Hi, welcome, thanks for having me. I'm really pleased to be here, and welcome to the match. On behalf of the NRMP, my name's Jeanette Calley. I'm the Chief of Match Operations. I think I've seen hopefully some of your faces on Zoom boxes over this process of trying to bring interventional cardiology to the match. So I don't have any disclosures. I just, you know, we're from Washington, D.C., and we're here to help you, I guess. So that's really what we wanna do today. So we'll talk a little bit about the schedule, some of your to-dos, talk a little bit about some of your program setup options and some flexibility that the match has for you, obviously a little bit about applications and interviews, the algorithm itself, and then just some of the logistic kinds of things that I think will be helpful to you as you move forward in the match. But most importantly, I wanna leave lots of time for questions, because I'm sure you have those. So I wanna make sure that you all have a chance to get some of those answered. So we'll start off with the schedule. So the match will open for registration on August 21st, and that's actually, you all are part of the medicine and pediatric specialties match. That specialties match has 32 different subspecialties across both medicine and pediatrics. So we have, you know, subs, and then what we consider subsubs, so you all will be participating in that larger match. And the nice thing about that is it does allow applicants the opportunity to couples match as well, which we do have a fair number of couples that participate at the fellow level in the specialties matching service through the medicine and pediatrics specialties match. It also allows applicants who are looking at multiple subspecialties to cross rank those specialties. So it's really a trainee centric thing for us as we look at matches, and we do try to combine those based on kind of the larger core specialties. So that match does open for registration on August 21st, and then you can begin ranking your fellows on September 25th. A ranking opens for both applicants and program directors at the same time. The other kind of next big milestone is gonna be that quota change withdrawal deadline. The quota is the number of positions that you intend for the match to fill when we run the algorithm. So you will need to have decided the number of positions you intend to fill in the match by November 6th. That's also the withdrawal deadline. So if your program does decide to not participate in the match, you must withdraw from the match by November 6th. The rank order list certification deadline is actually November 20th, and it is the same, Dr. Drachman, for both applicants and programs. Yeah. I was checking my little thing. I'm like, oh no. Yeah, I wanna make sure I had that right. So it is November 20th. So that will be the same date for both applicants and programs. So that deadline is at 9 p.m. Eastern time, and it is a hard and fast deadline. So once that deadline passes, the system will actually shut the ranking function down entirely. So just want you to kind of circle that one in red on your calendars to make sure that your lists are both in and certified so that we don't have any issues moving forward with the match. And then we do have to take a little bit of time there to run the algorithm, and of course we do have some holiday issues when we're looking at some of the fall matches. So it does take a little bit longer for the medicine and pediatric specialties match to go to results. So the results for that match will be at noon Eastern time on December 4th. And so that's when the results will be released. Unlike the main residency match, the results are released at the same time for both applicants and programs. You find out both if you matched and where you matched at the same time. That is different if you're familiar with the residency match. It is a little bit different. Programs also find out at the same time both whether or not they filled and with whom they filled. And all of your reports are available at that time. So you'll have your confidential roster of your matched applicants as well as your match results by ranked applicants so that you can see where all of the applicants that you ranked also matched so you can get some insight there as well. So all of those reports will be available on December 4th. And of course, training begins on or around July 1st, 2025. So we're talking about what happens next from right now to when that match opens. So the first thing on kind of the to-do list for everyone is to provide your program information. And that's the number of entering fellows, your match quota, your PD and your PC information to SC&I. So, and that's what's going to be how you register, register your program for the match. And I'm not sure how Laura, how that's happening from your side, but maybe we can get to that. But that will be kind of the piece. You'll find if you look on our website, there is a new program form. We do not want you to fill that out because we're gonna be loading everyone electronically kind of in one fell swoop with the information provided to us by SC&I. So SC&I is gonna make sure that they have all of the program information and all of this information. They're gonna provide it to us and we're gonna load it so you all don't have to fill out like multiple forms and try and get this information in multiple places. So we will load your system, your program into the match and then it will be prepared to open on August 21st. On August 21st, then you will receive as a program director and your program coordinator will also receive information on registering in the registration ranking and results or R3 system, your individual user accounts to administer your program in the match. So that's what will happen on August 21st. So your program will already be registered through the information you provide to SC&I and then when the match actually opens, you'll register your individual user account as a program director or as a program coordinator. You should also probably let your DIO, your GME office know that you'll be participating