NRMP March 2021 Discussions & Results

[wanted101]

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.

if an IMG got accepted to the program you wanted instead of you, and you were both invited for interviews, they literally may have taken your spot because without them, you would be 1 spot higher on their rank list and may have matched otherwise.

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[whataschool_classof24]

Reading this thread as an M1 for sure induces some anxiety

 

[AnatomyGrey12]

if an IMG got accepted to the program you wanted instead of you, and you were both invited for interviews, they literally may have taken your spot because without them, you would be 1 spot higher on their rank list and may have matched otherwise.

No, the program decided the IMG was a better fit for their program.

Even if you complete eliminated IMGs there will always be unmatched US graduates.

 

[Banco]

if an IMG got accepted to the program you wanted instead of you, and you were both invited for interviews, they literally may have taken your spot because without them, you would be 1 spot higher on their rank list and may have matched otherwise.

Or you weren't ranked by the program at all.

 

[the argus]

Reading this thread as an M1 for sure induces some anxiety

AMGs have a residency placement rate of like 99%. The only AMGs that don't eventually get a residency spot either messed up somehow and have MAJOR red flags, or they insist on applying to a specialty they are not competitive for.

There remains >7000 more residency spots than AMGs on a yearly basis, and this is not going to change over the next 3 years when you will be applying.

 

[7331poas]

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.

Not really true. There are IMG applicants in neurosurgery every year that are literally already surgeons in their own countries. I know of applicants who are actually already neurosurgeons who are coming to the United States training programs so they can work here in the US.

Clearly these applicants are better than any medical student in the United States. There is no set of qualifications that a US MD Senior could have that would make them a better candidate than an already accredited neurosurgeon.

I disagree that "qualification" alone should allow a program to select an IMG. In my opinion US MDs should fill 100% of their applicants and then programs can seek out IMGs. Or at least a 1st match for US MDs and a 2nd match for IMGs.

 

[Lem0nz]

when you have people from other countries taking what belongs to us.

People who say stuff like this are actually insane.

 

[AnatomyGrey12]

Not really true. There are IMG applicants in neurosurgery every year that are literally already surgeons in their own countries. I know of applicants who are actually already neurosurgeons who are coming to the United States training programs so they can work here in the US.

And how many IMG's match neurosurgery every year?

The placement rate for US graduates is about as close to 100% as you can get. Not everyone gets to match the program or specialty they want. That's just life. None of us are entitled to a career in X speciality simply because we went to medical school.

 

[Banco]

And how many IMG's match neurosurgery every year?

The placement rate for US graduates is about as close to 100% as you can get. Not everyone gets to match the program or specialty they want. That's just life. None of us are entitled to a career in X speciality simply because we went to medical school.

As harsh as it may sound, this is true. That's why I made sure I was okay with "just" internal medicine prior to medical school and that's what I tell current pre-meds who ask me about specialty choices too.

 

[DokterMom]

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.

Not really true. There are IMG applicants in neurosurgery every year that are literally already surgeons in their own countries. I know of applicants who are actually already neurosurgeons who are coming to the United States training programs so they can work here in the US.

Clearly these applicants are better than any medical student in the United States. There is no set of qualifications that a US MD Senior could have that would make them a better candidate than an already accredited neurosurgeon.

I disagree that "qualification" alone should allow a program to select an IMG. In my opinion US MDs should fill 100% of their applicants and then programs can seek out IMGs. Or at least a 1st match for US MDs and a 2nd match for IMGs.

Some IMGs are just that good. They are that brilliant. That well-qualified. That much more dedicated to becoming a neurosurgeon in the US that they would pass up on specialist attending salaries in their home countries to come here for training peanut wages. In short, that much better than home-grown applicants.

So US residency programs should pass them up, uh, why? That sounds a lot like entitlement speaking.

As has been noted, there are still many more residency positions available than US grads to fill them. Protectionism isn't the answer.

 

[deleted645092]

Not really true. There are IMG applicants in neurosurgery every year that are literally already surgeons in their own countries. I know of applicants who are actually already neurosurgeons who are coming to the United States training programs so they can work here in the US.

