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What happens on Match Day? How many residency programs are there in the US? How many medical students matched in 2025? What happens if you don't match? Jeanette Calli, chief of match operations at the National Resident Matching Program, discusses the latest main residency match results, including Match Day participation rates and trends in the residency match process. Also covering Supplemental Offer and Acceptance Program (SOAP) results for residency placements. American Medical Association CXO Todd Unger hosts.✶✶✶✶
What happens on Match Day? How many residency programs are there in the US? How many medical students matched in 2025? What happens if you don't match? Jeanette Calli, chief of match operations at the National Resident Matching Program, discusses the latest main residency match results, including Match Day participation rates and trends in the residency match process. Also covering Supplemental Offer and Acceptance Program (SOAP) results for residency placements. American Medical Association CXO Todd Unger hosts.
Episode 165. Let's break down the Supplemental Offer and Acceptance Program, also known as SOAP, and how to know your chance of needing to SOAP. We'll also cover the four steps all applicants should do ahead of Match Week to prepare for the scenario of not matching on Monday.Visit First Line's website and blog: https://www.firstlinepodcast.comEditing Service for Pre-Med and Medical Students (CV, personal statement, applications): https://www.fiverr.com/firstlinepod For a discount on your TrueLearn subscription use https://truelearn.referralrock.com/l/firstline/ and code firstlineContent on First Line is for educational and informational purposes only, not as medical advice. Views expressed are my own and do not represent any organizations I am associated with.
Match day is the long-awaited day in March that many medical students anticipate with mixed emotions. In this episode, we sat with Dr. Baoanh Vu, a recent graduate who went through a rollercoaster ride in getting to match day. Join us on a personal and candid conversation going into the process of applying, coming up with a rank list, participating in the Supplemental Offer and Acceptance Program, and matching into a preliminary year.Music: https://pixabay.com/music/id-112777/ Episode Team: Guest - Baoanh Vu (Alumni, CUSM)Host - Ria Angelica Laxa (MS2)Script Writers - Baoanh Vu (Alumni, CUSM), Yuu Ohno (MS2) Audio - Lien Ha (MS2), Anthony Mamaril (MS2)Producers - Yuu Ohno (MS2), Ria Angelica Laxa (MS2)Director - Vy Han, MD
**LISTEN HERE, THEN WATCH THE VIDEO FORM OF THIS EPISODE ON YOUTUBE.COM/ACMEDICALORG** For today's episode, we further elaborate on Supplemental Offer and Acceptance Program (SOAP): what it is, the timeline schedule, how it can benefit you, and discuss ways to prepare for it. If you did not get to chance to attend our most recent webinar "Final Chance to Match During the 2022 SOAP" on Dec. 2, we invite you to watch the recorded version, soon to be released on our YouTube channel some time within the next week or two. Have questions? Contact us at podcast@acmedical.org
In our world of today, many marginalized communities face systemic injustices when seeking medical care, which leads to disproportionate rates of chronic illness and even death. OBGYN resident Dr. Nina Snowden, after having felt the brunt of these disparities herself, has dedicated her life to making a difference no matter how small. Keep listening to find out more about this IMG's story of determination and resilience. As a US IMG, Dr. Snowden completed her undergraduate and master's degrees in the US and even served as a registered dietician. After having faced a tragedy, however, Dr. Snowden felt inspired to start medical school at a later age than most students. It is this resolve that guided her through her medical education as she moved step by step to fulfill her calling to be a physician. She attended the St. George's University in Grenada and was able to maintain good grades throughout her time there. When asked to share the highlights of her journey to the match, Dr. Snowden dropped the following gems of advice: Make good use of your resources - Dr. Snowden recommends the IMG Roadmap course as an excellent guide to help IMGs land the residency they've been dreaming of. Networking is key! Dr. Snowden took it upon herself to show initiative and reach out to as many people within her intended field. She joined organizations, attended conferences and introduced herself to program