in the match. This is a large fellowship match so the DIOs will all get emails the day it opens as well to say hi, you have programs participating in the match. We don't love for them to be surprised when they are going down their list of programs like, oh look, here's a different program than usually participates in this match. So you may wanna let your GME office, your designated institutional official, know that you'll be participating in the match and that interventional cardiology is new to the match. We have been communicating with them as well through our regular DIO calls and providing information to them through our newsletters but you just may want to let them know that your program specifically is going to be participating in the match. You might also want to consider updating your program website to inform applicants that you will be participating in the upcoming medicine and pediatric specialties match and that it does open for registration on August 21st because the applicants will also have to register for the match once it opens on August 21st. And then there are a ton of resources on the NRMP website. And so I've given you there a QR code for the program checklist and that is a program checklist that's gonna walk you through the entire match season. So it provides all the different resources and links to support guides and all of the things you're gonna need to walk you through this process. There are also some built-in flexibility things that you can do. I don't know how many of you have multiple fellows that are entering your programs in a given year but if you do have different flavors of your training, you can have different program tracks. So for instance, you might have a research track and a clinical track. There are other, so we have all kinds of different fellowships, some will have global tracks, some will have rural tracks. So you can have all kinds of different tracks within your program. So if that's something that you're interested in, we would encourage you to reach out to the NRMP staff once we have gotten that program information from SC&I and we can build out those additional tracks for you. So they won't be built out initially when you provide your information to SC&I but it is something that we can do to help you later on. So when we talk about additional tracks, you would have separate rank order lists for each track that you have. So if you have a group of applicants that are interested in research and you wanna have a research track, you would rank those applicants that are interested in research on that research track and then the ones who are interested in clinical on that clinical track. And if you have folks who are interested in both, you could rank them on both rank order lists. Tracks are something that you can consider. I won't go into it a ton more here today but if it is something you're interested in, please do reach out to us because we're happy to talk you through that. Along with multiple tracks can come something called reversions and we won't spend a lot of time on this at all because it can get real complicated. But if you do have multiple tracks in the match, you can revert positions from one track to the other in the event one track doesn't fill. So for instance, if you don't have a ton of people interested in the research track but you still need those bodies, you would create a reversion that the system would know when it's running the algorithm, hey, this research track isn't gonna fill, it would just move those positions over to your main track and attempt to fill it there. So you still have the number of incoming fellows that you desire. So there are some built-in flexibility options for you and please work with us. We're happy to walk you through those. As Dr. Druckmann said, NRNP does not, specifically, but there is an interview and application process. The NRNP is strictly the match. We are separate, we are firewalled, we try to maintain independence and try and kind of stay away from the application and interview process. We try to be a very independent arbiter of the match. And so we do not oversee that application and interview process. So the application methods and dates are set by the specialty or the application service, you all are using ERIS. So kind of the standard application service that most folks do use in the medicine and pediatric specialties. So those dates are set by ERIS, but we work with the match, we work within the schedules of the application service and the specialty to make sure that the matches kind of fit the right timelines. Same with dates for interviews, they're set by the specialty or the individual programs. So we don't actually set those interview dates, but of course, you do need to have all of your applicants, of course, interviewed in advance of that ranking deadline so that you can make your ranking decisions and enter those in the interim piece system. So in terms of the matching algorithm itself, you've done all the things, right? You've registered your program, you've registered yourself, you've gotten in there, you've set your quota, you've reviewed applications, you've interviewed your applicants and you enter your rank order list. What do we do with it then, right? From there, it is in the interim piece hands and we do use a computerized mathematical algorithm that does place applicants into their most preferred fellowship program that also prefers them. So it is an applicant proposing algorithm and basically what that means that it just starts with the applicant's list rather than the program's list. But there is no match to the program if the applicant didn't rank the program or if the program didn't rank the applicants. You have to have what is called a mutual rank for there to be a match to happen. So you'll never get an applicant that you didn't want, right? Unless you put them on your list. So you wanna make sure that your list reflects your true preferences of the trainees that you intend or prefer to train. And then you can't, there isn't a match to the program of the applicant if the program and applicant ranked each other but the