the other draft

Monday, May 12, 2014

For fans of the NFL, the draft has become a Christmas like celebration of hope for the future and dreams of success. Each team has evaluated hundreds of college football players to find those few who might bring success in the years to come. The team hopes to find the player with skill and personality who can add to team value. The player hopes to be drafted by a team that will allow him to have an impact and play almost immediately and will have playoff potential. The fans want a player who will be skilled, loyal to team and bring pride, dignity and a trophy to their city. Through rounds of intervie

While the NFL draft spectacle occurs under the bright lights of the media, a much quieter draft takes place every spring and the results will affect the local quality of life much more than a quarterback or linebacker. This spring, more than 34,000 medical students applied for a residency training slot, their first step to becoming a specialist after getting their MD degree. Half were from US medical schools, half were international graduates and all were looking for one of 27,000 places to get training in specialties ranging from pediatrics to surgery to radiation oncology. Few people outside of the medical community care about the match, but the results will affect their lives and the lives of their families for a generation or more.

The match dance is pretty simple. Medical students decide what kind of doctor they want to become and apply to residency training programs who will screen the applicants to find the ones that are the best fit for their needs and style. Students visit hospitals and go through rounds of interviews and rank the places in order of preference. Residency directors, sift through applications, recommendation letters and decide on their draft list. On one fine spring day, a computer silently matches the student with their new home. The match is binding, just like the NFL; one goes where one is matched. There are also a few free agents who don’t get matched but a few spots may become available closer to July, when the hospital academic year begins.

But why should you care what newly minted MD might show up to be trained at the hospital down the road? It seems that after spending, three to seven years of more in training, most docs tend to settle down near where they trained. That new medical school graduate may be looking after patients in your neighborhood for the next 30 years. Their kids will go to school wit hyour kids. The next soccer or little league coach may be your family doctor; the obstetrician may sing alto in the church choir and in a few cases, they may be your next Governor or Senator.

The statistics are in from the 2014 match and there is some good news for patients. Almost 40% of US medical students opted for training in primary care, either family medicine, internal medicine or pediatrics. The percentage entering radiology was the lowest in 15 years. The shift away from surgery specialties and radiology may signal that people enter medical school to develop relationships with their patients and that leads them to practices where they can again grow with their patients and their families. It also signals an altruistic change. Primary care is not a highly compensated specialty and while physicians are comfortably paid, the average medical student debt at graduation is north of $170,000. The benefits are not always financial when it come to looking after people.

The new crop of doctors will arriving by the end of June. They will begin forming opinions of their hospital, neighborhood and city relatively quickly. They will develop relationships and roots will be established. If the community is lucky, that doctor will decide to stay a lifetime. If not, it’s just like the NFL, there is always a hospital that will enter the free agent market looking to lure another doctor to their town, and the hope will begin again for the next spring draft.

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