coordinators in order to improve her chances of matching. Ignore the naysayers - Though Dr. Snowden admits to not having had the most stellar scores on USMLE, she did not let the negative opinions of others prevent her from applying to the specialties that she was interested in. Ultimately, the only person who needs to believe in you, is you! Leverage your application if your scores are not within your desired bracket - Dr. Snowden ensured that she had a back up plan and so, attained letters of recommendation from each one of her core rotations in case she had to participate in the The Supplemental Offer and Acceptance Program (SOAP). She boosted all the other areas of her application so that her scores were just one component of many. Overall, despite a rough beginning, Dr. Snowden was determined not to become a statistic, and despite being an underdog, she was determined to achieve all of her goals. As such, she constantly reminded herself to: Strive to do better in all things. Once you do your best, everything else will fall in line. Feeling inspired? You can reach out to Dr. Snowden to find out more about her phenomenal story via her Instagram @drnina_obgyn and her email: nina.s.snowden@gmail.com Listen to the full episode using the links below: Apple: https://podcasts.apple.com/us/podcast/69-imgroadmap-series-77-dr-nina-snowden-obstetrics/id1490731292?i=1000522741273 Spotify: https://open.spotify.com/episode/5aP5rRjsmZM2aXkx63ymag Google Podcasts: https://podcasts.google.com/feed/aHR0cHM6Ly9hbmNob3IuZm0vcy9mOGMzY2EwL3BvZGNhc3QvcnNz/episode/N2QzYjEyNjEtY2E1Yy00MGE5LTg3NjAtYWY4NzhhNzU3M2M5?sa=X&ved=0CAUQkfYCahcKEwiwv4-3nejwAhUAAAAAHQAAAAAQAQ --- Support this podcast: https://anchor.fm/ninalum/support
Have your challenges and bad experiences ever made you feel like giving up? Dr. Foluwakemi Olufehinti's story will give you all of the inspiration you need to persist in the face of adversity until you achieve your goals! Nigerian-born Non-US IMG Dr. Olufehinti completed her medical education at Ross University, which was then situated on the Caribbean island of Dominica. As a student, she had to adjust to a different learning and testing style, but eventually, she gained success despite the various difficulties she faced. When it comes to the match, Dr. Olufehinti's story is far from traditional. She essentially applied on three occasions, twice in the traditional match process and once through the the Supplemental Offer and Acceptance Program (SOAP). On her first try for the 2019 match period, though she received 7 interviews, she did not match. She decided to try again through SOAP, which was also unsuccessful. Dr. Olufehinti did not let these setbacks define her and she used this as an opportunity to consult with resources such as the IMG Roadmap Course and to seek feedback from her interviewers in order to highlight areas needing improvement. With this in mind, she applied for the 2021 match period and received 20 interviews this time around! In December of 2020, however, she received an offer from one of the programs she had applied to prior to the 2021 cycle and decided to accept it. As a result of her very unique journey to the match, Dr. Olufehinti is a wealth of insight and advice. Here are a few of the topics she touches on in during this interview: The match: After not having matched the first two times, Dr. Olufehinti attributes her success thereafter to an increase in confidence and to the understanding that while she was being interviewed, she was also interviewing the program coordinators. The moment she saw herself as a potential asset to the program, the coordinators began to share the same view. Preparing for the USMLE: Dr. Olufehinti advises IMGs to study in groups if this style works for you, and to use plenty of practice questions from reputable sources. While your grades do not define you, program coordinators just want to see that you are diligent and capable of improvement. Persistence is key: Though there were times where it seemed like all the odds were stacked against her, Dr. Olufehinti was able to stop, take stock, and improve until she was able to achieve her goals. You can reach out to Dr. Olufehinti via her Instagram @fomoshgreen Watch the full episode using the links below: Apple: https://podcasts.apple.com/us/podcast/the-img-roadmap/id1490731292 Spotify: https://open.spotify.com/show/45NNJ7ewtqynqyssbwm1xz Google Podcasts:https://podcasts.google.com/?feed=aHR0cHM6Ly9hbmNob3IuZm0vcy9mOGMzY2EwL3BvZGNhc3QvcnNz Overcast: https://overcast.fm/itunes1490731292/the-img-roadmap-podcast RadioPublic: https://radiopublic.com/the-img-roadmap-GE0MMg --- Support this podcast: https://anchor.fm/ninalum/support