program's already filled with more applicants it prefers. So it really does iterate through the applicant's list until it makes the best match possible for both the applicant and the program. Matches are final when it completes that cycle of going through all of it. It just keeps iterating until it gets to the best possible solution. And then tentative matches that are made during that process are confirmed. Mentioned earlier, there is couples matching. The algorithm, couples will match when the algorithm can place both partners on their highest ranked pair of programs on that rank order list. You all as program directors don't really have to worry about the couples function. You should still rank according to your true preferences. Whether or not a partner or a couple is couples matching really shouldn't impact how you rank at all. Because there are lots of different combinations that the applicants can do on their rank order list. They can rank a program multiple times to a different rank, to a different program on their partner's rank list. So you don't want to try and worry about the couple status when it comes to your particular rank order list. Want to talk about the fees a little bit. There is, there are some kind of fairly nominal fees for participation in the match. There is an institution registration fee, but that is per match. And so what we mean by that is that if your institution is already participating in the medicine and pediatric specialties match for any other medicine subspecialty or pediatric subspecialty, interventional cardiology joining the match is not going to be an additional fee. It's already going to be being paid by your institution. So I would hazard a guess that every one of your institutions already participates in the medicine and pediatric specialties match. So they've already paid or they're already paying that $250. So the additional fee for the interventional cardiology participation would just be that program registration fee, which is $60. And that's $60 per track. So if you have multiple tracks, it's $60 each. And then $60 per applicant that we matched to your program. So those are the fees. Those fees are billed to the institution, not to the individual program. They're billed to the institution at the conclusion of the match. Whether or not your DIO then passes that cost along to the department is up to the institution. So there is no cost to the sponsoring organization. So SC&I does not have any sort of fee for participation in the match. Wanted to spend a few minutes talking about match policy. As Dr. Drachman said, there is a binding commitment. So placing an applicant on your rank order list and an applicant placing your program on their rank order list and a match occurring creates a binding commitment for you to provide the training that you've said you're going to provide and for the applicant to attend that training. So that binding commitment is one that only the NRMP can waive. So if for some reason there is an issue with your program or your funding or there is a problem, you can't just say to the applicant, sorry, we can't provide this training. Only the NRMP can do that. So a waiver would have to be submitted to the NRMP of that binding commitment. Same thing on the applicant's side. If something happens, if life intervenes somehow and they cannot come to your program, they would have to submit a waiver to the NRMP. Waivers are only granted in the event of a, usually it's just hardship. So it's got to be an unforeseen hardship situation that occurs. And those waiver cases are adjudicated on an individual case-by-case basis with NRMP policy and compliance staff and our board. So there is a subgroup of our board that is the Policy Review Committee and they adjudicate all of those waivers on a case-by-case basis. So unanticipated hardship is generally the only kind of waiver issue that we would have. But for loss of funding, obviously would be an unanticipated hardship on the program. So those are the kinds of things that we would grant waivers for. But only the NRMP would be able to grant those waivers. In addition, your program does have a requirement to provide complete, timely, and accurate information to your candidates. And so what that means is that you do need to provide both the institution and the program policies that you expect your applicants to abide by and to meet in advance of that ranking deadline. So you need to make sure that you've been able to provide all that information, whether it's on your website or whether it's through something that you provide to them at the interview process. You want to make sure that you are providing complete, timely, and accurate information about your program. That also includes the contract that the fellow will be expected to sign. So that information does have to be provided to the applicants in advance of the rank order list deadline so that they can make informed choices as they're creating their rank order list. All of our policies go both ways. The applicants are required to provide you complete, timely, and accurate information about their training, about themselves, on their application in the interview process. There are also restrictions on persuasion. So you cannot ask an applicant if they intend to rank your program, and applicants cannot ask you if you intend to rank them. So there are restrictions on persuasion. In addition, you also cannot ask questions about where else an applicant is applying or interviewing. So you want to make sure that you are only focusing on whether or not the applicant is a good fit for your program. Last but certainly not least, I've already talked about waivers, interview policies. We do have some interview policies. They are not super impactful when it comes to the fellowship level. They're mostly focusing on the main residency match. But we do require that for interviews, if you're sending out interview invitations, you only send out as many interview invitations as you have interview slots. So I would imagine that for most of you, I mean, some of these internal medicine programs are sending out hundreds of