Clearly these applicants are better than any medical student in the United States. There is no set of qualifications that a US MD Senior could have that would make them a better candidate than an already accredited neurosurgeon.

I disagree that "qualification" alone should allow a program to select an IMG. In my opinion US MDs should fill 100% of their applicants and then programs can seek out IMGs. Or at least a 1st match for US MDs and a 2nd match for IMGs.

Their qualification is what got them the job then. And they deserve it. This is America, we were built on the backs of immigrants, and the American ideal is meritocracy. This kind of thinking is what gets Nationalists elected to office. *cough*

Edit: The above might sound hyperbolic but it’s literally the next step up after “I support legal immigration” arguments in the context of American jobs being “stolen”. It’s saying “I support immigration...but...they don’t deserve to have a shot at my job”.

 

[Matthew9Thirtyfive]

Some IMGs are just that good. They are that brilliant. That well-qualified. That much more dedicated to becoming a neurosurgeon in the US that they would pass up on specialist attending salaries in their home countries to come here for training peanut wages. In short, that much better than home-grown applicants.

So US residency programs should pass them up, uh, why? That sounds a lot like entitlement speaking.

As has been noted, there are still many more residency positions available than US grads to fill them. Protectionism isn't the answer.

Maybe because that’s literally how almost every other country does it. This is the United States. We should be ensuring our own citizens who have amassed an absurd amount of debt to go into a service profession have a job before we are giving them to other people who are not US citizens. You know, like virtually every other first world country does.

 

[VA Hopeful Dr]

Maybe because that’s literally how almost every other country does it. This is the United States. We should be ensuring our own citizens who have amassed an absurd amount of debt to go into a service profession have a job before we are giving them to other people who are not US citizens. You know, like virtually every other first world country does.

Pretty much this. I don't think we should guarantee that every medical student matches 100% just because they went to a US school, but there should be, and there is, a significant preference for US graduates.

 

[MDMechEngr]

Maybe because that’s literally how almost every other country does it. This is the United States. We should be ensuring our own citizens who have amassed an absurd amount of debt to go into a service profession have a job before we are giving them to other people who are not US citizens. You know, like virtually every other first world country does.

unless the FMG/IMG are the Werner Von Braun or the J. Robert Openheimer of medicine.

 

[AnatomyGrey12]

Pretty much this. I don't think we should guarantee that every medical student matches 100% just because they went to a US school, but there should be, and there is, a significant preference for US graduates.

I agree. I just don’t think we’re to the point of “IMGs stealing our spots.” Not with US placement rates still essentially 100%.

When US grads who have successfully passed everything can’t get a rural FM spot then we can be more concerned. The people I see complaining most often either didn’t match a program they wanted or their specialty or choice. It can be a tough pill to swallow, but at the end of the day there are still jobs.

 

[Banco]

Here is a post from an IMG forum:
"It takes 6–8 hours a day for 6–8 months on average to study for the Step 1 (for IMGs). Agree with the post below that the study material and questions are considerably different from the curriculum in other countries. Step 1 is the most important aspect of your residency application. 5 months may be enough to get an average score (unless you’re a naturally gifted student and were nationally ranked in the top 100 or so in any of the competitive exams)."

So if an IMG does dedicated full-time study for 8 months for Step 1 and scores 265 and a US student has dedicated full-time study for 6 weeks for Step 1 and scores 250, then are you saying the IMG is better qualified and should be picked for the neurosurgery spot over the US grad?

Amazing reasoning.

 

[7331poas]

Their qualification is what got them the job then. And they deserve it. This is America, we were built on the backs of immigrants, and the American ideal is meritocracy. This kind of thinking is what gets Nationalists elected to office. *cough*

Edit: The above might sound hyperbolic but it’s literally the next step up after “I support legal immigration” arguments in the context of American jobs being “stolen”. It’s saying “I support immigration...but...they don’t deserve to have a shot at my job”.