What if you had dreamt of being a surgeon, but somewhere along your medical journey your passions and interests changed? Dr. Morakinyo represents a very important part of many of our lives - the reality that things may not always go according to plan and the fact that we always have the power to make the best of every situation. Keep listening to find out how this IMG navigated SOAP and landed his current residency match! Nigerian-born, Canadian citizen Emmanuel Morakinyo is the picture of a non-traditional IMG. His medical journey began at the St. Georges University after which he landed a residency in internal medicine at the Orange Park Medical Center, just outside of Jacksonville, Florida. While he had every intention of pursuing a career in surgery, after four months of surgery-based rotations, he decided that such a specialty did not align with the life that he had come to envision for himself. Upon this realization, he re-evaluated his interests and their compatibility with his life-plan and proceeded to begin the match process. He eventually ended up enlisting in the Supplemental Offer and Acceptance Program (SOAP) and took the gamble of not submitting a rank list! When asked how he was able to navigate SOAP, especially with such a risky start, and how he would advise others to approach the process, he outlined the following: If you have even the slightest inkling that you will need to go through SOAP, get all of your documents in order as soon as possible. Upgrade, tailor and personalize your personal statements to their intended recipients. Use any advantage or leverage that you may have to increase your chances of landing a match. Ensure that you have a good internet connection and that you prioritize so that you can dedicate enough time to monitoring the various online portals. Have a solid support system - this process is indeed anxiety-inducing, but having people around to help you makes all the difference. Stay away from irrelevant online forums that may bring unnecessary negativity and stress. Exhaust the number of applications that SOAP allows you. Even after such a seemingly daunting process, Dr. Morakinyo is currently transitioning into his second year of residency and maintains a positive attitude. Here are some inspirational tidbits that he hopes will inspire us to do the same: Speak your goals into existence Do not be discouraged if you do not match and have to go through SOAP - it's not the end of the world. Put in your best and leave the rest to God. You can reach out to Dr. Morakinyo on his instagram @iyanulive.md and through his email iyanulivecontact@gmail.com Listen to the full episode here: Apple: https://podcasts.apple.com/us/podcast/the-img-roadmap/id1490731292 Spotify: https://open.spotify.com/show/45NNJ7ewtqynqyssbwm1xz Google Podcasts:https://podcasts.google.com/?feed=aHR0cHM6Ly9hbmNob3IuZm0vcy9mOGMzY2EwL3BvZGNhc3QvcnNz Overcast: https://overcast.fm/itunes1490731292/the-img-roadmap-podcast RadioPublic: https://radiopublic.com/the-img-roadmap-GE0MMg --- Support this podcast: https://anchor.fm/ninalum/support
**PODCAST VIDEO OF THIS EPISODE AVAILABLE ON YOUTUBE.COM/ACMEDICALORG: Listen here, then watch on YouTube** The third week of every March signifies Match Week and its Supplemental Offer & Acceptance Program (SOAP): on that Monday, NRMP registrants and residency programs learn if they 'Matched'; if a candidate or program 'Did not Match', then the following 4 days present an additional opportunity for programs to make offers to SOAP eligible unmatched candidates. The SOAP process is quite fast, and the interview questions asked by programs during SOAP will be unique. In this 9th FutureDocs Podcast episode, ACMedical's Dr. Pedram Mizani and Cody Phan discuss what you need to know coming into SOAP and how to best prepare for SOAP interviews when a program contacts you. Have questions? Contact us at podcast@acmedical.org
**PODCAST VIDEO OF THIS EPISODE AVAILABLE ON YOUTUBE.COM/ACMEDICALORG: Listen here, then watch on Youtube** In an unprecedented 2021 Match cycle, there have been numerous changes as a result of the COVID-19 pandemic. With all of these variables, the Supplemental Offer and Acceptance Program (SOAP) is worth considering now more than ever as detailed in our previous episodes. Understanding the steps that are necessary to be SOAP eligible and the SOAP process may seem daunting at first, but we make it easy. For Episode 