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Session 48 Pediatrics is a primary care specialty. Usually, primary care spots are easy to match into. Does pediatrics keep up the trend? We’ll dig into their data. The reason for this episode is to give you an idea as to how hard or easy it is to match into a specific specialty. I'm getting all of this data from the NRMP Match Results and Data for 2017. An overview: When you're in medical school, you apply to match into residency in the U.S., through an algorithm-based system. The three people who created this algorithm won a Nobel Prize for it. It's not a usual job application where you apply to 40 places, get interviewed in all of them. Then whoever wants you offer you something you say yes or no. With residency matching, you rank based on what programs you like. And the programs will also rank based on who they like. And the magic happens. [02:47] General Summary of the NRMP Match Results and Data for 2017 Table 1 of the NRMP Match Results and Data for 2017 shows the general summary. Pediatrics for categorical slots have 204 programs and there are 2,738 different positions available. "Categorical means you are going for all three years to that program." They have a pediatrics preliminary (PGY-1) slots. So maybe for those who didn't match into a categorical, you can apply for a preliminary slot to make sure you're going somewhere. In this episode, we're covering mostly categorical.That means you're applying to one program for all three years for your pediatric residency. Comparing it with other specialties, Family Medicine has 520, Internal Medicine has 467, Psychiatry is 236. So there are more psychiatry programs than there are pediatric programs. Surgery is 267. Number of unfilled programs based on Pre-SOAP.  SOAP is the Supplemental Offer and Acceptance Program. The students who match in SOAP are not counted in this chart here. There were 13 programs that went unfilled in the 2017 match. That means they have at least one spot left. Out of 2,738 positions offered, there were only 2,056 U.S. Seniors applying for those programs. So almost 700 spots available for U.S. Seniors assuming your qualified for the spot. This does not count the number of DO students applying for these programs or the number of international medical graduates. The total number of applicants is 3,763 so there are a thousand more applicants than there are spots available and about 700 less Seniors. This implies that there are a lot of international graduates likely applying for the spots. "This is an MD data. The U.S. Seniors in this chart means students at an allopathic medical school." Of those that matched, there were 1,849 U.S. Seniors. There are still 200 U.S. Seniors that applied and did not match. Why? There could be several different reasons for that. Their board scores were terrible. Pediatrics is not a board-heavy specialty but it doesn't mean you can bomb your boards and match. Or maybe they're a bad interviewer or didn't apply to enough programs. Again, 700 fewer U.S. Seniors were applying for the spots but a thousand more total applicants than there were spots available. [08:50] Table 2: Matches by Specialty and Applicant Type Table 2 of the NRMP Match Results and Data for 2017, out of 2,738 positions, number filled 2,693. That's 45 spots that went unfilled. U.S, Seniors that matched were 1,849. So there were 889 left for other applicants. 24 went to U.S. Grads. Again for this data, U.S. Seniors are students who are currently at an allopathic medical school. A U.S. grad is somebody that's already graduated from an MD-granting medical school. These could be students who didn't know what they wanted to do so they did more shadowing or research. Or these could be former students who didn't get in previously. Moving on, there were 361 allopathic students that got into a Pediatrics (Categorical) residency and two students were Canadian.  It doesn't mean a Canadian at a U.S. school means a Canadian graduate. When you look at the overall numbers, only 7 total Canadian graduates got into a PGY-1 position and two of them went into Pediatrics. There were 204 U.S. IMGs (International Medical Graduates). This is somebody who's a U.S. citizen who went to an overseas school - the Caribbean, Israel, Australia, Scotland, or wherever that may be. And 253 were non-U.S. citizen international medical graduates. Lastly, there were 45 spots that went unfilled for the Pediatrics (Categorical) rotation. "Good for allopathic and U.S. IMGs since there's still a big opportunity for you to go into Pediatrics." [12:13] Trends in the Match Program (2013-2017): Growth, PGY-1, Osteopathic Students Pediatrics is growing pretty substantially to about 10% every year from 2013 to 2017. 