hopeful Doc has seen some utility in debt forgiveness for M.D's (just not up to these days amounts). But the others.. sheesh!!

 

[VA Hopeful Dr]

See anybody saying otherwise is only saying that because they (presumably) have the Laws and the Guns on their side. If enough people get straddled with insurmountable debt, beating them over the head with "yOU siGNed tHE CoNtraCT!!" Will only work for so long. There will come a day where you will have neither the Law or the Guns on you side

Soon they rip those laws you lean on apart to shreds and they will point those guns right back at you. The Debt Truthers, for if anything self preservation need to show some also show some empathy and understanding of the other side. Squeezing the little guy for MUTUAL DEAL gone wrong is not going to work for very much longer and folks

At least VA Hopeful Doc has seen some utility in debt forgiveness for M.D's (just not up to these days amounts). But the others.. sheesh!!

That's some grade A conspiracy stuff you're spouting up there. Contract enforcement has always been a thing, I don't see that going anywhere.

 

[WingZeroMD]

assume in this grand Mutual Deal scenario, you are cool with the bank/lender/school also getting to determine which specialty, and programs within specialty, you apply to and rank? I mean, if this is a Mutual Deal and everyone is on the hook for your failure to match, then very logically they should be able to assure that you do everything possible not to fail.

Right but just like @TJRock says.. There are no guarantees. Of course the Student is making an intense good faith effort to mach. Why would s/he not? So students are out here burning the most precious commodity know to man (TIME) in bad faith?

The Student Is not guaranteed a residency, Fine. Solid Logic there I got you. Then, In that case, the Bank/School/Lender is not Guaranteed their money back. Everybody Wins or Nobody Wins
Seems completely logical to me

 

[GoSpursGo]

The Student Is not guaranteed a residency, Fine. Solid Logic there I got you. Then, In that case, the Bank/School/Lender is not Guaranteed their money back. Everybody Wins or Nobody Wins
Seems completely logical to me

Is that how things work when someone takes out a loan to fund, say, a restaurant, or any other endeavor?

 

[DokterMom]

Right So there should be no guarantees that the Loan Company or Bank Gets their money back No?

Loans of this Magnitudes are given with the underlying/implicit understanding that one can command a salary to pay that money back..With Interest. Its an double sided business venture if you ask me. It was all fine and dandy when match rates were 100%. Loan Companies were getting their money back With interest and everybody was winning. But Now this is not the case. People are quarter milly in and banks still want their money.... with interest...uhhh I think Not

But As I said, I refuse to give credence to a scheme whereby regardless of student outcome, the bank/school/Lender still comes out on top. Bank/Lenders/School and Students are all in it together. "If We Win, then We Win, if We Lose We Lose." Life Continues. If the Student Loses, the Bank/School/Lender Should lose too. That is all I am saying.

Sure, we know what you're saying. You want to shift the risk over to the lender, so it's the lender who suffers if the student fails. So the lender is betting that the students they choose to finance with their loans will succeed.

Interesting. Now consider what the loan application process will look like. Instead of the current semi-automatic 'stamp here' approval process, lenders would have to vet their prospective borrowers (most of whom have negligible credit, remember) pretty carefully.

Rememeber also that it's the student who controls their own outcome. Students who work hard and smart rarely fail. When it's their own money on the line - as borrowed money is for most med students - they have every incentive to make it work. When there are minimal economic consequences to failure, that option becomes much more palatable.

 

[sunshinefl]

Right but just like @TJRock says.. There are no guarantees. Of course the Student is making an intense good faith effort to mach. Why would s/he not? So students are out here burning the most precious commodity know to man (TIME) in bad faith?

The Student Is not guaranteed a residency, Fine. Solid Logic there I got you. Then, In that case, the Bank/School/Lender is not Guaranteed their money back. Everybody Wins or Nobody Wins
Seems completely logical to me

No. The bank is not investing in you. They are loaning you money to be paid back at an agreed upon rate.

