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We estimate the impact of a matched savings account program on high school students’ college enrollment and persistence through a randomized controlled trial carried out in Italy. The tested program (Percorsi) provided low-income high school students with a 4:1 match rate for savings dedicated to higher education expenditures and required that they attended financial education classes. The program increased rates of enrollment and persistence in university by about nine percentage points. Effects were even larger for vocational school students, who have poorer social backgrounds and lower academic preparation. Incentivized savings programs have potential to reduce social disparities in higher education participation, though the lower saving capacity of poorer households can generate regressivity in program design.

This paper presents an extern program, developed 10 years ago, which recruited unmatched medical graduates and involved them in publishing articles in academic journals, presenting poster presentations, writing grants, and networking with psychiatrists. The study examined how involvement in the extern program affected the candidates’ Match reapplication outcome. Respondents were previous externs who joined the extern program. They were sent questionnaires on how the program affected their Match reapplication outcome. Out of 22 externs surveyed, 15 completed the questionnaire. Results showed that the externship offered graduates opportunities in academic and clinical work, which improved their chances of getting a Match. The 15 respondents had a 100% match rate into a psychiatry residency program upon completing an average of 16 months of academic work in the externship. Respondents agreed that the extern program was beneficial, and they would highly recommend it to struggling medical graduates. Unmatched graduates urgently need guidance during the critical gap year. They should be given options and interventional plans, such as Dr. Rahn K. Bailey’s extern program. The externship provides participants exposure to research and the scientific underpinnings of clinical medicine. It continues to expand and grow, serving unmatched medical graduates and students who need help getting into medical school or a PhD program. Further studies should be conducted on unmatched candidates, in particular, international medical graduates, who reapply and eventually match. This will provide information and insight into what they can do to advance themselves during the intervening period.

The purpose of this study was to compare factors that contribute to increased match rates into general surgery.Survey study.University of Kansas School of Medicine Campuses.A survey assessing experiences and perceptions during their surgical clerkship was sent to graduating medical students from a single university with a hybrid (academic-affiliated community-based) campus, and an academic campus. Specific questions were asked with regard to residents and attendings, procedural experiences, perceived lifestyle, and general interest in surgery before and after clerkship.The match rate into general surgery was significantly higher on the hybrid campus (14.7% vs 4.0%, p = 0.215). Factors that were positively correlated with interest in surgery included interactions with attendings (0.86) and residents (0.63), time spent in the OR (0.77), participation in the OR (0.62), and complexity of cases (0.61). Students on the hybrid campus spent more weeks on general surgery services (6 vs 4, p0.001). More students from the hybrid campus were "Not interested at all" in surgery prior to their surgery clerkship (26.5% vs 16.0). Significantly more academic students indicated they were "Not interested at all" in surgery after their surgery clerkship (52.0 vs 17.6%), while more students on the hybrid campus indicated they were "extremely interested" (29.4 vs 12.0%, p = 0.005) after their surgery clerkship.The rate of students matching into general surgery between the 2 campuses are different, with the hybrid campus having nearly 4 times the rate of students matching into general surgery. Programs may be able to increase their match rate by allowing students more opportunities to participate in the operating room, spending more time on a general surgery service, and by ensuring that medical students are included as members of the surgical team.

BACKGROUND Overlapping surgery is a long-standing practice that has not been well studied. The aim of this study was to assess whether overlapping surgery is associated with untoward outcomes for orthopaedic patients. METHODS Coarsened exact matching was used to assess the impact of overlap on outcomes among elective orthopaedic surgical interventions (n = 18,316) over 2 years (2014 and 2015) at 1 health-care system. Overlap was categorized as any overlap, and subcategories of exclusively beginning overlap and exclusively end overlap. Study subjects were matched on the Charlson comorbidity index score, duration of surgery, surgical costs, body mass index, length of stay, payer, and race, among others. Serious unanticipated events were studied. RESULTS A total of 3,395 patients had any overlap and were matched (a match rate of 90.8% of 3,738). For beginning and end overlap, matched groups were created, with a match rate of 95.2% of 1043 and 94.7% of 863, respectively. Among matched patients, any overlap did not predict an unanticipated return to surgery at 30 days (8.2% for any overlap and 8.3% for no overlap; p = 0.922) or 90 days (14.1% and 14.1%, respectively; p = 1.000). Patients who had surgery with any overlap demonstrated no difference compared with controls with respect to reoperation, readmission, or emergency room (ER) visits at 30 or 90 days (a reoperation rate of 3.1% and 3.2%, respectively [p = 0.884] at 30 days and 4.2% and 3.5% [p = 0.173] at 90 days; a readmission rate of 10.3% and 11.0% [p = 0.352] at 30 days and 5.5% and 5.2% [p = 0.570] at 90 days; and an ER visit rate of 5.2% and 4.6% [p = 0.276] at 30 days and 4.8% and 4.3% [p = 0.304] at 90 days). Patients with surgical overlap showed reduced mortality compared with controls during follow-up (1.8% and 2.6%, respectively; p = 0.029). Patients with beginning and/or end overlap had a similar lack of association with serious unanticipated events; however, patients with end overlap showed an increased unexpected rate of return to the operating room after reoperation at 90 days (13.3% versus 9.7%; p = 0.015). CONCLUSIONS Nonconcurrent overlapping surgery was not associated with adverse outcomes in a large, matched orthopaedic surgery population across 1 academic health system. LEVEL OF EVIDENCE Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Objective: The objective of this study was to analyze the match rates of psychology predoctoral internship applicants by disability type. Method: Through the use of publicly available data from the 2008, 2011, 2012, 2015, and 2016 Association of Psychology Postdoctoral and Internship Centers internship applicant surveys, differences in match rate for applicants with different types of disabilities, as compared with nondisabled applicants, were analyzed. Additionally, trends in match rates for applicants with different disability types over time were analyzed. Results: Across disability type, applicants with disabilities tended to have lower match rates than did applicants without disabilities. These differences were particularly large in applicants with physical/orthopedic disabilities and learning disabilities. These gaps in match rates were narrowing for some types of disabilities but widening for others. Conclusion: Disabled internship applicants experience consistent, negative disparities internship match rates compared with their nondisabled peers. Psychologists must take action to identify and ameliorate the causes of these disparities and address the chronic underrepresentation of psychologists with disabilities. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Changes were made to the independent plastic surgery residency in 2009 to 2010 that included full prerequisite training and increased from 2 to 3 years of independent residency. The authors sought to determine subsequent match trends and predictors of a successful match.With American Council of Academic Plastic Surgeons approval, the San Francisco Match provided data for the independent match (2010-2018). Trends in the independent plastic surgery were reviewed. Applicant variables were analyzed to determine correlation with a successful match and a match at top-ranked programs using Doximity Residency Navigator.Total independent applicants per cycle decreased 18% while foreign medical school applicants increased from 19.4% to 27%. Available positions decreased from 97 to 66 (32%) and match rate decreased from 82% to 78%. Applicants who matched were from US medical schools, had higher USMLE Step 1 scores, were from University and top General surgery residencies, and averaged more interviews (p0.05). By multivariate regression, number of interviews completed (odds ratio [OR] 15.35 95% confidence interval [CI] 7.7-30.6, p0.001) and having completed prerequisite training at a university based program in addition to having graduated from an allopathic medical school (OR 1.78 95% CI 1.1-2.97, p = 0.027) were predictive of a successful match. Step 1 score ≥ 240 (OR 3.2, 95% CI 1.0-10.2, p = 0.046), Alpha Omega Alpha membership (OR 2.2, 95% CI 1.1-4.9, p = 0.048), and having completed prerequisite training at the same institution (7.6, 95% CI 2.2-25.7, p0.001) were predictive of matching at top-ranked programs.Since 2010, independent plastic surgery applicant and program participation have decreased. Greater number of interviews, university-based prerequisite training, and allopathic medical school background are variables that correlate with a successful match. Factors predictive of a match at top-ranked Doximity Residency Navigator plastic surgery programs include high Step 1 scores, Alpha Omega Alpha membership, and prerequisite training at the same institution.