2013 started off at 2,616 and there were 2,738 in 2017. It's between 9.5% and 10% growth year after year. Figure 5 of the NRMP Match Results and Data for 2017 shows just how big Pediatrics is. Internal Medicine has the most positions offered followed by Family Medicine and Pediatrics is third at 2,821 and 2,775 of those were filled, and 1,880 were filled by U.S. Allopathic Seniors. Table 8 shows the Percent Filled by U.S. Students and All Applicants. In 2017, 67.5% were filled bu U.S. Seniors. And in 2013, 70.2% were filled. It has gone down a little bit for the last couple of years. It's not a huge shift but it's showing you that it's roughly the same every year. "When you look at the average total PGY-1 slots being filled by U.S. Seniors, 60.6% is the average based on all of them." Table 9 shows that 9.7% of all applicants matching into a PGY-1 specialty are categorical Pediatrics. Just for comparison, Family Medicine is 11.6%, Internal Medicine is 25.6%, OB/GYN is 4.7%. Table 11 shows that 12.3% of all osteopathic students an allopathic PGY-1 position program match into Pediatrics. Family Medicine is 19.6%. 23.5% of osteopathic students match into Internal Medicine. [16:37] % of Unmatched U.S. Seniors and Independent Applicants and SOAP For this data, independent applicants refer to IMGs and osteopathic students. For Pediatrics, the total unmatched is 12.4%. The unmatched independent applicants is 30.5%. It's very heavy with independent applicants. Unmatched U.S. Seniors is only 2.3%. In comparison with other specialties, Internal Medicine/Pediatrics shows 0.5% of U.S. Seniors are unmatched. Surgery (Prelim) is 1.3%. Surgery-General is 9.6%. Neurosurgery at 10.4%; Orthopedics at 15.1% for unmatched U.S. Seniors. So pediatrics is relatively low as you would expect. Table 18 shows the programs and positions filled in the SOAP program. SOAP (Supplemental Offer and Acceptance Program) is for students who didn't match in the first go round. This used to be called Scramble. There were 12 programs in Pediatrics that did not fill and participated in the SOAP program. 44 positions were available and all spots were filled through the SOAP program. "In Table 2, it looks like there's unfilled spots. But that doesn't count the SOAP and filling those spots through the SOAP." [18:44] Charting the Outcomes in the Match 2017: Apply Broadly Now, we dig into the Charting the Outcomes in the Match for U.S. Allopathic Seniors in 2016. It displays the information a little bit different so it's very interesting to look at. Chart 4 shows the Median Number of Contiguous Ranks for U.S. Allopathic Numbers. For Pediatrics, students who did not match only have 3 programs contiguously ranked. While those that matched ranked 12 programs. "This is going to be the theme of matching or not matching for every specialty. You need to rank enough programs to match." This being said, you cannot be super selective with programs where you're applying to match. You have to apply broadly. Just like medical school where the average number for the AMCAS applications is 14-15 as well as for DO schools. The same goes for your rank list when applying for residencies. The biggest mistake you can make is not ranking enough programs. Chart 8 looks at the Mean Number of Research Experiences for U.S. Allopathic Seniors that matched and did not match. The numbers are almost identical - 2.4 for those who did not match and 2.5 for those that matched. Chart 12 shows the percentage of U.S. Allopathic Seniors who are members of the AOA. In pediatrics, 16% of the Seniors that matched are members of AOA (Alpha Omega Alpha), the U.S. MD Premed Honor Society for Medical Students. In comparison with other specialties, Dermatology is 53%, Plastic Surgery at 52%, and ENT at 45%. "AOA is very much tied to the more competitive specialties." [22:44] Mean Number of Contiguous Ranks, USMLE Step 1 and Step 2 Scores Still looking into the Charting the Outcomes in the Match for U.S. Allopathic Seniors in 2016, PD-1 (Page 159 of 211) shows the summary statistics on U.S. Allopathic Seniors  for Pediatrics. The mean number of contiguous ranks for those that matched is 11.9 and for those that did not match is 4.0. Again, you have to rank enough programs. Mean USMLE Step 1 Score is 230 for those that matched and 207 for those that did not. Mean Step 2 Score is 244 for those that matched and 224 for those that did not match. Graph PD-1 (page 161 of 211) shows the curve of the probability of matching which is around 64% if you only ranked one program. 