interview invitations to hundreds of candidates. Probably not a huge issue at the fellow level. In addition, you are required to provide an applicant 48 hours to accept or decline an interview invitation before you move on to the next applicant for that interview slot. So those are just some of the policies. There is a match participation agreement that you will all sign when you register for the match. It includes all of these policies, and there's also a lot of policy information on our website. Did I go the wrong way? Oh, I'm going the wrong way. Sorry. Just some frequently asked questions. Can I use the match if I have an internal applicant? Yes, you can, and we would encourage you to use the match for your internal applicant. If you rank an applicant number one on your list and they rank you number one, your program number one on their list, it's a guaranteed match. So you are allowed to say to the applicant, to the internal candidate, we would really like to keep you here, and we intend to rank you number one. You cannot ask if they intend to rank you number one, but you can say, we want to keep you here, and we're going to rank you number one. So then it is, of course, up to the applicant whether or not to then rank your program number one, but you can say those things with the goal of trying to keep an internal applicant in your program. But you would, of course, still want to continue to, you know, have other interviews and look at other candidates, but we do encourage, even with internal applicants, for you to participate in the match because it's the trainee-centric right thing to do for your trainees so that they can still look at all of their options. In terms of what if your program doesn't fill, you will find out at noon on match day whether or not you have filled your program, and we do provide the list of applicants who did not match to programs who did not fill so that you can reach out to those applicants. And then for the applicants who didn't match, we also provide a list of unfilled programs. So that information is made. It's more of the traditional scramble. There is not a SOAP process, which is the Supplemental Offer and Acceptance Program that is available in the main residency match. We do not currently have that for the fellowship match. So it's just the list of unmatched applicants and unfilled programs that are exchanged so that you all can reach out to each other and try and fill any remaining positions. And then if my matched applicant backs out of their match commitment for July 1, you should know it's a pretty rare occurrence, but it would be the waiver process. So you would need to submit a waiver of the match commitment to the interim P so that you would be able to then go and fill that position. But you cannot fill a position until that binding commitment has been waived by the interim P. So if the matched applicant tells you that they're going to back out, then you put it in the interim P's hands. We will work through the waiver process with you and the applicant to waive that commitment so that you can then go out and recruit a new applicant. Last but not least, the match is going to provide you with lots of results and data information. So we do provide, as you have multiple matches, of course, you'll have more trend data, but we do provide a lot of data for you. One of the new things that we're doing also that we are getting ready to release this week, actually, for the Specialties Matching Service, which is all of the fellowship matches, the demographic information for all of the matches across all of the specialties. And so that is the types of information that you all will have about your applicant pool, about what your specialty looks like, and help you inform some of the workforce decisions you all make as a specialty. And last but not least, we have a ton of support guides, video resources that are available, and so I've got a QR code there on the screen if you need to review any of those resources. And I think that's my time, except to allow you guys to ask some questions. Thank you. It's, first, so great to hear your perspective. A question I have is, say you have an internal candidate. A lot of programs will have internal candidates that they're hoping to recruit. And the program director says to the applicant, we're ranking you number one. The applicant themself knows they're ranking the program number one, but doesn't disclose that to the program director. Does that applicant have to fill out letters of recommendation and everything else in ERS, do you know? Or is there a way that they can just sort of put in a shell in ERS and still go through it? Yeah, so we don't actually care whether they apply at all. I mean, we don't even get that information. We have no idea who has applied to your program, and we have no idea who has interviewed with your program. So if the applicant never fills out an ERS application at all, we don't care, as long as they register for the match and rank your program. Okay. So the number that you get is through NRMP? That's correct. That is their ID number as opposed to ERS that assigns an NRMP? Yeah, NRMP assigns the NRMP ID. Got it. ERS does not. So an applicant doesn't, I mean, from our point of view, an applicant, I mean, they could walk down the street with a sandwich board. We don't care how they apply. So you can get all your applications outside of ERAS? I mean, I would imagine it would matter to ERS. Do you mean the letters of recommendation that you're an administrator and maybe just apply that way? I would leave that as a specialty decision or an individual program decision, but from the NRMP standpoint, we are application agnostic. So we do not have a dog in the fight in terms of applications. So it's really up to the specialty and the programs. Yes, they can apply completely outside of ERAS if they choose. Yep, that's guaranteed match. Yep, if you rank them one and two and they both rank you number one, guaranteed match. Yeah, yeah, thank you for mentioning that. I mean, just like, I think we feel really committed as a society to support this idea of a match, and