555 EM spots did not fill in Match

[EthylMethylMan]

The constant digging and craping on img/ do’s and inferior choices for residents is getting exhausting and is a really ugly look for ya’ll.

I don't think most of the posts here referencing those trends are trying to dig on DOs/IMGs or claim that they're inferior. I think they're contrasting that that trend with the fact that these programs tend to want USMDs. The implication there being that the programs aren't getting the applicants they primarily want in many cases.

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[RustedFox]

The constant digging and craping on img/ do’s and inferior choices for residents is getting exhausting and is a really ugly look for ya’ll.

IMG is one thing.
I want to SGU despite a good GPA and *amazing* MCAT scores.

IMG with board failures is another thing.

 

[EMhawkeye]

IMG is one thing.
I want to SGU despite a good GPA and *amazing* MCAT scores.

IMG with board failures is another thing.

Yeah and you could just say candidates with board failures and red flags without painting everyone with a broad brush. I work with some amazing grads from places like sgu and ross as well as do’s.

 

[VA Hopeful Dr]

Yeah and you could just say candidates with board failures and red flags without painting everyone with a broad brush. I work with some amazing grads from places like sgu and ross as well as do’s.

Same here.

But, historically you can tell when a specialty is in high demand because it accepts very few DO and Caribbean graduates. This isn't me making a value judgement, but that's the pattern and we all know it.

So while some of the posts here can read as being very negative towards those grads, I don't think looking down on them was the goal.

 

[Splenda88]

Maybe I missed it. I did not see anyone crapping on DO/IMG/FMG... People just acknowledged the reality of the match.

It is no secret that PDs have their preferences.

 

[hopefulgasman]

The University of Chicago known to never match DOs let alone IMGs, matched an IMG from a caribb school. Why the sudden change of heart huh? Parkland with IMGs too.

Going to the Carrib should no longer be viewed as a 500K mistake. Low GPA and low MCAT score? No problem. Just pass your boards and you can rest assure that you’ll basically walk into an academic EM residency program three years later that will be forced to train you. Sounds like a solid investment to me.

 

[alpinism]

No one here is trying to put down IMGs rather just point out how bad this match was for EM residency programs.

 

[alpinism]

The perfect example is NYU which has always openly refused to interview DOs let alone rank them for the match.

Guess which program finally had no other choice but to match their first one in their entire program's history.

 

[emergentmd]

If you had 300k cash now, and a schedule where you're only working 12 shifts a month and thus free time to start some side hustles and business what would you do in 2023?

I understand the generic answer you may give us "real estate" or "syndications" or "FSED" but if it's not too much trouble, I'd appreciate it if you could be more descriptive.

Would you take 50k of that and find a rental that you can cash flow? Would you put another 50k of that into some dividend-earning equity? Would you take 100k of that and start urgent care or FSED? Maybe consider starting some other para-medicine business after doing some market research and finding an edge? How much would you keep as cash if any of the ventures above fails?

I will preface this by saying that experience is very important so I would invest while educating yourself in the process. Choose what you are interested in is very important. Assuming a typical city

1. Put 100K and buy a place. If you can do STR great, if not do MTR. I have learned LTR is low yield, and can be a big pain between renters
2. Put 50K into apt/RE/Commercial syndication. Imp to find good operators. I can help point you in the right directions if interested
3. Hold the 150K and if #1 and #2 works out, do it again. If not, invest in the S&P500.

FSERs are too big of a hill to climb by yourself. If you want to slowly leave the hospital, then talk to your friends and find a good doctor owned FSER to pick up shifts. If it looks good, buy in, or buy into new sites. Again, very imp to have good operators who treat the docs well.

UCs are a decent choice.. Break even about 15ppd, if you can achieve 30ppd, then you could make close to 1M a year. Cost of entry reasonable but you need to find a good site. If you can find 4-5 ER docs to go in with it, split the risk and gains.

Once you get into owning your own business, doing RE, doing FSERs, Syndications you will meet more people who are like minded. Connections are very important. Working the PIT all your life connects you to essentially similar ER docs who just works the pits.