70% for two programs. Roughly 75% for three programs. 83-84% for four programs. The more programs you rank, the better your chance will be, even up to a 100% of matching at around 13 programs ranked. [24:14] Medscape Lifestyle and Physician Compensation Reports 2017 The Medscape Lifestyle Report 2017 looks at which physicians are most burnt out. Slide 2 shows that Pediatrics is right above the halfway point at 51% with Emergency Medicine as the highest at 59%. As to how sever the burnout is, Slide 3 shows that Pediatrics is on the lower end at 4 on a scale between 1 as the lowest and 7 as the highest. Which physicians are the happiest? Slide 18 shows Pediatrics is higher up at 36% happiest at work and 70% happiest outside of work. Based on the Medscape Physician Compensation Report 2017, Slide 2 shows that overall, Specialties earn $316k while Primary Care (where Pediatrics is a part of) is $217k. Who has the highest average annual physician compensation? Slide 4 shows that Orthopedics is at $489k and Pediatrics is the lowest at $202k. If you've listened to our previous episodes where we talked to pediatric specialists, on average, they say they're always paid less than their adult counterparts. It's still a great salary though. "On average, they all say that pediatric specialties are always, always, always paid less than their adult counterparts." Slide 5 shows Who's Up, Who's Down and Pediatrics is the only one that went down by 1%. Interestingly, even though Pediatrics is the lowest paid specialty, more than half of the physicians feel compensated at 52% as presented in Slide 18. In Emergency Medicine, 68% of them feel fairly compensated while Nephrology is the lowest at 41%. Would you choose medicine again? Slide 38 of the Medscape Physician Compensation Report 2017 shows that the highest is Rheumatology at 83% and the lowest is Neurology at 71%. Pediatrics is at 78%, right in the middle of the pack with everybody else. Slide 39 shows who would choose the same specialty again. Dermatology is the highest at 96% where they say they would choose the same again and Internal Medicine is at the lowest at 64%. For Pediatrics, 81% of them say they would choose the same specialty again. [27:44] Final Thoughts If you're interested in going into Pediatrics, these are great information to figure out what you want to do with your career moving forward. Additionally, if you know a physician that you want me to talk to, shoot me an email at ryan@medicalschoolhq.net. I'm always looking for a guest for this podcast. If know someone on Facebook or Instagram, reach out to them and let them know about me. Put us in contact. Links: NRMP Match Results and Data for 2017 Charting the Outcomes in the Match for U.S. Allopathic Seniors in 2016 Medscape Lifestyle Report 2017 Medscape Physician Compensation Report 2017 ryan@medicalschoolhq.net

Session 21 General Surgery is gaining in popularity, which shows in its competitiveness for residency. You need to be on the top of your game to match. And similar to Internal Medicine, it is the gateway to a lot of subspecialties. As we're presenting the data here, remember that this is not just for those looking to be general surgeons their whole life but those who are looking into other subspecialties which we will be featuring here on the podcast in the future such as Surgical Oncology, Colorectal Surgery, Surgical Critical Care, Minimally Invasive Surgery, etc. There are certainly a lot of things you can go on and do after your general surgery residency. The 2017 NRMP Main Match Data is now available since the match happens in March of every year. [01:45] Total Number of Programs and Applicants For General Surgery, there are a lot of physicians available with 267 programs around. There are 236 Psychiatry residencies and 204 Pediatric residencies so that gives you an idea that there are more general surgeons than pediatrics. There are 241 OB/GYN residencies so there are a lot of surgical residencies. General Surgery has two categorical residency programs. A categorical program is one where you apply to the program from medical school and that's where you're going to do your five years of General Surgery residency. Then there are prelim surgery positions and there are more prelim surgery positions than there are categorical. Somebody doing a surgical prelim can do it because they're going into a surgical subspecialty straight out of medical school and they're required to do their PGY-1 year separate from their categorical residency.  