Back to the Basics: Looking at GME from the Outside

Authors: Viktor LaPorte, MHA, Consultant & Cynthia Gomez, Consultant  

Medical Students
Once a medical student is in their final year of or has previously graduated from Medical
School, they start to apply for residencies through the National Resident Matching
Program (NRMP) also called the MATCH. It is at this time the medical student selects his or
her Specialty of choice and, with the support of the NRMP MATCH, chooses a Specialty
Fourth Year medical students and graduates:
  • Apply for residency positions
  • Interview with programs
  • Complete all scheduled interviews
  • Rank programs at which they interviewed by preference
  • Are ranked by programs at which they interviewed by preference
  • Are matched to a program by NRMP’s algorithm
Once both rank lists are submitted, an algorithm designed and managed by the NRMP runs
for approximately 2-months. At the end of this time frame, both programs and medical
students are notified of their match status: MATCHed or unMATCHed. Those unMATCHed
continue through a second process called SOAP (Supplemental Offer Acceptance Plan)
wherein they can entertain more opportunities to MATCH. By the end of the week, the vast
majority of medical students or graduates are MATCHed and programs filled. The Friday of
this week, usually in mid-March, is a celebrated day for all involved called “Match Day”. This is
an exciting time for medical students and graduates to see where they are going to be
spending the next several years of their life in training. Now, the onboarding process begins
to integrate them into their program, its affiliated hospitals, and affiliated clinics.
Now that the newly MATCHed medical students and graduates are onboarded and oriented
to their new learning environment, they are ready to start caring for patients and learning
about their specialty from the physician experts and associated program faculty. Residents
are supported by senior residents, faculty, and program leadership as well as by the GME Office,
which includes institution-level administrators with a more holistic view of overall culture across all
programs and participating sites. The GME office is in contact with programs constantly
throughout the academic year to ensure the program is running smoothly and residents are
properly credentialed to train across all hospital and clinic sites associated with the
program. Each year residents must meet specific requirements to be eligible to be promoted
to the next level in the training program.
Unlike most academic years, GME Programs run from July 1st to June 30th. Programs will
evaluate their residents semi-annually and residents will be asked to evaluate the program
and its faculty. These evaluations are crucial to the development and continued
accreditation of the training program. After completing a program successfully, residents
can move to staff physician or may choose to advance their clinical skills to the more
focused fellowship training program.
Similar to Residency, fellowships are applied for during the last year of residency. The
match timeline for fellowships vary but is generally during mid-December. Programs will
learn who has matched into their fellowship programs during this time. A lot of times
residents from the current training program will just transfer into a fellowship at their current
institution. Many hospitals have specialized training programs that other hospitals don't offer,
so, at times, fellowships can be competitive and hard to acquire. These
training programs are highly focused. For example, Cardiology, Gastroenterology, and
Hematology/Oncology are three highly sought fellowships following Internal Medicine
residency. Evaluations are given to fellows to help develop training and the program. Once
the fellowship is complete, the now specialized physician can apply for another
subspecialty fellowship (such as Interventional Cardiology following a Cardiology fellowship)
or apply for staff physician positions anywhere in the U.S., and begin studying for National-
level board exams in the specialties and subspecialties of their training.

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