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

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.

Visiting Student Away Rotations in Ophthalmology: A Study of Medical Students' Experiences and Perspectives

“…This may demonstrate a decline in the emphasis on their importance, as previous literature reports a prevalence ranging between 70 and 90%. 1,2 It may also reflect regional variation given the majority of respondents in this study attended a medical institution in the Midwestern region of the United States (►Fig. 2).…”

“…Our study found a cost of 1,700 U.S. dollars per rotation, which is in the range of what has been observed in the literature for other specialties. 1,2 Keep in mind that the away elective expense is in addition to the costs of the ophthalmology residency application process. Such high costs also present a challenge for residency programs, as they risk inequitably selecting for applicants with greater financial resources.…”

“…In fact, in regard to visiting rotations among all fields, the average expenditure per rotation observed in the literature was cited between 958 and 2,494 U.S. dollars. 1,2 There is also an opportunity cost. Away electives are typically performed during the fourth year of medical school and compete with curriculum time that might otherwise be used for broadbased medical coursework in other medical specialties.…”

“…11 Nonetheless, the prevalence of ophthalmology bound students performing away rotations ranges as high as 70 to 90%. 1,2 This ultimately leaves physicians, program and education directors, and mentors of these medical students in a difficult position from an academic advising standpoint. There are currently two major gaps in the body of knowledge on the subject.…”

The “Race” Toward Diversity, Inclusion, and Equity in Pathology: The Johns Hopkins Experience

“…The additional significant costs of applying to residency, reported by Oladeji et al, to be an average of US$4420 in 2014, further exacerbate the financial burden of the fourth-year medical student. 20 -23 When considering these combined elective and residency application expenses in the greater context of established racial disparities in medical student debt, pipeline programs such as ours must strongly consider providing financial support. 24…”