INTRODUCTION Students seek gap years to enhance knowledge and improve chances of professional success. Although many institutions offer research opportunities, no studies have examined outcomes after these experiences. This study evaluates a dedicated year of orthopaedic research on a cohort's ultimate orthopaedic surgery match rate. METHODS From 2001 to 2018, 129 learners spent a year with our Department of Orthopedic Surgery at a major academic medical center. The students were either completing a gap year after college, during or after medical school, or after an unsuccessful match. Participants were asked to respond to a survey, which included demographics, educational information, and metrics related to the program. For the subcohort of students who ranked orthopaedic surgery, the match rate was compared with the mean for the US orthopaedic surgery match rates from 2006 to 2018 using a chi-square analysis. In addition, a Mann-Whitney U test was used to compare the number of publications before and after the year. RESULTS One hundred three students (80%) returned completed questionnaires. Of all learners who applied to and ranked orthopaedic surgery, 91% matched into an orthopaedic surgery residency program. These results compared favorably with the US orthopaedic match from 2006 to 2018 (67.9%; P < 0.001), despite a 4-point lower United States Medical Licensing Examination (USMLE) Step 1 score for the research cohort. Finally, the research cohort had a greater percentage of women (23%) and minorities (40%) than the proportion of woman and minority practicing orthopaedic surgeons. CONCLUSION Students who completed a gap year in research matched into orthopaedics at a higher rate than the national average, despite a lower Step score. Mentors may also target traditionally underrepresented groups to help increase the pool of diverse applicants.

Background Minimally Invasive Surgery (MIS) is one of the more recently established surgical fellowships, with many candidates applying due to a perception of inadequate exposure to advanced MIS during residency. The desire for advanced training should be reflected in increased competitiveness for fellowship positions. The aim of this study is to determine the desirability of MIS fellowships over time through review of national application data. Methods We reviewed the fellowship match statistics obtained from The Fellowship Council, the organizing body behind the MIS fellowship match. Data from January 1, 2008 - December 31, 2019 were included. We compared match rates to other specialties using the National Resident Matching Program, a nonprofit organization established for US residency and some fellowship programs. Results In the period of 2008 to 2019, the number of certified MIS fellowship programs increased from 124 to 141. While this program expansion was associated with a 19% increase in available positions, the number of applications increased 36%. As a result, the number of positions filled increased from 83% to 97%, but the match rate among US applicants fell from 82% to 71% during this interval. In comparison, the match rates for pediatric surgery, surgical oncology, vascular surgery, and surgical critical care fellowships remained largely unchanged, most recently 50%, 56%, 99%, and 100% respectively. Conclusion Over the last decade, US residents have shown an increased interest in pursuing MIS fellowship positions. As a consequence, the match process for MIS fellowships is becoming increasingly competitive.

Due to the Coronavirus Disease 2019 Pandemic (COVID-19), guidelines regarding both elimination of visiting subinternships and substitution of virtual interviews for the 2021 match were adopted. We hypothesize that these changes will result in an increase in home institution match rates compared to previous years.Program match data was obtained using information posted to residency program Instagram pages and the hashtag #PRSMatch2021. Chi square was used to assess differences between groups.Medical school regions were categorized as West, Midwest, South, and Northeast and compared to match program region.Matched candidates to integrated plastic surgery residencies RESULTS: A total of 181/187 (96.8%) integrated plastic surgery matched candidates were identified. Compared to historical controls, there was a statistically significant increase in the home match rate (24.3%, p = 0.004) and statistically significant decrease in match rate for students without a home plastic surgery program (21.0%, p = 0.004). Similar to prior years, applicants were more likely to match in their own region for all regions (p0.001); however, there was a statistical increase in students staying in the South region for residency compared to previous years (p = 0.007).The 2021 match cycle resulted in an increase in home program match rates, while decreasing match rates among students without a home plastic surgery program. COVID-19 polices may have resulted in disadvantages to students from diverse institutional backgrounds. Influences of virtual subinternships and virtual interviews should be further evaluated.

Introduction In 2018, orthopaedic trauma had the lowest match rate among orthopaedic subspecialties. The purpose of this study was to determine the importance of factors evaluated by orthopaedic trauma fellowship directors when ranking applicants after the interview. Methods An electronic survey was submitted to fellowship directors and consisted of 16 factors included in a fellowship application. Respondents were asked to rate the importance of these factors for applicants they interviewed on a 1 to 5 Likert scale, with 1 being not at all important and 5 being critical. Results Thirty-seven fellowship directors responded (63.8%). The highest-rated factor was the applicant interview (mean score 4.82), followed by the quality of letters of recommendation (4.69), personal connections made to the applicant (3.89), and potential to be leader (3.86). Fellowship directors at academic programs rated interest in an academic career (P = 0.003), research experience (P = 0.023), and exposure to well-known orthopaedic traumatologists (P = 0.003) higher than their counterparts at private institutions. Programs with more than one fellow rated potential to be a leader higher than programs with one fellow (P = 0.02). Discussion Trainees may use this study when compiling an application to optimize their chances of matching at the program of their choice.

