Match Day for American doctors and foreign medical grads

Today is Match Day for the National Resident Matching Program. Congratulations to all the newly matched residents.

Here are some articles in honor of match day, concerning difficulties in the interviewing process that proceeds the formal match, and some other things (including the US travel ban that is once again being adjudicated):

Match Day is coming up. Here’s how medical students game the residency system
"Writing love letters

This is the most common way to game the match. Applicants send emails to residency program directors expressing their interest in the program, hoping to influence how the director ranks them. Applicants sometimes end up writing multiple letters professing their love to different programs. Sometimes, they tell more than one program director that their program is their first choice.

While programs often say that they don’t adjust their rankings based on “love letters,” some do. For one of my friends, a residency director for surgery told her, “the love letter could be a deciding factor in how we rank you.”

So, we’re stuck: If you don’t send one, it might look like you’re not interested."
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Am Surg. 2016 Dec 1;82(12):1163-1168.

Behind the Match Process: Is There Any Financial Difference Lurking Below the Specialty of Choice?

Oladeji LO1, Raley JA, Smith S, Perez JL, McGwin G, Ponce BA

Abstract: The Match was developed in response to a chaotic residency selection process. While the match has remained relatively unchanged since it was introduced, the number of medical school graduates has increased at a rate outpacing the number of residency positions leading to a more competitive process for applicants. In May 2014, an 18-question mixed-response questionnaire was distributed to fourth year allopathic medical students via an E-mail distribution list for student affairs representatives. The individual surveys were accessible via SurveyMonkey and available for completion over the course of a 4-week period. Approximately 65.1 per cent of students performed at least one audition rotation and documented average expenditures of $2494 on housing, food, and transportation. The average applicant applied to 32 programs and attended 12 interviews while spending $4420 on the interview trail. Applicants for surgical programs applied to approximately 42 programs and attended 13 interviews compared with primary care applicants who averaged 23 programs (P < 0.001) and attended 12 interviews (P = 0.002). Surgical applicants averaged 20 days on the interview trail while spending $5500 ($423/interview) on housing, food, and transportation compared with primary care applicants averaged 19 days away from home (P < 0.05) and spending $3400 ($283/interview) on these same items (P < 0.001). The findings in our study indicate that the "Match process" contributes to the financial burden of graduating medical students and it is more expensive and time consuming for the candidates interested in surgical specialties.

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No Heart Surgeon Match Day for Major Medical Center
Columbia University missed deadline to submit residents' ranking list
"Medical students hoping to train in cardiothoracic surgery at New York-Presbyterian/Columbia University Medical Center in New York City got some bad news over the weekend: The center will not be able to select residents in Match Day for cardiothoracic surgery.
The center confirmed Monday that it missed the deadline to submit its ranking list for residents in the specialty."
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And this:( 
Travel Ban Adds Stress To 'Match Week' For Some Doctors

Here incidentally is the NRMP statement on the travel ban:

NRMP Statement On The Executive Order On Immigration

February 3, 2017

NRMP has released a statement on the Administration’s Executive Order on immigration. We ask the medical education community to support all international medical graduates and their families during these difficult times. Please be assured that NRMP will do all it can to address the uncertainties the order has created. As for the current Match cycle, we hope that applicants and programs will continue to rank each other in the order of true preference, based on the qualifications and qualities each seeks in the other.

NRMP statement

Maria C. Savoia, M.D., Chair
Mona M. Signer, President and CEO

What do immigrant doctors affected by the travel ban bring to America?

"What do immigrant doctors bring to America" is the question asked (and answered) by The Immigrant Doctors Project, a website compiled by a team of youthful looking scholars in response to the six country travel ban reinstated by the White House after an earlier version was found illegal by the courts.

One of the authors, Jonathan Roth, is quoted at length in a news article on the particular effect this ban may have in Los Angeles: Hundreds of doctors in LA County could be affected by new travel ban

"The executive order, which is due to go into effect on Thursday, temporarily blocks visas from being issued to citizens of Iran, Libya, Somalia, Syria, Sudan and Yemen to "to protect the Nation from terrorist activities by foreign nationals." The ban does not include permanent residents and those who already have visas, but doctors applying for new visas or seeking to renew expired ones would require a waiver. Several states are challenging the order's constitutionality in court.

"Los Angeles is actually the metro area in the United States which has the highest number of doctors from the banned countries," according to Jonathan Roth, a Harvard PhD student and one of the researchers who worked on the Immigrant Doctors Project.  

Roth, along with other researchers from Harvard and MIT, used the location of the medical school where a doctor was trained as a way to calculate a doctor's country of origin. Since many doctors train abroad, Roth says it's likely that the number of doctors affected by the ban is much larger than their estimates. 

