Transcript Neurosurgery Resident Matching Program ERAS/NRMP: AAMC

Neurosurgery Resident Matching
Program
ERAS/NRMP: AAMC
Society of Neurological Surgeons
Philip R. Weinstein, MD
SNS Match Committee
NSRMP
TRANSITION SFM
TO ERAS/NRMP
MATCH RESULTS FOR 2009
Program Director Survey
PROBLEMS ENCOUNTERED
GOALS FOR THE FUTURE
QUESTIONS AND CONCERNS
Rationale for Transition
to AAMC Match
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Financial considerations
Separate applications for GS internship
Integration of PGY 1 into neurosurgery
Neurology and ENT transition was satisfactory
Disadvantages
– Loss of personalized service
– Later match date: simultaneous
– Longer interview period
Background/Contacts
• NRMP
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37,000 students processed /yr.
4,100 programs matched
24,000 matches
User guide: www.nrmp.org
Help: [email protected]
866-617 5837
• ERAS
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1952
1995
31 specialties
22.650 million documents/yr.
Help: [email protected]
(202-828 0413)
Cost
• ERAS
– Free to programs
– Students:
$60/1-10 programs
$8/11-20
$15/21-30
$25ea./31+
• NRMP
– $175/Dean’s Office institutional fee
– $30/Program + $30/matched applicant
– $50/Student
Timeline for NSRMP:
2009-2010
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ERAS REGISTRATION
4-30-09
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INTERVIEW DATES LISTED: SNS/ERAS
INTERVIEW DATE COORDINATION
7-1-09
7-8/10
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NRMP REGISTRATION
APPLICATIONS SUBMITTED
DEADLINE: APPLICATIONS
INTERVIEW INVITATIONS
INTERVIEWS
QUOTA CHANGE DEADLINE
DEADLINE: RANK LISTS
MATCH WEEK
MATCH DAY
MATCH OUTCOME: STUDENTS/ PROGRAMS
9-1-09
8-10/09
11/1-09
9 to 11-09
10-09 to 2/10
1-31-10
2-24-10
3-15-09
3-18-10
3-22-10
Interest/qualifications for NS
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Rank lists submitted
Positions/applicants
Applicants/position
Ranked applicants/position
Applications: total
US seniors matched
Positions offered
NS only/first choice
Av. USMLE/matched
Av. Applications/student
Av. Offers received
2008
254
0.7
1.9:1
--356
88%-154
179
--236
24
4.7
2009
317
0.6
2.4:1
3.9
458/272
82%-171
191
221
239
38
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NS Residency Positions Available/US
Senior Student
Applicants Matched
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1998
2001
2004
2007
2008
2009
148/71%
151/93%
153/79%
171/83%
179/88%
191/82%
Unmatched US Seniors/Total 2009
(n=44/126)
• Only 10 of 44 US seniors ranked an alternative in the match
– PGY-1 gen’l surg. only
2
– Gen’l surg. Categorical
2
– Neurology
1
– Radiology
1
• Remainder used Scramble or chose to wait, take fellowship and
try again
• No open NS positions this year
• 19% US Seniors unmatched
• Students go to Dean’s Office or NS mentors for
advice/assistance
• Unmatched 2008
70 US+IMG vs 126 (2009)
Stressful Circumstance
for NS committed students
• Application, interview, rank listing and
acceptance for a back up non-neurosurgical
specialty eliminates possibility of participating
in the Scramble (if there is one) for an open
unfilled position in a NS program because of
the NRMP contractual agreement to accept
the position if matched to a backup specialty.
Comparative Match Data
Neurosurg.
Neurology
Orthosurg.
Fam. Med.
Pos.
%US
%Tot.
191
196
641
2535
90
63
92
42
100
100
100
91
Neurosurgery Program Directors
Match Survey- 2009
Response rate: 60% (58/99)
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Easy Difficult
Data download
91%
9%
System use overall 93%
7%
Rank list entry
100% ---Help Desk
100% ---Compare SFM
94%
4%
Favorite Features
• Online, electronic
• Paperless, efficient
• Easy to track, score, rank,
complete, distribute, review
applications
• Sorting, grouping, filter,
reports
• Post office, communications
• Interview manager
• Easier for students to
prepare and submit
applications
• Additional later submissions
filed automatically
• Project data for selection
meetings
Problems Encountered
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ERAS not user friendly, difficult to rank, files lost
Letters of recommendation not transmitted
Download to disc difficult
Unable to access from home (should not be a
problem)
• Not MAC compatible (pdf files download to disc)
Interview Process
• Number increased
• Range
• Number Same
44%
10-25%
30%
• More time better
• No difference
• Started later
42%
39%
73%
Interview Process
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Listed dates on SNS website
Coordinated regionally
Willing to coordinate 2010
Interview during externship
Second visit allowed
Second visit encouraged
90%
50%
82%
29%
85%
35%
Number of Applications: 2009
• Increased
68%
• Unchanged
32%
• Range increase: n=20-100 20-25%
Profile of Applicants: 2009
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Quality improved
Quality unchanged
More females
Backup specialty selected
Students advised re backup
66%
34%
41%
22%
23%
Use of ERAS to prepare/export rank list
to NRMP
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Easy
45%
Fair
20%
Not used
68%
Comment: This is easy and saves lots of
time/effort. Call Help desk as needed.
Application additions requested
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Undergraduate transcripts
List of neurosurgery rotations
USMLE II scores (sent when available)
Additional 2-3 reference letters (?neurosurgeons)
Statement of goals after training
Comment: Each of these items can be requested
by individual programs on department web sites
and/or in interview acceptance letter but are not
required by ERAS.
Interview Scheduling
• Programs list dates on SNS and ERAS
websites: Coordinators attempt regional scheduling
by weeks and days
Suggested remedies:
Earlier interview invitations
Shorter interview period:
Nov. and Dec. or Nov. and Jan.
Allow interviews during externship visit
Transition Action Items
for 2009-10
• List special application requirements or preferences on department
web site, brochures, interview acceptance letter
• Inform less qualified NS interested students at your school that
simultaneous application to a back-up specialty is advisable since
unfilled positions are rarely if ever available through the Scramble
• Avoid repeat recruitment visits and expense payments and pre-match
commitments despite late match date
• Refine PGY-1 curriculum/rotations
• Coordinate interview dates with neighboring programs in July; offer
multiple dates
SNS Match Rules
• Don’t ask; don’t tell about rank list:
• No commitments prior to match by students or
program
• Clerkship helps but is optional
• Second visit allowed but not encouraged or required
or official
• No interview or visit expenses paid
• Avoid gender or marital discrimination
Summary
• Neurosurgery is continuing to attract qualified,
competent and dedicated residency applicants
• The transition to ERAS/NRMP has occurred
smoothly and without major adjustment
problems in most cases
• Future efforts to reduce the number of
applications to programs and interviews per
student and to coordinate interview travel time
and expense are needed
• Counseling and alternative planning for
potentially and actually unmatched US senior
students is needed