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Welcome back to Sevo Sistas, the podcast where we demystify and diversify the field of anesthesiology, all within the duration of an anesthesia break. In this week's episode, we conclude our insightful interview with Dr. Alanna Gordon, a Black woman DO who recently matched at the University of Connecticut (UConn) for her anesthesiology residency. Dr. Gordon shares valuable advice that applies not only to DOs but to anyone considering a career in anesthesiology.Key Topics Discussed:Choosing Residency Programs:Dr. Gordon's strategic approach to selecting anesthesiology residency programs.Importance of networking at events like AMEC hosted by UConn.Factors such as geographic preference, program diversity, and program culture.Application Strategy:How Dr. Gordon applied to 42 programs, utilizing the new signaling system with 15 signals (5 gold and 10 silver).Insights on evaluating program friendliness toward DOs and the significance of diversity.Signaling in Residency Applications:Explanation of the signaling system and its strategic use.The impact of signaling on program selection and interview invitations.The balance between expressing interest and managing application costs.Interview Process:Dr. Gordon's experience with 11 interview invitations and her approach to preparing for them.Special experiences during her UConn interview, including the supportive environment and mentorship.Navigating the Match Process:The importance of ranking programs and the emotional journey of Match Day.Dr. Gordon's experience with the SOAP (Supplemental Offer and Acceptance Program) and securing a transitional year at Stony Brook Southampton.Final Thoughts:The importance of asking questions and taking initiative in the residency application process.Encouragement for medical students to network, attend open houses, and make personal connections.Notable Quotes:"You have to be very strategic in how you're applying, especially now with the signaling that anesthesiology has decided on." – Dr. Alanna Gordon"Make sure you're at every AMEC and you're networking with everyone, because that's really what's going to get you through the door." – Dr. Alanna Gordon"You can't be afraid to put yourself out there... The worst thing that can happen is someone can tell you no, and you go on to the next experience." – Dr. Alanna GordonResources Mentioned:AMEC (Annual Medical Education Conference) hosted by the Student National Medical Association (SNMA)Visiting Externship for Students Underrepresented in Medicine (VESUM) Program at UConnConnect with Us:Email: sevosistas@gmail.comLinkedIn:  sevo sistasTwitter: @sevosistasSupport the Show:If you enjoyed this episode, please consider leaving a review on your preferred podcast platform and sharing it with friends and colleagues. Your support helps us continue to bring you valuable insights and stories from the field of anesthesiology.Want to keep the convo going? Join our FB group!https://www.facebook.com/groups/sevosistasHave a burning question? A concern? A controversy or issue you want to hear covered? We got you, boo! Leave a voice message at 202 743 1404. We will play your recording on the podcast and address your topic (if you don't want it played just say it in the voicemail, we will still cover your topic!). This podcast is for you and we want to include you on this journey! Hope to hear from you soon

In this compelling follow-up episode of Sevo Sistas, we continue our conversation with Dr. Julisha Patten. Dr. Patten shares her inspiring journey of overcoming significant academic challenges to achieve her dream of becoming an anesthesiologist. From failing step exams to navigating the match process, Dr. Patten's story is a testament to resilience and determination. Tune in to hear her practical advice on maintaining confidence, seeking mentorship, and the power of perseverance.Overcoming Step Exam Challenges:Dr. Patten discusses her initial success with Step 1 and her unexpected failure on Step 2.The critical changes she made in her study approach for the second attempt.Importance of critical thinking and adapting study techniques to different exam formats.Mentorship and Tutoring:How hiring a tutor helped Dr. Patten succeed on her second attempt at Step 2.The role of mentorship in her journey and advice for others facing similar challenges.Navigating the Match Process:Dr. Patten's experience of not matching initially and the emotional toll it took.The SOAP (Supplemental Offer and Acceptance Program) process and her eventual job offer.The importance of perseverance and not giving up on her goal of becoming an anesthesiologist.Transitioning to Residency:The transitional year at LewisGale and how she treated it as a one-year interview.Dr. Patten's proactive approach to securing an anesthesia rotation and gaining valuable experience.Receiving a surprise interview and acceptance from Yale, and the significance of this achievement.Advice for Aspiring Anesthesiologists:Dr. Patten's encouragement to those who face academic setbacks.The importance of believing in oneself and not letting a single test define your capabilities.Practical tips on maintaining confidence and seeking support from mentors and peers.Closing Thoughts:Dr. Patten's final words of inspiration for listeners pursuing their dreams in the medical field..Call to Action: Don't miss this episode filled with resilience and practical advice for overcoming obstacles in the medical field. Subscribe to Sevo Sistas on your favorite podcast platform and leave a review to support the show! Share this episode with friends and colleagues who might benefit from Dr. Patten's inspiring journey.Follow Dr. Julisha Patten @Julisha_Patten on TwitterWant to keep the convo going? Join our FB group!https://www.facebook.com/groups/sevosistasHave a burning question? A concern? A controversy or issue you want to hear covered? We got you, boo! Leave a voice message at 202 743 1404. We will play your recording on the podcast and address your topic (if you don't want it played just say it in the voicemail, we will still cover your topic!). This podcast is for you and we want to include you on this journey! Hope to hear from you soon

We couldn’t be more proud of our Class of 2020. In case you didn’t hear, the Cincinnati Medicine community celebrated #CincyMatch2020 this past Friday, March 20th. It was a massive success and we loved getting to see where all our MedCats ended up. Although we will be sad to see them go, we know that they are off to save lives and undoubtedly do amazing things. We put together this episode to share a few of the Match Day details and, honestly, we just wanted to keep the celebration going!Want to learn more? Reach out to medcats below: Hiley Cammock (M4): cammochd@mail.uc.edu Ian Patterson (M4): patterit@mail.uc.edu Madison Epperson (M4): eppersmv@mail.uc.edu Robbie Daulton (M4): daultors@mail.uc.eduResources: AAMC Excellence in Medical Student Career Advising Program Award: https://www.uc.edu/news/articles/legacy/healthnews/2017/11/h29551.html The Match Algorithm: https://www.youtube.com/watch?v=kvgfgGmemdA Robbie mentioned he didn’t match this year; just to clarify, he is on a research year. Don’t worry! SOAP: Supplemental Offer and Acceptance Program

Alex is a 4th year medical student who successfully matched into an Anesthesia Residency in Chicago. However, it certainly wasn't smooth sailing. Alex matched in an advanced placement program, meaning he would join the other residents for his second year. Initially, Alex did not match into an intern year (first year) residency program. Alex describes the intense emotional experience of potentially losing his anesthesia residency. Alex talks about the wild ride of "scrambling" or going through SOAP (Supplemental Offer and Acceptance Program). Adding to his stress, students and residency directors experienced significant technical difficulties using the online interface. Alex describes how he didn't even have time to process his emotions, before he was forced to start applications and interviews. Alex eventually received an offer for his intern year, and will be completing all of his residency training in Chicago. Alex and I have a great discussion about the interview and application process in the first 30 minutes of our conversation. If you prefer to only listen to his "Match Week" story, please fast forward to about 31 minutes in.

