Postgraduate Medical - Page 2
has the option of requiring or recommending a
specific type of first year program (rotat-
ing, mixed, or straight) acceptable as part of
the residency program, or even assigning
trainees to an outside hospital for their first
residency year. A significant amount of flexi-
bility has been introduced so as to permit the
graduating physician to secure postgraduate
training that is specifically designed for
individual interests and career goals. It will also
facilitate long-term plans and ensure a more
stable personal life.
RESIDENT MATCHING PROGRAM
Almost all graduates of U.S. and Canadian
medical schools secure internship appoint-
ments in U.S. hospitals through the National
Resident Matching Program (NRMP).
More specifically, in a recent year, 93% of
about 14,300 U.S. senior medical students
who participated in the NRMP received a
first-year residency position. This reverses the
trend for placement in proceeding years.
Foreign medical graduates are eligible to par-
ticipate if they have passed the USMLE in
September or earlier. In recent years, the
number of foreign medical graduates
participating in the Matching Program signifi-
cantly increased. They filled almost all of the
500 residency slots that were offered.
Currently, about 50,000 residents are training
at U.S. civilian hospitals. The number of
residency slots has increased slightly in
recent years, particularly in the fields of anesthesi-
ology, internal medicine, and, to a lesser
degree, psychiatry and emergency medicine. There
were decreases in positions for residents in
the fields of pathology and plastic surgery.
In the fall of the senior year, all medical
students apply to the hospitals to which
they would like an appointment. Sometime during
the winter, after the students' marks
have been submitted to the hospital residency
program director, they may be invited to
visit the hospital where they will be
interviewed by one or several attending physicians
as well as the director of the training
program. After the interviews are completed in the
early spring, prospective interns make up a
list of hospitals to which they have applied,
with the number one choice at the top, the last
choice at the bottom. All the participating
hospitals submit similar lists of the students
they have interviewed. The lists are gath-
ered in a central office and fed into a
computer, and pairings are made. The seniors'
preferences are then matched with the
hospitals' preferences. This program, which was
instituted in 1952, avoids a great deal of
chaos and anguish, since previously neither stu-
dents nor hospitals knew where they were until
the last moment. The match rate for U.S.
medical graduates is usually higher than
90%.
All specialty boards have made significant
modifications in their requirements to
adjust to the plan for integrated postgraduate
training; senior medical students may now
apply for a first year of graduate medical
education (PGYI), either in one of the existing
types of "internships" or in a first year of
residency in most specialties. For additional
information contact: National Resident Matching
Program, 2450 N Street NW, Suite
201, Washington, DC 20037.
The current average salaries for residents are
in the $25,000 to $50,000 range. How-
ever, as a result of the deterioration of their
financial status because their salaries have
not kept up with inflation and their education
indebtedness has increased, many residents
hold second jobs. Married people, especially
those with children, are the most likely to
be forced to supplement their incomes by
"moonlighting"--working at outside jobs.
The rate of annual increase in house staff
(resident) salaries has been growing
slowly over the past few years. Some hospitals
have not increased their stipends at all,
and a number have even decreased them. In
general, pay increases are higher at hospi-
tals located in the Northeast and lowest for
those in the South. Also, the pay for house
staff at university-owned hospitals, because of
their higher status as teaching institu-
tions, tends to be lower than the national
average, while that for hospitals with limited
university affiliation tends to be
higher.
Most hospitals offer health insurance for house
staff and their dependents as part of
the benefit package. Vacation time varies from
one to four weeks annually with the
amount increasing by the number of years of
training.
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