 

[WingZeroMD]

Sure, we know what you're saying. You want to shift the risk over to the lender, so it's the lender who suffers if the student fails. So the lender is betting that the students they choose to finance with their loans will succeed.

Interesting. Now consider what the loan application process will look like. Instead of the current semi-automatic 'stamp here' approval process, lenders would have to vet their prospective borrowers (most of whom have negligible credit, remember) pretty carefully.

Rememeber also that it's the student who controls their own outcome. Students who work hard and smart rarely fail. When it's their own money on the line - as borrowed money is for most med students - they have every incentive to make it work. When there are minimal economic consequences to failure, that option becomes much more palatable.

But Again you have no Issues about this paradigm when the Student Wins? It's all groovy when the student is winning right @DokterMom?

I sense alot of Baby boomer energy here But those days are long gone. And even though Dr. Paul laments the introduction of the federal loan systems in public education (I agree with the guy), it is here. Long gone are the Days of Ron Paul, M.D paying for Duke Medical School with his summer Job. Medical School at Georgetown Cost 350,000K dollars. This debt is non-dischargeable as it stands. But they were though.. What makes you think that these laws just can't change?

If you somehow think in the near future when medical school will cost up to 400K in the US, squeezing already downtrodden students that failed to match is going to work, think again. Student will only let you get away with "you took out the loan" for so long while they get crushed by mountains and mountains of loans. A fight back WILL ENSUE. This is America, the citizens of this country have fought for less.

The "Pay the Loan Back" Truthers need to if anything engage in some self preservation. This why The Cancel the debt movement is growing. And it crazy to see the people against it offer no at least self-perserving solution. They think they can just keep pointing to contract and call it a day. As if someone that owes 450K with an MD from Creighton with little to no prospects is just going to sit there and take it. SMH.. See how that worked out for the French Elites ~220 years ago?

 

[sunshinefl]

But Again you have no Issues about this paradigm when the Student Wins? It's all groovy when the student is winning right @DokterMom?

I sense alot of Baby boomer energy here But those days are long gone. And even though Dr. Paul laments the introduction of the federal loan systems in public education (I agree with the guy), it is here. Long gone are the Days of Ron Paul, M.D paying for Duke Medical School with his summer Job. Medical School at Georgetown Cost 350,000K dollars. This debt is non-dischargeable as it stands. But they were though.. What makes you think that these laws just can't change?

If you somehow think in the near future when medical school will cost up to 400K in the US, squeezing already downtrodden students that failed to match is going to work, think again. Student will only let you get away with "you took out the loan" for so long while they get crushed by mountains and mountains of loans. A fight back WILL ENSUE. This is America, the citizens of this country have fought for less.

The "Pay the Loan Back" Truthers need to if anything engage in some self preservation. This why The Cancel the debt movement is growing. And it crazy to see the people against it offer no at least self-perserving solution. They think they can just keep pointing to contract and call it a day. As if someone that owes 450K with an MD from Creighton with little to no prospects is just going to sit there and take it. SMH.. See how that worked out for the French Elites ~220 years ago?

You’re not “just gonna sit there and take it”? What does that even mean? What are you going to do instead? Pay it back? Pay on it IBR for 25-30 years and then have the balance forgiven? Get a PSLF eligible job, pay for 10 years, and then have the balance forgiven? I mean those options are all already available to you. Btw I’m not a “boomer” I’m a Millennial.

 

[xffan624]

Is that how things work when someone takes out a loan to fund, say, a restaurant, or any other endeavor?

Well to play devil's advocate, they can discharge their loans through declaring bankruptcy, no? Many failed businesspersons have availed themselves of that opportunity including the former president. I think an argument for an easier bankruptcy process for medical students who fail repeatedly to match could be made.

The bonus trickle down effect for that might be a little closer scrutiny to giving out loans to schools that historically are poor bets. (cough*Caribbean*cough)

 

[AnatomyGrey12]

But Again you have no Issues about this paradigm when the Student Wins? It's all groovy when the student is winning right @DokterMom?