 

[miacomet]

Things are more bleak than I thought. There are IMGs with multiple failures who matched.

I can't wait to see how many US MD students will apply to EM next cycle.

Multiple failures? Pray tell us more....

 

[miacomet]

The constant digging and craping on img/ do’s and inferior choices for residents is getting exhausting and is a really ugly look for ya’ll.

So many new DO schools of questionable standards, run by VC. We aren't the ugly ones here.

 

[miacomet]

The perfect example is NYU which has always openly refused to interview DOs let alone rank them for the match.

Guess which program finally had no other choice but to match their first one in their entire program's history.

I'm surprised they interviewed a DO. Must have seen the writing on the wall!

 

[cyanide12345678]

It’s official.

I’m seeing Facebook posts of match lists. IMGs from India, pakistan, and Middle East have officially started to be accepted into EM to fill the gaps.

Game over. Every spot will be filling up most likely. We filled 500 spots in soap this year it seems -_-

 

[Splenda88]

It’s official.

I’m seeing Facebook posts of match lists. IMGs from India, pakistan, and Middle East have officially started to be accepted into EM to fill the gaps.

Game over. Every spot will be filling up most likely. We filled 500 spots in soap this year it seems -_-

The question is how many US MD students will jump into that sinking ship next cycle?

 

[rokshana]

Well maybe EM programs will now think about actually interviewing good candidates that happen to come from DO and foreign schools instead of turning their noses up at them and think that they can only look at US seniors…if they had interviewed some of these people, then maybe so many spots would have not gone unfilled…let’s see if the programs re evaluate their strategy… otherwise it’s going to be more of the same 225…555…next year? 700?

 

[miacomet]

Well maybe EM programs will now think about actually interviewing good candidates that happen to come from DO and foreign schools instead of turning their noses up at them and think that they can only look at US seniors…if they had interviewed some of these people, then maybe so many spots would have not gone unfilled…let’s see if the programs re evaluate their strategy… otherwise it’s going to be more of the same 225…555…next year? 700?

This is like really far from the biggest problem. And why would good candidate from DO and foreign schools be any more likely to want to do EM than MD grads? It's a sinking ship.

 

[rokshana]

This is like really far from the biggest problem. And why would good candidate from DO and foreign schools be any more likely to want to do EM than MD grads? It's a sinking ship.

Well that is true enough

 

[Prehealth1011]

As long as the SLOE system exists, I don’t think EM will ever be as FMG friendly. US-IMGs/Caribbean grads sure but for med school grads from India/Pakistan/China, getting a rotation where there’s an EM residency and obtaining a SLOE is a big barrier. That probably diverts some of these applicants to FM/IM

 

[Rekt]

Filling almost all the spots and the rest will fill in the post soap.

These FMGs will take any job at any rate.

Speciality is one hundred percent dead.

 

[miacomet]

Does anyone have a list of the 53 unSoaped slots?

 

[Frazier]

The original unmatched stat means little in reality versus whatever number ultimately remains unfilled come July. They can have 2000 unmatched spots, but if the available spots balloon to 5000 and 1500 of them fill in the soap, you are still looking at 4500 new EM docs searching for jobs that graduating class. Some will jump ship, some will do fellowship... but I do not think the HCA/CMG machine will in any way be dissuaded by the results this year. HCA/CMG machine doesnt give a crap about the pedigree of the incoming class, they want the residents. More residents = more patients seen/managed with cheaper labor. They actually get paid by the government for each resident -- so the cost of the liability insurance, north face team jacket, and pizza social all balances out. What does HCA/CMG get? 6-15 extra bodies in their ED/ICU/Wards that can stop the clock, order tests, do procedures, admit the patient. That resident is much cheaper for them than having another doc on staff that costs 400k.

They dont care if they are from the islands, other side of the world, or from outer space -- they want spots that can fill. Doesnt fill? Okay open more programs. Increase the denominator. I dont think this will slow anything and the only folks that are embarassed are likely PD's.

Get the butts in the seats wherever around the globe those butts have to travel from... open more programs. MOAR!

