Yesterday was Match Day, when all fourth-year medical students nationwide learn where their medical careers will begin. While we tend to think about our own medical students on Match Day, an important group of medical educators are thinking about something else—the incoming class of residents.
As the reputation of UMass Medical School grows, so too does the number and quality of applicants to the residency programs. In addition to attracting 15 new residents from among our own competitive class of graduates, this year’s residents come from medical schools as far away as Tulane and Washington University and as nearby as Harvard and Boston University.
“We have over the last couple of years attracted people from all over the country, and that’s a result of our growing reputation,” said Deborah DeMarco, MD, senior associate dean for clinical affairs and professor of medicine. .
The Office of Graduate Medical Education oversees the recruitment of more than 135 residents who will join UMass Medical School and clinical partner UMass Memorial Health Care this summer. The directors of the residency programs at UMMS were just as eager to learn the results of the match as were the fourth-year students who gathered in the Faculty Conference Room yesterday. Thursday marked for them, too, the end of a months-long search for just the right individuals.
The process begins in the fall, when fourth-year students begin filing their residency applications. Residency directors begin poring over the applications, looking for interested candidates who fit the unique criterion of each program. The next step is to set up interviews with applicants, which generally happen in the late fall and winter and are an essential part of the evaluation process.
“From the program side, it’s a pretty anxiety provoking process. The programs put a lot of time and effort into it. For example, Internal Medicine probably interviews 300 people for its 28 openings,” said Dr. DeMarco. Even in smaller programs where there is a lot of competition for a handful of spots, the outlay of time and effort by the programs is large. This can mean an extensive interview process with multiple people or residency selection committees involved. Usually, current residents themselves have an informal role in the interview process—they often lead the tours and share their impressions of how the applicants comported themselves.
“It is important to the dynamic of the program to ensure that the incoming residents are a good fit for the program and the institution,” said Dr. DeMarco. “We’re trying to promote cohesiveness, collegiality, professionalism. Those are the intangible things that are hard to get at.”
In addition to interviews, applicants are evaluated on the basis of their educational records, letters of recommendation, standardized test scores, clinical evaluations and their personal statements. Once all the interviews have been conducted and application materials reviewed, the prospective residents are ranked by the residency program and the information goes into the National Resident Matching Program (NRMP) database. The applicants also rank the institutions where they have interviewed. The aggregate information is then analyzed by the NRMP system and the matches are made.
The NRMP computer algorithm is more favorable to applicants than to programs, meaning that the NRMP attempts to match each applicant with his or her first choice, and will continue to try to match the applicant based on the order in which he or she has ranked the institutions. For example, if an applicant has UMMS as his or her first choice in internal medicine, the match will be made if the applicant is ranked by UMMS.
Announcing residency matches is a multistep process that begins on the Monday preceding Match Day, when fourth-year medical students are told whether or not they have matched, but not where. On Tuesday at noon, residency program directors are notified of whether or not all of their spots are filled. Thus begins the “scramble,” an anxiety-filled 48 hours when the handful of fourth-year students who didn’t match scramble to find their place among the handful of spots left open in residency programs. Last year, UMMS didn’t have to scramble at all—all slots were filled through the main match (with the exception of preliminary surgery, which strategically chose to fill all slots during the scramble), and this year, only three openings needed to be filled during the scramble (again, excluding preliminary surgery).