Alex is a 4th year medical student who successfully matched into an Anesthesia Residency in Chicago. However, it certainly wasn't smooth sailing. Alex matched in an advanced placement program, meaning he would join the other residents for his second year. Initially, Alex did not match into an intern year (first year) residency program. Alex describes the intense emotional experience of potentially losing his anesthesia residency. Alex talks about the wild ride of "scrambling" or going through SOAP (Supplemental Offer and Acceptance Program). Adding to his stress, students and residency directors experienced significant technical difficulties using the online interface. Alex describes how he didn't even have time to process his emotions, before he was forced to start applications and interviews. Alex eventually received an offer for his intern year, and will be completing all of his residency training in Chicago. Alex and I have a great discussion about the interview and application process in the first 30 minutes of our conversation. If you prefer to only listen to his "Match Week" story, please fast forward to about 31 minutes in.

Session 63 In this episode, we do a deep dive into the numbers of the Family Medicine Match. How many spots are there, how many unfilled, and so much more. First off, we need your help! We are in need of more podcast guest recommendations. We need physicians for this podcast. Shoot us an email at ryan@medicalschoolhq.net so we have more physicians to interview. There are over 100 specialties and we're doing both community and academic setting. So there should be over 200 episodes available there. I also want to do retired physicians and program directors. Yet we're only 63 episodes in. So we need your help! [02:35] Match Summary Data here is taken from the 2017 NRMP Residency Match Data. As far as number of positions offered, internal medicine is huge at over 7,233. Family medicine is the second largest and half as big, with 3,356 positions offered. Table 1 shows that 520 programs, more than internal medicine, but half the spots. So although it has more programs, it's half the spots. Hence, the programs are much smaller. Interestingly, there were 67 unfilled programs. This means people were not applying to family medicine. While there are so many that are applying to internal medicine. This is probably because of the fellowship training that you do after internal medicine. Which means you can go to Cardiology or do GI, or do Pulmonology or Rheumatology. You can do a lot of different subspecialties after Endocrinology, after Internal Medicine. So even the International Medical Graduates (IMGs) want that opportunity. "People are not applying to Family Medicine." So out of 3,356 positions offered for Family Medicine, 1,797 U.S. Seniors applied fro those positions. Now, there were 6,030 total applicants for those 3,356 spots. Comparing this with internal medicine, they have over 7,000 spots and almost 12,000 students applying for those spots. Just by numbers, you have more people applying for those Family Medicine spots than you do for internal medicine. [06:35] Matches by Specialty and Applicant Type Out of 3,356 positions, there are 3,215 filled positions and there were 141 spots that were left open. Of those, 1,513 were U.S Seniors, 132 were U.S. graduates - students who graduated from an MD medical school who may have taken a gap year to do research or travel. Or maybe they didn't get in the first time. There are 574 osteopathic students so a lot of them are going into family medicine. Interestingly, there's a similar increase in osteopathic students going into internal medicine but there's only 690 of them. Nevertheless, this means there's a big opportunity for osteopathic students in family medicine. There's one Canadian and 658 U.S.-citizen international medical graduates, and 337 non-U.S. citizen international medical graduates. This is a huge discrepancy here with foreign grads applying to internal medicine at a way higher number than family medicine. There were over 2,003 non-U.S. citizen international medical graduates applying for internal medicine and getting into internal medicine, and only 337 in family medicine. And I really think it's that fellowship piece - just a wild guess! "This is a huge discrepancy here with foreign grads applying to internal medicine at a way higher number than family medicine." [08:40] Growth Trends (2013-2017) Table 3 shows the increase in size from 2013 to 2017. Family medicine has gone up 11.5% every year over this four-year period. It's growing so it's a much needed primary care specialty. Moving down to Table 8 is positions offered and percent filled by U.S. Seniors and all applicants from 2013 to 2017. Again, not a lot of U.S. Seniors are applying to family medicine. Out 3,356 positions offered, 45.1% of those spots filled were by U.S. Seniors. Internal medicine is lower at 44.9%. Shockingly, Pathology is way lower at 35.9% filled up U.S. Seniors. This suggests that U.S. Seniors are not going into Pathology, and in fact, it's getting less and less. In 2013, for Family Medicine, it's 44.6%, then 45% (2014), 44% (2015), 45.3% (2016), and 45.1% for 2017. Table 9 shows how big Family Medicine is compared to all other specialties. Internal medicine is the largest specialty for students matching every year, specifically at 25.6% in 2017. The second largest is Family Medicine at 11.6%. This is followed by Pediatrics at 9.7%, another big primary care specialty. "A quarter of all students matching matched into Internal Medicine and just 11.6% matched into Family Medicine. It's the second largest." [10:48] PGY-1: U.S. Seniors and Osteopathic Students, Matched and Unmatched, and SOAP Table 10 shows the U.S. Seniors matching into PGY-1 positions. The numbers don't hold up here for U.S. Seniors though compared to all applicants. Internal Medicine has 18.6%,s still the largest. But Family Medicine here is not the second largest and only falls third or fourth at 8.7%. Emergency Medicine is larger with 9.2%. Osteopathic students (Table 11) keep the trend going with 23.5% of students matching into an allopathic Internal Medicine program, while 19.6% matched into Family Medicine. When you look at the previous number of all applicants, 11.6% of all applicants matched into Family Medicine but 23.5% of osteopathic students matched into Family Medicine. "It seems like a good fit for osteopathic students who want to match into Family Medicine." Figure 6 shows the percentages of unmatched U.S. Seniors and independent applicants. Family medicine and overall total unmatched of 25.3%, which is the fifth highest. The highest is Internal Medicine Prelim at 37% total unmatched. Second is Dermatology at 33.8%. Followed by Psychiatry at 30.8%, and then PM&R at 27.5% and fifth is Family Medicine. It has a high overall unmatched rate which is surprising considering there were so many programs that went unfilled. Independent applicants are the majority of those unmatched with 40.9% and U.S. Seniors are pretty low at 3.5% unmatched. "With so many open programs, the assumption is that they applied to not enough programs or they were very picky on where they were applying." Table 18 shows the SOAP (Supplemental Offer and Acceptance Program). These is offered for programs with MD spots that need to be filled. Family medicine had 67 programs that went unfilled and 141 spots. All of those programs participated in the SOAP. 64 programs filled and there were 3 spots at 3 programs that went unfilled. [14:05] Charting the Outcomes 2016 Table FM-1 shows a summary of all the data for U.S. Allopathic Seniors. Mean number of contiguous ranks means that those who matched ranked 10.7 programs on average. This means that those who matched ranked a lot of programs. And those that did not match only ranked 4.5 programs. So they were much more strict with the programs they ranked and that hurt them. The mean USMLE Step 1 Score is 221 and the average is around 230 for this data. So it's a much