 

[emergentmd]

Like everything in life, a once unicorn job becomes more average. Competition always brings more supply and lowers demand. Once med students saw 120-140hrs/wk making 400K with little outside interference, you knew supply/demand balance would take place.

No different than early Opthos making millions off Lasix but supply will increase.

There is no field that stays golden too long. Anesthesiology and radiology were some of the least competitive fields when I graduated in 2001. They will fall back. Where do you think the AMGs who would have done EM match into? Psych will have the same fate. They better make their money now b/c it will not be the same in 10 yrs.

 

[emergentmd]

To those who think they can not save 1M after residency or that its too much sacrifice, then I say you will be the 8 EM docs being dinner for the sharks. The ones who can have learned to swim faster than you.

I am not saying to go into EM but if you are or already starting, learn to outswim the 8 who can't teach themselves to swim fast.

 

[FlaminHotER]

I talked to a buddy that graduated with me that stayed on as core faculty. He told me they only matched 3, then yesterday had to scramble to fill in the rest.

IMGs from the Caribbean with multiple red flags and board failures.

PD was told to fill or lose funding.

He said it was NOT a good week.

And this is a level 1 trauma center we’re we got amazing training. The area sucks but the type of place you go for great training and get out.

F CK. ACEP, ACGME, and all of the CMGs for what they have done to our field.

 

[Splenda88]

All EM docs should have a 5-yr exit plan.

 

[bronx43]

All EM docs should have a 5-yr exit plan.

All EM docs should have a 5 year exit plan.

 

[GonnaBeADoc2222]

It's easy to say have an exit plan, but most people in here just talkin vague terms about their successes and say "get connections" without offering any assistance with that.

 

[FlaminHotER]

All EM docs should have a 5 year exit plan.

While Ortho guys are working until they drop dead haha

 

[Splenda88]

All EM docs should have a 5 year exit plan.

I do have a 10-yr exit plan as an IM (hospitalist).

 

[VA Hopeful Dr]

All EM docs should have a 5 year exit plan.

Nah. Plenty of us like our low stress jobs just fine.

 

[Splenda88]

Nah. Plenty of us like our low stress jobs just fine.

Until we are replaced by midlevels.

 

[VA Hopeful Dr]

Until we are replaced by midlevels.

Maybe. But giving the increasing trend, at least in outpatient medicine, of quality metrics being where a large part of the money comes from, I'm not especially nervous.

Hospital system I work for is actually started changing how they utilize the mid-levels we already have. Going forward, they will not have their own patients whatsoever, they will be for overflow acute care for the doctors' patients only.

 

[Kryptocoin]

It’s official.

I’m seeing Facebook posts of match lists. IMGs from India, pakistan, and Middle East have officially started to be accepted into EM to fill the gaps.

Game over. Every spot will be filling up most likely. We filled 500 spots in soap this year it seems -_-

So EM is the new pathology.....

 

[cyanide12345678]

So EM is the new pathology.....

Pathology isn’t a bad gig. Is their job market terrible? Their hours are great, and they don’t have to deal with patients. Not a terrible specialty i would think.

 

[miacomet]

Pathology isn’t a bad gig. Is their job market terrible? Their hours are great, and they don’t have to deal with patients. Not a terrible specialty i would think.

Good point. EM is now a worse option than pathology.

 

[Entadus]

Pathology isn’t a bad gig. Is their job market terrible? Their hours are great, and they don’t have to deal with patients. Not a terrible specialty i would think.

multiple essentially mandatory fellowships, no jobs, poor pay. no jobs.

 

[thegenius]

A big problem with docs is b/c most are high earners, they get trapped in the cycle of overworking to keep up with their lifestyle. Lets be honest, if EM doc work 70 hrs a month making 200K, they are better off than 90% of Americans and would be much happier.

I'm in this position. I'm just happy that my hourly is about 300k/hr

 

[cyanide12345678]

I'm in this position. I'm just happy that my hourly is about 300k/hr

300k/hr. I could just work 1 12 hour shift a year at that rate and call it a day🤣🤣

 

[gamerEMdoc]

There are some truly crap residencies on there, like anything HCA and many of the NY and PA programs, but also some decent ones, like Sparrow.
Texas seems pretty unpopular- is it normal for Baylor not to fill?