we want to be supportive to all program directors, certainly, as well, and practices that they have. But going through the match process to recruit even internal candidates will be imperative for us to get a 75% success rate. And if we don't, then you can tell us what the, what the peril is here. I mean, we're here to help, right? I mean, we're not, we're not, we're not going to say, you didn't reach 75% this year, no match for you. So we're generally not super punitive. We will work with a specialty who falls below the 75%. If it becomes a pattern, then yeah, we will have to talk about whether or not the NRMP can continue to manage a match for your specialty. And the reason we set those thresholds is because we know that that is where success lies. We've been doing this for 72 years. Once you start to fall below those 75% thresholds, the applicants are going to go where the positions are. And so the more applicants that leave your match, the more programs are going to leave your match, and it becomes a spiral. And so for the good of your specialty, and for, frankly, the good of the applicants, keeping as many positions in the match as possible keeps your match healthy and provides the trainee-centric experience and process that I think is important to professionalize the recruitment for your specialty. Yeah, I mean, from, I would think from most programs' perspective, I mean, whatever application system you choose to use, I mean, EROS being a national system, being on it maybe exposes you to a greater number of candidates that may have been unaware of your program, and now if you're on a list, they can do some research about what type of program you are, and it may expand your applicant pool. So I really see zero disadvantage to EROS, whereas if you have a separate application, separate questions you're asking them, that's additional work that applicant has to do, and then they may be like, hmm, maybe it's not worth putting that program on the list. So it seems like it's, many programs have been using EROS for over a decade plus, so that's not new, and it's very familiar. And I think the other reason as a program to continue to participate, even if you know on a certain year you have enough internal candidates to fill, it is not a guarantee that every single year in the next decade you will have enough internal candidates that you feel are competent or that you wish to stay. And I, you know, one thing I think is going to be difficult for the fellows to figure out, I'm going to be putting an application in, I'm going to check this box, but I don't actually know if they're interested or going to offer any spots to external candidates. There's no guarantee. So that's something as a community that maybe we have to be transparent about. I mean, in the past, we've always, like if the candidates call our program coordinator at Brown, we can give them a sense that, yes, we are definitely accepting and we have at least one spot for an external candidate, such that there's not, like, they're going to be wasting their time. So I think each program is going to have to decide how to communicate that to potential applicants, because I think applicants understand over the years, and they have, like, lived service with each other, certain programs take external candidates, certain programs never do. So I think you have to somewhat just keep it transparent, and it would be nice to know if you're going to open it up. But I think keeping everything in the match every year is the best for everybody. Well, you just said that we want to stay with all these key positions in the match rather than, say, offer one position outside the match and have two, for example. Correct. Let's say if you have an internal candidate and you know 100% you want to take them, one option would be just that they will, you know, will debut. That's, that one, one spot will be taken. I would just go in as a program with two positions in the match rather than going in with each. But even though this is an option, I think the encouragement is to put all these key in the match. Absolutely. Absolutely. It's a little more challenging when you're splitting it up. It's just then you're a single process. And again, then you're, if you match them, number one, and they match you, number one, that's, that's automatic. And then you maybe only have to go down three on the list or four on the list. We don't know. Are you going to go how many applicants per spot, et cetera? But it's to your advantage to have a successful match. I do want to speak to your comment, though, because, you know, I think just numerically, you know, if you know that the candidate is going to rank you to match, although you're not entitled, you can't ask. You can't ask them. Let's just say that you know that they may, they may rank you number one. Maybe their general cardiology fellowship program director has disclosed as such confidentially. It would be very helpful for you to continue to pursue them through the match because otherwise you are going to be at 66 and two-thirds percent participation for your, for your fellowship program as it comes into the national average. And we're trying to get 75 percent of the positions as well as 75 percent of the programs participating in the match. So it's societally incredibly helpful. It does open your program up to the vulnerability that that fellow may select another program number one. They don't have to disclose it to you. And it gets back to the culture of why we are having a match so that there isn't an exploding offer, offer to somebody prior to the match transpiring in which they feel pressured to make that decision. It is allowing them the space to breathe and think and look at other options. And so we all have to be candid. And we have a number of internal candidates who, you know, are probably interested to match with us but we don't know that for a fact. And we're going to look at all other options and make sure that we have a rank list that can support irrespective of their decision making and we'll participate 100 percent with all of our spots in the match. But it is the fairest