Scrambled Eggs and Other Facts

I thought I’d take some time to give further information on a couple comments from yesterday.

what exactly can your dean's office blame on the students? I am confused by that remark, it seems that any blame would reside on the people who make up the curriculum for the students.

Our school started a new curriculum with my class. In fact, we were the class that had to go through everything new – EVERYTHING. Just to let us know that we weren’t forgotten in our last year, they added an additional class late last summer that screwed up a lot of schedules and didn’t know what to do about the extra month’s requirement until January. Because of these road bumps and obstacles our class expressed ourselves regularly. Some of us, me included, were old enough to know when we needed to be in class and when it was just smoke being blown up our ass. The faculty didn’t like people not coming and responded with grades being marred by poor attendance. Because the administration felt we were being recalcitrant the hospital staff was alerted to our disdainful attitudes during our first year. Any form of disagreement we expressed, about anything, began to be viewed with a roll of the eyes and a lecture about what life’s really like in the hospital and as a physician– so we’d better just shut up and take it. That’s what I meant by the school holding it against us – they’ve felt we weren’t properly humble and appreciative of some of the bullshit they’ve laid out before us and have lectured the incoming classes to not listen to our sage advice. It's absurd, since it's they're curriculum and we're providing feedback that should be evaluated, but they've wanted us to fail (I feel) in order to justify to themselves that we were just bad apples.

From an outsider's perspective, what does the "scramble" mean - do they still have a chance of entering into the specialty they want?

Perhaps. Scrambling, or the new PC term “rematching” refers to the chaotic mess that is the Tuesday afternoon that follows Match Monday when everyone finds out their match status. On this day those students who were unlucky enough to not match are allowed to see the residencies that didn’t completely fill their spots and contact them. Naturally it is expected that if a specialty is competitive there is a lot less chance that there are any open spots. The students and the dean’s office have to coordinate information and delivery to various programs that the student called or e-mailed and was asked to submit their application. Sometimes people “rematch” by submitting their ERAS app only, but others have to purchase plane tickets and try to interview between Tuesday and Wednesday. Many times people enter fields they aren’t interested in just to have a job for a year with the intention of entering the match next year. It sucks (from what I’ve heard and seen) and is rather stressful for all involved. Since surgery and OB/Gyn are more competitive it’s likely that people will have less chance of getting into these fields and may end up in Medicine or Peds for a while.

you have to keep in mind that sometimes the scramble rate has nothing to do with the school and a lot to do with the choices people make when they rank...ie where they will live, not giving up on wanting that super competitive spot. and then you have the limitation of the number of interviews you are granted which limits your rank list. scrambling is really just a clusterf**k of many variables.

Correct. I honestly think that some of the people were just not honest with themselves about their chances. Last year a girl had to scramble because she only applied to Derm, wasn’t a great candidate to begin with, and the school has never had a student match in Dermatology. Stupid. If you want to try and get into something highly competitive or into a specific location you need to understand that you’re risking a lot. Suicide matching (trying to get in to only 1 or 2 programs) for whatever reason is also extremely risky and can really screw you. It is worth it to review data from the previous match year on the field you’re entertaining (like the number of places ranked that resulted in higher match rates - Anesthesia was around 10 for a 100% match rate), having frank discussions with people in the field about your chances, and applying to some safety nets to avoid having to scramble - those being a poorer program than you’d like or fields that aren’t as competitive.

I think part of the problem as well is our school’s reputation in certain areas (since I was asked a few times why I was a student there), but more likely bad luck and other factors affected our class. One person with whom I'd talked with had interviewed at enough places, but the programs didn’t take a large number of residents which narrowed the chances. Those are other things that must be considered – 11 programs interviewed with and ranked, but each taking only 5-6 residents, really makes it harder.

Ultimately I think we have a very high unmatched number regardless of a smaller class size (less than a hundred), but I’m really not sure. We’ve only ever been told about the school’s match numbers after everyone scrambled at which point it was nearer the 90th percentile – so maybe we’re not worse. It’s scary as hell though.