Great, then why do we force foreign docs to do a residency at all? Are training programs in Germany worse than training programs here? Maybe we should just have all of our physician jobs populated by doctors from South America who will work for less than 60k here in the United States.

 

[the argus]

Maybe because that’s literally how almost every other country does it. This is the United States. We should be ensuring our own citizens who have amassed an absurd amount of debt to go into a service profession have a job before we are giving them to other people who are not US citizens. You know, like virtually every other first world country does.

Again, there are >7000 more first year residency positions than AMGs (MD + DO) on a yearly basis.

AMGs are essentially guaranteed a job as a physician unless 1) they messed up enough in med school that their basic competence/judgement is in question, or 2) they insist to pursue a specialty they are not competitive for. Otherwise they will be able to find a job that eventually leads to practicing as a physician.

This idea that any AMG doesn’t get a residency position because of an IMG is not based in reality.

 

[Matthew9Thirtyfive]

Again, there are >7000 more first year residency positions than AMGs (MD + DO) on a yearly basis.

AMGs are essentially guaranteed a job as a physician unless 1) they messed up enough in med school that their basic competence/judgement is in question, or 2) they insist to pursue a specialty they are not competitive for. Otherwise they will be able to find a job that eventually leads to practicing as a physician.

This idea that any AMG doesn’t get a residency position because of an IMG is not based in reality.

I already said in this thread that IMGs are not “takin our jerbs.” My post that you quoted wasn’t saying that either. It just said we should prioritize AMGs.

 

[7331poas]

2) they insist to pursue a specialty they are not competitive for. Otherwise they will be able to find a job that eventually leads to practicing as a physician.

This idea that any AMG doesn’t get a residency position because of an IMG is not based in reality.

We know this is not true. I know of at least 3 people who did not match into "competitive" specialties with above median scores. Do you really think that 40% of ENT applicants "were not competitive" for seats?

Even if you are correct, I assert that we should take US Seniors from both of your groups and offer them residency positions in "less competitive" fields before resorting to IMGs.

 

[the argus]

I already said in this thread that IMGs are not “takin our jerbs.” My post that you quoted wasn’t saying that either. It just said we should prioritize AMGs

This is the whole point, AMGs are already prioritized, heavily!

You're upset that there isn't an official policy/procedure that prioritizes AMGs? No offense, but that seems a little silly to me. Yes that's how most other countries do things, but there's a reason the USA is the best ****ing country in the world and not those other countries. Our country's entire history is forged on the idea that it doesn't matter where you come from, if you're the best at what you do then you should succeed.

There's no practical reason to officially prioritize AMG residency placement over IMG other than the idea that an AMG should empirically be entitled to a position over an IMG based solely on their status as a medical student in the US. Sorry, but that just doesn't cut the mustard in my book...

 

[the argus]

We know this is not true. I know of at least 3 people who did not match into "competitive" specialties with above median scores. Do you really think that 40% of ENT applicants "were not competitive" for seats?

Even if you are correct, I assert that we should take US Seniors from both of your groups and offer them residency positions in "less competitive" fields before resorting to IMGs.

Board scores are not everything. And yes, if you don't match into a specialty (assuming you applied broadly, etc) then by definition you were not competitive enough for that specialty. Baseball players in AAA are amazing at baseball, but they are not amazing enough to be major leaguers.

And we already do offer US Seniors positions before resorting to IMGs, it's called the SOAP...

 

[VA Hopeful Dr]

We know this is not true. I know of at least 3 people who did not match into "competitive" specialties with above median scores. Do you really think that 40% of ENT applicants "were not competitive" for seats?

Even if you are correct, I assert that we should take US Seniors from both of your groups and offer them residency positions in "less competitive" fields before resorting to IMGs.

If those above median applicants applied to IM/FM as backup, that's likely exactly what would happen.

 

[Matthew9Thirtyfive]

This is the whole point, AMGs are already prioritized, heavily!

You're upset that there isn't an official policy/procedure that prioritizes AMGs? No offense, but that seems a little silly to me. Yes that's how most other countries do things, but there's a reason the USA is the best ****ing country in the world and not those other countries. Our country's entire history is forged on the idea that it doesn't matter where you come from, if you're the best at what you do then you should succeed.