More than 900 doctors in Los Angeles went to medical school in one of the six countries listed in the executive order, more than three-quarters of them in Iran, he says. "

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You can here a brief interview with Jonathan R. here: http://www.byuradio.org/episode/01e0c780-5621-4307-ba99-954c81776308?playhead=2440&autoplay=true
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Tomorrow is Match Day for new medical residents and fellows, and we have yet to hear how the immigration ban may have affected this year's match. (See earlier post: Travel bans and rank order lists for the resident match)

Travel bans and rank order lists for the resident match

Residency programs have to submit their rank order lists of applicants by Feb 22. Should they try to match with doctors from countries subject to a possible renewed US travel ban?

Travel Ban Confusion Complicates Match Day Decisions

"UPDATE:  The Trump administration announced February 16 that it would discontinue its legal push in appeals court to reinstate their travel ban, but would instead issue a new, revised immigration order next week. No other details were given.

As medical school students look ahead to Match Day on Friday, March 17, some international students have additional anxiety in light of the uncertainty surrounding President Trump's executive order banning travel for people in seven Muslim-majority countries.

Residency programs also have to decide whether they will hold spots for students from the targeted countries who may not be allowed to come to the United States if legal rulings change.

First comes decision day February 22, when preferences must be ranked by both programs and students.

"Some applicants are concerned that the program directors won't rank them and there's concern from programs on whether the students can begin training on time," Mona Signer, president and CEO of the National Resident Matching Program (NRMP), told Medscape Medical News.

Trump's executive order, issued on January 27, aims to prevent citizens of seven majority-Muslim countries — Iran, Iraq, Libya, Somalia, Sudan, Syria, and Yemen — from entering the United States for 90 days. It suspended entry of all refugees for 120 days and barred refugees from Syria indefinitely. A federal judge has since imposed an emergency stay, halting the key parts of the executive order.

The administration's next step is unclear, but news sources have reported that Trump may take the fight to the Supreme Court or issue a revised order.

According to the Association of American Medical Colleges (AAMC), 260 medical students have applied to US residency programs from the seven countries the ban covers.

Questions include whether the ban will be reinstated, and, if it is reinstated, whether medical students would be exempted. Some worry the ban could spread to other countries. Last year, 3769 non-US citizens who studied medicine abroad matched into a US residency program, according to the American College of Physicians."

An interview about travel bans, and universities, and science...

NOBELPREISTRÄGER ALVIN ROTH ZUM EINREISEVERBOT

„Grenzschließung wäre eine große Schande“

von:

• Thomas Jahn

Datum:

• 14.02.2017 11:05 Uhr

PREMIUMStanford-Professor und Nobelpreisträger Alvin Roth sorgt sich um den Forschungsstandort USA. Im Interview spricht er über die Folgen von Donald Trumps Einreiseverboten und die Universitäten als Spiegelbild Amerikas.

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Nobelpreisträger Roth

„Wir haben viele Vorteile durch Einwanderung – Universitäten profitieren ganz besonders.“

(Foto: AFP)

Im Jahr 2012 gewann Alvin Roth den Nobelpreis für Wirtschaftswissenschaften. Der 65-Jährige, der an der Universität Stanford in Kalifornien lehrt, macht sich Sorgen um den Forschungsstandort Amerika.

It's in German, and it's gated, but the interviewer asked me what I thought the effects of travel bans and immigration bans would be on the U.S. I replied that universities are in some ways a microcosm of the US, in that both have thrived by being open to participation from people around the world.  Universities, American science, and America will all suffer if we cut ourselves off from the rest of the world.

U.S. academic conferences and the travel ban. What would be the effect of a boycott? Can conferences usefully be moved?

Part of the international reaction to the recent U.S. travel ban on people from seven countries has been a call to boycott U.S. academic conferences.
Here, e.g. is one such call: In Solidarity with People Affected by the ‘Muslim Ban’: Call for an Academic Boycott of International Conferences held in the US
"Among those affected by the Order are academics and students who are unable to participate in conferences and the free communication of ideas. We the undersigned take action in solidarity with those affected by Trump’s Executive Order by pledging not to attend international conferences in the US while the ban persists. We question the intellectual integrity of these spaces and the dialogues they are designed to encourage while Muslim colleagues are explicitly excluded from them."

I have had an opportunity to think about this regarding the ASSA conference run in January by the American Economic Association, and it seems to me that such a boycott won't help the majority of academics (students and professors) from the banned countries who come to our conference, or to many American academic conferences.

In our (the AEA's) particular situation, my sense is that we have had few if any Yemeni and Sudanese economists participating in the AEA meetings, and the people potentially affected by the current U.S. entry bans are mostly Iranian.*  And the majority of Iranians who have participated seem to be working or studying in the U.S.

So…if a travel ban is in place next January, and we moved the conference to some civilized city like Toronto, we would be depriving most of the potential Iranian participants of the ability to attend, since they couldn’t leave and then reliably re-enter the U.S..