In this episode, I will only tackle the full five-year categorical surgery programs consisting with 267 programs for categorical surgery. Out of 267 programs, there are 1,281 spots. There are almost 5 spots at each program. Interestingly, there are not a ton of U.S. Seniors applying for these categorical programs. And out of these spots, there were only 1,383 that applied and 2,388 total applicants. For the purposes of this data, U.S. Seniors equals Seniors at an allopathic (MD) medical school. Hence, this does not include graduates of an MD medical school. These are only students who are still in school. Those who took some time off to do some research or didn't match the first time are not included in the U.S. Seniors data. There were 3 unfilled programs which means a lot of of people are matching with 99.6% of the spots filled. I want to briefly mention that if you don't match in a categorical spot, it's typically pretty easy to do a Supplemental Offer and Acceptance Program (SOAP), which used to be called Scramble. There are only 61.7% of those spots were filled. So it's very easy to do a SOAP into a program if you don't match in a surgical program. But assuming your stats are decent and you're a good person, you're probably going to match because it's not overly competitive for U.S. Seniors which is interesting. [06:55] Types of Applicants Table 2 of the 2017 NRMP Match Data breaks down the types of applicants for each specialty. For categorical surgery, there were 1,281 positions and there were 1,276 were filled. So there were 5 empty spots and 3 programs that went unfilled. Out of the 1,276 filled positions, 1,005 were U.S. Seniors while 74 were U.S. Grads (students that either didn't match the first time or didn't apply because they were doing research or something else. Total number of U.S. Seniors (allopathic MD students) was 1,079 out of the 1,276 positions. The rest of it was filled by 64 osteopathic students and 62 U.S. International medical graduates. Something that is highly debated in the premed world is whether to go to a U.S. DO school or an international MD school, specifically Caribbean schools. If General Surgery is something you're interested in, there were 64 students that matched from U.S. osteopathic schools and 62 from international medical schools. Moving along, there were 71 Non-U.S. International medical graduates that matched into General Surgery. For me, this is a peculiar number and is not something I would have thought to see. It just goes to show that there is still a high demand for General Surgery spots so they're taking as many possible and the most qualified and a lot of those happen to be non-U.S. citizen international medical graduates. [09:47] Trends in Positions Offered and U.S Seniors (2013-2017) Table 3 of the 2017 NRMP Match Data illustrates the total number of physicians offered from 2013 to 2017. This is the fourth time I've looked at the Match Data and the numbers always seem to very consistent. Surgery is no different at 4.4 to 4.5 every year, going at a a good, steady pace and hopefully it continues that way. Table 7 shows the number of U.S. Seniors being accepted compared to all applicants over the course of the last five years. As the number of seats in each program has increased all the way up to 1,281 for 2017, the U.S. Seniors are increasing as well. This is a good thing in that more U.S. allopathic students are going into General Surgery to fill this increasing need for spots. It's not necessarily a good thing for DO students or U.S. International medical grads because the demand is rising among U.S. Seniors as there are more spots. Table 8 shows the actual percentage of U.S. Seniors for each of the programs. There were 80.8% of U.S. Seniors in 2013 and it dropped down to 76.5% in 2014, back up to 80% in 2015, back down to 76.4% in 2016, and then up again at 78.5% in 2017. This suggests that maybe the demand is not as high also looking at the data in table 7. Table 9 shows the percentage of applicants that matched into a given field compared to the rest as a whole. 