There's no practical reason to officially prioritize AMG residency placement over IMG other than the idea that an AMG should empirically be entitled to a position over an IMG based solely on their status as a medical student in the US. Sorry, but that just doesn't cut the mustard in my book...

I was responding to a specific post. I suggest you go back and read that post to see the context of my response, because your arguments against it don’t really apply.

 

[Cranjis McBasketball]

In response to RVU-UT, how much should be placed on the school and how much on those individuals..? I go to a new medical school and I am shocked at some of my classmates and their specialties they are going to pursue here soon. Its almost like "career day" where they think you snap your fingers and you'll match. Im talking about guys who did average/below avg on comlex, no usmle, no research and are seriously applying for auditions in ortho, ENT, and derm. My guess is that happened to RVU-UT

 

[AnatomyGrey12]

In response to RVU-UT, how much should be placed on the school and how much on those individuals..? I go to a new medical school and I am shocked at some of my classmates and their specialties they are going to pursue here soon. Its almost like "career day" where they think you snap your fingers and you'll match. Im talking about guys who did average/below avg on comlex, no usmle, no research and are seriously applying for auditions in ortho, ENT, and derm. My guess is that happened to RVU-UT

Very true. It wouldn't surprise me at all if that were the case. DO student's in particular are very prone to being in denial about how uncompetitive for X specialty their app is.

 

[7331poas]

Board scores are not everything. And yes, if you don't match into a specialty (assuming you applied broadly, etc) then by definition you were not competitive enough for that specialty. Baseball players in AAA are amazing at baseball, but they are not amazing enough to be major leaguers.

And we already do offer US Seniors positions before resorting to IMGs, it's called the SOAP...

The problem with your logic is that we do not know the "competitiveness" of a specialty ahead of time, especially in small fields like ENT. One year the match rate could be high, another it could be 70%. We can only postulate. Additionally, programs purposefully do not publish their individual class profiles in order to drive up application revenue and create uncertainty within the applicant population.

If those above median applicants applied to IM/FM as backup, that's likely exactly what would happen.

So what I am hearing is that by keeping the status quo we are doubling the number of applications US MDs should submit (and ERAS profits) because we won't protect students who go unmatched into competitive fields. Oh and btw, applying IM as a "backup" with 4 neurosurgery sub-I's is not going to be be a cakewalk where you submit 5 applications and guarantee a match.

 

[Jack Donaghy]

The problem with your logic is that we do not know the "competitiveness" of a specialty ahead of time, especially in small fields like ENT. One year the match rate could be high, another it could be 70%. We can only postulate. Additionally, programs purposefully do not publish their individual class profiles in order to drive up application revenue and create uncertainty within the applicant population.



So what I am hearing is that by keeping the status quo we are doubling the number of applications US MDs should submit (and ERAS profits) because we won't protect students who go unmatched into competitive fields. Oh and btw, applying IM as a "backup" with 4 neurosurgery sub-I's is not going to be be a cakewalk where you submit 5 applications and guarantee a match.

What you're hearing is cognitive dissonance from physicians who haven't participated in the match in a decade. Anyone arguing for the status quo just isn't seeing the big picture here.

 

[VA Hopeful Dr]

So what I am hearing is that by keeping the status quo we are doubling the number of applications US MDs should submit (and ERAS profits) because we won't protect students who go unmatched into competitive fields. Oh and btw, applying IM as a "backup" with 4 neurosurgery sub-I's is not going to be be a cakewalk where you submit 5 applications and guarantee a match.

That's a nice strawman you've constructed. Unfortunately for you, I never said anything like that.

It boils down to this: you are not guaranteed a spot in a competitive field (or any field, really) just because you want one. US graduates already get preferential treatment by the vast majority of programs. Match rates for US seniors back this up. From 2016-2020 for US MDs, 3.5%ish went unmatched by choice (this excludes withdrawn from the Match or those who didn't submit a list at all). DOs are slightly worse but have been improving every year to 6%ish in 2020. The 2021 full data isn't available yet, but this year will hopefully be an anomaly from COVID.