lower score than average. Those that did not match was 208. So they're struggling with their USMLE score. With that low score, they probably didn't get interviews. And because they didn't get interviews, maybe they didn't rank the programs. So it's not an issue with being too strict with the programs they're ranking but it could just be an issue with their Step 1 score. Hence, they're not getting interviews in order to be matched to rank. Mean USMLE Step 2 score is 237 for those that matched and 223 for those who didn't. Research experience is about the same at 2 and 1.7. Mean number of abstracts, presentations, and publications are the same at 2.6. AOA members are 6.1% for those that matched and 0 for those who didn't. It doesn't mean though that you have to have AOA. It just means that the people didn't match didn't have it. [16:38] Happiness, Burnout, and Compensation Now, let's look into the 2018 Medscape Physician Lifestyle and Happiness Report. In terms of happiness, 30% of physicians are very happy,  outside of work is 12%, and extremely happy at 26%. As to who is the happiest, Family Medicine is in the lower half at 51%, within the range of 40%-61%. As to which physicians are most introverted, Public Health and Preventive Medicine doctors are the highest at 48%. Family medicine is near the bottom at 37%. Radiology was at the lowest at 36%. As to which physicians say they have three or fewer close friends, Family Medicine is near the top at 53%, Pathology is the highest at 58%. So this does not do any justice to Pathology and the stereotypes that come with Pathologists. Looking at the 2018 Medscape National Physician Burnout and Depression Report, which physicians are most burned out, Family Medicine is near the top at 47%. Critical care is 48%. Neurology is 48%. There are a lot of specialties above 40%. The lowest is Plastic Surgery at 32%, along with Dermatology. As to which physicians experience both depression and burnout, Family Medicine is still near the top of the list at 16%. OB GYN is the highest at 20%. As to which physicians are more likely to seek professional help, Family Medicine is again near the top of the list at 31%. Psychiatry is at 40%. Moving on to the 2017 Medscape Physician Compensation Report, Family Medicine being a primary care specialty is right near the bottom at $209K a year. Just to compare it, the highest paid specialty is Orthopedics at $489K, more than double that of a family medicine doc, while Pediatrics is the lowest at $202K. "When you say you can't make money going into primary care, it's not true. You don't make as much as somebody who's a specialist... but still very good money." As to which physicians feel fairly compensated, even though Family Medicine is near the bottom of the list for compensation, they're up near the top half for feeling fairly compensated at 53%. Emergency medicine doctors are the highest at 68%. Would a family medicine doctor choose medicine again? They're near the bottom half at 77%. The highest is Rheumatology is 83% and Neurology is the lowest at 71%. Which physicians would choose the same specialty? Interestingly, Family Medicine ranks second from the bottom at 67%. Internal medicine is the lowest at 64%. Links: 2017 NRMP Residency Match Data Charting the Outcomes 2016 2018 Medscape Physician Lifestyle and Happiness Report 2018 Medscape National Physician Burnout and Depression Report 2017 Medscape Physician Compensation Report ryan@medicalschoolhq.net

Session 59 Looking at the Psychiatry Match data, it's easy to see that it is becoming a more popular field. I discuss all the data in today's Specialty Stories podcast. Finding physicians for this show has been a challenge so we'd like to ask for your help. If you know a physician who would be a great addition to this podcast, shoot me an email at ryan@medicalschoolhq.net . Go to medicalschoolhq.net/specialtiescovered and you'd find a list of physicians that we've already covered here on the show. Today, we cover Psychiatry match data based on the 2017 NRMP Main Residency Match Data. [03:20] General Summary There are 236 programs in psychiatry. Comparing it with other specialties, pediatrics has 204 programs. So there are 32 more psychiatry programs than there are pediatric programs. The total number of positions offered for Psychiatry is 1,495 spots. This means a little over 6 spots per program. Whereas pediatrics is much bigger with twice as many spots of 2,738 in 204 program. So it's almost 13 1/2 spots per program - almost double the size of psychiatry programs. There were 3 unfilled programs in 2017 and the total number of U.S. Senior applicants for those 1,495 spots was only 1,067. These are the students at MD medical schools who are still in school, and not those that have graduated. So there were less students applying to those spots than there were spots available. There were 2,614 applicants. It's almost 1,200 more applicants than there were spots available. This is still pretty competitive to apply. Looking at the number of those that matched, only 923 of those 1,067 U.S. Seniors did match while over a hundred of those did not match into Psychiatry. It was only about 61.7% of those that matched are U.S. Seniors. Looking at other fields that matched, Anesthesiology was 66.8%, Dermatology at 92.3%, and PGY-2 positions for dermatology is 81.8%. [07:05] Types of Applicants and Growth Trends Table 2 of the NRMP Match Data for 2017 shows the matches by specialty and applicant types. For Psychiatry, there were four spots that went unfilled, 923 were U.S. Seniors and that's about almost 62%. 49 were U.S. Graduates. These were students who went to anMD school but had graduated already. Maybe they didn't get in the first time or they were just taking a gap year doing some research or travel, whatever. "A good percentage of osteopathic students are getting into Psychiatry." There were 216 osteopathic students, 166 U.S.-Citizen International Medical Graduates, and 137 non-U.S.citizen International Medical Graduates. There were four unfilled positions. Table 3 shows the growth trends covering 2013 to 2017. Psychiatry is growing a bunch, about 5% every year. In 2017, it grew 5.2%. Table 7 shows positions offered and number filled by U.S. Seniors and all applicants from 2013 to 2017. There's an interesting trend in Psychiatric that it's becoming more popular among U.S. graduates. When you go back to 2013, it was only about 52% of the class who were U.S. graduates. "If you're interested in Psychiatry, it seems to be growing. Hopefully there'll be spots for you as you continue down your training path." In 2017, U.S. Seniors comprised 61.7% while in 2013, it was only around 52% and been going up year over year. Table 9 shows you how big a specialty is int he grand scheme of specialties. Ophthalmology is a separate match so that's not included. For Psychiatry, 5.4% of all students who matched, matched into Psychiatry. Just to give you a scale, Anesthesiology was only 4.1%, Emergency Medicine is 7.4%, Internal Medicine is 25.6%, Family Medicine is 11.6%. OB/GYN is 4.7%. [11:40] Osteopathic Students And if you're an osteopathic student interested to know your chances, Table 11 will show it to you. 7.4% of all DO students who matched into an MD program, matched into Psychiatry. Compared to the rest, Family Medicine and Internal Medicine are huge, Anesthesiology is 5.6%, Emergency Medicine is 9.6%. So the ratios are very similar. Figure 6 shows the percentages of unmatched U.S. Seniors and Independent Applicants who ranked each specialty as their only choice. If you are only ranking Psychiatry, there's a total unmatched percentage of 30.8%. But don't let that scare you if you're a U.S. Senior. Because their unmatched percentage is only at 7.4%. 