4.6% of all applicants that matched in all fields matched into Surgery (categorical). So it's up there. Internal Medicine is huge at 25.6%, Family Medicine at 11.6%, Emergency Medicine at 7.4%. This gives you an idea of where Surgery lies. Interestingly, Psychiatry (categorical) is at 5.4% which is more than Surgery and Pediatrics at 9.7%. [13:25] Osteopathic Students, Unmatched U.S. Seniors, Independent Applicants, and SOAP Table 11 looks specifically at Osteopathic students who have matched into PGY-1 spots as a whole. This is similar to the last table but this one looks specifically at osteopathic students. As expected, General Surgery has a lot less total number of osteopathic students percentage-wise. Looking at all specialties adding up to 100%, Surgery only made up 2.2% of all osteopathic students that matched into an allopathic General Surgery (categorical) program. Students may think it's harder to go to an MD General Surgery residency as a DO student and if this is what they want to do, then they should probably only apply to MD programs. My different perspective on this is that if osteopathic schools are doing a good job at recruiting students that meet this "osteopathic" philosophy and are looking at recruiting and attracting more students that are interested in Primary Care, then there should obviously be a lot less that are matching into a surgical program. Figure 6 of the 2017 NRMP Match Data shows the percentages of Unmatched U.S. Seniors and Independent Applicants (outside of the U.S. Seniors which, for these purposes, are considered U.S. allopathic students who are still in school). General Surgery had one of the higher unmatched rate at 20.7%, which is 9th on the list. Majority of those are unmatched, independent applicants (non allopathic students, non MD Seniors). The unmatched U.S. Seniors was only 9.6%. This is still high compared to a lot of the other specialties. It seems it's getting more and more competitive and this is a trend that I've heard from speaking to others that General Surgery is becoming more and more competitive as there are more options available for these subspecialties and fellowships afterwards. Table 18 breaks down the SOAP process and looking into Surgery (categorical), there were 3 programs that needed to fill 5 spots and all 3 programs filled those 5 spots through the SOAP process. Looking at the National Matching Service Data for 2016 for the different program types, there were 49 programs for General Surgery for osteopathic students and 155 positions. 149 positions were filled and 6 went unfilled. The data given is not as robust at the NRMP so I'm uncertain if there were a lot more applicants than these 155 spots and a lot went unmatched or if there weren't just that many applicants. [17:43] 2016 Charting the Outcomes - NRMP Based on the 2016 Charting the Outcomes for the NRMP, Chart 3 shows the match rates and there was an 83% match rate for U.S. Allopathic Seniors for General Surgery. Looking at other specialties, Dermatology at 77%, Neurosurgery at 76%, Orthopedics at 75%, Plastic Surgery at 77%, and Vascular Surgery at 71%. So General Surgery is right there with all of the other surgery subspecialties. Chart 4 shows the Median Number of Contiguous Ranks of U.S. Allopathic Seniors. For students that matched and those who didn't, the chart shows you how many programs they ranked on their rank list when they submitted. Those that matched ranked 13 as a median number while those that did not match ranked 5. If you are picky about where you go or if you didn't get an opportunity to apply or to interview at a lot of spots, then you have a lot less chance of matching. Chart 12 shows the percentage of U.S. Allopathic Seniors who are members of AOA (the Honor Society for medical students showing good academic success in medical school). For those that matched only 17% of the U.S. allopathic Seniors were AOA whereas 52% for Plastic Surgery and 53% for Dermatology. So General Surgery is in the lower end for a surgical specialty. Looking at the Summary Statistics (Table GS-1) for General Surgery, those that matched have a decent Step-1 Score at 235 and those that did not match at 218, which shows a big difference in Step scores. This is one of those things where you need to be very realistic with your chances of matching. If you don't match, why? Could it be that because your Step score is not high enough? The mean Step 2 score is 247 for those that matched and 231 for those that did not. [21:20] Burnout, Happiness, and Compensation The Medscape Lifestyle Report 2017 and Medscape Physician Compensation Report 2017 are two separate reports that Medscape releases every year. For the Lifestyle Report, more than 14,000 physicians over 30 specialties have responded in the survey. The numbers are not necessarily the best data-wise because it's a survey so just take this with a grain of salt. Who is the most burned out? General Surgery is lower on the list at 49% which is more than halfway down the list. This is good. But looking at how severe is the burnout, surgery is higher up on the list at 4.3 from a scale of 0-4.5. Which physicians are happiest