What you're hearing is cognitive dissonance from physicians who haven't participated in the match in a decade. Anyone arguing for the status quo just isn't seeing the big picture here.

Funny you should say that, the US MD match rate has been essentially unchanged since 2006 (I went through this in 2010). The DOs in the NRMP match did way worse in that time, but a) DOs still had their own match and b) they were much more of an unknown back then to many.

 

[the argus]

The problem with your logic is that we do not know the "competitiveness" of a specialty ahead of time, especially in small fields like ENT. One year the match rate could be high, another it could be 70%. We can only postulate. Additionally, programs purposefully do not publish their individual class profiles in order to drive up application revenue and create uncertainty within the applicant population.

People know what the competitive specialties are and are not. Sure there is some variation from year to year, but look at the "positions per USMD senior" from the NRMP reports over the past few years and you will see that these wild swings of competitiveness for a given specialty don't actually exist.

And as had been mentioned, this idea that you should be able to try and become a physician, i.e. get a spot in the top 5% of US household incomes, without any amount of risk is really just entitled nonsense. You are not doing our profession/society any giant favor by trying to become an otolaryngologist, there's really no reason you should be entitled to pursue that career path with absolutely zero risk and a guaranteed spot in a less competitive field just because you managed to attend medical school in the US.

What you're hearing is cognitive dissonance from physicians who haven't participated in the match in a decade. Anyone arguing for the status quo just isn't seeing the big picture here.

I have participated in the match in the past decade, twice actually if you include fellowship. The big picture here is that you guys seem to be suggesting that just by completing medical school in the US you feel entitled to not only a guaranteed residency position, but also the ability to apply to a competitive specialty in a risk-free manner where you still get your pick of the "noncompetitive" positions if you fail to obtain a spot in the competitive field. Just seems bonkers to me...

 

[YCAGA]

Maybe because that’s literally how almost every other country does it. This is the United States. We should be ensuring our own citizens who have amassed an absurd amount of debt to go into a service profession have a job before we are giving them to other people who are not US citizens. You know, like virtually every other first world country does.

This isn't true though. Canada has protectionism for the match due to limited spots, whereas we have literally 7,000 more spots than we can fill with AMGs. Same with Australia, they have protectionism but also have specialist saturation in cities and saturation in residencies. UK has a metric **** ton of IMG's. That leaves the EU which only has protectionism in SOME countries for applicants outside the EU/EEA/Switzerland...but there are 27 countries within the EU plus the 3 EEA countries and Switzerland, so it is not like they are keeping out every nationality but their own. And the EU protectionism exists in every single profession due to EU law, it is not specific to medicine which you seem to be implying is the case in "first world countries." In countries with physician shortages like Germany and Eastern Europe, the EU protections don't even apply and there is no real downside to being an IMG as long as you speak the local language well. In other countries like Portugal, France, Spain, and Italy, the residency match is as pure of a meritocracy as you can imagine: a single exam decides where you rank in the match system. They do have restrictions on non-EU spots, but like I said, that is EU law, not something specific to medicine. Jobs have to be filled by equally qualified EU citizens before being opened up to non-EU workers, but a more qualified non-EU worker can beat an EU-worker just like in the US (more qualified IMG beats AMG). The reason we give J1 and H1B visa to residents is that medical residency is a high skilled and specialized job that cannot be filled by American citizens alone.

 

[Lem0nz]

We know this is not true. I know of at least 3 people who did not match into "competitive" specialties with above median scores. Do you really think that 40% of ENT applicants "were not competitive" for seats?

Even if you are correct, I assert that we should take US Seniors from both of your groups and offer them residency positions in "less competitive" fields before resorting to IMGs.

