Residency comes next

Was talking to an ObGyn residency applicant today who said they changed the process for them this year. Apparently something like 90% of the programs decided on a single date to issue interviews - 25th of October. They have set up rules where they only issue the number of interviews for which they have slots unlike the past where if someone didn’t click within 15 minutes, the slots disappeared because too many were asked for too few slots. The applicant/invitee has 24 hours to say yes to an interview after which an untaken spot gets released to whoever is next in line for interviews.

On top of that, the applicants are allowed to indicate their top 3 programs as gold, next 15 as silver. So the programs know where the candidates are ranking them. It seems like a hard and changing field for the applicants since their training may be different based on local laws going forward in each state.

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It’s definitely a nice change to have slots for all invited. I felt bad for those who didn’t get slots even while I helped monitor my guy’s offers so I could snap one up when he was too busy to do so himself. If someone didn’t have help, they were sunk for some places.

I’m not sure it’s helpful to indicate gold/silver, etc.

And yeah, ObGyn is going to have it rough with training in the new political world.

It’s something the OB/GYN programs have been piloting over the past 3 years.

ACOG agreed that that current residency interview system had issues with top, highly desirable applicants taking 20+ interviews. Since each applicant can only occupy one slot in the end, some programs had to interview & rank 40 or more med students just to fill 5 slots. Programs got tired of ranking applicants who really had no interest in the program.

OB/GYN programs have been preparing for changing laws for almost a year now. Some programs are sending their students to rotate OOS. Other programs are considering using sims. But programs who do not offer sufficient training in certain procedures like D&E, suction curettage and medication terminations will lose their accreditation since ACOG has indicated they will not loosen their standards to accommodate state law changes.

Abortion training is not and never has been a mandatory part of OB/GYN residency. It’s an elective, but OB/GYNs do need to know how to do those procedures that can used for abortions because they are also used to handle incomplete miscarriages, fetal deaths, ectopic pregnancies, medically necessary abortions and other critical obstetric situations.

OB/GYN is one of those specialties with a national shortage of physicians. Losing accredited residency programs is only going make it harder and harder for pregnant women to find appropriate care.

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this link unlocks the article from the paywall.

Interesting but not surprising. Especially about the “de-titling’” of female physicians.

My husband (who had doctorate in physics) always felt that if a physician addressed him by his first name (ignoring his title of Doctor), then he was allowed to address the physician by their first name.

(I will note that DH worked in a organization where nearly everyone held a PhD and the workplace culture was to ignore titles because since everyone had one everyone was a peer. See: Spies Like Us (1985) - Doctor, Doctor Scene (4/8) | Movieclips - YouTube)

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When i first came to this country as a grad student 35+ years ago, I was in Seattle where all profs went by first name. Very casual and also a bit shocking for me. There were students sitting in the classroom and eating lunches during the class and some even had legs on the desk.

I transferred to the south to Clemson six months later and felt more at equilibrium with the respect culture coming from India. All profs expected to be called Dr. , no desks to put legs on in most classrooms (tablet chairs), no food allowed in the classrooms.

Hello all! I’m sitting at home with lots of time on my hands due to Covid (first time) and it dawned on me that I hadn’t been on here in a while to read updates and give an update. My D is applying for residency. She has several interviews scheduled and completed one school’s interview thus far.

The process is somewhat different this year. Students are given tokens (the amount varies by speciality) that they can include with an application, and they can also mark regions (I think up to 3 total). This group of applicants also has some students with Step 1 scores and some with “pass” scores. The consensus seems to be that most PD’s are now just focusing on Step 2. It’s an interesting application year, for sure! Best of luck to everyone who has a loved one applying!!

@icuinNm best of luck to your daughter! Wow! I hadn’t heard about this token thing. Is this for all specialties?

@WayOutWestMom

It’s called preference signaling. So “token” probably wasn’t the best word. I should have said “signal.” Here’s the info:
Preference Signaling

Not all specialties use it.

Specialties that use ERAS:

Which specialties use preference signaling?? Anesthesiology, Diagnostic Radiology, Interventional Radiology, Emergency Medicine, General Surgery, Internal Medicine (Categorical), Neurological Surgery, Pediatrics, Physical Medicine and Rehabilitation and Psychiatry.

Additionally plastic surgery, urology, ophthalmology and ENT all have their own optional system for signaling preferences. Ob/Gyn also has its own signaling system where residency candidates have 3 gold (highest interest) and 15 silver (very high interest) tokens.

wishing everyone a successful Match season!