at work and outside of work? General Surgery is higher up on the list with 35% happiness at work and 69% happiness outside of work. So it's on the higher end of the scale. Moving on to the Medscape Physician Compensation Report 2017, General Surgery is higher up on the list with an average annual salary of $352,000. Above it is Anesthesiology and below it is Ophthalmology. So it's a decent living as a general surgeon. Although if you think about the lifestyle and everything else, it's harder. So you're compensated for that harder lifestyle. Looking at the rate of increase year over year,General Surgery had a 9% increase which is pretty decent. The number of physicians who feel fairly compensated for General Surgery is lower at only 48%. Whether a specialist would choose medicine again, General Surgery is right in the middle at 77%. While only 82% said they would choose the same specialty, which is a little in the lower half of all the specialties there. [24:50] Final Thoughts If you're not sure what you're interested in yet, go through these numbers. It's eye-opening to see what is going on in the world when it comes to matching and physicians that are happy and making money and those that aren't. Links: MedEd Media Network 2016 Match Data NRMP Supplemental Offer and Acceptance Program (SOAP) National Matching Service Data for 2016 Charting the Outcomes - NRMP Medscape Lifestyle Report 2017 Medscape Physician Compensation Report 2017 AOA

Session 19 Today, I'm going to do a deep dive into some match data for Orthopedic Surgery, which is one of the more competitive specialties out there. Let's look at the data to see if this holds true and find out who you can set yourself up for success early on if this is something you’re interested in. In general, Orthopedic Surgery is a surgical specialty. It's a five-year residency with a lot of subspecialties after that. I had Dr. Muppavurapu to talk about being a hand surgeon back in Episode 05 and he talked about the many other things you can do like joints, spine, hand, and so much more. Today we're going to talk generically about ortho residency matching as a medical student. [02:55] Number of Programs, Spots, U.S. Seniors NRMP is the MD application. (If you're reading this way in the future, words like ACGME and AOA won't really mean much because the MD and DO residency programs will have merged assuming all goes well as planned out for 2020.) Looking at Table 1 for the NRMP Results and Data 2016 Main Residency Match, there are 163 programs in the country for orthopedic surgery. Just to give you an idea of the number of programs for other specialties, Anesthesiology had 119 PGY-1 spots and 77 PGY-2 spots, a total of 196 compared to 163 for Orthopedic Surgery. Neurosurgery had 105 programs, Emergency Medicine had 174 programs. This somehow gives you an idea of how many programs are out there for Orthopedic Surgery. Another important number to look at here is the number of spots available. Orthopedic Surgery had 163 programs with 717 different spots available so that's average of 4.398 spot per program. Comparing to other programs, Emergency Medicine had only 11 more programs but more than double the number of spots offered. Out of the 63 programs for Orthopedic Surgery, none of the programs went unfilled. Many residency programs here had 100% fill rate so it's not unusual but again, an important thing to keep in mind. As you think about your specialty, how competitive is it for you to match into? How spots are going to be available? If you don't match for some reason, can you do the Supplemental Offer and Acceptance Program (SOAP)? Can you find an open program? For something competitive like Orthopedics, you probably won't be able to find one and it's going to be much, much harder for programs that typically go completely filled. There were 717 available spots while there were 1,058 total applicants. 874 of those were U.S. Seniors. Note that the number of U.S. Seniors applying are even more than the spots offered. Out of the number of students that matched, 650 were U.S. Seniors. That means U.S. Seniors make up 90.6% of students that matched into orthopedic residency. U.S. Seniors here are allopathic U.S. Seniors (students at MD Programs). Ortho do not have any programs that match directly into PGY-2 positions. They are all categorical spots where you apply for ortho, you do your internship right there in that one program for five years. [07:25] Allopathic and Osteopathic Students There is always this DO versus MD "competitiveness" going on in the premed world. Here is where there is some bias among