What alternate reality are you living in that you think ENT should have enough spots for most of its applicants? ENT is wildly competitive. People saying there are plenty of spots for AMGs and that AMGs are wildly unrealistic are talking about YOU dude, and people who think like you. You are WILDLY unrealistic with this thinking. If AMGs, even who were competitive, failed to match ENT and didn't apply to and have a thorough backup plan, those medical school applicants were idiots. I'm sorry, someone has to say it. They were stupid future doctors who were overly confident. Everyone should have a backup plan. And the backup plan should be in a specialty and path that you over OVERLY qualified for and should be able to fall into as a safety net. I guarantee you that if those 40% of unmatched ENT docs applied to general surgery, or prelim years, or *insert any medical specialty here*, they would match.

 

[YCAGA]

WTF alternate reality are you living in that you think ENT should have enough spots for most of its applicants? ENT is wildly competitive. People saying there are plenty of spots for AMGs and that AMGs are wildly unrealistic are talking about YOU dude, and people who think like you. You are WILDLY unrealistic with this thinking. If AMGs, even who were competitive, failed to match ENT and didn't apply to and have a thorough backup plan, those medical school applicants were idiots. I'm sorry, someone has to say it. They were stupid future doctors who were overly confident. Everyone should have a backup plan. And the backup plan should be in a specialty and path that you over OVERLY qualified for and should be able to fall into as a safety net. I guarantee you that if those 40% of unmatched ENT docs applied to general surgery, or prelim years, or *insert any medical specialty here*, they would match.

Exactly. 99.9% of ENT unmatched applicants can match into FM or IM their second cycle, and that is if they can't SOAP into IM, FM, or a prelim surgery spot. I mean...come on, the match rate for US MD Senior with a Step 1 of 194-200 (lowest passing to 8th percentile) is 92% and that is including people who failed Step 1 one or more times and/or failed a year of medical school which is very likely amongst that cohort who are barely passing. If you control for a Step 2 above 9th percentile among the cohort and ranking more than 2 spots, it goes up to 98% matched into FM.

So it is peak insanity to suggest that unmatched ortho, nrsg, derm, ENT, etc applicants are going to end up chronically unemployed and in perpetual debt. I guess unless they applied to those competitive specialties with a Step 1 < 210 and realistically <200 in which case they brought the situation on themselves.

 

[7331poas]

What alternate reality are you living in that you think ENT should have enough spots for most of its applicants? ENT is wildly competitive. People saying there are plenty of spots for AMGs and that AMGs are wildly unrealistic are talking about YOU dude, and people who think like you. You are WILDLY unrealistic with this thinking. If AMGs, even who were competitive, failed to match ENT and didn't apply to and have a thorough backup plan, those medical school applicants were idiots. I'm sorry, someone has to say it. They were stupid future doctors who were overly confident. Everyone should have a backup plan. And the backup plan should be in a specialty and path that you over OVERLY qualified for and should be able to fall into as a safety net. I guarantee you that if those 40% of unmatched ENT docs applied to general surgery, or prelim years, or *insert any medical specialty here*, they would match.

My assertion is not that those unmatched applicants should get into ENT. My assertion is that we should have a better option for US Seniors who do not match than the SOAP.

 

[VA Hopeful Dr]

My assertion is not that those unmatched applicants should get into ENT. My assertion is that we should have a better option for US Seniors who do not match than the SOAP.

Ah, ok that's not at all unreasonable. But you do need to keep 2 things in mind. First, the SOAP is still pretty new. I can't remember exactly when it started, but it wasn't a thing when I (2010) and my wife (2011) went through the Match. Rather than come up with a brand new system, I'd bet they could tweak SOAP itself.

Second, SOAP is 100% better than the previous way of doing things. Go talk to anyone that had to scramble back then and compare that to people who SOAP now. So progress is definitely being made.

 

[Matthew9Thirtyfive]

And the EU protectionism exists in every single profession due to EU law, it is not specific to medicine which you seem to be implying is the case in "first world countries."

I never said it was specific to medicine, so that’s a straw man. I said they have protections for their own citizens. Which they do.

 

[Lem0nz]

My assertion is not that those unmatched applicants should get into ENT. My assertion is that we should have a better option for US Seniors who do not match than the SOAP.

