Half MD: How to fix the scramble before Match Day

The following is reader take by Half MD.

The third Thursday of March each year is Match Day for fourth-year medical students. There are many smiles and frowns made on this day when soon-to-be doctors discover where they will obtain their first job to continue their medical training. While Match Day is the most famous day of the week, Monday and Tuesday are the most nerve-racking.

At noon on Monday, everyone who is participating in the Match will receive an e-mail stating whether or not he/she secured a position for the following year. Those who did not match will then enter the scramble on Tuesday. At noon on this day, a list of all of the nation’s unfilled programs will be released and applicants will try desperately to call and e-mail these programs in an attempt to secure a job. They will also fax and electronically submit their application to any place that sounds remotely interesting. Interviews will be conducted over phones. Deans and department chairs will call in favors from friends known long ago. Of the more than one thousand unfilled positions available during the scramble, over half of them will be taken within four hours.

Participants in the scramble are forbidden from contacting programs prior to noon on Tuesday. Since this is also the time at which the list of unfilled programs is released, participants and their friends will make a mad dash to apply to and contact as many programs as possible in a short amount of time. While there are varying degrees of organization between each group participating in the scramble, when done poorly, the result looks like a frantic day on the New York Stock Exchange with medical students running in circles and yelling, “Buy! Buy! Buy! Sell! Sell! Sell!”

In an effort to bring some organization to the scramble, I suggest the following changes:

1. On Monday at noon, applicants should receive the Did I Match? e-mail. Also, the list of unfilled programs should be released at this time.

2. Applicants should use the ERAS system to apply to these unfilled programs. Applications should not be accepted by fax, e-mail, or telephone, and no one will be allowed to contact programs or vice versa until Tuesday.

3. Tuesday should be reserved for telephone interviews. No spots may be offered during this time.

4. Applicants and programs will submit new rank lists to the National Residency Match Program early on Wednesday morning. The computers at NRMP will then compute a second Match. At noon, participants will receive a second Did I Match? e-mail. If they did not Match a second time, then the scramble will open.

5. At noon on Thursday all participants in both Match I and Match II will discover where they are going for residency.

Half MD is a medical student and blogs at Half MD.com.

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  • B

    Your suggestions are very similar to the way Canada runs its second iteration match. http://www.carms.ca/

  • Anonymous

    As someone in medical school with a partner NOT in medical school, I’ve got to say that I find the justification for the Match unconvincing and frankly find the current arrangement barbaric.

    There is no other profession I can think of that fills positions in this way. We don’t apply to college of medical school in this way, plenty of fellowship positions get filled by a ‘normal’ application process and the world goes on.

    Consider the position of any senior medical student whose partner is not also a senior:
    One partner is forced to enter the job market in a way where, one day in March you find out what city you’ll be in for the next 3-5 years and you then have until July to line up a job in that city.

    The alternative is for the medical student to only apply to programs in one city.

    Neither is desirable. All of these problems are supposed to help us avoid the evil of some well connected medical students securing positions through personal connections. Except that I’m not sure it does that very well. Where are people most likely to match? At their home program where the program knows them well. What can you do to get a leg up at an outside program? Away rotations are almost certainly over-rated, but loads of people have success by having one of their own professors make a call to an old friend/colleague. These are the same deals under another name.

    We’d all be better off by getting rid of the black box and letting US Seniors apply for positions out in the open, with programs making offers on a rolling basis with a date in March as the deadline for accepting initial offers and programs working down waitlists to fill unfilled slots.

    Students could weigh 3-4 offers and take one earlier in the year if they wanted, allowing spouses more time to find jobs and easing problems with relocation.

  • Dave

    For historical reference, the Match was created because previously, the system was a free for all and programs were locking people in to positions earlier and earlier. It may well work better to have a semi-open system with rolling acceptance as long as there were some time constraints.

    The idea of a second match has been around for at least 5-10 years, since I was in medical school. For whatever reasons, the NRMP insists that they cannot turn around the data quickly enough to do a second match in that time frame and the last proposal I saw (when I was in the AMA student section in 2005) was that it would extend the Match process by another 2 weeks.

    Of course, that doesn’t mean the process couldn’t stand for some improvements.

  • halfmd

    There are indeed other professions that use the match. Psychologists apply to internships through their match, and Texas medical schools use a match.

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