Taking the Mystery out of the Match Tom Perera MD

3/16/2010 Template copyright 2005 www.brainybetty.com 2 Should I Stay Awake? Mechanics of the match The process from the dark side Hints on doing well

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3/16/2010 Template copyright 2005 www.brainybetty.com 4 Congratulations You found Emergency Medicine

3/16/2010 Template copyright 2005 www.brainybetty.com 5 What program should I go to?

3/16/2010 Template copyright 2005 www.brainybetty.com 6 1)List 2)Interviews 3)A lot of antacid or beer 4)Rank list

Geography People you like

3/16/2010 Template copyright 2005 www.brainybetty.com 8 The match

3/16/2010 Template copyright 2005 www.brainybetty.com 9 It is Fair The Truth about The Match.

3/16/2010 Template copyright 2005 www.brainybetty.com 10 It Favors the Student The Truth about The Match.

3/16/2010 Template copyright 2005 www.brainybetty.com 11 You do not Need to Game the System. The Truth about The Match.

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3/16/2010 Template copyright 2005 www.brainybetty.com 13 Hx of the Match ”The Evolution of the Labor Market for Interns and Residents: A Case Study in Game Theory.” Alvin Roth

3/16/2010 Template copyright 2005 www.brainybetty.com 14 Hx of the Match Turn of Century Internships became the standard. Salaries and working conditions were specified ahead of time. Competition was in timing not in price. Contracts were finalized in junior year.

3/16/2010 Template copyright 2005 www.brainybetty.com 15 Hx of the Match 1950’s Centralized matching system.(bad algorithm) NRMP 1952 hospital–optimal version of algorithm. Jan 1998 student-optimal algorithm

3/16/2010 Template copyright 2005 www.brainybetty.com 16 How the match works. It works.

3/16/2010 Template copyright 2005 www.brainybetty.com 17 How the match works. The NRMP Web site www.nrmp.org Proof of fairness http://tedlab.mit.edu/~dr/nrmp.html

3/16/2010 Template copyright 2005 www.brainybetty.com 18 How the match works. Steps: 1: Provide info 2: Interview 3:Enter into contract Match Participation Agreement 4: Rank 5: Get results

3/16/2010 Template copyright 2005 www.brainybetty.com 19 How the match works. “College Admission and the Stability of Marriage” American Mathematical Monthly Gale and Shapley

3/16/2010 Template copyright 2005 www.brainybetty.com 20 How the match works. In the language of boys and girls Girls make a list of boys in order of preference and vice versa. In round 1 Each girl goes to her first choice boy and says “will you marry me?”

3/16/2010 Template copyright 2005 www.brainybetty.com 21 How the match works. The boy says “maybe” (gets engaged) to the most desirable girl on his list who asked him to marry her and “no” to all the rest. “no” also goes to all girls not (ranked) on the boys list

3/16/2010 Template copyright 2005 www.brainybetty.com 22 How the match works. In round 2 Each rejected girl goes to the next boy on her list and proposes to him. Each boy again looks at all of his proposals (including last rounds engagement) and picks the highest on his list and says “maybe” to them.

3/16/2010 Template copyright 2005 www.brainybetty.com 23 How the match works. In round 2 This could leave the previously engaged girl engaged or it could displace her for another more highly ranked girl.

3/16/2010 Template copyright 2005 www.brainybetty.com 24 How the match works. In round 3 Each rejected girl (possibly including the now rejected first engagement) goes to the next boy on her list and proposes to him.

3/16/2010 Template copyright 2005 www.brainybetty.com 25 How the match works. In round 3 Again each boy chooses the highest on their list. This goes around and around.

3/16/2010 Template copyright 2005 www.brainybetty.com 26 How the match works. The rounds continue until all the girls either have a mate or their list of possible boys is exhausted.

3/16/2010 Template copyright 2005 www.brainybetty.com 27 How the match works. Once this stops the “maybes” become “I do”

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3/16/2010 Template copyright 2005 www.brainybetty.com 29 How the match works. For the actual match a program can be engaged and then married to as many positions as they take each year.

3/16/2010 Template copyright 2005 www.brainybetty.com 30 How the match works. This results in you being ”matched” with your highest choice that has not filled with students that programs have higher on their list.

3/16/2010 Template copyright 2005 www.brainybetty.com 31 How the match works. The system slightly favors proposers(you) Effects 1-1000

3/16/2010 Template copyright 2005 www.brainybetty.com 32 Couples Match Couples are basically treated as a unit.

3/16/2010 Template copyright 2005 www.brainybetty.com 33 Couples Match 2008-738 couples 94% success rate

3/16/2010 Template copyright 2005 www.brainybetty.com 34 Couples Match What is a couple?

There are other matches Osteopathic or AOA match Must choose one match Osteopathic internship Canadian match 3/16/2010 Template copyright 2005 www.brainybetty.com 35

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3/16/2010 Template copyright 2005 www.brainybetty.com 37 ERRORS 1)Listing too few programs 2)Listing any program you would not go to. 3)Adjusting list to where you think you can get in.

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How hard should I push to get an interview? 3/16/2010 Template copyright 2005 www.brainybetty.com 39

3/16/2010 Template copyright 2005 www.brainybetty.com 40 Pregnancy Couples Match How do program director’s deal with:

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3/16/2010 Template copyright 2005 www.brainybetty.com 42 Aspects of the interview trail

3/16/2010 Template copyright 2005 www.brainybetty.com 43 Aspects of the interview trail Show up on time

3/16/2010 Template copyright 2005 www.brainybetty.com 44 Aspects of the interview trail Do your research

3/16/2010 Template copyright 2005 www.brainybetty.com 45 Aspects of the interview trail Get information from fellow students

3/16/2010 Template copyright 2005 www.brainybetty.com 46 Aspects of the interview trail Have something you want to talk about

3/16/2010 Template copyright 2005 www.brainybetty.com 47 What most Program Directors Want The night before get together

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3/16/2010 Template copyright 2005 www.brainybetty.com 49 What Program Directors do not want 1)Whiners/Complainers 2)Arrogance 3)People with no understanding of EM 4)People passing through the field

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3/16/2010 Template copyright 2005 www.brainybetty.com 51 Dealing with Program Directors We are people and predictable Think about Who would Become Program Directors We are proud of our program

3/16/2010 Template copyright 2005 www.brainybetty.com 52 Dealing with Program Directors We love to Talk/Teach

3/16/2010 Template copyright 2005 www.brainybetty.com 53 Dealing with Program Directors We are social people

3/16/2010 Template copyright 2005 www.brainybetty.com 54 Dealing with Program Directors We believe we work hard We believe that we do a public service

3/16/2010 Template copyright 2005 www.brainybetty.com 55 Dealing with Program Directors No matter what we say we are not courting weakness

3/16/2010 Template copyright 2005 www.brainybetty.com 56 Dealing with Program Directors You are always being judged

3/16/2010 Template copyright 2005 www.brainybetty.com 58 If you have a black mark Do not hide it Do not obsess on it Be ready to discuss it

3/16/2010 Template copyright 2005 www.brainybetty.com 59 Big Secret Most medical students do not present themselves well

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3/16/2010 Template copyright 2005 www.brainybetty.com 61 Odd is good Broken is bad

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3/16/2010 Template copyright 2005 www.brainybetty.com 63 Things not to say The three myths of EM 1)No follow up 2)Burn out 3)Glorifide triage Lifestyle

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3/16/2010 Template copyright 2005 www.brainybetty.com 65 Last bits Know your application The program COORDINATORS run the world