We do. Apply more realistically. Or hell, even apply to multiple specialties and rank first ENT and then anything else less competitive.

We DO have other options. Excellent, realistic, grounded other options. SOAP is for the people who fall through the cracks anyway because they didn't do any number of 100 other options to ensure they matched and instead reached.

 

[order66.exe]

Lol Im going to add my story as someone who went unmatched in ENT last year. I thought about SOAP but felt that the IM programs available wouldn't get me to my goal (wanted IV pulm or cards). Home program convinced me to reapply to ENT. I delayed graduation and dual applied this year after crushing a few IM rotations. Got plenty of IM interviews at great academic programs and good community programs with a few ENT places. Just matched ENT.

I was definitely worried about whether anyone would offer me a job and it turned out to be fear without basis in reality!

 

[YCAGA]

I never said it was specific to medicine, so that’s a straw man. I said they have protections for their own citizens. Which they do.

It seemed pretty implied to me since you replied to someone who was talking about residency specifically and you said other countries don’t work like that. Even if we get rid of that strawman and simplify things: what first world country with an excess of residency spots compared to domestic graduates restricts their residency spots from IMGs? The spoiler is that a country like that doesn’t exist.

 

[Dr.Bruh]

Very true. It wouldn't surprise me at all if that were the case. DO student's in particular are very prone to being in denial about how uncompetitive for X specialty their app is.

This. There is only one person in my class who I was actually shocked didn't match (true fell through the cracks of the system story) and they grabbed a good categorical spot in the SOAP. The other all were apply to over competitive specialties and/or had red flags. In fact, there were many many more people who I was shocked that actually matched (people with red flags, board failures, really awkward/abrasive personalities etc) than shocked they didn't match

 

[YCAGA]

This. There is only one person in my class who I was actually shocked didn't match (true fell through the cracks of the system story) and they grabbed a good categorical spot in the SOAP. The other all were apply to over competitive specialties and/or had red flags. In fact, there were many many more people who I was shocked that actually matched (people with red flags, board failures, really awkward/abrasive personalities etc) than shocked they didn't match

This 1000%. There are a non-zero number of posts on SDN and Reddit of DO students with 220s Step 1 and 230s Step 2 asking what they can do to match ortho, derm, etc. Normally with little to no research and no home program. It’s totally their decision to shoot their shot at those specialities, but no equitable system can or should guarantee a spot to someone who is taking that gamble. That person deserves an IM residency over a more qualified IMG? because that is who will be “taking their spot” if they don’t match to a backup. Give me a break.

 

[Matthew9Thirtyfive]

It seemed pretty implied to me since you replied to someone who was talking about residency specifically and you said other countries don’t work like that. Even if we get rid of that strawman and simplify things: what first world country with an excess of residency spots compared to domestic graduates restricts their residency spots from IMGs? The spoiler is that a country like that doesn’t exist.

We seem to be arguing different points. My argument is not that we should make it difficult for IMGs to match here if there are an abundance of spots. My argument is that it is totally fair for programs to prefer US grads because that is how it should be. And yes, I didn’t realize the UK had added medicine to the critical list, exempting immigrants from the RLMT.

 

[Matthew9Thirtyfive]

There is an abundance of spots, and programs already prefer American grads over IMGs.

As they should. No one is saying they don’t. Or at least I’m not.

 

[YCAGA]

We seem to be arguing different points. My argument is not that we should make it difficult for IMGs to match here if there are an abundance of spots. My argument is that it is totally fair for programs to prefer US grads because that is how it should be. And yes, I didn’t realize the UK had added medicine to the critical list, exempting immigrants from the RLMT.

Gotcha. I thought you were arguing that we should match all AMGs before any IMG matches and/or have a max number of IMGs who can match and/or have a first match for AMGs and a second match for IMGs, which are all “solutions” I have seen in this thread/similar threads. And I was saying that no country with a surplus of residency spots does that.