I sense alot of Baby boomer energy here But those days are long gone. And even though Dr. Paul laments the introduction of the federal loan systems in public education (I agree with the guy), it is here. Long gone are the Days of Ron Paul, M.D paying for Duke Medical School with his summer Job. Medical School at Georgetown Cost 350,000K dollars. This debt is non-dischargeable as it stands. But they were though.. What makes you think that these laws just can't change?

If you somehow think in the near future when medical school will cost up to 400K in the US, squeezing already downtrodden students that failed to match is going to work, think again. Student will only let you get away with "you took out the loan" for so long while they get crushed by mountains and mountains of loans. A fight back WILL ENSUE. This is America, the citizens of this country have fought for less.

The "Pay the Loan Back" Truthers need to if anything engage in some self preservation. This why The Cancel the debt movement is growing. And it crazy to see the people against it offer no at least self-perserving solution. They think they can just keep pointing to contract and call it a day. As if someone that owes 450K with an MD from Creighton with little to no prospects is just going to sit there and take it. SMH.. See how that worked out for the French Elites ~220 years ago?

I sense a lot of entitlement in here.

 

[WingZeroMD]

Yes you are missing that they aren’t your spouse that said they believe in you, your journey, and investing in you. They are a financial institution that lent you money that you agreed to pay back

Ohh Yes Of Course, this is a straight Business Deal. But When the Match Rates were 100% The deal was effin sweet. But now circumstance have eroded the rigor of those initial premises. There are no guarantees correct? So now that which was once guaranteed now has a certain level of uncertainty/risk it. That sounds LIKE a BET to me

And the last I checked, if you pony up the money in a bet and lose the bet (despite dotting your eyes and crossing your T's and doing all the research). The money is gone.

If I have inside Information that Bayern Munich was going to win the Champions League by hanging on to a 1-0 lead, but somehow Manchester United Scores 2 goals in stoppage time to win, you don't get the money from the bet. period. It looked like Munich was probably going to win. They were winning all game. The likelyhood of them winning as of the 90th minute was probably 93% or so. You were so thrilled and patted youself on the back for making this awesome, well-informed bet. But They Ended up losing. You Can't now after watching all game, knowing how hard it is to get to the European Cup final now say, well Munich Threw that game! They weren't well prepeared. The Coaching sucked!! Naw Playa. You Bet and You lost..

Don't see how it is different.

 

[the argus]

Right but just like @TJRock says.. There are no guarantees. Of course the Student is making an intense good faith effort to mach. Why would s/he not? So students are out here burning the most precious commodity know to man (TIME) in bad faith?

The Student Is not guaranteed a residency, Fine. Solid Logic there I got you. Then, In that case, the Bank/School/Lender is not Guaranteed their money back. Everybody Wins or Nobody Wins
Seems completely logical to me

I think you're missing the biggest point. AMGs are virtually guaranteed a residency position if they are willing go anywhere in any specialty, excluding the very small amount of applicants that have huge red flags.

The vast majority of AMGs that fail to match do so because they overestimate how competitive they are for residency, which generally includes underapplying to a noncompetitive specialty or applying to a competitive specialty you are not competitive enough for. That's why the residency placement rate for AMGs (i.e. grads that start any residency position, not just NRMP match rate) is like 99%.


And no one is forcing you to go to medical school and to try and become a doctor. This idea that you should be able to choose this path with absolutely no risk to your financial life is ridiculous. No one who opens a small business gets to do so risk free.

This isnt a baby boomer vs. gen x vs. millennial argument. This is just a "I feel entitled to a risk free life earning in the top 5% of US households" argument ... and is quite ridiculous.