thing to do because the second you start to work outside of that, the framework, it's a little bit of the old system again all due respect. So, yeah. Yeah, I thank you for asking the question. There's so much discussion among program directors across the nation about whether one should. I love the good old days when we did that because I loved first assimilating like we had our entire faculty interview with every candidate. It was one day we had all the candidates come in on one day. They could take a tour of the institution and see what it's like. They can meet our fellows and talk confidentially about whatever skeletons we may have in the closet as a fellowship program. You know, and I think there's a lot that's great to that. I think that in the contemporary era, it's so convenient to use Zoom or Teams. I think that it provides opportunity for a more equitable access to interviews for those who either can't take the time off or who have other constraints that don't enable them to travel or the expense of traveling. And especially enables people to consider more options without having to fly to look at, you know, 10 or 15 programs. On the other side of this, as certainly you've probably seen in your general cardiology programs or in the medicine residency programs, the number of candidates who apply is just booming. You know, it's 5X, 10X, the number that we used to see because it's a common app through ERS. They'd all have to just check a box and maybe I don't know if there's a fee associated for how many they apply to. So there's some constraint, but, you know, it enables people to kind of, you know, take a flyer and say, like, I'm just going to, it's a lottery. I'm going to just try for your institution, which is out of my reach, but they're going to do it anyway and they can still rank you. And if you want them, then they'll match theirs. Yeah, I would also say that some institutions, where I am at Brown, it's an institutional policy that you offer virtual interviews. We're not actually allowed because it's discriminatory, but the GME office sets up a day or two where interested applicants are able to visit the campus to see if the campus suits their needs, if the areas we meet, they are able to meet with the different groups on campus, like the diversity groups, et cetera, but they don't link it. It's not, we don't keep track of who comes or not so that it's not like, oh, so-and-so came. They must be more interested in the person who didn't come because maybe the person who didn't come, like their parent just died or they, you know, don't have money to get on a plane or train or whatever it is. Like, it's, so I think more and more there may be, and I think there are statements from, you know, AMA and other organizations that really support the virtual interview format. Yeah, the NRMP strongly encourages virtual interviews. You have to choose either or, right? And you have to, yeah, my understanding is you have to have either in-person interviews or virtual interviews. You cannot have an option. The NRMP only provides guidelines on this. We strongly encourage virtual interviews and while what we would call a second look visit is allowed, it's discouraged for all the same reasons that they just talked about. I mean, so we don't set, it's not part of our policy that you will sign with the match participation agreement, but our goal is always to try and be as trainee-centric as possible. And so for us, it is, we strongly encourage virtual interviews and discourage second looks. Yeah, I would say what I experienced in the 12 years I was a program director is that I don't think I offered a single position to someone outside of my institution without speaking to someone on the phone. Their program director, a faculty member at their program, a fellow who used to work with them, like there is the ability still to do some vetting that can still take place in this process. I mean, I tell the fellows like, we're obviously going to know where else you're applying. People are going to call and ask about you. This should be an open and transparent, I try to help the fellows that don't want to stay at Brown. If they prefer to be in a different state or in a program that offers structural as a, you know, guarantee, I would work to help that fellow go to the program that suits them rather than trying to get them to stay where they are because I think they're great. Like, this is what Doug's talking about, the culture of interventional cardiology. We really have to, I think people will be happier, they'll have better performance and wellness if they end up in the right place. So, that's sort of like the whole point of this whole thing, right? Like, as a physician, it's the patients at the center. As educators, it is the trainees and learners at the center of why you guys are here and why you signed up for all this. Yeah, that would that would certainly be helpful something I think Mike can put on the list but I think we internally you know historically have had like 150 to 170 applications and we generally offer 12 interviews. We had a committee you know it started as just me when it was like 80 applications and then we expanded so we had some of the key clinical faculty volunteer to screen and we split them up maybe 30 at a time and we had some certain criteria that we were looking for and then each you know then we got it to a smaller group and then then again smaller ranking looking at the diversity of the pool and it's a process for sure and so you may internally have certain metrics like whether everybody has some sort of metric they're using whether it's going to be a step score or a number of publications or they're something in their personal statement you know I think every program focuses in a little different aspect of the application so you can maybe take your application as it existed and see what you were emphasizing what you were really looking at and that and then translate it the nice thing about ERAS is because you're logging into the site you can as you're evaluating like put some kind of notes like selected for interview like check it or uncheck