Even a country like Spain with more domestic graduates than residency spots allow 4% of spots to go to non-EU foreigners as long as they beat a Spaniard/EU citizen on the MIR exam. After 4% of spots are filled by foreigners, it doesn’t matter if a foreigner beats a Spaniard/EU citizen, they won’t get a spot. Seems pretty fair to me. Spain gets the cream of the crop from Latin America (vast majority of foreigners taking the MIR exam come from that region) and still “protects” their domestic graduates somewhat. It is a similar situation in other European countries with more domestic graduates than residency spots.

Source: Información General sobre el Examen MIR it’s in Spanish and Google Translate appears to butcher it so if anyone is actually curious about this let me know haha

 

[Matthew9Thirtyfive]

Gotcha. I thought you were arguing that we should match all AMGs before any IMG matches and/or have a max number of IMGs who can match and/or have a first match for AMGs and a second match for IMGs, which are all “solutions” I have seen in this thread/similar threads. And I was saying that no country with a surplus of residency spots does that.

Ah, yeah I was getting the impression that’s what you thought I was pushing for. I was just saying that we shouldn’t be demonizing programs for preferring AMGs. The poster I was responding to originally was, and I was saying they shouldn’t be lol.

 

[whataschool_classof24]

What alternate reality are you living in that you think ENT should have enough spots for most of its applicants? ENT is wildly competitive. People saying there are plenty of spots for AMGs and that AMGs are wildly unrealistic are talking about YOU dude, and people who think like you. You are WILDLY unrealistic with this thinking. If AMGs, even who were competitive, failed to match ENT and didn't apply to and have a thorough backup plan, those medical school applicants were idiots. I'm sorry, someone has to say it. They were stupid future doctors who were overly confident. Everyone should have a backup plan. And the backup plan should be in a specialty and path that you over OVERLY qualified for and should be able to fall into as a safety net. I guarantee you that if those 40% of unmatched ENT docs applied to general surgery, or prelim years, or *insert any medical specialty here*, they would match.

I agree but I bolded that sentence because I have heard that for fields like ENT, if you dual apply it makes you look less committed to the field which then makes it more difficult to match into ENT

 

[slowthai]

I agree but I bolded that sentence because I have heard that for fields like ENT, if you dual apply it makes you look less committed to the field which then makes it more difficult to match into ENT

Not true. ENT has never been a backup specialty, lol. If you're applying I6 CT and GS, then yeah, the GS programs might get pissed that you're using them as a backup (if they somehow find out), and even that seems to vary program to program.

 

[YCAGA]

Not true. ENT has never been a backup specialty, lol. If you're applying I6 CT and GS, then yeah, the GS programs might get pissed that you're using them as a backup (if they somehow find out), and even that seems to vary program to program.

Will they though? CT surgery is a fellowship of GS unlike ENT, ortho, or urology which I could see GS being salty about. Maybe some uneducated PD that doesn’t know I6 CT has a match rate of like <50% but even that seems unlikely since basically every GS program has CT surgeons involved that will know about the I6 programs at least vaguely.

Also, an I6 CT applicant that ends up in GS is most likely going to be dedicated to their general surgery residency because they want to match into a CT fellowship, unlike a failed ortho applicant who is probably going to try to transfer to an ortho program or eventually drop out.

 

[whataschool_classof24]

Not true. ENT has never been a backup specialty, lol. If you're applying I6 CT and GS, then yeah, the GS programs might get pissed that you're using them as a backup (if they somehow find out), and even that seems to vary program to program.

No I'm saying if you are applying to ENT as your top choice and you apply to lets say IM as a back up the ENT folks will question your dedication to the field and IM will think you are using them as a backup. Seems like a lose lose

 

[slowthai]

No I'm saying if you are applying to ENT as your top choice and you apply to lets say IM as a back up the ENT folks will question your dedication to the field and IM will think you are using them as a backup. Seems like a lose lose

I understand that's what you're saying, but I'm saying that that doesn't/wouldn't happen. You're using another field as a backup, not ENT. Dedication to the field is demonstrated by doing research and away rotations.

Edit: Didn't see the part about IM being a backup. I don't think they really care. Everyone knows IM/FM are often used as backups. Rads is another example that I know for a fact doesn't care.