 

[sunshinefl]

Ohh Yes Of Course, this is a straight Business Deal. But When the Match Rates were 100% The deal was effin sweet. But now circumstance have eroded the rigor of those initial premises. There are no guarantees correct? So now that which was once guaranteed now has a certain level of uncertainty/risk it. That sounds LIKE a BET to me

And the last I checked, if you pony up the money in a bet and lose the bet (despite dotting your eyes and crossing your T's and doing all the research). The money is gone.

If I have inside Information that Bayern Munich was going to win the Champions League by hanging on to a 1-0 lead, but somehow Manchester United Scores 2 goals in stoppage time to win, you don't get the money from the bet. period. It looked like Munich was probably going to win. They were winning all game. The likelyhood of them winning as of the 90th minute was probably 93% or so. You were so thrilled and patted youself on the back for making this awesome, well-informed bet. But They Ended up losing. You Can't now after watching all game, knowing how hard it is to get to the European Cup final now say, well Munich Threw that game! They weren't well prepeared. The Coaching sucked!! Naw Playa. You Bet and You lost..

Don't see how it is different.

The difference is when you place a bet, you get odds. You are gambling.

the bank isn’t betting on you. They are loaning you money at an agreed upon rate.

 

[GoSpursGo]

This entire side-conversation on student loans is really only tangentially-related to the original poll and point of the thread, which was how to make changes to the NRMP match. Let's try to stay more or less on-topic. Anyone wanting to discuss the separate topic of student loans, please open a separate thread in Topics in Healthcare.

(Or, ya know, don't. That would be OK too)

 

[WingZeroMD]

Dang @GoSpursGo
You deleted just MY comment LOL. SMH? you ain't seem in there, holding my own while they went like 5 vs 1 on me.. But Anyways. An Other Suggestion I recommended is to Publish FERPA-Compliant publications of Program Match Lists. As in they should publish to students what position on the List they were exactly on AND on request should be willing to substantiate why they were low or not on the list at all for next time. The Former should be mandatory, the later is be encouraged.

 

[Lawpy]

Why are we still talking about loans in a thread about match reform?

We need app caps now!

 

[GoSpursGo]

Why are we still talking about loans in a thread about match reform?

We need app caps now!

Yeah this. I think I made it clear on which side of the debate I stand, but I think we should all move on please. Anyone wishing to continue that debate can start a new thread.

 

[SurfingDoctor]

All I know is I took out a loan for $100,000 and put it all on $GME. If I don’t go to the moon, it’s the banks fault.

 

[NotAProgDirector]

Since the gov't is guaranteeing loans, neither the bank nor the school has any skin in the game. I think this is a poor plan.

If a student can't get a residency for X years in a row, then I think the loss should be shared by the student, school, and gov't. If we put he banks into the mix, then we'll have a problem that banks may start turning down students whom they think are poor risks. This way, everyone is held accountable. I'm fine with leaving the student with 10%, school 45%, and gov't 45% of the debt. Whether X should be 3 or 7 or something in between is debatable. And if people are worried about students scamming the system, just make them ineligible for CMS funding.

Leaving the student will all the debt is pointless -- they will never pay it back. (This assumes the student doesn't go off into high finance and make lots of $$$ -- so it would need to be income sensitive).

And if you want to add the banks in for 10% or something, I'm good with that too.

 

[nimbus]

I think you're missing the biggest point. AMGs are virtually guaranteed a residency position if they are willing go anywhere in any specialty, excluding the very small amount of applicants that have huge red flags.

The vast majority of AMGs that fail to match do so because they overestimate how competitive they are for residency, which generally includes underapplying to a noncompetitive specialty or applying to a competitive specialty you are not competitive enough for. That's why the residency placement rate for AMGs (i.e. grads that start any residency position, not just NRMP match rate) is like 99%.


And no one is forcing you to go to medical school and to try and become a doctor. This idea that you should be able to choose this path with absolutely no risk to your financial life is ridiculous. No one who opens a small business gets to do so risk free.

This isnt a baby boomer vs. gen x vs. millennial argument. This is just a "I feel entitled to a risk free life earning in the top 5% of US households" argument ... and is quite ridiculous.