it invited like you kind of know the status of where that applicant is and that communicates to your program coordinator like they go on they'll know you said select that one for an interview so there's not that's pretty it's a pretty easy system but yeah you're right the number is going to go up I think we're all going to have to deal with that and like I think putting on a large fee after a certain number helps maybe people think twice about every program ad after this numbers 20 30 more bucks but nowadays there's a lot of privileged individuals in medicine who maybe don't care about spending a thousand dollars checking every single one and and I can just see like I hope if there are a hundred applicants and they all apply to a hundred programs that's going to be hard to just to settle out so you you can use whatever algorithm you were using but on the ERAS application and ERAS does have filters that you can use to winnow down your it's really customizable how you view the data that each candidate kind of enters into ERAS and you can kind of prioritize or create kind of a screen that shows you what you want to see I would say just first I totally agree with how Don kind of described their perspective and support that I would caution so first having a match will be great because I can remember in 2021 you know trying to review 168 applications in a weekend and we don't have like the ability or capacity or time to have like a whole committee and get together and understand what people's respective scoring was you just got to crunch through it because people are under time pressure to make their decisions the candidates were so having a match in an open terrain will enable the time to do this in bite-sized you know amounts whether you want to review all of them yourself or not or if you want to have a committee how approach it you have the time and space to think about it that way I would just caution that you know avoid the mentality of rounding up the usual suspects which is looking at specific institutions based on their reputation or solely looking at someone based on a national you know kind of board level score that's a controversial topic presently of course for college applications as well but I think you know it enables the opportunity to think about each candidate for what it was it is that they might represent for your institution we talked about how because you're not guaranteed you could tell both your fellows you're ranking them number one what if they rank you number two you're not getting that fellow so you you by default have to rank maybe you have four internal candidates in two spots so you're definitely not gonna what two of them are definitely gonna stay but for the majority and particularly larger programs you know we've we've always reserved at least one spot for someone outside the institution so fellows know maybe it's only one but that's all they need to know right they know there's a chance they'll apply so I think you just again you're not gonna know I think that part of the nuance also comes in with a sense of how people communicate about their preferences which is very complicated and we're trying to be diplomatic you have to close your ears and I'm totally teasing but um you know what I think that candidates often at least in general cardiology feel the pressure to express their you know kind of priority to one institution and I think that's a detriment I think some institutions subtly convey especially in general cardiology that they want somebody and I've heard so far as maybe even making assurances about a faculty matriculation after fellowship which I think is just unconscionable when it comes to the match I think though that we would want in an ideal system for any applicant to feel that they can rightfully you know place their top selection as the top even if there are two internal candidates that will likely match and fill the two spots they should still be able to put institution a as their top choice and be in no way penalized because if they move on to institution B they will still have exactly the same priority to get that institution because institution a has already filled with their internal candidates based on the algorithm so they're not disadvantaged to rank what would otherwise have been their top choice second in any way shape or form based on the computer algorithm. That's correct the algorithm there is no gaming it I mean it's straight math and the algorithm works best when you rank your true preferences that's the only way to to guarantee yourself the best outcome. The only breakdown the system is when a selfish program demands that the people that they're going to rank at the top have somehow expressed even they're not supposed to. That's the problem. Jeanette, does the program get a report so say you ranked an individual and they don't match with you do you find out directly where they match do you get a report of where whoever you ranked matches? So you get a match results by rank to applicant report so you will get your what is in essence your rank list and it will show where all of those applicants matched however I will caution there are some savvy fellowship program directors who will then rank every single applicant so they can see where every single applicant matched and we will find you and we will have conversations about the behavior so while you while you do have no limits on your rank order list we would encourage you to please play fair in the system and only rank you and keep in mind if that applicant doesn't rank you you have the chance of matching with them so super super risky behavior on your part if you do that so please keep that in mind as well but yeah you will have a match results by ranked applicant report available to you when the match results released at noon on December 4th. What is the difference for the public on the street? I know what I meant to tell you is you know there's a different style some programs offer upcoming two years one plus one some programs you have to pay them some programs give you the option like you have to walk out you know so you do get a fee