Bumsted Tracy, Schneider Benjamin N, Deiorio Nicole M
T. Bumsted is associate dean for undergraduate medical education and associate professor of pediatrics, Oregon Health & Science University, Portland, Oregon. B.N. Schneider is assistant dean for student affairs and assistant professor of family medicine, Oregon Health & Science University, Portland, Oregon. N.M. Deiorio is assistant dean for student affairs and professor of emergency medicine, Oregon Health & Science University, Portland, Oregon.
Acad Med. 2017 Jul;92(7):918-922. doi: 10.1097/ACM.0000000000001672.
Increasing numbers of graduating U.S. medical students are not securing a graduate medical education (GME) position, even after participating in the National Resident Matching Program (also known as "the Match") and the Supplemental Offer and Acceptance Program. The reasons for an unsuccessful Match include increasing numbers of applicants compared with nearly unchanging numbers of available GME positions, academic problems or professionalism lapses, and a poor fit between applicants and their first-choice specialty.In this Perspective, the authors (1) examine the current Match landscape; (2) discuss the environmental factors that affect that Match landscape such as increasing medical school enrollment without a corresponding increase in GME positions; (3) review historical data on unmatched MD students; (4) discuss medical schools' responsibilities to unmatched students and to society; (5) explore controversial issues related to unmatched students, including graduation delays and altering the Medical Student Performance Evaluation for subsequent Match applications; and (6) outline various pathways for unmatched students to secure a GME position in the future or to pursue an alternative, nonclinical position. Finally, they share guidelines for advising unmatched students in the weeks and months following an unsuccessful Match. These recommendations aim to clarify what options exist, and are practical, for unmatched students, with the hope that further study will enable the development of best practices in this area.
越来越多即将毕业的美国医科学生即使参加了全国住院医师匹配计划（也称为“匹配计划”）和补充录取与接受计划，仍未能获得研究生医学教育（GME）职位。匹配失败的原因包括申请者数量增加而可提供的GME职位数量几乎不变、学术问题或职业操守失误，以及申请者与他们首选专业不匹配。在这篇观点文章中，作者们：（1）审视当前的匹配情况；（2）讨论影响该匹配情况的环境因素，如医学院校招生人数增加但GME职位数量未相应增加；（3）回顾未匹配医学博士学生的历史数据；（4）讨论医学院校对未匹配学生和社会的责任；（5）探讨与未匹配学生相关的争议性问题，包括毕业延迟以及为后续匹配申请更改医学生成绩评估；（6）概述未匹配学生未来获得GME职位或寻求替代性非临床职位的各种途径。最后，他们分享了在匹配失败后的几周和几个月里为未匹配学生提供建议的指导方针。这些建议旨在为未匹配学生阐明存在哪些实用的选择，希望进一步的研究能促成该领域最佳实践的发展。