residencies. Orthopedic Surgery has been known historically as one of the biggest residency programs out there that has some negative bias towards DOs. NRMP Match Data Table 2 shows matches by specialty in applicant type and looking at Orthopedic Surgery with 717 positions, 717 filled, 650 were U.S. Allopathic Seniors, 49 were U.S. Grads (this refers to those who either took some time off and didn't apply during the normal time you're supposed to apply to residencies or maybe didn't match the first time, went and got some research opportunities and ended up matching after graduating), and only 4 of the 717 were osteopathic students. That is just about half of 1%. Compared to other specialties, Anesthesiology seemed very favorable to DO's with osteopathic students comprising 14.4% of all that matched. While in Emergency Medicine, 11.8% of those that matched in the filled spots were osteopathic students. Apparently, Orthopedic Surgery stuck with the the tried and true position of not being very "DO friendly." Remember that osteopathic schools and students can apply to osteopathic residencies and you can also apply to the MD residencies which accounts for the number of osteopathic numbers on the NRMP (allopathic) data. But in the osteopathic world, there are orthopedic surgery residencies. Therefore, don't think that just because you only got into an osteopathic school that your chances of getting into an orthopedic surgery residency are going to be slim to none. Based on the AOA Match Data for 2016, there are 40 Orthopedic Surgery programs in the osteopathic world, with 121 positions, 118 were filled, 3 went unfilled. In the MD world, it's highly unusual to have unfilled orthopedic spots. [11:06] Growth, Positions Filled, U.S. Seniors and All Applicants NRMP Match Data Table 3 shows the growth of each of the specialties over the period of five years (2012-2016). Orthopedic Surgery is among those growing at a good pace around 2.5% each year. With 682 spots in 2012, it has grown to 717 in 2016 which suggests a pretty steady growth. This is good for you especially if you're thinking about Orthopedics since it means there are more and more spots offered. The data in Table 7 confirms how Orthopedic Surgery is usually a specialty that doesn't go unfilled. There were no available spots in 2016, 2015 and 2012, only 2 spots in 2014, only 1 spot in 2013. Looking at Table 8, it shows the Positions Offered and Percent Filled by U.S. Seniors and All Applicants (again, U.S. Seniors being MD Seniors that have graduated from an MD school). In 2012, 94% of those offered a position consist of U.S. Seniors. This percentage dipped to 91.9% in 2013 and went back up to 93.4% in 2014, and 94.3% in 2015, and then dropped down further to 90.7% in 2016. This tells us that there are a lot of students who are non-U.S. Seniors filling these spots. They could be international medical graduates or U.S. grads that were not Seniors who are people that have taken some time off. [14:15] PGY-1 for All Applicants and Osteopathic Students and Unmatched Students Table 9 shows the percentage of applicants that have matched to a PGY-1 spot in each specialty compared to the whole. Anesthesiology is at 4%, Emergency Medicine with 7.1%, Family Medicine 11.5%. Orthopedics is 2.7% which is pretty small compared to some of the bigger ones like Family Medicine, Internal Medicine, and Pediatrics. Even Psychiatry is pretty big at 5.1%. For the Osteopathic students looking at the NRMP Match Data Table 11 shows the percentage of students that are osteopathic graduates that matched into Orthopedics with only 0.2% of all osteopathics students that matched did match into Ortho that means only 0.05% osteopaths matched into a spot. And comparing this to the bigger programs, Anesthesiology at 6.4%, Emergency Medicine at 9.3%, and Family Medicine at 15.9%. Again, it is very hard for an osteopathic student into a MD orthopedic surgery residency. NRMP Match Data Figure 6 shows the percentages of unmatched U.S. Seniors and independent applicants who ranked Ortho and other specialties. 