OT: Medical School Match Day
I hope that this is not too OT for the board today but good luck to all of the Michigan Medical Students who have their match day today at noon. All the hard work by these individuals will finally be realized when they match for residency. I have been looking forward to this day for fiance to match for months now. We are hoping to match here at Michigan!
Good luck and GO BLUE!
[EDIT]- My fiance matched here at Michigan!
Going to Medical School nowadays is a sucker bet. The only way to make real money in the future will be going into private practice to do cosmetic surgery for the Baby Boomers. And when you graduate with $300k in debt, that's tough to do.
Depends where you did undergrad. There are some people who go to Michigan out of state, and graduate undergrad with $250k in debt. If you stack Medical School on top of that, it's probably $400-500k.
There's nothing like a nice $5000 per month student loan payment for ten years.
In-state tuition is now $35K a year, with living expenses, books, notes and fees, $53K/year
Barf
http://financialaid.med.wayne.edu/cost-of-attendance.php
aka a metric fuckload.
I'm going to disagree with a lot of people here: the match itself is a great idea.
It is definitely a challenging process, and getting everyone together at noon with envelopes is not necessarily the best way to announce results (plus there are a pile of other issues with medical education), but the match is much better than the alternative. Compared to other grad programs, residencies have very limited space, and very strong needs to fill that space exactly (even being one resident short can have a huge impact in all but the largest programs), which would exacerbate the problems of doing this the more traditional way.
The alternative is for residency programs to grant acceptances to however many people they have space for, and applicants to have a deadline to accept them. The problem is that they need to fill their spaces, so, if they have too few people accept (which they almost certainly would), they need to ask the next people down on their list. If those people switch, then that residency program needs to get new people, and this creates a domino effect where programs are constantly trying to entice people to switch, and almost every program is scrambling to find people, and people keep shifting which residency they're going to.
Not only is that system chaotic to an extreme, it means programs have an incentive to choose less qualified candidates who they think are more likely to stick with the program. More limited acceptances also means there are a lot of unmatched residents who keep hoping a program will sink to calling them (which would happen a lot in this system, but it would really not be fun to be in limbo for a long time).
Instead, that process gets automated and so it happens out of sight, and all you see is the final result. It makes for a terrifying day, but it really is better than the alternative. In my opinion, one of the best advantages is that everyone gets the best results if they are truthful: a program gets to say who they really would prefer, even if they think the student would prefer to be somewhere else.
It won the Nobel Prize in economics because it's so much better than the alternative (okay, I guess the guy who studied it won the prize, but whatever).
outside of the show...i would agree that the match process is the best, most fair way to assign residencies.
Excuse my ignorance (I'm just a caveman lawyer; your world frightens and confuses me), but what happens if you don't match? Is your career hosed, or can you just try again next year?
(Good luck and/or congrats to all the Michigan grads, BTW.)
There is a managed scramble for open positions. There is a list of programs with open positions that you and everyone else who didn't match into a program can apply to a certain number on the first day. If one of the programs you applied to wants to interview you they set something up and so on with the other programs you applied to. You and the program submit a rank list and the computer tells you whether there is a match. If no match the process repeats itself with an updated list of the programs from round one that still have open spots. I think there are 3 or 4 rounds of this and by then there is almost nothing left.
If you still haven't secured a spot you basically have to find a job. Which in itself isn't easy as you have a professional degree without a profession... people do research if they can find someone to take them on or one person my wife knew took an admin position at a hospital. There will be spots that open up during the year (people can't get visas in time to start, people get fired, etc.) that you can apply for but this is real longshot.
You can apply and interview the next year but each year you're out of med school it gets successively harder as you're further away from your grad date. There is also the issue mentioned above that there are more med students being churned out each year without a corresponding increase in residencies. Most places would rather take on a fresh grad than someone who failed to match in previous cycles.
The person I mentioned above who took the admin position eventually matched two years later but she was extremely lucky and most people are pretty much screwed after not matching once or twice.
Thanks!
Are the subsequent rounds sort of like a seconday match program? Also, what are the most common reasons for not matching? Are the people who don't match the ones who aimed too high (e.g., applied only to neurosurgery residencies despite mediocre numbers)? Are they socially inept who couldn't hack it in their interviews? Or is it just the bottom of the class types?
Exactly right, the "scramble" used to be a more typical offer/accept process, but now each day is basically its own match process for people that didn't match and programs that have vacancies.
At Michigan, people who don't match tend to be people who at least somewhat shot themselves in the foot--either by not interviewing with/listing enough schools or by only going for a program above their ability (you can actually list several different programs--so if you want to do neurosurgery but your numbers are borderline for that, you can also list programs in general surgery, and then general internal medicine if you really want to have a long list--the only limitation is that a small set of areas have a different match process). Bottom of the class or bad at interviewing people generally had enough sense (and warnings from the advising office) to expand their interview process, and list a lot of backups.
It's not always bad decision-making, though, since lives are very complicated. My wife flirted with this danger some because she only listed programs in the area where I was working (it would have been hard for me to find a job like my current one near a random residency, and she decided to take the risk of not matching). The advising office definitely let her know they wanted a bigger list, but she decided she'd rather sit out a year if it came to it--in all honesty, she was pretty tired of medicine by that point which influenced her decision. Fortunately, it all worked out (not entirely dumb luck--I considered potential residencies when I was doing the job hunt the year before, and intentionally landed somewhere with a lot of them). Even better, she's done with her residency (which, while still incredibly hard, was much better than med school) and has a great job.
