The “New & Interesting” series is a biweekly compilation of select research findings, news articles, and random tidbits in bullet-point format. The entries are highly abbreviated, but provide links to the original articles or abstracts if you desire to read further.

General Articles

• Comparison of health care systems from around the world. The BBC graphs the health care expenditures, life expectancy, infant mortality, and out-of-pocket spending in four different health care systems. The United States represents a private payer system. The United Kingdom has a universal, tax-funded system. France has a social insurance system, and Singapore has a dual system. (BBC)

Technical Articles

• Randomized trials have demonstrated that aspirin use reduces the risk of colorectal cancer. A recent study published by researchers at the Massachusetts General Hospital evaluated the relationship between aspirin and survival after a diagnosis of colorectal cancer. They found that regular aspirin use was associated with decreased mortality. (JAMA)

• Hospital-acquired MRSA from discharged patients is transmitted to nearly 20% of household contacts (Arch Intern Med)

• Training residents on patient simulators resulted in fewer catheter-related bloodstream infections in the ICU (Arch Intern Med)

The “New & Interesting” series features short compilations of select research findings, news articles, and random tidbits in bullet-point format.

• Implementing the Institute of Medicine’s (IOM) new recommendations for further reducing resident work hours would add costs, but without clear benefits for patient care (NEJM)

• Acid-suppressive medications may increase risk for hospital-acquired pneumonia (JAMA)

Today is Residency Match Day, the moment when over 20,000 applicants learn where they have “matched” to pursue residency training come July. For the uninitiated, here are more articles on match day and the residency match process.

You can imagine the amount of jubilation surrounding this event. Stress- and anxiety-ridden medical students discover the light that follows their four years of slavery through medical school (little do they know that the slavery continues into residency, but let’s not spoil the moment). Families proudly rejoice the significant achievements of their loved ones. Friends find another reason to capture the excitement over a pint or two. And then … there are the overworked, overstressed, over-everything interns who look forward to their replacements arriving soon.

Read more … »

Congratulations to all the medical students who matched today! I hope you matched to the residency program and specialty of choice. Different medical schools have their unique ways of commemorating this occasion, but I gather from others that most Match Day ceremonies involve public humiliation celebration. That is, the student is called on stage, opens a mystery envelope, and proclaims his or her match results before a sea of onlookers. Some schools are more discreet, permitting the student to discover their destiny via e-mail. The next step from here involves preparation for the big move: paperwork galore, moving sales, housing searches, etc. But for now, bask in the excitement surrounding the Match.

For those who went through the Scramble, I sympathize for the added hurdle you had to jump to locate a residency position. I hope that, in the midst of the chaos, you were able to find a good fit.

For everyone else who may not have the slightest clue what I am talking about, here is a super brief summary of the residency match process.

It is interesting what you can find while browsing your hard drive archives. As I pored through my mountain of blog drafts (okay, it’s more like a hill or even a knoll), I bumped into an article I had intended to use in February 2006, before the NRMP rank list deadline last year.

What is the NRMP and how is it like a dating service?

The NRMP (National Resident Matching Program) is an organization that oversees the residency matching process for all but a few medical specialties in the United States. Among a myriad others, these include anesthesiology, dermatology, emergency medicine, family medicine, general surgery, internal medicine, neurology, obstetrics and gynecology, pediatrics, psychiatry, radiology, … you get the picture. There are a few exceptions, such as urology, ophthalmology, plastic surgery, neurology, and neurological surgery, which are part of the San Francisco Matching Program.

The NRMP can be compared to an online dating service. Medical students apply to different residency programs in their desired area of specialty. After the interview process (a series of “big dates”), the students and residency programs submit their respective “rank order lists” (ROL). As the term implies, the applicant’s rank list is an ordered list of residency programs from most to least desired. The program’s rank list is, as you guessed correctly, a list of applicants in order of preference. There can only be one #1, one #2, one #3, and so forth.

Soon after the submission deadline for the rank lists, a computer performs the “matching” process, based on a time-tested algorithm. The computerized process supposedly takes a mere few minutes, but applicants must wait three weeks before hearing where they have matched. A reason given for the delay is that the results need to be re-checked to the nth degree. The match is a binding contract. In essence, this is a marriage that follows a series of dates, but determined by the matchmaker. And just like in the dating world, there is an unfortunate minority who do not match. They enter the “Scramble” to find a position somewhere somehow.

One week from now, over 20 000 residency applicants (and roughly 6000 who enter the Scramble) will discover where they are destined to train and live for at least the next few years. There will be many tears shed, both of joy and of pain.