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The ob/gyn applicant I mentioned further up had a pretty good outcome with the new signalling system. Apparently they had all 3 gold and 14 of the 15 silver invitations.

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Huh - hadn’t heard of the preference signaling system. Interesting.

Preference signaling is new this year.

It’s kind of like a soft cap on the number of residency applications an individual can submit.

Also new this year–applicants can indicate a geographic area preference on their ERAS. This is for individuals, who for on reason or another, want to stay in a particular city or region for residency.

Need to create an account to read this. Can you either provide a different link or summarize why two days would have been better?

Here’s the text:
The National Resident Matching Program’s (NRMP) decision to nix a proposal for a 2-day medical resident matching process has left some students scratching their heads about why the organization discounted the opinions of the majority of respondents — mostly medical students, residents, and fellows — who supported the change.

The program’s decision comes after nearly 3 months of feedback from the public, medical students, and education community. Although about 60% of public respondents believed the change could reduce stress and allow students more time for momentous career decisions, the program’s board of directors decided the disadvantages were “of greater consequence,” according to a October 28 statement.

Those disadvantages included introducing application or interview behaviors that could increase students’ stress; potentially identifying partially matched or unmatched applicants, which could lead to bias and stigmatism; and extending the match process time for those applicants.

In addition, members of 12 medical education and student organizations raised other concerns, such as the proposed change not addressing high application numbers, according to the statement. NRMP has reported record numbers of applicants over the past few years, typically with more applicants than available program slots.

“While the testimony gave nod to the positive aspects of the proposal…there was substantially more concern voiced about the potential negative consequences identified in the public comments,” NRMP President and CEO Donna Lamb told Medscape Medical News. Some of those issues could not be addressed without further study, so the board decided not to proceed with the proposal, she explained.

Donna Lamb

The proposal would have separated the Main Residency Match into two phases and replaced the Supplemental Offer and Acceptance Program (SOAP), in which unmatched or partially matched applicants apply for unfilled residency positions. Under the proposed change, each phase would have operated the same way, from rank order lists and using a matching algorithm to a pair of Match Days instead of a single day.

The two-phase process would have given students who didn’t match more time to carefully weigh residency programs — they can apply to up to 45 placements as part of SOAP — that will guide their career path for the next few years, PGY-1 intern Asim A., who asked not to be identified further, told Medscape. The alternative is a hasty decision once students learn which residency spots are available, he added. “Applicants would have breathing room to make a more informed decision.”

Asim, who is Canadian, said he is participating in a transitional year in internal medicine in the hopes of being matched into internal medicine or psychiatry. He said Canada’s two-phase match is a “lot less stressful” than the US system.

Meanwhile, students on Reddit’s medical school community also questioned NRMP’s decision.

“A significant majority of those surveyed thought it would be beneficial. But NRMP decides to not go through with it,” one Reddit user wrote. Another posted, “The one thing that could have improved the match and they chose not to do it.”

Others supported the decision to retain a 1-day match.

“I think this was the right call,” Bryan Carmody, MD, an outspoken medical education blogger, tweeted after learning of NRMP’s decision. Carmody, a pediatric nephrologist, previously expressed to Medscape misgivings about whether the two-phase match would make it difficult for programs to thoroughly review candidates and vice versa. Adding that it would compress the interview season and pressure programs to rapidly review applicants and conduct interviews.

More than 8000 people responded to the public survey that began in August and ran for a month. Nearly two thirds of the respondents (60%) were students, residents, or fellows. About 25% included faculty, program directors, and staff. Among the survey findings, respondents were equally divided between whether the two-phase match would be modestly advantageous (30%) or significantly advantageous (30%) compared to 20% who viewed it as modestly or significantly disadvantageous.

The NRMP said it would continue engaging with the community through focus groups and other means to improve the match experience and transition to residency.

“It is important to remember that a proposal is just that,” Lamb told Medscape, “an opportunity to discuss the pros and cons of an idea or framework…and to mitigate unwanted consequences determined to be detrimental to learners and programs.”

The NRMP will involve the community in future discussions “to continue to give learners a voice,” she said.

For more news, follow Medscape on Facebook, Twitter, Instagram, and YouTube.

@oldmom4896

So basically this is really a revision of the SOAP match portion of the match week. Right?

My daughter is just a third-year med student and doesn’t share much. When I saw the article, it sounded like it may be of interest to some of you.

I would agree the SOAP is more like a scramble (which I think it used to be called). I like the idea of a secondary match process for those who don’t match initially.

@WayOutWestMom your thoughts?