25.1% of all those that applied to Orthopedic Surgery went unmatched, 20.8% were U.S. Seniors, 56.6% were unmatched independent applicants (the DOs and international medical grads). As a non-US allopathic medical school grad, it's very hard to match into an allopathic orthopedic surgery residency. [17:05] Charting the Outcomes for U.S. Allopathic Seniors Looking at the data found in NRMP Charting the Outcomes 2016, Table 1 breaks down the number of applicants per position for Orthopedic Surgery. With 717 positions offered and 1,034 applicants, there were 1.4 applicants per position. Outside of four other specialties, Orthopedic Surgery is the most competitive. Dermatology is last at 1.4, General Surgery at 1.49, Psychiatry at 1.54, and Vascular Surgery at 1.91. This goes to show how Orthopedic Surgery is a highly competitive residency. Chart 4 shows the Median Number of Contiguous Ranks of U.S. Allopathic Seniors. This is the ranking of how many programs they've ranked, they've matched and didn't match. And this is always one of the biggest question marks if you don't match into a residency, which is: Did you apply to enough spots? The answer is usually no. This is very similar to medical school application where if you didn't get it, you'd have to ask yourself if you applied to enough schools to increase your odds. For Orthopedic Surgery, the median number of contiguous ranks was 12. Those that did not match was only 6. So if you only ranked half of those that matched, then you'd have a much better shot at not getting in. [19:15] USMLE Step 1 Scores, Research Experiences, and AOA If you're a medical student getting ready to study for the Boards or if you're in your first year and just preparing, we are launching a Step 1 Level 1 Board Review Podcast called Board Rounds in the next couple of weeks so stay tuned for that! Subscribe to it now. Charting the Outcomes 2016 also shows the USMLE Step 1 scores for U.S. Allopathic Seniors. For Orthopedic Surgery, it's at the top spot with some of the other more competitive specialties with those that matched averaging at 248-250 and those that did not match were right there on 240. Therefore, you need to do well on Step 1 to match into Ortho. One of the misconceptions about Orthopods is them being dumb jocks but that's not true of course. You need to get really great board scores to get into Ortho and research experience doesn't lack either. Based on Chart 8, the mean number of research experiences is 4 for those that matched and 8 for those that did not match. So if you're interested in Orthopedics, do some research as it seems important based on this data. Chart 12 shows the percentage of U.S. Allopathic Seniors who are part of AOA (Alpha Omega Alpha), the honor medical society that highlights the students who do well the first couple years of medical school. For Orthopedic Surgery, 34% of those that matched are AOA students while 12% for those that did not match. The takeaway here is to start off medical school doing really very well so you can try to get AOA. [21:47] Medscape Lifestyle Report 2017 The Medscape Lifestyle Report 2017 presents data on burnout, bias, race, etc. Orthopedic Surgery is in the bottom half of the burnout chart at 49%. Yes, this is still a lot but this is the bottom half of the chart. The biggest takeaway is that a lot of physicians are burned out and Orthopedics is one of the least, which is good. How severe is the burnout? Orthopedic Surgery is in the lower half of the chart. Which physicians are the happiest? Orthopods make up the top half with 37% saying they're happy at work and 71% saying they're happy outside of work. This is another pretty good data compared to the rest. [23:00] Medscape Physician Compensation Report 2017 Looking at the recently updated Medscape Physician Compensation Report 2017, Orthopedics is at the top of the list for most compensated physicians with an average annual compensation of $489,000. If you're interested in Orthopedics then you will probably make a very good income which is well-deserved. And this is up 10% from last year. Only 48% of Orthopods feel fairly compensated and this is strange considering they're the highest paid of all the specialties. 79% of Orthopods say they'd choose Medicine again, and unsurprisingly, 95% of Orthopods say that they'd choose Orthopedics again. In general, Orthopods are pretty happy with their career choice. [24:29] My Final Thoughts I hope this helped you get some clarity with Orthopedics Surgery if this is something you're interested in. I hope you're also pretty early on in your journey because as I've mentioned, research is necessary and you need to do well on Step 1 as well as try to get AOA. Therefore, you need to start setting yourself up for success as soon as you can. Links: NRMP Results and Data 2016 - Main Residency Match AOA Match Data for 2016 NRMP Charting the Outcomes 2016 Medscape Lifestyle Report 2017 Medscape Physician Compensation Report 2017 Board Rounds Podcast SS 05: What Does the Life of an Orthopedic Hand Surgeon Look Like? NRMP ACGME AOA Supplemental Offer and Acceptance Program (SOAP) AOA (Alpha Omega Alpha)