The AAMC has recommended that residency programs offer only virtual interviews for the upcoming season.
Who wins, and who loses? Let’s find out!
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WINNER: Homegrown applicants.
Every year, many students choose to stay at the same institution for residency. Many PDs will be eager to snap up these “known quantities” from an otherwise more uncertain applicant pool.
LOSER: DOs and IMGs, who may not have a “home” program.
WINNER: Student travel budgets.
Previously, many applicants spent upwards of five figures traveling to in-person interviews. You gotta try *really* hard to spend that kind of money sitting in your living room doing Zoom and WebEx interviews.
LOSER: Student ERAS budgets.
For years, the number of programs to which students apply has been steadily increasing. Throw in all the extra uncertainties of this application season, and I think it’s safe to expect a new record for 2020-2021.
WINNER: The AAMC.
ERA$ was already the AAMC’s cash cow. And if applications climb even higher this season - which they will unless we impose some limits - it will benefit no one more than the AAMC.
LOSER: Community and lesser-known programs.
If you can’t see the program in real life, which program would YOU rank more highly?
A) a lesser-known program
B) whatever the Doximity/USNWR rankings say is the “best” program
(Yeah, me too.)
WINNER: Residency programs with good web-designers, Instagram managers, and videographers.
If you’re asking applicants to come to your program sight unseen, you’d better show them as much as you can online. Those that do it well will prosper on Match Day.
LOSER: Programs that don’t increase the number of applicants interviewed.
Last year, a qualified applicant with 50 interview offers had to choose ~15 programs to travel to. Now, they can interview at all 50. Programs that don’t interview more applicants will risk going unfilled.
WINNER: The attractive and non-obese.
Already, these applicants enjoy an advantage equivalent to around 10 points on USMLE Step 1. You’ve got to think that will be magnified even more when all PDs have to go on is somebody’s head on a screen.
Will a short virtual interview be more bias-affirming than a more in-depth in person interview? (I fear it might... but I’d be happy to be wrong on this one.)
WINNER: Public health.
I have deep reservations about the consequences of this recommendation... but we’re all in the business of helping patients, and it’s hard to justify having 40,000 applicants flying from hospital to hospital this fall/winter. Less travel = lives saved.
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The reason a physician in graduate medical education training is called a “resident” is because back in the day, they *literally* lived in the hospital.
(a short thread)
One text recommended two medical and two surgical residents per 100 beds, a number which would “prove sufficient for all purposes.”
(If you’re wondering why the residents lived on the upper floors, it’s because “in case of fire, they, being in good health, could easily escape.”)
But that’s not all.
A century ago, residency had no fixed time endpoint - training could last any amount of time.
Most programs also had a ‘pyramid’ structure, in which many interns competed for fewer resident positions at each level and ultimately just one chief resident spot.
Well, another residency application season is in the books.
And in 2019, the average residency applicant (all comers) submitted 92 residency applications.
Yes.
NINETY-TWO.
And each year, this number creeps higher and higher.
We need to talk about this.
(thread)
First:
Can we please stop defending application inflation by saying that applicants *HAVE* to apply to so many programs because the number of residency programs isn’t growing at the same rate as applicants?
It’s not true.
Statistically-speaking, there’s never been a better time IN THE PAST 50 YEARS for a graduating U.S. medical student to get a PGY-1 position.
But don’t take my word for it - let’s get it straight from @TheNRMP.
Since the announcement that Step 1 will go pass/fail, there’s been a growing false narrative that USMLE scores allowed IMGs to compete on a level playing field with U.S. MDs for competitive residencies.
Here is the uncomfortable truth - and what to do about it.
(thread)
Even with a scored USMLE Step 1, DOs and IMGs were not “beating out” U.S. MDs for competitive residency positions or specialties.
Does this look like a level playing field?
Almost all IMGs match in specialties in which there are not enough U.S. MD graduates to fill the available positions. The number of IMGs who match in competitive fields (like surgical subspecialties) is vanishingly small.
It’s striking to me how the interviewee poignantly shares his own story of burnout from his internship - which occurred “before duty hours were truly implemented” - but seems largely oblivious to the fact that *systems* contribute to student burnout today.