"Wilderness medicine" sounds like the sort of medicine you hope you never need as a patient. But there is a medical fellowship program that draws on a cross-disciplinary group of docs, and their decentralized labor market has run into the usual difficulties. Here's a report on a new centralized clearinghouse, run in-house and partly manually, following a simulated run.
Davis, Christopher A., Stephanie Lareau, Taylor Haston, Arun Ganti, and Susanne J. Spano. "Implementation of a Specialty Society‒Sponsored Wilderness Medicine Fellowship Match." Wilderness & Environmental Medicine (2022, in press).
"Previously, wilderness medicine (WM) fellowships offered spots to applicants using an offer date. Due in part to increases in the number of WM fellowships and applicants, in 2021, the WM program directors (PDs) agreed to conduct the first WM fellowship match through the Wilderness Medical Society graduate medical education committee. This article outlines the process used and demonstrates its feasibility.
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"Wilderness Medicine (WM) fellowships previously filled positions using an offer-date set by fellowship directors each fall.1 Applicant(s) were called in the order of preference by each director until all available positions were filled. Once called, applicants would have 30 min to accept or decline the offer. Limitations included the potential for verbal, nonbinding offers to influence candidates’ and directors’ actions on the offer day, as well as pressure on candidates to accept initial offers owing to the lack of knowledge regarding potential forthcoming offers. These concerns cast uncertainty on whether participants were placed in a disadvantageous position by the offer-date system.
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"Formal fellowship matching services are not exclusively managed by the NRMP; other businesses, the military, and professional societies host matching services. The San Francisco match currently provides fellowship matching services to 22 subspecialties.6 The military does not use a computer-generated match list; the selection committee arranges negotiated pairings between programs and applicants, with the ability to place an applicant in a program they did not rank.7 The American Urological Association, in conjunction with the Society of Academic Urologists, has overseen the urology residency match program for >35 y, which includes fellowship matches.
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"After completion of the simulated trial/test match, all PDs and WMS GME committee members agreed to participate in the proposed inaugural WM match via email or telephone verification. The deadline of October 25, 2021 was set for the submission of all rank lists to the WMS staff member by all participating applicants and programs. Individual emails were sent to both the programs and applicants to encourage timely completion of the process. On October 28, 2021, at 0900 PST/1200 EST, initial emails were sent simultaneously to each applicant and each PD to inform them of either a successful match or eligibility for the secondary match.
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"A total of 13 programs and 15 applicants completed the match process. After the first round, 11 of 15 applicants had matched, and 2 programs and 4 candidates had the opportunity to complete the secondary match. During the secondary match period, the unfilled programs2 withdrew, obviating the need for the secondary match.
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"Many PDs noted in 2021 that they had a significant increase in the number of applicants in 2020 and cited this as motivation for moving away from the previous telephone-based offer system and pursuing a match for the subsequent year."
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