My current sense is that the AEA will decide to take care of the Iranians as best we can (which for the minority who aren’t in the U.S. may involve some electronic communication efforts), rather than cater to any economists whose scruples would require us to abandon the Iranians living and working in the U.S.  by moving the conference elsewhere.

To be clear, I think moving the AEA meetings outside of the U.S. would harm the majority of Iranians who participated in past years.

Of course I’m hopeful that we’ll have come to our senses long before then.


*see this article in the Chronicle for a wider view of who studies in the U.S.:
Why the Travel Ban Probably Hits Iranian Professors and Students the Hardest

see also the data compiled by the Institute of International Education:
 International Students: All Places of Origin 2014/15 - 2015/16, and for previous years:  2016 | 2015 | 2014 | 2013 | 2012 | 2011 | 2010 | 2009 | 2008 | 2007 | 2006 | 2005 | 2004 | 2003 | 2002
Selected Years 1950-2000
and see
Universities Spoke Up in Case That Led to Ruling Halting Trump’s Travel Ban

Rotman School of Management is offering to help business scholars and students affected by the US restrictions

A worthwhile Canadian initiative from the Rotman School of the University of Toronto:

Rotman School of Management is offering to help business scholars and students affected by the US restrictions

Market for ideas vs travel bans: academic societies and universities react

A large group of scientific societies have signed this Multisociety letter deploring the recent Executive Order regarding travel to the U.S.  (The American Economic Association is represented through its membership in COSSA, the Consortium of Social Sciences Associations.)
http://www.cossa.org/wp-content/uploads/2017/01/Multisociety-Letter-on-Immigration-1-31-2017.pdf
"The Executive Order will discourage many of the best and brightest international students, scholars, engineers and scientists from studying and working, attending academic and scientific conferences, or seeking to build new businesses in the United States. Implementation of this policy will compromise the United States’ ability to attract international scientific talent and maintain scientific and economic leadership.
Today, we urge the Administration to rescind the Executive Order and we stand ready to assist you in crafting an immigration and visa policy that advances U.S. prosperity and ensures strong borders while staying true to foundational American principles as a nation of immigrants. "

Below are a variety of other reactions (in no particular order), many of which balance charters which require some scientific societies to be nonpartisan, with the concern that the recent Executive Order negatively affects their core mission.

http://president.mit.edu/speeches-writing/best-serve-nation-and-world

http://www.asanet.org/news-events/asa-news/statement-american-sociological-association-concerning-new-administrations-recent-and-future

AMS Board of Trustees Opposes Executive Order on Immigration 
Monday January 30th 2017

Statement from the International Association for Cryptologic Research (IACR)

Condemning the U.S. President’s 2017-01-27 Executive Order

Barring Entry into the U.S. of Citizens from Seven Muslim-Majority Countries

https://www.insidehighered.com/news/2017/01/30/higher-education-leaders-denounce-trumps-travel-ban

https://www.macalester.edu/president/writing/statement-january2017executiveorders.pdf
"We are heartbroken and we are angry, but we are not defeated. This is far from the first, and will not be the last, shameful moment in our country’s history. But at every one of those moments, people have arisen to call forth and inspire “the better angels of our nature.”

http://news.stanford.edu/2017/01/28/community-letter-stanford-leadership-immigration/

http://www.harvard.edu/president/news/2017/we-are-all-harvard

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Update: February 3 letter from American Council on Education, signed by about 600 colleges and universities, to the Secretary of Homeland Security 
http://www.acenet.edu/news-room/Documents/Letter-From-Institutions-to-DHS-on-Immigration-Executive-Order.pdf

Academics against blanket immigration bans

As you may have heard, President Trump has signed an executive order that, among other things, temporarily bans visa entry to the U.S. for people from several countries (including Iran, which sends many students to U.S. universities, including many who remain as professors and in industry). It also takes a position I strongly disapprove about refugees (and was signed on Holocaust Remembrance Day, an occasion for me to recall with regret that we Americans did not rise well to the occasion of welcoming Jewish refugees from that genocide). I am among many academics who have signed a petition deploring these measures and imploring that they be reconsidered.

Here's the petition, still open for signatures.

Academics against immigration executive order

And here's a story in the Washington Post that explains some of the issues that particularly concern academics in our professional roles (and not just as American patriots committed to the freedom of ideas and many other freedoms).

12 Nobel laureates, thousands of academics sign protest of Trump immigration order
"What’s at stake, said Emery Berger, a professor in the College of Information and Computer Sciences at the University of Massachusetts Amherst, who is not one of the organizers of the petition but supports the effort, begins with free exchange of information.

"But there’s more. He said he has already heard academics overseas planning to avoid, or boycott, conferences in the United States. “It’s very chilling,” he said.

"Students are horrified, he said, at the prospect of not being able to get back to their U.S. university if they return to their home country.

“I’m sure it will send really promising star students across the border to Canada or elsewhere,” Berger said. The order comes just as many U.S. universities are offering admission to overseas students for the next academic year."