Saturday, March 20, 2021

Match Day 2021 for medical residents

 Yesterday was Match Day, during Covid Year, and the aggregate data are reassuring that virtual (instead of in-person) interviews left the Match, in aggregate, much as before. The NRMP reports on match results, and Thalamus reports on interviews among the largest specialties.

Here's the NRMP press release:

Press Release: NRMP Delivers Strong Residency Match During Uncertain Times

"The 2021 Main Residency Match was the largest in NRMP history. There were 38,106 total positions offered, the most ever, and 35,194 first-year (PGY-1) positions offered, an increase of 928 (2.7%) over 2020. The growth in positions was supported by continued growth in the number of Match-participating programs. A record-high 5,915 programs were part of the Match, 88 more than 2020. In five years, the number of Match-participating programs has increased by 845 (16.7%), spurred in part by the completion of the transition to the single accreditation system for allopathic and osteopathic programs.

"Rather than faltering in these uncertain times, program fill rates increased across the board. Of the 38,106 total positions available, 36,179 filled, representing a 2.6 percent increase of filled positions over 2020. Of the 35,194 first-year positions available, 33,535 filled, representing a 2.9 percent increase of first-year filled positions. Those fill rates drove the percent of all positions filled from 94.6 to 94.9 percent and the percent of PGY-1 positions filled from 94.6 to 94.8 percent in 2021. There were 1,927 unfilled positions after the matching algorithm was processed, a decline of 71 (3.6%) compared to 2020.

...

"Percent of Applicants Matched to PGY-1 Positions Declines Slightly for Seniors; Rates Remain High. With all applicant groups demonstrating increases in the number of applicants submitting rank ordered lists of programs and ultimately matching to first-year PGY-1 positions, the overall percent matched declined modestly for some groups. Specifically, the percent of U.S. MD seniors matched to PGY-1 positions declined from 93.7 to 92.8, and the percent of U.S. DO seniors matched to PGY-1 positions declined from 90.7 to 89.1 percent. Non-U.S. citizen IMGs saw the largest decline, from 61.1 percent in 2020 to 54.8 percent in 2021. The unavailability of medical licensure examinations in the early stages of the pandemic coupled with permanent changes to the scoring and administration of those examinations by the end of 2020 created significant challenges for IMGs this year and likely contributed to the decline. Additionally, changes in clinical rotations may have affected match rates. The overall percent of applicants matched to PGY-1 positions declined from 80.8 to 78.5 percent."

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And here's a post from Thalamus, the interview managing service whose motto is "connecting the docs."

Explaining COVID’s Impact on the 2020-2021 Virtual Recruitment Season and NRMP Match Outcomes  March 19, 2021 by Team Thalamus

Here are their concluding remarks:

"1. The number of interview invitations stayed the same.

"2. The number of interviews completed by both applicants and programs went up. 

"3. The rate of interview cancellations decreased. 

"4. And while the candidates receiving the top 20% of interview offers completed more interviews than other candidates, overall applicants and programs both completed more interviews, thereby lengthening rank lists and providing each greater opportunity to match.

"While the slight decrease in match rates is due to a disproportionally larger number of applicants entering the match in comparison to the growth rates of the number of available residency positions, more candidates matched than ever before, because significantly more unique applicants received opportunities to interview.

"And therefore, overall, the match rate held steady as it has had in recent years, driven by its Nobel Prize winning application of the stable marriage algorithm.  

"Of course, there are several factors at play here including where applicants and programs enter preferences of where or whom they would like to match, respectively.  Similarly, given visa restrictions "IMGs were particularly disadvantaged this year more than usual, which lead to their larger resultant drop in their match rate.  There are continued challenges here including increasing the number of positions of available training positions to match a continued acceleration and growth of the applicant pool, and data can help expand upon this work. "

"Overall, the challenges of over-interviewing in GME was not greatly affected by the virtual interview process, and the greatly hypothesized “match crisis” appears to have been avoided.  Yet, this process shed significantly light on a continued systemic problem: Due to a lack of transparency, applicants continue to overapply, and residency programs continue to over-interview, creating a costly and anxiety-ridden process for all.  Data and technology can help change this for the future as COVID leaves its recognizable mark on the medical residency recruitment and match process."

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