OTOH I think every school, every USMD, every USDO, and every offshore school should be required to publish their match rates as a condition of participation in federally guaranteed student loan programs. This is important information. Why are these not published every year in great detail? How many graduates got their 1st choice, 2nd choice, etc. How many SOAPed or got a position outside the match. Anonymized and in great detail.

Schools require highly detailed applications. Applicants should demand similarly detailed important information of the schools.

 

[WingZeroMD]

Why are these not published every year in great detail? How many graduates got their 1st choice, 2nd choice, etc. How many SOAPed or got a position outside the match. Anonymized and in great detail.

This quote right here>>>>>

Granular, FERPA-Compliant Detail should be Available upon request. PERIOD. Publish It all. We know medical schools keep it. Race and Gender of Students that match and into what specialties? % of Students by Race that match into their 1st choice, Statistics of the Unmatched by R&G.

Also an Intersting stat I want to see is the Percentage of Students by R&G that pass the USMLE.. I'D LOVE TO SEE THE STATISTIC ON THE STEP 2CS.. Willing to Wager my entire life existence you will see some funny business going on with the Step 2CS

But Medical Schools are not dumb institutions. They too are engaging in self preservation Publishing such granular data would open these folks up more and you medicine supposed loves its "autonomy." With how it is now some medical school would either be burnt to ashes or entire departments would have to resign en masse

 

[nimbus]

This quote right here>>>>>

Granular, FERPA-Compliant Detail should be Available upon request. PERIOD. Publish It all. We know medical schools keep it. Race and Gender of Students that match and into what specialties? % of Students by Race that match into their 1st choice, Statistics of the Unmatched by R&G.

Also an Intersting stat I want to see is the Percentage of Students by R&G that pass the USMLE.. I'D LOVE TO SEE THE STATISTIC ON THE STEP 2CS.. Willing to Wager my entire life existence you will see some funny business going on with the Step 2CS

But Medical Schools are not dumb institutions. They too are engaging in self preservation Publishing such granular data would open these folks up more and you medicine supposed loves its "autonomy." With how it is now some medical school would either be burnt to ashes or entire departments would have to resign en masse

I wasn’t talking about race and gender but sure, why not. The more transparent, the better.

 

[WingZeroMD]

I wasn’t talking about race and gender but sure, why not. The more transparent, the better.

If we are gong to commit ourselves to transparency, then we have to commit ourselves to transparency. Just watched a fantastic interview given by Richard Sander on the topic of Affirmative Action and his resultant Mismatch Theory. Fascinating stuff but one must be willing listen to the other side. In it, he too advocates for complete transparency of Schools and Their Graduation statistics, admission statistics etc..

Suprise, Schools fight him tooth and nail to not have this information released under FOIA. They have it, but these schools don't want to get lynched by it.

 

[The Med-Peds Dude]

How to get your medical school loans discharged (according to this scheme):

1. Apply to every FM and/or prelim position in the country
2. Attend a single interview and completely bomb it
3. Fail to match at said program
4. You're off the hook!

I cannot imagine how this could possibly be abused or lead to unintended consequences.

I'm trying to see the benefit to a graduate to not match....

 

[VA Hopeful Dr]

I'm trying to see the benefit to a graduate to not match....

If they decide medicine isn't for them, that hypothetical would offer a way out of the accumulated debt as well

 

[wanted101]

It's not perfect but some requirement for programs to tell the truth about their program requirements/applicant selection process would help greatly, especially for DO and IMGs. Indirectly, this also helps USMD students because less IMGs and DOs send apps to places that don't actually give them a look which results in programs theoretically having more time to review the apps they do care about.