plus one but you don't want to do that. I think the individual program can you know decide what they want to do like at our institution there's separate fellowships that are competitive we consider internal and external candidates for advanced structural and endovascular training so in that case it doesn't affect our interventional 12-month program but if you have if you have a spot that you wish to be two years like you're gonna funnel a certain applicant directly into structural you can just do multiple tracks so you can offer the two the two-year and the one year through the match and then say nobody picks the two-year it could default you they can arrange it so it defaults them to the one year rather than leaving it blank so that way if nobody that interviewed chose your two-year program you still get them for the one-year program so the matches set up for that I don't know how many programs set up that many different tracks but I think if you have two verse one year that's a good reason to have two tracks absolutely it's a different track yes you can and if that's all you have to offer then that's all you're matching people for you know if you would intend to have someone who's going to come to your program who's not going to stay for two years you could just do a straight-up match and say to everybody who's applying our expectation as you spend two years and you don't have to have a track for instance if you only have one applicant that's interested in a two-year track you can just rank them and then when they match you can say we intend to keep you for two years because that's what you're interested in if you don't have like critical mass of applicants who are interested in a two-year track for instance you don't have to have a track but if you do you certainly can and then we can set up a version to ensure that we can't guarantee anything right it's a match but to to do our best to try and fill and make sure that you have the positions That's correct. Yeah, I mean, you have to give them the training that you've promised them, yeah. Janet, are these slides confidential? Can you share them with us? You all are welcome to them, yeah. Yeah, I'll make sure that they're distributed. Yeah, some of the program directors that couldn't be here asked for if this is recorded or if they could have the slides yet. Yeah, this portion will be posted. Perfect. I'm new to the fellowship and to this guy, but is there a way where we can have like a, I don't know, like a group or something? Some kind of, some kind of... Are you going to tell them what happened? As program directors, so people, you know, as you can see, there's different questions, even not related to the honor or the master. For example, what are you thinking about, you know, which dates you're going to interview? Are you going to do in-person versus virtual? Like, just to take on, you know, other opinions. Because I personally have to go through them. I have to try to find out, you know, other program directors. I reach out to them and call my friends and say, hey, can you connect me to your program director? You know, I can talk to them. So your question is very timely and you must not have gotten our invite. So we literally just launched a WhatsApp group. And basically we're supplied with pretty much as many program director emails as possible. I know some of them may not be current and some may have changed. So definitely connect with us afterwards. I'll make sure you're on it. But it's already pretty robust. I feel like we've got at least 80 of the program directors on it so far, maybe more. So, but it's a great way to sort of have an open forum, confidential. Obviously some guidelines of conduct, which everyone's aware of, on it. But I think this is going to help to revolutionize the program director's community and help us to keep in better touch with each other. So, yeah, we'll make sure that you're on that list for sure. The other thing, just as a plug, I'm sure Sky would appreciate it, there still is the message board or listserv on MySky for the Program Directors community that you can always post to there as well. That's certainly more public and not confidential, but the WhatsApp is confidential. Yeah, it's possible that you could talk to your general cardiology program director to get a sense, because they really have an amazing number of applicants. And I know at our institution, they do 10 to 1, and we historically did 4 to 1. So we're deciding now, we will probably go up to like 6 to 1, just because of the uncertainty in the first year. And then over the first few years, that could be streamlined a little bit. I mean, there is somewhat certainty, I mean, certain candidates, you just have a gut feeling they're going to say, so we used to do it for external spots. So now we have to make a decision too, do we do it for all four spots, times 6, that's 24, that's probably still doable, or do we do it for half the spots? But yeah, I think at the beginning, you're going to have to do a little more, and then hone it down. And the more matches you have, the more data you're going to have, right? So you all are going to start to get a full picture of what your applicant pool looks like, and what the ratios look like of the number of spots to applicants, at least that are ranking it in the match. I was asked to bring up whether or not, I know we sort of had a certain format, we certainly could break out into groups and have sort of more micro discussions and bring it back, or we can kind of keep it open at this point. Do people have a preference? People want to break out into groups versus open? I think open looks good. One thing to float that Don and I were just talking about as people are coming in, I guess, do as a show of hands, do any programs have a standardized approach to their interview day, to their questions, that sort of thing? Is it kind of a free-for-all? We're certainly a free-for-all.

Jeanette Calley

Chief of Match Operations

NRMP

interventional cardiology residency matching

fair play

transparency

registration schedule

rank order list certification

virtual interviews