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No SOAP to Clean Up Columbia's Match Day Mess

— Opted for no heart surgery residents after accidentally skipping Match

MedpageToday

After New York-Presbyterian/Columbia University Medical Center missed the deadline to participate in Match Day for cardiothoracic surgery, the institution could still have accepted residents from the Supplemental Offer and Acceptance Program (SOAP).

But the program opted to pass.

"We did participate in SOAP, all by the book, but didn't fill the two spots through SOAP. They will remain unfilled indefinitely," surgeon-in-chief Craig Smith, MD, told app.

The two slots represented a not-trivial proportion of the thoracic surgery training available, for which there were just 34 positions filled in the main residency match nationwide.

NYP/Columbia's fits under the thoracic surgery category in the main National Resident Matching Program (NRMP), but Mona Signer, MPH, president and CEO, noted that there were also 855 thoracic surgery fellowship positions filled in this year's match.

Smith acknowledged that there were plenty of candidates in SOAP among whom to chose. The problem was the caliber of available candidates.

"They were all 4th year medical students, so experience was not the issue. We didn't find anyone in SOAP that we felt was a good fit for the program," Smith said.

But he suggested that the loss could be absorbed without too much detriment to the department's surgical capacity.

"The intern year for our cardiac surgery residents is spent mostly in general surgery and related rotations," he noted. "Therefore, a much larger critical mass of residents and extenders is available to get the work done. The missing two positions are spread broadly over at least a few layers of redundancy."

The spots could fill at the end of the year with residents who have completed a year or two at other centers, which does not involve the match, he suggested.

"There have definitely been consequences, and there may be more," Smith noted, although he would not comment on consequences for administrative staff in the department.

"All of this pain and suffering was avoidable if NRMP had the flexibility necessary to accept our list the next morning, plus whatever punishment for the program they thought we deserved," Smith added.

Attending physicians and medical students on the Student Doctor predicted that the example made in this case will be a durable deterrent to Match Day slip-ups.