52.9% of those who are independent applicants (ex. DO students, U.S. citizen and non-U.S. citizen international medical graduates, Canadian students) did not match [13:13] SOAP Let's go to the SOAP (Supplemental Offer and Acceptance Program). There were four unfilled programs, when you look at the data. But interestingly, when you look at the SOAP for 2017, there were only three available positions. One of those positions was either filled or taken off of the board. So there were two programs with three positions available. And all three of those spots were filled through the SOAP. [13:45] NRMP Charting the Outcomes 2017 - Contiguous Ranks Based on the 2016 NRMP Charting the Outcomes, Table 1 shows the number of applicants and positions in the 2016 match by preferred specialty. Psychiatry has 1,586 spots, 2,134 applicants, number of all applicants per position was 1.54, as one of the highest on this list. There are a lot of International Medical Grads and DO students are applying for these spots. Specialties like vascular surgery only has 56 positions and the total number of applicants per position is 1.91. The only one here above Psychiatry other than that is Neurosurgery which is 1.58. So there are a lot of applicants for those spots. Chart 4 tells the median number of contiguous ranks of U.S. Allopathic Seniors. Those who matched in Psychiatry ranked 9 programs in a row; while those that did not match only ranked 5. "You need to apply to a lot of programs and rank a lot of programs. That is the same across the board for every specialty." Further down the report is Table P-1 is the summary stats for Psychiatry. The mean number of contiguous ranks for those who matched is 9.6 while those who didn't is 5.6. Mean number of distinct specialties ranked is 1.1 for those who matched and 1.3 for those who went unmatched. For those who did not match were a little bit wishy washy with their specialty choice. [16:30] Step 1 and Step 2 Scores, AOA Members, and PhD Degree Step 1 scores for Psychiatry is not as high as some of the other programs. Psychiatry has 224 for mean Step 1 score and 214 for those that did not match. For Mean Step 2 Scores, 238 for those that matched, and 226 for those that did not. For AOA (the honor society for medical students) members, only 6.2% of the students who matched were AOA members while none of those that did not match were AOA members. 4.4% had a PhD degree and 0 unmatched had a PhD degree. You could look at that saying that you have to have a PhD degree to match into Psychiatry or you have to be an AOA member to match. But you have to look at the data yourself. [18:00] 2018 Medscape Lifestyle and Compensation Reports The 2018 Medscape Lifestyle Report shows the highest outside of work is 61% for Allergy Immunology and the lowest is Cardiology at 40%. Psychiatry is right in the middle at 51%. But let's also look at the 2017 NRMP Main Residency Match Data. Psychiatry and mental health are at the bottom for burnout at 42% versus Emergency Medicine at 59%. How severe is the burnout, they're much lower at 4 on the scale. "Not surprisingly, the question which physicians are most burnt out, Psychiatry and Mental Health are at the very bottom. They probably have some coping skills." Which physicians are happiest outside of work and at work? Psychiatry is lower on the list with 66% happy outside, and 37% are happy at work. And they're found on the lower end of the scale. Looking at the 2017 Medscape Compensation Report, Psychiatry is on the lower end. That's understandable because usually, the more procedure-heavy specialties are compensated more. Their average annual compensation is at $235K while Orthopedics is up at $489K. So that's a big difference. Pediatrics is the lowest at $202K. However, they're getting 4% salary increase year over year. Slide 18 shows which physicians feel fairly compensated and Psychiatry is top 3 at 64%, next to Dermatology and Emergency Medicine (first). Slide 38 is a question about whether they'd choose medicine again and Psychiatry is top 2 at 82%, Rheumatology is at 83%. 87% of Psychiatry also say that they would choose the same specialty again. The highest is Dermatologist and Orthopedics is next. [21:38] Final Thoughts As mentioned earlier, we are in need of more physicians to interview. Please help us find out which physicians are interested in coming on the show. Go to medicalschoolhq.net/specialtiescovered and see which ones have been done. Links: medicalschoolhq.net/specialtiescovered 2017 NRMP Main Residency Match Data 2016 NRMP Charting the Outcomes 2018 Medscape Lifestyle Report 2017 Medscape Lifestyle Report 2017 Medscape Compensation Report

Session 56 Neurosurgery follows the rules of economics. There are very few spots, so it is really competitive to get into. We covered the NRMP Match data for Neurosurgery. Neurosurgery is one of those residencies that are super hard to get into. Ryan has had an academic neurosurgeon previously on Episode 20 of this podcast. Please subscribe to this podcast. We're on Spotify now! Check us out there as well as on any Android phone, or on Stitcher and Google. Nevertheless, the podcast app on the iOS is the best way to subscribe on an iPhone or iPad. You will also find all our episodes on the MedEd Media Network. Let's dive into today's data... All information here are based on the NRMP Main Residency Match 2017, Charting the Outcomes 2016, Medscape Lifestyle Report 2017, and Medscape Compensation Report 2017. Ryan walks you through the data along with some commentaries. So you will know what it means and what it looks like and what you should be thinking about if you're interested in Neurosurgery. [02:30] Match Summary for 2017 Looking at Table 1 of NRMP Main Residency Match 2017 Summary, Neurological Surgery is how they list it. For this field, they have 0 unfilled programs. This means lots of people are applying for neurosurgery and they're getting filled. There are 107 programs. Comparing this to other fields, Emergency Medicine has 191 programs and Anesthesiology with 124 programs. So for neurosurgery there are 107 programs and 218 positions. It's just over two spots per program. Comparing this to Anesthesiology, it has 124 programs and 1202 positions. This is almost 10 spots per program. This said, there are not a ton of spots and programs for neurosurgery, but every program is super small on average. As you think about your journey, and you're dead set on being a neurosurgeon, all this data shows that you need to well. "If you're dead set on being a neurosurgeon, you better buckle down for medical school...to make sure you have great board scores, great grades." So for U.S. Seniors there are 212. Again, U.S. Seniors here means that it's somebody who's an allopathic/MD still a senior in school. So this doesn't include U.S. Grads who are now taking a gap year, doing research, or doing something else who have graduated. There are 311 total applicants for those 218 spots. Through this episode, Ryan will discuss where these other 99 students are coming from. And out of those U.S. Seniors, 183 matched. So it's 83.9% U.S. Seniors matching in an allopathic medical school. This tells you that they're favoring students at allopathic medical schools. [06:45] Summary of Students: U.S. Seniors, U.S. Grads, IMGs, Osteopaths Table 2 shows where these students are coming from. Again, 83.9% of those that matched are U.S. Seniors. And 15% of those students are U.S. Grads. This means they probably took a year off or they didn't match their first time around so they did research or whatever. There are 2 osteopathic students and 4 U.S. citizen international medical graduates matched into neurosurgery. Looking at this data, is going to a Caribbean school better than going to an osteopathic school? Thinking this alone is wrong. You can't draw these conclusions as to why the numbers say so. If all four of those students when to a DO school, they might have still matched because of who they are, not the letters after their name. "You can't draw conclusions that says going to Caribbean school, Australia, or Ireland better than going to a DO school if you want to match into neurosurgery." Non-U.S. citizens international medical graduates are 14 of those that matched. They are obviously strong