Sholten Singer/The Herald-Dispatch Caroline Brady excitedly opens an envelope that will reveal her residency match during Match Day on Friday, March 21, 2014, in the Don Morris Room of the Marshall University Memorial Student Center in Huntington.
Saw this picture on the front page of a newspaper recently, in an article celebrating Match Day at the local university medical school. Reminded me I've been meaning to post about 'the match' in veterinary medicine. In May, our grads will...
... head to their first job, which for the majority will be an internship obtained through 'the match'.
The match is officially titled the Veterinary Internship and Residency Matching Program, or VIRMP. The VIRMP is a service run by the American Association of Veterinary Clinicians, or AAVC. That's the guys who work in the hospitals and clinics at vet schools:
"faculty in clinical departments at veterinary schools and colleges and practices and institutions involved in the education of veterinarians in internships and residencies."
The match is exactly what it sounds like, a service where applicants rank internships in order of preference and programs that have internships rank applicants in order of preference. Internships get filled, students get into programs and everybody gets matched.
Except... they don't.
After seeing a partial data set in a talk, I emailed VIRMP Director Roger Fingland back in December 2013 asking if stats for the match were publicly available. He shared with me the following data:
|
In the Match: VIRMP, 2009-2013
| |||||
|---|---|---|---|---|---|
| Internship positions | 850 | 881 | 871 | 915 | 951 |
| Residency positions | 247 | 267 | 273 | 267 | 295 |
| Internship only applicants | 899 | 1052 | 1092 | 1168 | 1136 |
| Residency only applicants | 605 | 662 | 624 | 595 | 572 |
| Applying for either | 205 | 208 | 245 | 234 | 290 |
| Internship matches | 667 | 725 | 753 | 793 | 794 |
| Residency matches | 219 | 239 | 252 | 241 | 268 |
| Unfilled intern positions | 183 | 156 | 118 | 122 | 157 |
| Unfilled resident positions | 28 | 28 | 21 | 26 | 23 |
| Unmatched applicants | 823 | 958 | 956 | 963 | 936 |
Almost half of all applicants fail to get a match. Nearly a thousand people go unmatched, while 16% of internships go unfilled.
Remember, these are carefully screened trainees who've made it through four expensive years of intense, demanding academic and clinical training. Most of them are applying for additional training at the same types of programs from which they are graduating- many at the same institutions from which they are graduating.
Is it possible some find a position after the match? The JAVMA senior survey reports that in 2012, 727 had accepted an internship prior to graduation... when 793 placed through VIRMP that year. The senior survey is "distributed approximately 4 weeks before graduation for each school or college, and the survey instrument remained active until graduation" which at most schools is in May. Match results are announced in February- well before the senior survey.
So did 66 of those 797 who *did* match not report it on the senior survey? Not take the senior survey? Decide to drop the internship before taking the senior survey?
And what about those who pursue equine internships, which are administered through the Avenues program of AAEP? They would be counted in the senior survey but not the VIRMP....
OK, so that's the internship picture. What about residencies?
In 2013, 862 trainees applied for a residency. Only 295 residency slots were available; that is 20% more than 5 years ago.
Even with 862 applicants, 23 of those residencies went unfilled. So either those 23 positions were unacceptable to any of those 624 unmatched applicants... or none of those 624 made the grade, after 4 years of passing?
This means only 268- not all 862, not even the full 295- just 268 newly minted veterinarians are even going to have the chance, via residency and board certification, of recapturing the missed value of their internship year, a year they spent working for less than minimum wage while interest piled up on their loans.
For the remainder, 624 souls with an average debt of $151,672 at the start of the year, their internship will prove to be a loss.
A loss of $47,758 each. That's $35,776 in salary they could've made in practice† plus $11,982 additional loan interest*. Assuming the loan interest was capitalized, and the salary difference would have been paid on their loans, this means those 624 interns saw their debt rise to $163,654 rather than having the chance to drop it by nearly 25% in a single year.
That's a cumulative loss of $30,000,000 incurred by a single year's graduating class.
As individuals and as a profession, how do we sustain this?
† $65,404 mean 2012 practice salary- $29,628 mean 2012 internship salary according to this JAVMA article
* assumes borrowing the average 2012 debt amount of $151,672 as a GradPLUS loan at 7.9%.