Medical students are anxious about not getting a preferred residency position. We described elective patterns of two recent cohorts and examined associated match outcomes.We conducted a retrospective review of the final-year electives of all students who participated in the residency match (first iteration) at one school for 2017 and 2018. We categorized elective patterns and associated them with aggregated match outcomes. We examined high-demand/low-supply (HDLS) disciplines separately.We described three elective patterns: High Dive, Parallel Plan(s), and No Clear Pattern. Many students had High Dive and Parallel Plans patterns; only a few showed No Clear Pattern. Match rates for High Dive and Parallel Plan patterns were high but many students matched to Family and Internal Medicine. When we separated out HDLS predominance, the match rate remained high but a significant number matched to disciplines in which they did not have a majority of electives. Most High Dive and Parallel Plan students who went unmatched did so with HDLS discipline electives.Many students chose High Dive and Parallel Plan strategies to both high-capacity and HDLS disciplines. Match rates were high for both patterns but students also matched to non-primary disciplines. Back-up planning may reside in the entire application, and not just electives selection.Les étudiants en médecine sont anxieux à l’idée de ne pas obtenir le poste de résidence souhaité. Nous avons décrit les profils de stages à optionde deux cohortes récentes et examiné les résultats des jumelages associés.Nous avons mené une évaluation rétrospective des stages à option d’externat senior effectués par l’ensemble des étudiants qui ont participé au jumelage de résidence (premier tour) dans un programme de médecine pour 2017 et 2018. Nous avons classé les profils de stage et les avons associés aux résultats de jumelage agrégés. Nous avons examiné les disciplines à demande élevée et à offre faible (DEOF) séparément.Nous avons décrit trois profils de stages à option : le « grand saut », le plan parallèle B et aucun schéma précis. De nombreux étudiants présentaient des profils de type « grand saut » et plans parallèles. Seuls quelques-uns ne présentaient aucun profil précis. Les taux de jumelage pour les schémas grand saut et plan parallèle étaient élevés, mais de nombreux étudiants étaient jumelés à Médecine familiale et Médecine interne. Quand nous avons séparé la prédominance DEOF, le taux de jumelage restait élevé, mais un nombre important d’étudiants obtenaient un poste dans des disciplines pour lesquelles ils n’avaient pas fait une majorité de stages à option. La plupart des étudiants avec profils « grand saut » et plan parallèle qui n’avaient pas été jumelés avaient fait des stages à option dans des disciplines DEOF.De nombreux étudiants avaient choisi des stratégies « grand saut » et plan parallèle pour des disciplines à haute capacité ainsi que des disciplines DEOF. Les taux de jumelage étaient élevés pour les deux profils, mais les étudiants se jumelaient également à des disciplines autres que leur premier choix. Une solution de rechange peut se trouver dans l’ensemble du processus, et non pas seulement dans la sélection des stages à option.

Background and Objectives: Medical students who train in rural communities are often exposed to physicians practicing a broad scope of care, regardless of discipline. We examined how rural education is associated with practice specialization rates for students who match in primary care or general core specialties. Methods: We linked practice and specialty data (2016 AMA Masterfile dataset), demographics (American Medical College Application Service data), and internal college data for 1974-2011 Michigan State University College of Human Medicine graduates who received clinical education on either the Upper Peninsula (rural) or Grand Rapids (urban) campuses. Current practice was verified using internet searches. We compared specialty and practice data by rural or urban campus, controlling for multiple variables. Results: More rurally-trained graduates entered primary care (PC) residencies (128/208, 61.5%) than urban-trained graduates (457/891, 51.3%; P

Supplemental Digital Content is available in the text., Problem Medical students are applying to increasing numbers of residency programs to increase their likelihood of success in the Match. However, they have limited data to help them understand their level of competitiveness or identify programs to which they should apply. Approach In 2014–2015 (Match year 2015), the University of Maryland School of Medicine’s (UMSOM’s) Office of Student Affairs (OSA) implemented an electronic interview tracking tool in which students update their residency application interview status on an ongoing basis. OSA deans can filter and sort data by student, specialty, program, academic metrics, and interview status. The deans use these data to advise students in real time, provide students with examples of programs to consider, and engage clinical faculty to support students at risk of not matching. Outcomes In the Match years 2015, 2016, and 2017, respectively, 86% (n = 135/157), 87% (n = 138/159), and 94% (n = 151/161) of UMSOM students participated actively in this tracking tool, adding over 3,000 data points per year. Following the tool’s launch, the average number of applications per student remained stable. The UMSOM’s Match rate and percentages of students self-reporting a match in their top three choices and rating the school’s advising as “very useful” all increased, without comparable increases in national data. Next Steps This tool, which provides students with data-driven examples of programs to which they should consider applying, may be beneficial to students, faculty, and program directors at other institutions—and to the residency application process, if adopted broadly.

Objective Recently, a multitude of new U.S. medical schools have been established and existing medical schools have expanded their enrollments. The National Residency Match Program (NRMP) reports that in 2016 there were 23,339 categorical residency positions offered in the match and 26,836 overall applicants with 17,789 (66.29%) of the total candidates being U.S. allopathic graduates. In view of the rapid growth of medical school graduates, the aim of this study is to determine if current trends suggest a shortage of residency positions within the next ten years. Design The total number of graduates from U.S. medical schools was obtained from the Association of American Medical Colleges (AAMC) for 2005-2014 academic years and was trended linearly for a 10-year prediction for the number of graduates. The yearly number of categorical positions filled by U.S. graduates for calendar years 2006-2015 was obtained from the NRMP and was trended longitudinally 10 years into the future. Analysis of subspecialty data focused on the comparison of differences in growth rates and potential foreseeable deficits in available categorical positions in U.S. residency programs. Results According to trended data from AAMC, the total number of graduates from U.S. medical schools has increased 1.52 percent annually (15,927 in 2005 to 18,705 in 2014); with a forecast of 22,280 U.S. medical school graduates in 2026. The growth rate of all categorical positions available in U.S. residency programs was 2.55 percent annually, predicting 29,880 positions available in 2026. In view of these results, an analysis of specific residencies was done to determine potential shortages in specific residencies. With 17.4 percent of all U.S. graduates matching into internal medicine and a 3.17 percent growth rate in residency positions, in 2026 the number of internal medicine residency positions will be 9,026 with 3,874 U.S. graduates predicted to match into these positions. In general surgery, residency positions note a growth rate of 1.55 percent. Of all U.S. graduates, 5.6 percent match into general surgery. Overall this projects 1,445 general surgery residency positions in 2026 with 1,257 U.S. graduates matching. In orthopedics with a growth rate of 1.35 percent and a match rate of 3.75 percent, there are projected to be 827 positions available with 836 U.S. graduates projected to match. Conclusions Despite the increasing number of medical school graduates, our model suggests the rate of growth of residency positions continues to be higher than the rate of growth of U.S. medical school graduates. While there is no apparent shortage of categorical positions overall, highly competitive subspecialties like orthopedics may develop a shortage within the next ten years.

Background and purpose To evaluate the impact of student pharmacist participation in a mock interview session on confidence level and preparation regarding residency interview skills. Educational activity and setting The study setting was a mock interview session, held in conjunction with student programming at the American College of Clinical Pharmacy (ACCP) Annual Meeting. Prior to the mock interview session, final year student pharmacists seeking residency program placement were asked to complete a pre-session survey assessing confidence level for residency interviews. Each student pharmacist participated in up to three mock interviews. A post-session survey evaluating confidence level was then administered to consenting participants. Following the American Society for Health-System Pharmacists (ASHP) Pharmacy Resident Matching Program (RMP), a post-match electronic survey was sent to study participants to determine their perception of the influence of the mock interview session on achieving successful interactions during residency interviews. Findings A total of 59 student pharmacists participated in the mock interview session and completed the pre-session survey. Participants completing the post-session survey (88%, n = 52) unanimously reported an enhanced confidence in interviewing skills following the session. Thirty responders reported a program match rate of 83%. Approximately 97% (n = 29) of the respondents agreed or strongly agreed that the questions asked during the mock interview session were reflective of questions asked during residency interviews. Discussion Lessons learned from this mock interview session can be applied to PGY1 residency mock interview sessions held locally, regionally, and nationally. Summary Students participating in the ACCP Mock Interview Session recognized the importance of the interview component in obtaining a postgraduate year 1 (PGY1) pharmacy residency.