students who crushed their boards that they were able to match almost as many students as U.S. graduates. [09:22] Yearly Trends Table 3 shows the yearly trend showing a slow, steady incline every year for the number of positions from 204 to 218 over the last five years. It's a 0.8% increase every year from 2013 to 2017. Looking at Table 8 shows the number of positions offered and the percent filled by U.S. Seniors versus all applicants. For 2017, 83.9% were U.S. Seniors and the numbers are pretty high every year. In fact, this is the lowest year since 2013. It's 92.6% in 2016, 89.5% in 2015, 91.7% in 2014, and 93.1% in 2013. This tells you a couple of things. That for 2017, less U.S. Seniors matched percentage-wise for the total number of positions offered. This tells you that either there were less qualified students applying this year or there are more qualified non-U.S. Seniors applying this year. Table 9 gives you scope of how big a specialty is. For neurosurgery only 0.8% of all applicants matched into neurosurgery. There are a total of 27,688 students and 100% of those students are matching. Another surgical subspecialty that is low is ENT with 1.1%. Not a ton higher but still higher. "Out of the 27,688, only 0.8% of those are matching into neurosurgery. So it's a very, very small specialty." [12:35] Unmatched U.S. Seniors and Independent Applicants, SOAP Looking at Figure 6, Neurosurgery has an unmatched percentage of 20.6% so one out of every five students is not matching into neurosurgery. 55.4% of the independent applicants go unmatched. So it's a large percentage of that are non U.S. Seniors. Only 10.4% of U.S. Seniors are unmatched. Comparing this with other specialties, plastic surgery is 16.3% for U.S. Seniors, Dermatology is at 13.8%. This is a high percentage but not the highest. Table 18 shows the SOAP (Supplemental Offer and Acceptance Program). Neurosurgery had 0 unfilled programs so no neurosurgery programs needed to participate in SOAP. [14:00] Charting the Outcomes 2016 Digging into the Charting the Outcomes 2016, looking at percent match by preferred specialty, Chart 3 shows that 76% of U.S. allopathic seniors matched into it. This the third lowest. Vascular surgery is 71%, Orthopedic surgery is 75%. This tells you that it's one of the most competitive specialties out there, at least for U.S. Seniors. Table 2 talks about the mean USMLE score for Step 1 and Step 2 CK (Clinical Knowledge) versus CS (Clinical Skills). The mean USMLE Step 1 score for all specialties combined for those that matched was 233 and 230 for those that did not match. Keep these numbers in mind. "To match, you have to rank a lot of programs. The more programs you rank, the higher the chance that you will match." Chart 4 shows that in Neurosurgery, the median number of contiguous ranks is at 16 while those that did not match only had a median number of 11. So you need to rank enough programs to match. If you want to match, you cannot be very picky. Are these people not ranking programs because of location? Or prestige? Or are they not ranking programs because they just didn't interview there and decided not to rank them. So there are many questions there. Again, the data is just data. You can't draw conclusions based on this data. We can only make some inferences and discuss what is behind these numbers. But there is no way of knowing specifically why the numbers are what they are. [17:23] Ranking by Specialty and Step 1, Step 2 Scores Ryan always tells students that if you want to be a physician, don't have a plan B of being a PA. Don't have a Plan B of being an NP. Don't have a plan B of using your Biology degree or something else. If you want to be a physician, figure out how to get there. "Don't have a plan B of being a PA... If you want to be a physician, figure out how to get there." Chart 5 talks about the mean number of different specialties ranked by U.S. Allopathic Seniors. This tells you that those who have a plan B did not match at a much higher percentage in most instances than those that didn't have a plan B. Looking at Neurosurgery, the mean number of different specialties ranked was 1.1. This means a  large majority of students only ranked neurosurgery on their rank list. The mean number of those that did not match was 1.4. It means there are more of those students putting in different, most likely, surgical specialties. If you're applying for neurosurgery, that means you like the operating room. This probably means you're applying for maybe general surgery as a backup. And that back up might hurt you. Psychologically, it might hurt you. And the data shows it leans that way. Chart 6 looks at Step 1 scores. The mean Step 1 score for all specialties was 233. For neurosurgery, the mean Step 1 for those that matched was 249. Those that did not match was closer to 238. So you need to have great board scores to match into neurosurgery on average. The same thing for Step 2 scores. The mean Step 2 scores for all specialties was 244.8. For those that matched into neurosurgery, the number was upward to 251-252. For those did not match, it's closer to 242. "You need to have great board scores, if you're planning on being competitive for neurosurgery." [20:21] Scores, Research, Publications, AOA Table NS-1 shows that Mean USMLE Step 1 Score is 249 for those that matched and 238 for those that did not. Step 2 Score is 251 for those that matched and 241 for those that did not match. Research experience is 4.8 versus 4.2. Number of abstracts, presentations, and publications for neurosurgery is 13.4 for those that matched versus 8.4 for those that did not. This tells us that research is very important for neurosurgery. "Research is very important for neurosurgery." The number of students that are AOA (the medical student honor society) based on grades, almost 33% of those that matched were AOA versus only 11.5%. It's not just about having the AOA label, but having the grades that made you competitive and that led you to AOA. It means having the grades to give you the knowledge to do well in the boards. So you can look at this thinking you have to be AOA but you have to have a solid foundation of scientific knowledge of all those courses you've taken in medical school. And this leads to AOA. But it also leads to great board scores. So it's not just AOA. So 9.5% of those that matched have a PhD degree versus 7% who did not. Mean number of contiguous ranks is 15.7% of those that matched versus 10.2% for those that did not match. Again, you need to rank a lot of programs to increase your chances of matching. [22:27] Burnout Rates and Compensation Moving on to the data of Medscape Lifestyle Report 2017, Neurosurgery is not on the list since there are only a few number of them. And looking at Medscape Compensation Report 2017, it's the same thing, Neurosurgery did not have enough representation to be in this list. Anecdotally, Neurosurgery is one of the highest paid specialties out there. If this is something that's motivating you, which shouldn't be, neurosurgery is up there. Based on the NRMP Match Data, it's very hard to get into neurosurgery. But if this is what you want to do, start now. Make sure you have a solid foundation of your classwork. Get AOA as much as possible and get great board scores. Get those connections to neurosurgery programs. Make a great impression as you go through this process. Links: MedEd Media Network Specialty Stories Podcast Episode 20 NRMP Main Residency Match 2017 Medscape Lifestyle Report 2017 Medscape Compensation Report 2017 Charting the Outcomes 2016 The Premed Years Podcast

