Match/Pre-Scramble Research - What Should I Focus On

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Match/Pre-Scramble Research - What Should I Focus On

Match/Pre-Scramble Research - What Should I Focus On

As we get near the match day anxiety builds up. Will I match? How competitive are the programs that I had interviews with? What should I do if I don‘t match? Is there a way to prepare for the Scramble? If any of these questions rings a bell, you are not alone. Join the crowd of applicants that are anxiously waiting for the Match results. This feeling of uncertainty will be with you day and night. It will tickle you through the Super Bowl and Oscar awards up till March 17th, when you have the definitive answer in form of an e-mail from NRMP with the magic words, Congratulations, you matched or less pleasant, Sorry you did not match. The goal of this letter is to help you control your anxiety by estimating your chances of matching as well as preparing you for the worst - The Scramble.

Estimating your chances of matching

  1. The first and most important factor is how well your interviews went. This is your gut feeling and nothing else. So, try to think of positive and negative impressions you could have made.
    1. Did anybody from the program reply to your Thank You Letter?
    2. Did a PD send you a letter asking to rank them high?
    3. Did you manage to make personal connections with any of faculty/residents?
    4. Did anybody give you a hint on whether or not you were well perceived by the program?
    5. What is your overall impression? See our Who Is The Ranking Boss letter we sent earlier for ranking general criteria used by most programs (Academic Performance; Personal Statement; LORs; Compatibility with the Program; Compatibility with the patient population; Altruistic qualities/activities; Sensitivity to Social, Cultural, and Political issues; Communication skills; Commitment to the Specialty)
  1. Second factor is the number of interviews. This is actually the number of positions you interviewed for. You should check quotas for the programs that you interviewed with. Program quota is usually equal to the number of PGY-1 class; however, it can be reduced by pre-matches. You can research if the programs you interviewed with did pre-matches last year by looking up the program at [1] – look at the PreMatches column there. A good number would be 70-90 positions.
  2. Third is the specialty (or specialties) of your interviews. Anesthesiology is more competitive than IM; IM is more competitive than FM, etc. The two most popular IMG specialties, IM and FM, typically require 7 and 4 good interviews respectively for a successful match. There is no way to come up with a magic number, so this is just a general estimate.
  3. Fourth is competitiveness of individual programs you interviewed with. There is no way to assign a number to this factor, so just use your common sense.
    1. Program specialty is one of the most important factors determining competitiveness.
    2. University programs are typically more competitive than Community ones.
    3. Programs with a fellowship are more competitive.
    4. Programs in cities with a medical school are more competitive. Houston is a good example: 4 medical schools located in or around the city make all the programs hard to get to.
    5. Programs in a tri-state area (New York/New Jersey/Connecticut) are very competitive.
    6. Programs in large metropolitan areas are more competitive than in a small city.
    7. Programs that had unfilled spots in the past matches are less competitive. This is one of the few factors that can be measured objectively.

Most of the factors above are subjective and you are the only one who can assign a rank to them based on your own feelings.

A Disaster Plan

It will undoubtedly make you feel better if you did all the homework and know where you stand in terms of matching chances. You will get even more peace of mind if you are prepared for the unexpected - not matching.

  1. Find out what programs are most likely to have open spots. Have these programs pre-selected in ERAS, so that you can apply to the ones that have open spots as soon as the Unfilled Positions List becomes available.
  2. Gather all your documents, so that you have an application ready to be presented to the programs outside of ERAS via E-mail, Fax, or walk-in.
  3. Set up your application for e-mail and fax delivery to the programs by means of friends‘ help, fax service, or a Scramble service.
  4. Know the programs in your city that had unfilled spots in the past and be ready to show up at their doors after you are done sending your application to the unfilled programs.

Research the Programs that Had Unfilled Spots in the Past

One of our sponsors provides a free Program Research tool at [2] Or you can follow this link, [3], and click on the Unfilled Positions link on the main page. If you are not registered, registration is free and does not require sharing your personal information. You will see a list, which you can sort by Specialty, Location, and, most importantly, by the Number of Positions. Here is an example of the top 10 programs that had open spots year after year:

Spec Identifier Program Name State 2007 2006 2005 2004 2003 2002
SU [440-05-21-056-] Los Angeles County-Harbor-UCLA CA 11 13 12 14 9 9
IM [140-35-11-284-] [New York Methodist Hospital Program-] NY 19 9 7 2 9 3
SU [440-16-21-099-] [Loyola University Program-] IL 7 9 7 8 7 9
IM [140-21-21-148-] Louisiana State University (Shreveport) LA 9 7 12 5 8 2
SU [440-35-21-237-] [SUNY Health Science Center at Brooklyn -] NY 13 11 5 10 4
SU [440-35-21-202-] [Albert Einstein College of Medicine -] NY 7 7 4 8 8 6
SU [440-03-22-025-] [Maricopa Medical Center -] AZ 7 9 7 5 6 5
SU [440-33-22-181-] St Barnabas Medical Center NJ 7 8 8 5 6 5
SU [440-41-21-287-] [Penn State University/Milton S Hershey -] PA 7 8 8 5 5 4

You can click on each program to get more detailed information.