Did @gamerEMdoc fill or is he scrambling?

Filled all my spots from the top half of my list.

 

[Fecal_Occult]

Filled all my spots from the top half of my list.

Needs more context. What's the top half of your list? How many of them needed J-1 visa's?

 

[finalpsychyear]

10 year exit plan was the best advice an attending told me when i graduated 7 years ago. "Market is hot but it won't always be. Use this time to maximize your efforts not kick your feet up doing sub 30 hr weeks assuming it goes forever" I don't blame anyone for not doing it though. After so much delayed gratification of med school and residency it's hard to control spending when your pay increases so much let alone doing
"live like a resident" for 2-5 years. The blueprint is there however for most any doc to be able to reach FI in 10 years.

I honestly think new gen of docs are screwed. Not just in the influx of mid level drones, but also a lack in desire to work over 40 hrs/wk as wages and inflation are out of control in opposite directions. I hope i am wrong.

 

[DoctorMD1]

Pathology isn’t a bad gig. Is their job market terrible? Their hours are great, and they don’t have to deal with patients. Not a terrible specialty i would think.

I am married to a path. Path has a great job market lately and excellent lifestyle.

 

[EctopicFetus]

I talked to a buddy that graduated with me that stayed on as core faculty. He told me they only matched 3, then yesterday had to scramble to fill in the rest.

IMGs from the Caribbean with multiple red flags and board failures.

PD was told to fill or lose funding.

He said it was NOT a good week.

And this is a level 1 trauma center we’re we got amazing training. The area sucks but the type of place you go for great training and get out.

F CK. ACEP, ACGME, and all of the CMGs for what they have done to our field.

Wait til next year. Pin this. It’s gonna make this year look good.

 

[EctopicFetus]

Exit plan is different for everyone. It could be LeanFi, it could be outside revenue, it could be all of the above. I will admit i had a plan but it involved FI at age 51. I worked backwards, I said I need $X and how long til i get there. My $X has increased but luckily I earned well, saved well etc. The exit plan Has been laid out by emergent in this post I think. If not here then somewhere else. Reality is if you are gonna rely on clinical income long term you better be somewhere that no one wants to live and get a bit lucky.

 

[FlaminHotER]

Wait til next year. Pin this. It’s gonna make this year look good.

I agree.

This wholeheartedly scares me for the future of EM.

And we as a whole need to add pressure on acgme to shut down some of these horrible programs

 

[rokshana]

So EM is the new pathology.....

Pathology only had 2 unfilled spots…apparently they are the new EM.

 

[cyanide12345678]

Pathology only had 2 unfilled spots…apparently they are the new EM.

Except they don’t do nights, weekends, have great regular hours. Have a normal life with a normal circadian rhythm. And most likely don’t get yelled at and abused by drunk and psychotic people.

I mean…. What the hell was i thinking. I hate to admit it - my mom was right 😂😂. Her first words when i told her I’m doing EM were ‘you’re going into emergency medicine? That’s not a real doctor. What are you going to be a specialist of? Nothing’ 😂. Moral of the story, be a specialist. Own your patients

 

[bravotwozero]

Do pathologists own their own practices? Most of the ones I've encountered were all employees.

 

[Splenda88]

Except they don’t do nights, weekends, have great regular hours. Have a normal life with a normal circadian rhythm. And most likely don’t get yelled at and abused by drunk and psychotic people.

I mean…. What the hell was i thinking. I hate to admit it - my mom was right 😂😂. Her first words when i told her I’m doing EM were ‘you’re going into emergency medicine? That’s not a real doctor. What are you going to be a specialist of? Nothing’ 😂. Moral of the story, be a specialist. Own your patients

Most of the EM docs that work days at my site do not work night. I am guessing there must be a significant differential for working nights. Is it hard to find EM job in which one only work days?

EM might be able to solve this issue by providing a nice differential for night shift (eg., $40/hr extra).

 

[miacomet]

IMG is one thing.
I want to SGU despite a good GPA and *amazing* MCAT scores.

IMG with board failures is another thing.

Why? Just wanted a different experience?