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 37 This week, we take a deep dive into the match data for dermatology. We cover the Match data from 2016 and 2017 to give you an idea of what you're up against. Dermatology is one of the hardest specialties to match into. Historically, it has been known as the ROAD specialties (Radiology, Orthopedics, Anesthesiology, and Dermatology). "Dermatology is still one of the more competitive residencies to apply to as a medical student." As we dive into this data, it gives you an idea of what you should be thinking about or doing when it comes to starting your journey. Hopefully, this will help you determine how much effort you put into getting the best possible board scores and everything else you need to get into dermatology. Also, check out everything we have at MedEd Media Network including The Premed Years Podcast, OldPreMeds Podcast, and The MCAT Podcast. [01:51] Match Summary As always, all of this data come from the NRMP Main Residency Match Results and Data First off is Table 1 which shows the summary of the match. It starts with PGY-1 positions and Dermatology has 11 programs, 26 positions. Don't freak out since there are actually a lot more dermatology spots offered. Dermatology has a prelim typically a medicine or transitional or surgery year that you do before you start your dermatology residency. As a medical student when you are applying to dermatology, you need to apply typically to a dermatology residency. This starts at PGY-2. Then you apply for a prelim year or an internship year which is your PGY-1 year at either a medicine, surgery or transitional program. So you can't go look at those numbers on Table 1 alone. Instead, go down to the continuation of Table 1 which shows the PGY-2 positions. There you will will see they have 121 programs and 423 positions offered. Looking at this chart across the column, the total number of U.S. Seniors applying out of those 423 spots is 479. So there are more U.S. Seniors than there are spots available. For this purpose, U.S. Seniors for the NRMP refer to students who are in an allopathic/MD medicine program and they're still in school. Now, out of those 479, 81.8% matched into Dermatology. That's a pretty good number and it's one of the higher numbers around. "If you are a DO student or an international medical grad, your chances are already starting off not that great." [05:00] U.S. Seniors, U.S. Grads, Osteopaths, and U.S. IMGs Table 2 shows that out of 423 positions, 415 were filled on the main match. 346 of those 415 were U.S. Seniors, 48 were prior U.S. grads, which means prior MD graduates. These are those that possibly didn't match their first time around and then reapplied. Or maybe they didn't apply to a residency program the first time around because they weren't very competitive. They wanted to do some research. Maybe they really wanted to go to one specific program so they went to do some research in that program, reapplied, and got in. There were 7 osteopathic students which makes up less than 2% of the 415 spots that were filled. It a very low number. Just to give you an idea, let's look at other specialties. Anesthesiology has 1,146 spots, 164 of which were osteopathic students. That's over 14% of Anesthesiology but less than 2% for Dermatology. It's possible there's still some bias tin the Dermatology world for DO's. There were 3 International Medical Graduates or IMGs who are U.S. citizens that went to a foreign or international medical school and 11 were non U.S. Seniors or non U.S. citizens that went to an international medical school. So it's high numbers for U.S. Seniors and good numbers for U.S. grads. Not good numbers for osteopathic students, and terrible numbers for U.S. International Medical Graduates. Lastly, it's pretty bad numbers for non-U.S. citizen international medical graduates. "High numbers for U.S. Seniors and good numbers for U.S. grads. Not good numbers for osteopathic students." [07:20] Growth Trends, Unmatched Applicants, and SOAP Table 3 shows the growth trend of each specialty from 2013 to 2017. Dermatology has been growing and growing with 13.3% in 2013. In 2017, there was a 15.8% year over year growth. There were 399 spots in 2016 and 423 in 2017. There are more and more programs opening up for Dermatology which is good for you if you're interested in Dermatology. "There are more and more programs opening up for Dermatology." Figure 6 looks at unmatched U.S. Seniors and independent applicants ranking all the different specialties. Dermatology ranks up as the second highest for all of the programs with 33.8% total unmatched. The majority of that are the independent applicants. They're outside of the U.S. Seniors and those were 47.3%. Almost half of the applicants were applying independently. Again, these are the IMG's and osteopathic students. I assume the U.S. grads are included here as well. The U.S. Seniors that went unmatched made up 13.8%. At a quick glance, it's the third highest behind Plastic Surgery and Orthopedic Surgery. So Dermatology is very, very competitive. Looking at Table 18 is the SOAP (Supplemental Offer and Acceptance Program) process, for PGY-2 positions, Dermatology had four positions available and all four were filled. [09:48] Ranking, Steps 1 &2, Research, AOA Chart 4 is one of the most telling charts when it comes to residency matching. When you match or apply to match, it depends on what programs you're applying to. A lot depends on how many program you are ranking. It's a big algorithm that matches you to programs. "You submit a rank list. Schools submit a rank list. And the magic happens." The median number of contiguous ranks is eight. This means that student that matched put Dermatology program eight times in a row. Those who did not match was only three. So you have a much lower chance of matching if you are much more selective when it comes to matching. The same goes if you're also being selective with the programs your'e applying to or you're interviewing at. Or you're not a competitive applicant and you didn't interview at a lot of program so could not select a lot of programs to actually match to. A lot of it comes down to how many programs you ranked. It's a numbers game. You apply to more medical schools, your chance goes up. You apply to more residency programs, your chances goes up. The same with fellowship programs. Chart 5 dives into the mean number of different specialties ranked. Typically, if you want Dermatology, apply to Dermatology programs. "If you have a Plan B, you're less likely to succeed in your plan A." There's a lot of psychology research that shows having a plan B decreases the likelihood for your Plan A to succeed. But the data here shows that those who matched in Dermatology applied to a mean number of 2.2 different specialties and those that didn't match is 2.3. So the numbers are not very off. This could be skewed since in dermatology, you have to apply to a categorical or prelim year. I wonder if that data is being included in this. It doesn't mention anything in the graph data, but I wonder if that's the reason the numbers are so high at 2.2. It's much higher than everything else except for radiation oncology. Looking at Table DM1, it gives us all the hard data behind Dermatology. The mean number of contiguous ranks is 8.9 versus 4.2. Mean number of Distinct Specialties was 2.2 versus 2.3. The mean USML Step 1 score was 249 for those that matched and 239 for those that didn't match. The mean Step 2 score is 257 to those that matched and 246 to those that didn't match. Sometimes, Step 2 score isn't really that useful. But the Step 1 score is huge here. The mean number of research experience is 4.7 for those that matched and 3.8 for those that did not match. Mean number of abstracts, presentations, and publications is 11.7. You need to get out there. You need to do your research. "You need a very, very strong Step 1 score and a strong Step 2 score... you need to do your research." AOA  (Alpha Omega Alpha) comprised 2.8% of those that matched. This means they were very successful in their medical school classes early on. Their pre-clinical is 52.8% of those that matched and only 25.8% for those who did not match. Chart DM2 shows those that matched versus those that didn't with the number of contiguous ranks. You can clearly see that those that did not rank a lot of programs did not match. Then as soon as you get past