Gather Your Documents

You already have ERAS application, why bother? Unfortunately you cannot extract most of the information from ERAS for your own use. You cannot get the LORs, USMLE, and School Transcripts as well as the MSPE. What you can get is your CV/CAF and Personal Statements. You need to combine your documents in separate packages – one per specialty. Have the following documents ready to be sent to the programs:

  • Cover Letter to be sent as a first page of fax transmission or e-mail body
  • CAF or CV
  • Personal Statement
  • LORs
  • Medical School Transcript
  • MSPE
  • USMLE transcripts
  • ECFMG Certificate
  • Your Picture

Sounds easy, right? When you start getting them together, you realize that this is a lot of paper. Your application folder will contain 20-25 pages of various documents. Here are your options:

  • Have the pages handy and feed them to a fax machine as you send the faxes (does not really help with e-mails).
  • Scan them into a PDF file and use it as an attachment to the e-mails you send. You may use the same PDF file when faxing your application either directly from your computer or through a paid fax service. Most of them accept PDFs. The only negative side of PDFs is e-mailing. A PDF file will be quite large, which will slow down sending e-mails as well as cause some e-mails being blocked because of a large attachment or presence of an attachment.
  • Prepare your application as a web page, so that you can just e-mail links to the application web page with the E-mail Cover Letter. You can also print the page into PDF and use it for faxing.

Obviously the last option sounds most attractive. But how do you accomplish that? You are a doctor and not a web designer. Here comes our sponsor again. Residency Place provides a free web page design and hosting service. We would have mentioned this in our newsletter if it wasn‘t free with no strings attached. After you import your ERAS CAF and upload or fax copies of your documents, you get a personal web page that looks like this: [4] Now you can use this link when anybody requests your application package.

Set up your application for e-mail and fax delivery

Here are the options:

  1. Ask your friends and relatives to help you in the Scramble day. The more people/computers you get the better. Make sure you provide some basic training on what they should do. Share copies of your application and links to application packages with them. Provide them with a copy of your cover letter. As soon as the list of unfilled positions becomes available, they should share the load with you. You can share it either by specialty or by geography: Joe is doing IM e-mails, Jane is doing FM e-mails, Bob is doing IM faxes, etc. Review one of the past years lists at [5] and perform some test runs to make sure everybody knows what to do.
  2. Subscribe for a fax service, which lets you fax your application electronically. Just do a Google search for "fax service" and you will see a lot of options. Make sure you do a test well before the Match, so that you know what the steps are and, most importantly, what your documents look like.
  3. Subscribe to a professional service that does both e-mailing and faxing of the documents on your behalf. You still have to handle ERAS application, but this is a much smaller burden. You can use any of our sponsors depending on your needs: [] and [] . When you consider a service, make sure your application is not delivered in bulk, is individualized, and the unfilled positions list is cross-referenced with a pre-set program information, so if a program does not have e-mail or fax in the list, your application is delivered to the address on file.

Get your ERAS application ready

ERAS is the best way to deliver your application to the programs. Unfortunately there is a 45 application limit. This is a reasonable limit for a US graduate. However, it is too low for an IMG. This is why you still need e-mails and faxes. You must optimize your ERAS application to make sure you do it as fast as possible. Select the programs that you found in the Past Years Unfilled Positions Lists, [6], a couple of days before the Match. This way, when this year‘s Unfilled Positions List comes up, you already have them selected and the only thing left to do is check appropriate boxes for these programs and click Apply. This will take you only a couple of minutes and put you ahead of others who are cross referencing programs only after the list has come up.

Relax and enjoy your time off

Now, after you did everything you could, to prepare for the worst, you can afford to enjoy your time off. Enjoy the Super Bowl. If you do not care about the game, enjoy the commercials and the Half-Time Show. Enjoy the Oscars. Hopefully you won‘t have time to do that in the nearest three years.

Good Luck!