Introduction The current demand for pharmacy residencies far exceeds supply. The primary purpose of this study was to determine if presence of a pharmacy residency elective course has an effect on the American Society of Health System Pharmacists Residency Matching Program (“the Match”) rates. Methods Data from the 2018 residency match were collected. Independent variables such as presence of a residency preparation elective course, residency track availability, school's affiliation with a residency program, interest in residency (as measured by the number of students enrolled in the Match divided by the number of degrees conferred), age of pharmacy school, first-time 2018 North American Pharmacist Licensure Examination pass rates, number of degrees conferred in 2018, funding status, and geographic region were analyzed to determine factors that could affect or had an association with match rates. Results From 139 accredited pharmacy schools, data from 135 schools of pharmacy were included in this study. The match rate for schools with a residency preparation elective course compared to those without was 61% and 62%, respectively. Following univariate linear regression analysis, availability of a residency course did not significantly affect residency match rates. The covariates of geographic region and funding source were significantly predictive of residency match success. Conclusions The presence of a residency preparation elective course in the curriculum did not have a significant effect on 2018 match rates when accounting for various variables. It is uncertain whether enrollment in such an elective would have an effect on match rates.

To describe applicant characteristics and outcomes associated with the ophthalmology fellowship match.Retrospective case-control study.This study took place in San Francisco and matched data for ophthalmology fellowship applicants in the USA. The study population was registrants for the 2010-2017 ophthalmology fellowship match cycles. The match rate took place during the 8-year study period. Applicant characteristics were stratified by match status and factors associated with matching to ophthalmology fellowship positions.Between 2010 and 2017, most applicants (2,558/3,471; 73.7%) were matched into ophthalmology fellowship programs. No difference over time in the proportion of applicants that matched for fellowship was identified (P = .41). On average, ophthalmology residents who were matched into fellowships had higher step 1 (difference: 9; 99% confidence interval [CI]: 6.8-10.9; P.001), step 2 (difference: 9.5; 99% CI: 7-12; P.001), and step 3 (difference: 7.4; 99% CI: 5-9.7; P.001) scores than those who did not match. Applicants who matched also had a greater number of application distributions (difference: 9.6; 99% CI: 7.9-11.2; P.001), and ranked programs on the match list (difference: 6.2; 99% CI: 5.8-6.7; P.001). Among applicants who matched, 15% matched at the same institute, 29% matched in the same state, and 45% matched in the same region. On multivariable analysis, factors associated with an increased likelihood of matching into an ophthalmology fellowship program included graduates from the US versus graduates from non-US residency programs (odds ratio [OR]: 2.09; 99% CI: 1.27-3.44; P.001), increasing percentage of applications ranked (number of ranked programs and/or number of applications distributed) (OR: 1.02; 99% CI: 1.02-1.03; P.001) as well as having ranked more programs (OR: 1.24; 99% CI: 1.17-1.31; P.001). Medical graduate status outside of the US (OR: 0.58; 99% CI: 0.36-0.93; P.001) was associated with decreased odds of matching for fellowship.From 2010 to 2017, approximately three-quarters of residents applying for an ophthalmology fellowship position matched. Factors associated with increased likelihood of matching included the applicant's graduating from a U.S. residency, graduating from a U.S. medical school, ranking more programs, and having a higher percentage of applications ranked (number of programs ranked by applicant and/or number of applications distributed). The information gained from this study may help applicants as they consider applying to fellowship programs.

We examine the degree to which training models for specific sub-groups within a population can help improve precision and recall in linking historical records. We focus on an application of linking individuals between the 1900–1920 US censuses. Our results are an inverse of the transfer learning question and also relate to the ways in which training data built for the full population can result in biased predictions for minority groups in the population. We find that training a model specifically for German-born Americans improves our precision rate for these links from 79.1% to 92.7% while decreasing our recall from 94.5% down to 91.4%, thus dramatically increasing our true match rate for this subgroup. Similar analysis can be done based on gender, birthplace, race, and uniqueness of one’s surname.

Although nearly half of medical students are female there is still a significant discrepancy in the number of women specializing in radiology. In 2013, 26.9% of US diagnostic radiology residents were female, a 1% increase in 20 years from 25.5% in 1990.The purpose of this project is to determine the effectiveness of the interventions implemented at a single medical school at decreasing negative attitudes about radiology held by medical students of all genders and whether those same interventions will increase the number of female medical students matching into radiology.The interventions were implemented between 2012 and 2016 and included incorporation of radiology into preclinical curriculum, electives in radiology for 3rd year students, a "Women in Radiology Panel," and increase in female radiology faculty visibility. First year medical student participants of all genders used a free text box to write their attitudes about radiology, which were categorized into the "six most common attitudes about radiology." Fourth year medical student participants used a free text box to write the reasons why they did not choose radiology as a specialty, and those answers were then placed into the same six categories. We then analyzed the data using Fisher's Exact Test to determine whether there was a decrease in the negative misperceptions after exposure to the interventions. We also then determined whether there was an increase in the number of women matching into radiology using Chi-Square analysis.There was a decrease in the negative misperceptions between 1st and 4th years, with the most notable decrease from 51% of 1st years to 0% of 4th years listing radiologists as being antisocial (p0.01). There was also a significant increase in the number of female medical students matching into radiology in the years in which students were exposed to 4 years of intervention when compared to three and fewer (0.76%-4.2%, p = 0.01).Exposure to 4 years of the interventions demonstrated a significant increase in the female match rate into the specialty when compared to female medical students who experienced three or fewer years of intervention. Additionally, it appears that these same interventions decreased the number of students of all genders having some of the common negative misperceptions about the field of radiology.

OBJECTIVE To explore the effect of overlapping surgery on the risk of adverse outcomes in urologic surgery. METHODS Coarsened exact matching was used to assess the impact of overlap on outcomes among urologic surgical interventions (n = 4853) over 2 years (2013-2015) at 1 health system. Overlap was categorized as any overlap, beginning overlap or end overlap. Study subjects were matched 1:1 on 11 clinically relevant variables. Serious unanticipated events were studied. RESULTS Four hundred and thirty-four patients had any overlap and were matched (n = 575, a 75.47% match rate). For beginning/end overlap, matched groups were created (n = 108/83 patients, match rate was 83.07/75.45%, respectively). Among matched patients, any overlap did not predict unanticipated return to surgery at 30 or 90 days. Any overlap predicted neither reoperation, readmission, or ER visits at 30 or 90 days. Overlap patients showed no difference in mortality during follow-up. Beginning/end overlap had a similar lack of association with serious unanticipated events. CONCLUSION Nonconcurrent overlapping surgery is not associated with adverse outcomes in a large, matched urologic surgery population across 1 academic health system.

