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- William W Parmley, MD, MACC*
- ↵*Send correspondence to: William W. Parmley, MD, MACC, Editor-in-Chief, Journal of the American College of Cardiology, 415 Judah St., San Francisco, California 94122
I am writing this editor’s page during the first week in May. This is about three weeks before match lists must be sent to the National Resident Matching Program (NRMP) for computer matching of applicants to cardiology fellowship training programs that begin July 1, 2001. I have been the cardiology training program director here at UCSF for almost 27 years, and I have seen all the combinations and permutations regarding the selection of cardiology fellows. In the early days, it was every program for itself, with each program moving its individual selection date earlier and earlier to take advantage of the “bird-in-the-hand” philosophy of an anxious fellow applicant. This created chaos for both applicants and training programs.
The use of a common date and time for all programs to offer positions by telephone was a major step forward, although some East Coast programs used the time difference between the East and West Coasts to gain several hours’ advantage. Finally, the linkup with the NRMP provided a uniform acceptance procedure that leveled the playing field for all applicants and programs. This, of course, should have laid the issue to rest once and for all.
Unfortunately, as in past years, some programs (including ones of high quality) have elected to stay out of the match. By offering positions earlier than the match and requiring an answer relatively quickly, such programs have the advantage of getting good applicants who are worried about where, and if, they will match.
As I write this page, this process is well underway. The phone calls and e-mails have started to come in from applicants who have been offered a position outside the match and who want to know where they rank with us. This creates chaos and defeats the entire purpose of the match. Even more disturbing is the occasional call from an applicant indicating that he or she has received an early offer from a program that is in the match. If the applicant accepts, the program will reduce the number of available positions in the match by one.
It is a sad commentary that cardiology training programs cannot agree to all be part of the match and thus avoid these problems. Over the past few years I have heard many excuses for not being in the match:
“We take in different fellows than do the top programs; therefore, we offer no competition.”
“We have special tracks that don’t fit the mold of the NRMP.”
“We mostly take our own house staff,” etc., etc.
Of course, none of these reasons prevent a program from using the match. For example, if there are different specialized tracks, one can have a different match number for each track. Thus, we have two match numbers at UCSF. The usual track is two clinical years, followed by research. The unusual track is three years of research first, followed by two core clinical years. These two tracks have never posed a problem in our match process. I have to believe, unfortunately, that programs outside the match do so primarily to gain the advantage of an early offer with the requirement for a quick reply—all before the match takes place. At best, this is a lack of collegiality and cooperation. At worst, it reflects extreme selfishness and a disregard for others in the academic community.
My fond hope is that all cardiology programs will support the match. Not only will this level the playing field, but it will also markedly benefit fellow applicants and reduce the “hassle” factor for program directors. Is this too much to ask of our specialty, which sponsors Bethesda Conferences on Ethics? I hope not. Let’s all pull together next year!
- American College of Cardiology