(1)
Department of Radiology, UMDNJ-New Jersey Medical School, Newark, NJ, USA
Abstract
Approximately 20 years ago, the match for radiology residency was imposed and became universally accepted. It has engendered a salutary effect for both the applicants and the training programs. Before then, program directors were free to interview candidates whenever they wished. Some often completed their first year rosters with beginning third year students or even with those still in the second year of medical school. Applicants had to guess when was the best time to seek interviews, a procedure which often interfered with participation in and completion of clinical clerkships. Some program directors demanded immediate confirmation of their decision to offer a residency, often leaving students in a quandary even before they could visit other places for which they had an interest. Moreover, potentially excellent residents who would likely eventually become superb practitioners and investigators in Radiology were denied opportunities to enter our specialty because they decided to pursue it too late. The need for the imposition of a match was acute to protect the interests of applicants who otherwise had no political means to protect themselves from the arbitrariness of recruitment. Programs gained as well from adherence to the requirements of the match. The interview season was specified to extend from the late Fall to the early Winter of the candidate’s fourth year. Those who opted for Radiology after experiencing much of medical school were better able to articulate their reasons for seeking a career in our specialty. By then, for many, family situations had become more defined, allowing candidates to look for programs that met their geographical predilections.
Approximately 20 years ago, the match for radiology residency was imposed and became universally accepted. It has engendered a salutary effect for both the applicants and the training programs. Before then, program directors were free to interview candidates whenever they wished. Some often completed their first year rosters with beginning third year students or even with those still in the second year of medical school. Applicants had to guess when was the best time to seek interviews, a procedure which often interfered with participation in and completion of clinical clerkships. Some program directors demanded immediate confirmation of their decision to offer a residency, often leaving students in a quandary even before they could visit other places for which they had an interest. Moreover, potentially excellent residents who would likely eventually become superb practitioners and investigators in Radiology were denied opportunities to enter our specialty because they decided to pursue it too late. The need for the imposition of a match was acute to protect the interests of applicants who otherwise had no political means to protect themselves from the arbitrariness of recruitment. Programs gained as well from adherence to the requirements of the match. The interview season was specified to extend from the late Fall to the early Winter of the candidate’s fourth year. Those who opted for Radiology after experiencing much of medical school were better able to articulate their reasons for seeking a career in our specialty. By then, for many, family situations had become more defined, allowing candidates to look for programs that met their geographical predilections.
In the past 2 decades, advances in the technical virtuosity of Radiology as well as, frankly, augmented income expectations have made Radiology an increasingly popular career consideration, attractive especially to the most accomplished medical students. At least until recently when interest has declined somewhat, the competition for positions still is felt by the candidates to be keen indeed. Even though there are now 300 more first year slots than there were in 1999, prospective radiology residents initially apply on average to 20 or more programs in hopes of getting at least 15 interviews.
Moreover, there had been a consensus promulgated and maintained by program directors that interviews should not begin before the Dean’s letter was received on or about the first of November. Yet today, some programs have now moved up their interviews to begin in September. Still, for the most part, interviews take place from mid-November through January. In that span, the typical candidate may visit 12–15 Radiology residency programs and also 5–6 internship sites.
However, there is no general consideration made by the program directors to make the interviewee’s life easier during this two and a half month period by scheduling interviews in several programs in one city on consecutive days. Rather the prospective radiology resident must hope for the best as the luck of the draw determines the sequence of program visits. Most candidates are pleased if they are able to achieve their desired allotment of interviews including the programs they are most inclined to seek. Nonetheless, the proliferation of interviews often induces conflicts with the fulfillment of clinical responsibilities. For the most part, the consternation these scheduling difficulties may subject the applicant to, has not been the concern of program directors.
Thus, an unintended consequence of the otherwise beneficial reform afforded by the radiology match is now impinging on the prospective resident’s undergraduate medical education as well as his or her pocketbook. Two to two and a half months of their fourth year is now devoted to interviews with little time remaining for coherent clinical education or research participation. If the average tuition at medical school is $35,000 then $7,000 is forsaken because of the length of the interview process. Approximately 85 % of medical students graduate with debt and the average debt is now between $130,000 and $200,000. Given the mean resident salary of $50,000 per annum, an indebted medical student cannot expect his or her financial obligations to be pared down before the end of specialty training. And added to that burden is the expense the candidate must bear by their odyssey within a region of the country or by crisscrossing the continent to appear at 15–20 separate places for interviews.
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