Background Medical students in the United States are inconsistently exposed to ophthalmology. Not only is this eroding U.S. medical graduates' ability to diagnose and treat ophthalmologic conditions, it may potentially affect interest in the specialty. Methods To assess medical student's interest in pursuing ophthalmology training, this study sought to evaluate the match rate trend among U.S. medical school seniors applying into a U.S. ophthalmology residency and compare the trend to another traditionally competitive surgical subspecialty, otolaryngology (ENT). Results From 2009 to 2013, the rate of successful residency matching for ophthalmology increased (12% increase per year in the odds of matching [95% CI: 1.04, 1.20]), while the ENT match rate decreased (7% decrease per year in the odds of matching (95% CI: 0.87–0.99). The ophthalmology match rate increased despite the fact that the expansion in the number of graduating U.S. medical students outpaced the increasing number of ophthalmology and ENT residency positions. Conclusion The increasing match rate in ophthalmology is surprising and suggests that U.S. medical student's interest in ophthalmology may be waning. Future investigations are needed to determine the reasons behind the increasing match rate and the potential decreasing interest of medical students toward ophthalmology.

Aim: To compare the uniqueness of human dentition in both orthodontically treated and untreated populations and evaluate the reliability of bitemark analysis. Materials and Methods: A total of 1464 maxillary and mandibular casts were fabricated from orthodontically treated and nontreated population. After careful examination of the study teeth, 326 nontreated maxillary cast (Group 1), 333 nontreated mandibular cast (Group 2), 336 orthodontically treated maxillary cast (Group 3), and 320 orthodontically treated mandibular casts (Group 4) were selected for the analysis. For uniformity, the sample size of 320 was selected from each group for comparison. Results: The arch width was a major cause of variance. In Group 1, only 6.87% of similarity rate was seen, whereas in Group 3, the match rate increased to 55% showing similarity. In Group 2, only 1.87% similarity and Group 4 showed 42.7% match rate. Conclusion: The human dentition may be unique, but it loses its uniqueness once any dental treatment is carried out.

Background Combined internal medicine and pediatrics (medicine-pediatrics) residencies were Accreditation Council for Graduate Medical Education (ACGME) accredited separately from their corresponding categorical residencies in June 2006. Objective We investigated how ACGME accreditation of medicine-pediatrics programs has affected the levels of support (both financial and personnel), the National Resident Matching Program (NRMP) match rate, performance on the board examination, and other graduate outcomes. Methods From 2009 through 2013 we sent an annual SurveyMonkey online survey to members of the Medicine-Pediatrics Program Directors Association. Questions pertained to program characteristics, program director support, recruitment, ambulatory training, and graduate data. More than 79% of responders completed the entire survey for each year (sample size was 60 program directors). Results Compared to the time prior to accreditation of the specialty, there was an increase in program directors who are dually trained (89% versus 93%), an increase in program director salary ($134,000 before accreditation versus $185,000 in 2013, P < .05), and an increase in the average full-time equivalent support (0.32 before accreditation versus 0.42 in 2013, P < .05). There was also an increase in programs with associate program directors (35% versus 78%), programs with chief residents (71% versus 91%), and an increase in program budgets controlled by program directors (52% versus 69%). The 2013 NRMP match rates increased compared to those of 2005 (99% versus 49%). Performance on the American Board of Pediatrics examination was comparable to that for pediatrics residents. Since accreditation, a larger number of residents are choosing careers in hospital medicine. Conclusions Our data show widespread improved support for medicine-pediatrics programs since the 2006 start of ACGME accreditation.

The analysis of bronchoalveolar lavage fluid (BALF) using mass spectrometry-based metabolomics can provide insight into lung diseases, such as asthma. However, the important step of compound identification is hindered by the lack of a small molecule database that is specific for BALF. Here we describe prototypic, small molecule databases derived from human BALF samples (n=117). Human BALF was extracted into lipid and aqueous fractions and analyzed using liquid chromatography mass spectrometry. Following filtering to reduce contaminants and artifacts, the resulting BALF databases (BALF-DBs) contain 11,736 lipid and 658 aqueous compounds. Over 10% of these were found in 100% of samples. Testing the BALF-DBs using nested test sets produced a 99% match rate for lipids and 47% match rate for aqueous molecules. Searching an independent dataset resulted in 45% matching to the lipid BALF-DB compared to

Colon and rectal surgery fellowship has become one of the most popular surgical fellowships in recent years with the match rate reaching 100%. The field of colon and rectal surgery involves a technical expertise, diversity of skills, evolving technology, and multidisciplinary care. Maximizing your surgical talents while utilizing your professional relationships thus far will lead to a successful colon and rectal surgery fellowship placement.

The Harvard Medical School Cambridge Integrated Clerkship is a longitudinal integrated clerkship that has provided an alternative clinical model for medical education in psychiatry since its inception in 2004. This study was undertaken in an effort to better understand the student experience of the Cambridge Integrated Clerkship and how it may have impacted students’ perceptions of and interest in psychiatry, as well as performance. Qualitative surveys were sent via e-mail to the first 11 student cohorts who had completed the Cambridge Integrated Clerkship (from 2004 to 2014) and for whom we had e-mail addresses (N = 100), and the free-text responses were coded thematically. All available standardized scoring data and residency match data for Cambridge Integrated Clerkship graduates were obtained. From 2006 to 2014, 12 out of 73 Cambridge Integrated Clerkship students who entered the match chose a psychiatry residency (16.4%), four times more than students in traditional clerkships at Harvard Medical School (3.8% of 1355 students) or the national average (4.1% of 146,066 US applicants). Thirty of the 100 surveyed Cambridge Integrated Clerkship graduates (30%) responded to the qualitative survey with free-text remarks on a number of themes. Cambridge Integrated Clerkship students compared positively to their classmates in terms of standardized test performance. Their fourfold higher match rate into psychiatry compared to other students raises intriguing questions as to what role a longitudinal clerkship might have played in developing interest in psychiatry as a career.

Using new data from a field experiment in India, we test hypotheses about micropension design in a poor population. We elicit demand for the basic micropension in addition to variants with different minimum withdrawal ages, government match rates, and options for lump sum withdrawal. A majority (80%) of respondents report interest in the micropension, and the amount they are willing to contribute would be enough to cover about 40% of expected old-age consumption. We find that prospective policyholders value the inability to access the assets until a particular age. We also find that they respond positively to the government match rate.