that eight mark, it goes down. And after eight, only six people didn't match. So you have to rank a lot of programs. "You have to be competitive enough to get interviews and to rank a lot of programs." [15:40] Medscape Lifestyle and Medscape Physician Compensation Report The Medscape Lifestyle Report 2017 talks about the lifestyle of a Dermatologist. As to which physicians are the most burnt out, Dermatology is near the bottom at 46%. (See Slide 2)The lowest is Psychiatry at 42%. As to how severe is the burnout, Dermatology is hanging at the top at around 4.3. Highest is 4.6 with Urology. (See Slide 3). Slide 18 shows which physicians are the happiest and Dermatology is number three on the list at 43% happy at work and 74% are happy at home. The Medscape Compensation Report 2017 is the fun part. Highest salary is Orthopedics at $489K a year. Dermatology is number eight on the list at $386K. Below Orthopedics are Plastic Surgery, Cardiology, Urology, Otolaryngology, Radiology, Gastroenterology, and Dermatology. These are the top eight and all of these are procedure-based specialties. (See Slide 4) "The way our healthcare system is set up, those who perform procedures and do surgeries are compensated with more money." Even if what you're interested in is not within these eight, that's okay. You'd still make a good living as a physician. The lowest on this list is pediatrics at $202K. Dermatology pay according to this survey on Slide 5, only went up 1% (See Slide 5). Which physicians feel fairly compensated, Dermatology is the second highest at 65% (See Slide 18). Looking at slide 38, those who would choose medicine is up there at 80% and the highest is 83%. So Dermatologists are happy. They like being a doctor. They would choose it again. Who would choose the same specialty? Slide 39 shows it's Dermatology. They love their jobs. If you want to be a dermatologist, it might be good for you to check out Dermatology. [19:25] Be an Intern I'm looking for an intern. If this is something you're interested, email me at ryan@medicalschoolhq.net. I'm looking for one savvy for social media who can oversee my social media accounts and help me go out and find physicians to interview here on the podcast. It would be a great help to me and we can turn this into an extracurricular for you. We'll figure out a way to make it worth your time in helping this show succeed for every premed student, medical student, and even for residents out there looking for fellowships. In the subject line, kindly place Specialty Stories Intern. And I will get back to you as soon as you can. Links: MedEd Media Network The Premed Years Podcast OldPreMeds Podcast The MCAT Podcast NRMP Main Residency Match Results and Data Charting the Outcomes 2016 Medscape Lifestyle Report 2017 Medscape Compensation Report 2017

Session 23 Our episode with Dr. Chris Sahler was one of our most popular episodes. I decided to bring you the PM&R residency match data since many of you seem interested! [02:33] NRMP Main Match Data for 2017 - PGY-1 & PGY-2 Positions Table 1 shows the match summary for all the different specialties and Physical Medicine & Rehabilitation only has 32 programs under PGY-1 positions. This is also one of those specialties where you can match into a PGY-2 spot and you have to separately apply for your internship. This table shows there are 62 programs for PGY-2 positions and that gives you a total of 94 programs. Just be careful when looking at data since some specialties may have they PGY-1 built-in while some do not. Looking at PGY-1 spots, there are 119 positions. This is a relatively smaller program with almost 3 and 3/4 per program. And out of those spots, only one program went unfilled. There are 294 U.S. Seniors applying out of 595 in total who applied. (Remember for the purposes of this podcast when talking about match data, U.S. Seniors refer to U.S. allopathic students so these are students who are still in medical school going through the normal timeline so they're not taking any gap years after medical school.) This implies that more than half them applying for these spots are U.S. Seniors. Interestingly, only 74 U.S. Seniors matched for Physical Medicine & Rehabilitation out of 118 that matched. Only 62.2% of the students that matched were U.S. Seniors. Comparing this to other specialties, 78.2% of those that matched in Emergency Medicine were U.S. Seniors, Neurosurgery at 83.9%, Neurology at 50.6%, and OB-GYNE at 81.4%. There is a very wide spectrum of what percentages of students matching are U.S. Seniors. For PGY-2 Positions, students also need to rank and match into a PGY-1 spot, whether it's a surgery year, a transitional year, or an internal medicine year. So these are three different prelim years you can choose from. Out of those 62 programs, there were 294 spots available so it's almost 4 and 3/4 per program. This is a little bit bigger compared to PGY-1 position programs. And out of those 294 programs, none of them went unfilled. Out of 633 total applicants, 306 were U.S. Seniors and only 61.16% of those that matched were U.S. Seniors. [07:28] Matches by Specialty and Applicant Type Table 2 of the 2017 NRMP Main Match Data shows us where the other people are coming from. For PGY-1 positions, 33 were osteopathic students out of 118 physicians that matched in PM&R. This is 27.97% Compared to other specialties. Emergency Medicine had 283 matches for osteopathic students (a pretty big number for non-primary care) out of 2,041 total students. That's 13.9%. So PM&R is 14% higher than that which is very interesting. Looking at this data, you can't say osteopaths are at a disadvantage because less osteopaths are matching into some of these surgical positions. But if a student goes to an osteopathic medical school because they believe in their philosophy and manipulation, then going into surgery maybe doesn't make sense and so is going into pathology. So you can't just look at the numbers. You have to look at what's the reasoning behind the numbers. It's easy to hypothesize that osteopathic medicine fits very well with PM&R, which is basically, non-surgical orthopedics. You're dealing with people who have aches and pains and joint issues as well as other things and osteopathic medicine works with that. So these PM&R programs seem to be very open to osteopathic students. In fact, Dr. Sahler talked about this in Episode 13 that PM&Rs are very open to osteopathic physicians. For PGY-2 spots, all 294 positions went filled. 181 were U.S. Allopathic Seniors, 5 were U.S. Grads (these are students outside of the normal timeline), and 83 were osteopathic students, which means 28.2% of osteopathic students actually matched. So if you're an osteopath and are interested in this stuff, you have a good shot to get a spot here. Moving on, 17 were U.S. International medical graduates, 8 were non-U.S. citizen international medical grads. [11:40] Positions Offered, U.S. Seniors, All Applicants, Osteopaths (2013-2017) Table 3 tells us how the the number of spots is growing and looking at PM&R, it's growing slowly over the last four year at 0.4% every year for PGY-1 while for PGY-2, it's been growing much faster at 11% in 2017 from 10.9% in 2016. If you're interested in it, it's obviously a growing field for you. Table 8 shows the percentages filled by U.S. Seniors versus all applicants from 2013-2017. It basically shows us a trend of what programs are doing, whether they prefer U.S. Seniors or U.S. Graduates or other students. Looking at PM&R for PGY-1, 62.2% in 2017 were U.S. Seniors, 61.16% in 2016, 60.7% in 2015, 56.3% in 2014, and 59.8% in 2013. So it has gone up pretty steadily over the last couple of years with more preference towards U.S. Seniors. For PGY-2, 61.6% U.S. Seniors matched, 52.8% in 2016, 45% in 2015, 53.7% in 2014, and 51.7% in 2013. There was a huge dip in 2015 which is really interesting. Table 9 shows all applicants that matched by specialty. 