On a separate note, this year was a tragedy of the commons. I'm a great applicant for my field but I'm a dirty ****ing DO so I'm out at top programs (fair for several OT reasons) but I also got ghosted by some ****ty programs because they automatically think I don't want to go to some community program in an "undesirable" location (I actually do lol). This was wildly irritating. I think strong DO applicants got affected by this greatly with Covid but could see it happening every year to some extent. I think application caps actually makes this problem worse. Caps don't prevent this yield protection by programs!!! They are still going to think you don't want to go there.

I went to some bad interviews this year to fill out my list and ensure good geography for my personal life should it come down to it. I was interviewing with students from top med schools at these. During social time some of them even mentioned that they had no ties to the area or really any reason to apply there in the first place. Covid/Virtual interviews obviously made this happen and neither of us would be there in a normal year.

With application caps, you prevent some of this from top school students but you don't prevent it from good DOs or average MDs. I would still have to apply to that program to be safe as a DO but then I would feel even more obligated to attend the interview as I used one of my 20 (or whatever asinine #) apps on it. In a normal year, I would apply to that program and then drop it when the expected better interviews rolled in. This movement would happen with app caps and wouldn't happen ever again if we continue virtual interviews.

My initial proposal from stream of conscious rambling is:
1. Make programs actually be real about their process. This makes it easier for everyone but ERAS making $$$
2. LOOSE app caps to help prevent it from being insane to kill off the outliers doing just egregious amounts.
3. 20 same specialty interview cap if we continue virtual interviews.

I could probably polish this up better but basically I think you need some kind of very loose app cap for completely obvious reasons. I think it's obtuse to say it should be a constricting number because it clearly hurts a big group of applicants without having tons of utility. I think the key is not letting some people go on 25 same specialty interviews though because it's just stupid, frankly. That's far more important. A noticeable thing this year with virtuals was waitlists not moving. This prevented applicants from receiving the typical number and quality of interviews. We will have that again if we don't make some minor adjustments. There is no reason that myself or a JHU/Stanford/Harvard grad should be at a truly bottom tier interview. That interview should have gone to someone who needed it during a normal year. Hell, I've seen talk of not ranking some of these places by strong applicants. That's even worse! We were at the interview due to different ramifications but both could be fixed if we learn from this year.

the matching system is so screwed up, for the reasons you mentioned plus 1000000+ more. the people in charge of course are too scared of change. one of the big issues is that we have too many IMGs taking US MD and US DO spots. not fair at all to these students who can't even become a dr in their own country when you have people from other countries taking what belongs to us.

 

[Matthew9Thirtyfive]

the matching system is so screwed up, for the reasons you mentioned plus 1000000+ more. the people in charge of course are too scared of change. the people who designed the system and made it this way should be shot. one of the big issues is that we have too many IMGs taking US MD and US DO spots. not fair at all to these students who can't even become a dr in their own country when you have people from other countries taking what belongs to us.

I seriously doubt that anyone who is even remotely competitive for the programs they’re applying to is having their spots taken by IMGs.

 

[wanted101]

I seriously doubt that anyone who is even remotely competitive for the programs they’re applying to is having their spots taken by IMGs.

you'd be surprised. I would know having just matched and having many of my friends last year being unable to match into i med and surgery programs even though they were given interviews because IMGs ended up taking the categorical spots instead. same thing goes for fellowships (i med and surgery as well). people who say otherwise are just too far removed from the system or ignorant.

 

[AnatomyGrey12]

you'd be surprised. I would know having just matched and having many of my friends last year being unable to match into i med and surgery programs even though they were given interviews because IMGs ended up taking the categorical spots instead. same thing goes for fellowships (i med and surgery as well). people who say otherwise are just too far removed from the system or ignorant.

You're surrounded by a lot of people who just matched, so excuse us if we don't really accept that little appeal to authority. This might ruffle some feathers but if an IMG beat out a US grad for a spot the US grad didn't deserve the spot.... If you (metaphorical you) are competitive for X specialty, and you didn't match, it isn't because an IMG took your spot. Period. In the competitive specialties there will always be more US applicants than spots, so someone has to go unmatched.