Orthopaedic fellowship training is a common step before becoming a practicing orthopaedic surgeon. In the past, fellowship decisions in orthopaedics were made early in the residency and without a formal match. The process was disorganized, often not fair to the applicants or fellowship programs. More recently, there has been an organized match process for nine different disciplines in orthopaedics. Although the numbers of women applicants into orthopaedic residency has been reported and is the target of efforts to continue to improve gender diversity in orthopaedics, the numbers regarding women in orthopaedic fellowships have not been known. Other details including if there is a difference in match rate between male and female fellowship applicants and what discipline they choose to pursue across orthopaedic surgery has not been reported. (1) How have the numbers of women applying to orthopaedic fellowships changed over a 5-year period? (2) Is gender associated with fellowship match success? (3) Which subspecialties have greater proportions of female applicants? Available orthopaedic residency match data regarding number of applicants and number of female residents between 2010 and 2014 were obtained. For fellowship data, our method was a review of the applicants who submitted rank lists and the number of applicants who matched in all subspecialties through San Francisco Match and from the American Shoulder and Elbow Society from 2010 to 2014. For each year, the number of females versus males applying was abstracted. The total number of females versus males who matched was then obtained. For each subspecialty represented in this article, the number of female applicants and matches was compared with the male applicants and matches. The proportion of fellowship applicants who are female ranged from 7% to 10% annually, and the percentage of matched female applicants ranged from 8% to 12%. Overall, combining results from 2010 to 2014, female fellowship applicants had a higher proportion of match success when compared with men (women: 320 of 335 [96%]; men: 2696 of 3325 [81%]; p < 0.001). Pediatric orthopaedic fellowships had the highest proportion of women (79 of 318 [25%] followed by foot and ankle (42 of 311 [14%]; spine had the lowest (15 of 525 [3%]). Women applicants for advanced orthopaedic training matched at a higher proportion than men in fellowship training. Pediatrics has a higher proportion of women applicants and fellows. Orthopaedics should be a model for other surgical specialties by encouraging women to successfully pursue advanced training.

Summary Background For patients who do not have a suitable human leukocyte antigen (HLA)-matched family donor, unrelated donor registries of adult volunteers and banked umbilical cord blood (UCB) units provide the potential for successful haemopoietic stem-cell transplantation. The size and genetic composition of such registries determines the proportion of patients who will be able to find a suitable match. We aimed to assess the proportion of positive matches for Indian patients. Methods Using HLA data from ten existing donor and UCB registries and clinical transplant centres in India, we built population-based genetic models for 14 Indian regions to model Indian registry growth to predict the likelihood of identifying a suitable donor—either an adult donor or UCB—for Indian patients. We computed ranking tables of the top ten haplotypes in each regional group and compared these with four US samples from the National Marrow Donor Program (NMDP) registry. Findings The mean proportion of individuals who would have a 10/10 adult donor match within India ranged from 14·4% with a registry size of 25 000 to 60·6% with a registry size of 1 000 000. Only when donor registries increased to 250 000 did the match rate within India exceed that found by searching the US-NMDP registry combined with an Indian registry of 25 000 donors. The proportion of matches increased logarithmically with increased registry size ( R 2 =0·993). For a UCB registry size of 25 000, 96·4% of individuals would find a 4/6 match; however, only 18·3% would have a 6/6 match. Interpretation Serial match modelling and follow-up comparisons can identify the relative and progressively greater value of an India-based donor registry and UCB banking network to serve the Indian population. Understanding regional HLA haplotype diversity could guide registry growth and maximise benefit to patients. Similar modelling could guide planning for the needs of other ethnically distinct populations. Funding University of Minnesota and the Indian Council for Medical Research.

Purpose: Different strategies have been implemented to assist students in securing residency positions. The purpose of this study was to explore the impact of student participation in residency preparation activities on match rates. Methods: A retrospective observational study was conducted to explore the effect of participation in residency preparation activities and grade point average (GPA) on residency match rate. Match rates for students participating in the Residency Interview Preparation Seminar (RIPS) or mock interviews (ie, intervention group) were compared with students who participated in neither activity (ie, control group). Results: A total of 118 individuals were included in the comparison. Forty-eight students participated in RIPS (n = 29) or mock interviews (n = 19), while 70 students were in the control group. The intervention group had a statistically larger proportion of students securing residency than the control group (81% vs 57%; P = .009). Match rates between students enrolled in RIPS versus those in the mock interview group were not significant. No statistically significant differences were observed based on GPA. Conclusion: Students receiving additional preparation prior to interviews when seeking postdoctoral training were significantly more likely to obtain a residency position. In academic settings with limited resources, mock interviews may be preferred over comprehensive preparatory courses.

Although considerable attention has been paid to increasing internship positions in an effort to solve the internship crisis, lesser consideration has been given to solutions that focus on reducing demand for available positions. Using program match rate data from Association for Psychology Postdoctoral and Internship Centers (APPIC) over the past decade, I estimated outcomes for two strategies to reduce demand for internships: those aimed at increasing qualifications of internship applicants and/or their programs, and those aimed at reducing enrollments of doctoral training programs. Although immediate positive effects were observed for each strategy based on increasing the qualifications of applicants and/or their programs, effects on the internship imbalance would be negligible by the end of the decade. In contrast, methods to reduce enrollments of doctoral training programs were estimated to produce sustainable reductions in the internship imbalance over the same time period. I argue that a plan to reduce enrollments of all doctoral training programs, coupled with implementing a policy to limit access to the annual internship match to students from accredited programs, represents an effective and relatively palatable strategy to solve the internship crisis by the decades' end. Over 4,400 trainees in professional psychology doctoral training programs across North America registered to participate in the internship match sponsored by the Association for Psychology Postdoctoral and Internship Centers (APPIC) in 2012, an all time record high. This notable increase in registered match participants would not be a source of concern, except for the fact that there were only 3,202 internship positions offered in the APPIC match in 2012. Even if all available positions were filled in the annual APPIC match (a state never achieved because not all registered participants apply to all available positions), no internship posi- tions were available for over 1,200 match participants. Although methods for securing internships outside of the APPIC match exist (e.g., the California Psychology Internship Council), the vast ma- jority of internship matches occur under the auspices of APPIC, either through its two-phase electronic match system or postmatch vacancy service. Using data from APPIC, Hatcher (2011b) illustrated the mag- nitude of the match imbalance (p. 218) that has escalated in a linear fashion for over a decade. Although the number of available internship positions has grown annually, the number of applicants registering for the match has increased at a higher rate, leading many professional psychology educators to declare this disparity a crisis (Hatcher, 2011a; Stedman, Schoenfeld, Carroll, & Allen, 2009). The professional psychology training community has not ignored this crisis and in fact has spent considerable time and effort exploring various strategies to reduce the magnitude of the internship imbalance. The efforts described by Grus, McCutcheon, and Berry (2011) illustrate several contemporary strategies to either increase the number of internship positions available or decrease the number of registered trainees. Despite significant effort exerted in solving this problem, the magnitude of the prob- lem has persisted. Indeed, if one examines the APPIC data as Hatcher has, these efforts have had no discernible influence on the trajectory of the prevailing linear trend. In this regard, it is time to consider enacting more dramatic solutions to the internship crisis. Failure to do so constitutes an ethical breech of our responsibility as a training community to provide resources for the next gener- ation of professional psychologists to acquire the professional competencies we promised them when they entered doctoral train- ing programs in professional psychology. The purpose of this article is to consider the influence of several potential solutions to the internship crisis and estimated outcomes in terms of solving the internship crisis. Using publicly available data from APPIC regarding annual match statistics and match rates for each doctoral training program over the past decade, future match rates were modeled for each of these proposed strategies, and will hopefully encourage a more informed response to solving the internship imbalance from the professional training commu- nity.