0.4% of all students matched for PGY-1 spots matched into PM&R. Compared to other specialties, Surgery is 4.6%, Internal Medicine is 25.6%, Family Medicine is 11.6%, Anesthesiology is 4.1%. Table 11 shows us osteopathic students matching into PGY-1 spots with 1.1% of all osteopathic medical students are matching into PM&R. Comparing that with the previous table of 0.4% by percentage, more osteopathics actually match into PM&R than allopathic students. This is very interesting yet it still goes with the fact that it does fit with osteopathic medicine. [15:12] Unmatched and SOAP Figure 6 of the 2017 NRMP Main Match Data shows the Percentages of Unmatched U.S. Seniors and Independent Applicants Who Ranked Each Specialty as Their Only Choice. PM&R is near the top of the list for total unmatched students at 27.5%. Internal Medicine (Prelim) is the highest followed by Dermatology, Psychiatry, and then PM&R. Majority of these students are independent applicants which means they are not U.S. Allopathic Seniors. You have osteopathic students, U.S grads who are already out of school and international medical graduates making up this number. This is a little scary since PM&R is higher on the list. Remember there was only one unfilled position so it's highly sought after for a specialty. Table 18 is all about the SOAP (Supplemental Offer and Acceptance Program). Again, there was only one unfilled spot in all of PM&R. So for the SOAP, there was also only one spot available and as expected, it was filled through the SOAP. [16:48] Charting the Outcomes 2016 Based on Charting the Outcomes 2016, Table PM-1 (Page 168 of 211) shows the number of contiguous ranks, Step scores, research, work experience, AOA, etc., to give you a picture of what these students look like for those who matched and did not match. For U.S. allopathic Seniors, the mean number of contiguous ranks that matched are 14.2 programs while those that did not match were only 5.6. I can't stress enough the need for you to rank enough programs in order to match. When you submit your rank list, you actually don't have to apply to only one specific residency program. You can apply to General Surgery and Orthopedic Surgery programs. For Physical Medicine & Rehabilitation, the mean number of distinct specialties ranked is 1.6 for those that matched and those that did not match were 2.2. Those ranking more programs are not going to be able to verbalize and communicate to these programs why they specifically want to go into PM&R because maybe they're out there ranking other programs. Back on the data, the mean Step 1 score is 226, mean Step 2 score is 238. These are not terribly high Step scores. Those that did not match are 210 and 221 for Steps 1 and 2 respectively. They have data for osteopathic students as well. Looking at Level 1 score for those that took the COMLEX, they have a 551 for those that matched and 492 for those that did not match, 563 for Level 2 that matched and 491 for Level 2 that did not match. Charting the Outcomes 2016 Table PM-1 also looks at work experiences and volunteer experiences. AOA members comprised 6.2% of those that matched while 0% for those that were unmatched. (AOA in the allopathic world is for Allopathic medical students) [21:10] Medscape Physician Lifestyle and Compensation Reports Normally, I would also check on the Medscape Physician Lifestyle and Compensation Reports but PM&R is not included in the data probably because it's a smaller field so they didn't have enough respondents for it. So we do not have enough feedback to have the data here. Links: Specialty Stories Episode 13: What is Physiatry? (Physical Medicine & Rehabilitation) MedEd Media Network 2017 NRMP Main Match Data Supplemental Offer and Acceptance Program (SOAP) 2016 Charting the Outcomes - NRMP Medscape Lifestyle Report 2017 Medscape Physician Compensation Report 2017 AOA

Intro music: Ryan Little “Get Up” Hey everybody this is Myers Hurt with another edition of “Countdown to Match Day,” the official podcast of the Match Gurus, and the only podcast aimed at helping applicants shine on interview day. Remember to send any questions you want answered on the show via twitter @theMatchGurus or snapchat thematchgurus and we will get your questions answered. In true countdown style, this season we’ll release one podcast each week for the 40 weeks leading up to Match Day 2017.  This is season 1 episode 2 - 39 weeks to go until Match Day 2017. Let’s jump into today’s topics of discussion. Why focus on the interview? Where and when the interview comes into play. Anecdotally, umbers get your foot in the door, interview gets you a job. To prove that, this is the Program Director Survey. This is 2014 data, but is the most recent they have available, and I’m hoping for a new document soon. If you read the introduction the response rate is just over 50% from program directors, but I would say it is still a good resource. The full doc is 148 pages, and divided into speciality-specific data sets, we can dissect those later in the season, but now I would invite you to look at Figure 1 on page 3 and Figure 2 on page 4. Figure 1: Percentage of programs citing each factor in selecting applicants to interview. THIS is why USMLE step 1 is so important. The USMLE is primarilty a test for state medical licencing borads (NBME / FSMB), desigend to see if students pass or fail, not necessarily a ranking system to see which students are best - residency programs adopted it as an objective comparrison tool. DoctorsInTraining, Kaplan, Pass Program, MedQuest, USMLEWorld, Pathoma, SketchyMedical - the list goes on  - these are such successful entities for this reason. FIgure 2: Percentage of progarms citing each factor in ranking applicants. I'm guilty of speaking in hyperbole - but this is any area I think deserves it. No exageration, these are the two figures that I think are life changing - they show how students with 99%ile scores don’t match, and how mediocre IMGs can get their first choice.  They answer almost every question on the ValueMD and SDN message boards.  Is Step 3 important? Look at the chart. Should I do an away rotation? Look at the chart. How important are letters of recommendation? Look at the chart. If you look through the entire document at the speciality you are applying to, you will be able to tease out nuances that your speciality values, and wht program directors in that speciality have explicitly stated they are interested in. AAFP Strolling through the MATCH The 2016 AAFP booklet. Admittedly, as a family practice doc I am mostly exposed to AAFP materials, but this is a document that serves all medical students, not just thoise interested in primary care. My previous institution has a family medicine interest group that hosts an annual event that highlights this document. General residency application timeline and checklist, listing the Table of Contents:   Section 1 - Choosing a Specialty Section 2 - IMG resources Section 3 - Preparing your Credentials - CV, personal statement tips, LoR tips Section 4 - Selecting a Program Section 5 - The interview Process - etiquette, question types, etc Section 6 - The Match: What is it and How it Works Section 7 - The SOAP - Supplemental Offer and Acceptance Program Section 8 - Resources As you can see, a fairly robust document that is beneficial to all applicants, and a good place to look for up to date answers. Question of the Day: Alistair asks: Is research I did in undergrad signifignat enough to “count” for my ERAS application? Closing:     Unfortunately that’s all the time we have for today’s show. Please subscribe to catch each new episode as they are uploaded each week.  If you find the content valuable please take a bit of time to leave a review on iTunes to help get the word out to other med students looking for answers.  Also feel free to give us some feedback on what you think we could improve on. Check out our book on Amazon titled "Getting In" Thank you to everyone for listening, remember to send you questions to us through our website at www.thematchgurus.com, twitter @theMatchGurus, or snapchat.  Take care.