My impression from a couple of friends at a less prestigious program (including one I went to match day with) is that it's easier to not match because you get less leeway for being bottom of the class or a bad interviewer. Even then, I think the majority who didn't match probably didn't calibrate their expecations properly (i.e. aimed too high without good backups or didn't apply to enough programs), but perhaps others would disagree with me.
You have to scramble and try to find a program in the field you wish to study that did not fill all of it's residency slots. Depending on the specialty you are interested in it may be fairly easy (but you have to be flexible where you are going to live for a number of years, and it may not be the best program) or impossible for the upcoming year (in the very popular specialties.)
Occasionally a slot opens up because of unforeseen events and you may be able to wiggle your way into the slot if you are at the right place at the right time; more often you either start training in a less popular field and try to transfer after a year, or do a research year somewhere to burnish your resume' and try again the following year.
If you did not get into a less popular field to begin with you likely had a bad academic record, did not interview at enough instititions, are bad at interviewing, or went to school off-shore or a DO school ( and I have had residents fom both, one of whom later became my partner, but the success rate from these schools is lower, particularly is you apply for residencies on the coastlines or heavy academic/research universities.)
Interesting, thanks.
Related question: how hard is it for DOs to get the most competitive residencies (surgery and the like)? If all else is equal between an MD and a DO candidate for such a residency (grades, board scores, interviews, etc), is the DO at a huge disadvantage? The other day, a family member was referred to a neurosurgeon who was a DO, but I wonder if that guy was like the four-leaf clover of neurosurgeons...
neurosugery residency spots were filled by D.O. students. So pretty much four-leaf clover. But not base don any innate disadvantage...I just think D.O. prepares you for different stuff.
http://www.nrmp.org/wp-content/uploads/2014/04/Main-Match-Results-and-D…
I don't know much about D.O. school other than what my buddies and google tell me, plus the handful of MSU D.O. students who are at the Detroit campus.
The deck is definitely stacked against DOs getting residency slots at a place like U of M, but it is not as stacked as it used to be. It also totally depends on the speciaty. Dermatology or Orthopedics - very little chance as most competitive. Pediatrics - definite chance. We occasionaly take DO candidates in our program and in today's world I see no difference in how well they turn out at the end of residency.
So if I'm interested in orthopedic surgery, will I still be at a disadvantage if I go to a DO school?
1 D.O. student matched into orthopedic surgery last year...in the country.
vs. 649 M.D. students.
http://www.nrmp.org/wp-content/uploads/2014/04/Main-Match-Results-and-D…
page 30 and 31
Edit: don't listen to me on this matter. Guess I don't really know too much on this stuff.
But there are also DO specific orthopaedic programs.
6 in one hand, 1/2 dozen in the other.
If you have the choice, and you have a strong passion for an extremely competitive program like ortho, choose an MD school. It IS more likely just due to sheer numbers of residencies and perhaps a number of other factors. If you live and want to practice in a place like Michigan, Florida, Arizona, or Pennsylvania, these are considered "DO friendly" states. i.e. they have many current DOs working in the state as well as prominent DO programs. They have ACGME residency programs with many DOs as attendings and as residents. In a state like California...not so much.
Location matters. Academic center vs. Community hospital programs matter. If you're looking at a residency at UCLA medical center in orthopedic surgery, a DO degree would probably eliminate you.
Remember though, there are 141 or so MD schools compared to 30 DO schools. So if theres 650 MD students matching in ortho, there's prob 5X that applying to that as compared to a DO applying to that program. So that also will skew the statistics. DOs going into a competitive need to be smart and resourceful in how and where they apply. The thing is, I'd really say that for MDs as well.
Btw they just opened a new DO ortho residency program in MI.
Very helpful information from all of you. You have no idea how much I appreciate this. I was thinking of going to a DO school (after UM) but now I think a MD school would be better for me. I'll still apply and used it as a last resort if I get accepted.
I would put it this way:
Ease of post-graduation life: US MD > US DO > Carib or International MD
Personalize the other factors like cost, location, curriculum, interest in research, and your personal "feel" of the school when you go and interview. I chose a less "prestigeous" DO school vs a prominent one because I felt it was a place that would provide a great support system. I have no way of knowing whether or not my future has been negatively altered in some way as a result of this decision, but so far I'm very pleased with my decision to pick a school based on those factors.
Med school is becoming more competitive every year. Make sure you know you want to do it and get ready for the ride!
I am a UM undergrad and UMMS alum and trained at highly orthopaedic surgery programs. Along the road (and through first-hand adversity), I learned not to judge DOs or anyone for that matter without looking at the entire picture. Some of the best surgeons I've trained with have been DOs.
It is my opinion that undergrads aim for MD programs and most people settle for DO schools if they don't get in. For whatever reason some great candidates don't get into MD programs and kill it later on. Perhaps they had a bad test day or lacked maturity in undergrad or just fell through the cracks. Again, it's the finished product that matters.
Longtime lurker, first time poster here. Best of luck to those matching today.
Another wrinkle that hasn't been mentioned (for those match virgins out there) is that numerous specialities have an early match with a seperate timeline. Might not be a big deal, until you're trying to couples match and your wife matches early in Maine for optho and then you open your envelope a few weeks later and find out you've matched in Alaska for peds. Ahyhow, enjoy residency, fellowship is harder :)
Hope y'all had a great day!
Went through the match today. Those last five minutes were nerve racking as hell. I can happily say, after enduring 8 years at our rival schools, I am finally a Wolverine!