Keywords:forensic science;forensic odontology;bitemarks;dental uniqueness;geometric analysis;morphometric analysis;orthodontic treatment Abstract: Forensically identifying a suspect�s dentition from a bitemark in an open population requires the supposition that every person�s dental alignment is different. There have been few studies that have tested this claim. Four hundred and ten lower anterior dentitions from a selected population and 110 lower anterior dentitions from one that was orthodontically treated were measured using geometric morphometric analysis, allowing comparison of arch shape. Dental match rates of 1.46% and 42.7% of individuals were found in the respective populations, given an established measurement error. Orthodontic treatment had a strong effect on match rate suggesting that treated or naturally well-aligned dentitions may be indistinguishable. Sexual dimorphism was found to be only slightly significant. Principal shape variation in both populations was degree of arch curvature. Results of studying these populations show that dental matches can occur, and that statements of certainty concerning individualization in such populations should be approached with caution.

Background: Sports medicine is one of the most competitive fellowships in orthopaedic surgery. Despite its popularity, fellowship applicants have limited understanding of the orthopaedic sports medicine fellowship match process. Purpose: To define key outcomes in the orthopaedic sports medicine fellowship match, including the overall match rate, number of programs filled, and number of applicants ranked by programs that filled between 2010 and 2017. Study Design: Cross-sectional study. Methods: This study utilized data regarding the orthopaedic sports medicine fellowship match collected by the American Orthopaedic Society for Sports Medicine (AOSSM) from 2010 through 2017. Applicant data included number of applicants, number of matched and unmatched applicants, and percentage of applicants matching into their top choices. Fellowship program data included number of programs participating in the match and number of applicants ranked by filled and unfilled programs. Results: Between 2010 and 2017, the mean number of orthopaedic sports medicine fellowship applicants was 244.8. On average, 92.0% of applicants matched into a fellowship program. The mean number of programs participating in the fellowship match was 92.9, with a mean of 219.9 accredited positions and 5.4 nonaccredited positions. Over the time period studied, a mean of 75.8% of programs matched all available positions. Programs that matched fully ranked 9.0 applicants per position, on average, compared with a mean of 6.5 applicants ranked per position among programs that did not fully match ( P = .0016). Conclusion: From 2010 to 2017, the number of applicants, positions available, overall match rate, and number of programs participating in the orthopaedic sports medicine fellowship match have remained consistent. The mean number of applicants per position ranked by fully matched fellowship programs was 9.0 compared with a mean of 6.5 applicants per position ranked by programs that did not fully match. These data may be helpful as we look to the future of orthopaedic sports medicine fellowship positions and the match process. In addition, this study reveals characteristics that divide sports medicine fellowship programs that fully match from those that do not. Applicants and/or fellowship program directors may utilize this information to modify their approach to the match process going forward.

Using new data from a field experiment in India, we test hypotheses about micropension design in a poor population. We elicit demand for the basic micropension in addition to variants with different minimum withdrawal ages, government match rates, and options for lump sum withdrawal. A majority (80%) of respondents report interest in the micropension, and the amount they are willing to contribute would be enough to cover about 40% of expected old-age consumption. We find that prospective policyholders value the inability to access the assets until a particular age. We also find that they respond positively to the government match rate.

This paper focuses on the supply and demand imbalance from a scientist-practitioner perspective, emphasizing competency development. A conceptual framework, the Stairway Model, illustrates the basic steps leading to emerging professional competence and stimulates research leading to thoughtful solutions to the internship match imbalance. Three immediate recommendations are offered. Doctoral programs should be (a) held accountable for their match rates, and (b) required to publicly disclose program and national match rates. Third, research must be conducted to determine factors that influence match rate and competency development. Concerns with other commonly proposed solutions are also discussed.

Background The impact of influenza immunization on expenditures for inpatient, outpatient, and professional services among elderly Medicare beneficiaries between 1999 and 2003 was examined. Methods Data were from independent annual survey samples of 175,000 beneficiaries. Response rates ranged from 64% to 71%. Survey data included beneficiaries’ demographics, education, supplemental insurance, perceived health, and influenza vaccination. Baseline measures, derived from Medicare claims for the year prior to influenza season, included service utilization, comorbidities, influenza immunization, and health status. The outcome measure was medical expenditures for acute and chronic respiratory conditions (ACRCs) for each 33-week annual influenza season. Results Total expenditures for ACRCs were lower among the immunized population during all four seasons. The amount and statistical significance of the savings varied with the severity of the virus and the vaccine match to the prevalent influenza strains. During the 1999–2000 influenza season, which had the most severe virus and a close vaccine match, average costs for ACRCs were $88 lower among immunized beneficiaries than among nonimmunized beneficiaries (equivalent to a 3.06% savings). During the 2002–2003 season, which had a less severe virus but the highest vaccine match rate, average costs for ACRCs were $103 lower for immunized beneficiaries than for nonvaccinated beneficiaries (equivalent to a 3.12% savings). The relative reduction in ACRC expenditures among vaccinated beneficiaries is attributable to less frequent use of inpatient services. Conclusions In addition to improving the health of older Americans, meeting the Healthy People 2010 influenza immunization goal of 90% among the elderly should also result in lower Medicare expenditures.

Pause for just a moment to cheer this fact: on March 20, 2015, 3,060 graduating medical students choose a career in family medicine. That’s the news just released by the National Resident Matching Program (NRMP) for the annual celebratory event commonly referred to as the Match. And with that announcement comes the realization that for the 6th straight year, the family medicine match rate ticked upward. Furthermore, 3,216 family medicine residency positions were offered in 2015, an increase of 84 positions compared to 2014. That overall family medicine fill rate of 95.1%—down slightly from 95.8% in 2014—represents 60 more positions accepted by graduates compared to last year. (Read an in-depth analysis http://www.aafp.org/medical-school-residency/program-directors/nrmp.html of the 2015 Match provided by the AAFP’s Medicine Education Division.) The AAFP’s count of students matching to family medicine includes students who matched into traditional family medicine residency programs as well as into programs that combine family medicine education with other focused training. Those additional programs are family medicine/emergency medicine, family medicine/preventive medicine, family medicine/medicine and family medicine/psychiatry. “The Academy congratulates and welcomes these new family medicine recruits,” said AAFP President Robert Wergin, MD, of Milford, Nebraska, in an interview with AAFP News. “When these residents complete their training programs, there will be plenty of patients across the country eager to welcome new family physicians to their communities.” All the well-wishing must be tempered by this sobering reality: The number of US seniors choosing family medicine slowed at an unexpected rate in 2015, to 1,422—with just 6 more US seniors lining up for the specialty than last year. Although the Academy will work in to determine specific factors for that slowing, Wergin pointed to a health care environment in which policy makers and payers have caused instability by shifting positions, reversing decisions and changing the rules—sometimes simultaneously. “This uneven environment likely is taking its toll on medical students who are anxious to finish their clinical training and move on with their careers,” said Wergin. In a press release http://www.aafp.org/media-center/releases-statements/all/2015/match-2015.html the AAFP issued, Wergin put it this way, “We saw a consistent and increasing growth in US medical students matching to family medicine during the implementation of health system reforms that emphasized the importance of comprehensive primary medical care. That has slowed down as policy makers have pulled back from supporting primary medical care.” Wergin highlighted the country’s need for more primary care physicians as the health care system continues to change. “The increase we’re seeing needs to accelerate dramatically if Americans are going to have necessary access to primary medical care,” Wergin said. “The American health care system is evolving from one that reacts to disease with expensive tests and rescue treatments to one that prevents disease and helps avoid complications from chronic conditions. That kind of system will need the expertise of many more primary care physicians working with a team of health professionals.”

