The Difficulty of Re-Applying to a
Residency
https://www.youtube.com/watch?v=B_-Pjs2fl0Q
As a fairly optimistic person, I would usually err on the
side of optimism by encouraging a doctor who did not match into a residency the
first time, to re-apply again next year.
However, with all that I have deduced over the last 2 years of research
about the residency shortage, I would worry about setting up an unmatched
doctor for failure. Not matching the
first time is devastating. I actually
fear the outcomes for these doctors with subsequent failures to match. I have heard from several doctors who have
failed to match after 3 or 4 re-applications.
One doctor actually sounded suicidal…This is what caused me to try to
figure out what was happening and why.
I mentioned in my BIO
that I have been on the sidelines of Medical Education for 50 years. Based on my exposure to at least 7 different
residency programs, there appears to be one Program Manager or Administrative
Assistant assigned to the task of managing residency applications at each
program. With the current situation of
the residency shortage, the fear of not matching has caused graduate doctors to
apply to an average of 47 applications each.
The application process has been deluged with almost 2 million applications
per year (42,000 applicants X 47 applications = 1.974 million
applications). Depending upon the
specialty, that amounts to hundreds and thousands of applications to each residency
program, and in turn, to 1 solitary program manager! That is a lot of applications to read! The applications are lengthy as well. They include a personal statement and often 3
letters of recommendation, a dean’s letter, and other credentials. As I have mentioned in a prior blog, several
residencies in my area have received:
- 1,000 applications for 15 positions
- 900 “ “ 20 “
- 1400 “ “ 12 "
Based upon these numbers, I came to the conclusion that a
computer-generated screening device had to be used to “whittle-down” the number
of applications that actually had to be read.
I then realized that due to the “quantitative” screening (e.g. a STEP II
score) performed by a computer, the same applicants would be repeatedly passed
over, even though the applicants may have had additional years of training,
research, etc. This is why my normally optimistic outlook was fearful of
offering false hope to the doctors who had not matched the first time.
Part of me worried that readers would say, “How do YOU know
that is really happening? You don’t work
there…” Another part of me realized no
one would readily admit that this process was occurring. They would want to say, “We read all
applications we receive, and give fair consideration to each.”
So I contacted a residency Program Manager I know
personally, and interviewed her about their application procedures as well as
her other job responsibilities, knowing the full scope of her job would help to
generalize the process somewhat to the other residencies across the US
The crush of applicants has deluged the programs with phone
messages, emails, and cold- call visits.
It is useless to try to make contact with a residency to “state your
case” or get a foot in the door. The
program manager said she answers as many emails and phone calls as she can, and
lets the others go unanswered. Any
impromptu visits by applicants are not given an appointment. So your hands are tied. Your only chance is if your application made
the “cut” in the computer screening of programs with huge numbers of
applications. This is why my normally
optimistic self has become a realist…
- keep track of 27 milestones accomplished for each resident (16 of them), twice/yr.
- organize a week-long orientation program for new residents
- maintain independent contractor contracts for each faculty member
- keep the “on call” schedules (365 days/year)
- process physician payments based on clinic, surgery, on-call, supervision, etc.
- maintain ACGME requirements and credentials
- reimburse and make travel arrangements for faculty
- set up online recommendations system for each monthly rotation for each resident
- read apps, set interviews, arrange visits, answer emails and phone messages
- etc., etc.
At this point you are probably thinking this is too much
information. I thought that providing
this amount of detail would lend credibility to the plight of the unmatched
doctor and their chances of successfully matching with successive
re-applications. I have tried to expose
the “dirty little secrets” of what is going on during the residency
shortage. There are 42,000 applicants
for 32,000 positions each year. This has
to be corrected! It is complete insanity
to discard fully educated and qualified doctors, especially in view of the
projected doctor shortage!
keep it up
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