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“ All In (or Out) ” NRMP TIGHTENS THE NOOSE. Jay Shapiro, MD Program Director Anesthesiology. NRMP. A “ service ” of the AAMC Not-for-profit Est 1952 to provide a uniform date of appointment to positions in GME Became a mechanism for a “ level playing field ” for applicants.
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“All In (or Out)”NRMP TIGHTENS THE NOOSE Jay Shapiro, MD Program Director Anesthesiology
NRMP • A “service” of the AAMC • Not-for-profit • Est 1952 to provide a uniform date of appointment to positions in GME • Became a mechanism for a “level playing field” for applicants
Business Potential • $60/applicant x 38K applicants= $2.3M • $35/”track” x 4427 tracks= $145K • $35/match x 26772 matches= $940K • $200/Institution x 2000+ Inst= $400K • Total = $3.8M* • *Does not incl 38 specialty matches
NRMP Controls • “Agreement”
NRMP Controls • “Agreement” • Program Director Code of Conduct
Program Code of Conduct Respect applicant’s right to privacy in interview & ranking decisions Accept responsibility for interview team Refrain from illegal/coercive questions Decline to require second visits Discourage unnecessary post-interview communication From Signer Presentation 11/2012
NRMP Controls • “Agreement” • Program Director Code of Conduct • Reports
Reports Regarding Applicant Violations (7) the American Board of Medical Specialties (8) the applicant's residency program director if the violation occurred in a fellowship match (9) the Federation of State Medical Boards if the applicant is to be permanently identified as a Match violator or permanently barred from future NRMP Matches (10) any parties whom the NRMP has determined are relevant to its investigation. From “Agreement”
Reports of Violation by Programs (3) the ACGME for distribution to the respective Residency Review Committee (RRC) and the Institutional Review Committee (4) the respective specialty program director association
All In Policy • Why • History • Exceptions • Implementation
Benefits Evident in 2013 Match • 6% increase in number of positions offered • 10% more sponsored applicants • 20% more independent applicants • WHY
1110 217 527 114 75 214 207 97
Our Transition Journey • Past • 8 PGY 1 Positions in the Match • 4 PGY 2 Positions-outside match • Separate Application • Separate Interviews • Hire/Accept as we find good candidates • Process usually complete by late October
Our Transition-Journey • Present (for start 2013) • Letter of Commitment in Nov 2011-1 position • Current ReschFel-will continue clinical-1 position • Unexpected withdrawal of PGY 1-1 position - Match violator-can interview but not start before 7/13/2013-will start off cycle • 1 position in Physician “R” Match
Our Transition-Journey • Next Year • All positions in “R” match? • Separate Interview Program? • How do we select interviewees? • ERAS applications • Separate application process • What happens to military/career change applicants?????