Following an anxious week of waiting, graduating medical students recently learned the results of the 2014 National Resident Matching Program (NRMP), commonly referred to as the Match. Those results spotlight a positive trend for family medicine: for the 5th straight year, the number of medical

First, the good news. For the 3rd straight year, family medicine attracted more graduating medical students, according to preliminary figures released by the National Resident Matching Program (NRMP), also known as the Match. The gains made, however, were smaller than in the past 2 years. This year

Background Factors impacting medical student specialty career choice are poorly understood, but may include income potential and lifestyle features such as limited and predictable work hours. Methods Data from the National Resident Matching Program and the San Francisco Match were used to examine match rates into higher-income controllable lifestyle (CL), lower-income CL, and noncontrollable lifestyle (NCL) specialties from 2002 to 2007. We studied 3 cohorts: students from highly ranked, research-based medical schools, other US senior medical students, and independent applicants (consisting mostly of graduates from foreign medical schools). Results By 2007, 22.5% of students from highly ranked schools matched into a higher-income CL specialty compared with 16.5% of other US seniors and 8.4% of independent applicants. During the study period, students from highly ranked schools increased their match rate in higher-income CL specialties by 7.9%, while all cohorts experienced declines in match rates for NCL specialties. Compared with other US seniors, students from highly ranked schools were more likely to match into higher-income CL specialties (odds ratio [OR], 1.46; 95% confidence interval [CI]: 1.27–1.68), while independent applicants were much less likely to do so (OR, 0.46; 95% CI: 0.42–0.51). Independent applicants had the highest odds (OR, 2.38; 95% CI: 2.25–2.52) of matching into NCL specialties. Conclusions All cohorts had declining match rates into NCL specialties from 2002 to 2007. When compared with other US seniors, students from highly ranked schools had the highest odds of matching in higher-income CL specialties, while independent applicants had the highest odds of matching into NCL specialties. These trends are important to consider in light of recent efforts to better balance the physician workforce.

This study linked birth certificates with Minnesota Medicaid deliveries in order to identify Medicaid births. This article describes the link between methodology and results. Medicaid claims from 1997 were used to identify women with a delivery code. Identifiers for these women were linked to birth certificate files, with a match rate of 93.2 percent. Women's match status did not differ by maternal age. Women in some border counties matched at much lower rates than the rest of the population. The methodology was effective in linking Medicaid and birth certificate data and will be implemented as a data linkage protocol for Minnesota.

Aim The HLA haplotype frequencies for Middle Eastern populations are not well known relative to the rest of the world. At The King Faisal Specialist Hospital and Research Center in Riyadh we have collected HLA typing information for thousands of donors and cord blood units from years of stem-cell and renal transplants with the goal of establishing a stem cell registry in the Kingdom of Saudi Arabia. We aim in this study to use these HLA typings to estimate Saudi population haplotype frequencies and in follow-on work to project HLA match rates for the Saudi population as the registry expands. Methods We calculated HLA A∼C∼B∼DRB1∼DQB1 haplotype frequencies from 2,723 Saudi donors and cord blood units typed by DNA methods, resolving phase and allelic ambiguity using the Expectation Maximization algorithm. Haplotype frequencies were estimated to the allele family level for class I loci and to high resolution at class II loci. Results The most common Saudi HLA haplotype was A∗02∼C∗06∼B∗50∼DRB1∗07:01∼DQB1∗02:02 at a frequency of 4.5%. This haplotype is also the 32nd most common haplotype in the US Caucasian population at a frequency of 0.38%. The 2nd most common Saudi haplotype was A∗02∼C∗07∼B∗07∼DRB1∗15:01∼DQB1∗06:02 at 1.7% frequency, which is also the 4th most common haplotype among US Caucasians, and within Europe is most common in Scandinavia. The 3rd most common Saudi haplotype, A∗26∼C∗07∼B∗08∼DRB1∗03:01∼DQB1∗02:01 at 1.6% frequency, is the 14th most common haplotype in US Asian Pacific Islanders at 0.64%, but is quite rare in US Caucasians (rank 466; 0.0036%). Conclusions his pilot haplotype frequency study and the match rate projection to follow will help to form a data-driven approach to the establishment of a robust stem cell registry of adult donors and cord blood units that will aid the Saudi population in need of transplant. Collection of more detailed ancestry information on Saudi donors has the potential to improve match estimates and ensure all subpopulations are well-served.

Aim Innovative single and combined marrow and solid organ transplants used to treat patients with complex disorders and diseases are now being performed by transplant physicians. This study evaluated a method for calculating the probability of finding a suitably HLA antigen-matched deceased donor for a patient being considered for such an organ transplant. Methods A Monte Carlo sampling method was developed to calculate all possible matches for a three locus HLA system (HLA-A, B and DRB1) and estimate the probability of any individual finding a N/6 HLA antigen match (N = 0, 1, … , 6) in the general population. The study began with an existing data set of 250,366 high-resolution HLA haplotypes derived from the HLA typing data of the 21 populations contained in the NMDP registry. We converted each high-resolution haplotype to an antigen equivalent haplotype, thereby creating a reduced data set of 69,750 haplotypes. By selecting an extremely large set of genotype pairs at random, we estimated the number of N/6 matches for each of the 21 populations represented in the NMDP registry. Results The bioinformatics strategy utilized in this study allowed us to produce estimates of N/6 match rates for all 21 populations represented in the NMDP registry. We extended the application of this population-based approach and HLA match rate findings by creating an NMDP web-based tool that would allow physicians to input the HLA typing and race of their patient and calculate the N/6 match rate estimates specifically related to their patient. Conclusions The estimation of N/6 HLA match rates reported in this study will be of particular interest to HLA population scientists and transplant physicians. Availability of the bioinformatics tool will provide much needed support for transplant physicians as they consider the benefits and the risks of a transplant with an N/6 matched donor, set the patient expectations regarding transplant waiting time and outcomes, and determine if alternative treatments should be considered.