7, ACMedical's Dr. Pedram Mizani and Cody Phan detail the key changes in the 2021 SOAP as well as why it is so important to take advantage of the trend of unfilled positions and the additional Round 4, unique to this year only. Listen in as we detail the checklist our FutureDocs need to be verify their SOAP Eligibility. Have questions? Contact us at podcast@acmedical.org
When it comes to the U.S. Residency Application whether it is for NRMP's Main Match or applying to the Supplemental Offer & Acceptance Program (SOAP) your Letters of Recommendation (LORs) matter. LORs are used as a supplemental document that helps Program Directors and Admission Committees to predict your ability to execute the 6 ACGME Core Competencies, and reach PGY1 milestones at the same rate as your co-residents. Securing 4 LORs of this personalized magnitude is expected and doable by US medical seniors, but much more challenging for international medical graduates and other independent applicants. In today's episode ACMedical's Dr. Pedram Mizani and Cody Phan discuss the necessary tools and steps to securing ACGME Core Competencies based Letters of Recommendation. Have questions? Contact us at podcast@acmedical.org.
In today's episode, ACMedical's Dr. Pedram Mizani and Cody Phan highlight the ideal timeline to begin preparing for an upcoming Main Match Cycle, and 13 steps to stay on track and minimize your chances of being left unmatched. Preparation for the annual Main Match for medical residency should ideally begin 24 months before your planned residency start date, and anyone participating in the Match should be prepared for being 'Partially' or 'Fully Unmatched'. Additionally, it is important to train yourself to adhere to very challenging deadlines, such as those needed to gain residency-relevant U.S. clinical experience, pass US medical licensing exams, have supporting documents such as Letters of Recommendations (LOR) & Medical Student Performance Evaluation (MSPE) finalized and reviewed, all prior to certifying and submitting your residency application. And if you do not match during the regular Match cycle (like Dr. Mizani), this episode will guide you on how to use the final opportunity to Match this year through Match Week's Supplemental Offer and Acceptance Program (SOAP), as you prepare for the possibility of participating in next Match cycle. Have questions? Contact us at podcast@acmedical.org.
The annual U.S. medical residency 'Main Match' begins each September (October for 2021 Match, due to COVID), and ends the following March. By January, ~80% of interviews have already been offered, which can be anxiety provoking for those with insufficient number of interviews. Today our cohosts Dr. Pedram Mizani and Cody Phan discuss what to do with 6 or more residency interviews, fewer than 6, or no residency interviews at all. We discuss talking points of Rank Order List (ROL), Match Week's Supplemental Offer and Acceptance Program (SOAP), the general trends of the interview season and why 6 residency interviews is our average magic number. Have questions? Contact us at podcast@acmedical.org.
There are very few female physicians who are as open as today's guest. Despite always wanting to be a Pathologist she was “coerced” into Internal Medicine. Unfortunately most Caribbean medical students will be “advised” to choose a relatively “easier-to-match-into” specialty based on what I refer to as in “insecure advice”. The availability of more IM programs across the country makes for more open positions for IMGs. Now, IM is a great specialty. I would know. I practice hospital medicine as a board certified family physician. But not everyone loves IM and not every IMG should be an internist or a family physician. Dr. West shares her love for pathology and how an uncomfortable situation got her out from a comfortable place to seek her dream in pathology against all odds. She started out PGY-1 in Internal Medicine after 13 interviews but only matched via the NRMP's Supplemental Offer and Acceptance Program. After a horrific experience with a co-worker she resigned from the Internal Medicine program to pursue her true passion in Pathology. She is the definition of courageous, bold and beautiful! This is the vivacious Dr. West! Dr. Michelle West is a graduate of the Medical University of the Americas. She completed a Master's Degree in Public Health from Walden University, her undergraduate degree was obtained from Farmingdale State College. She is also a mother of three beautiful children who is thriving through a recent divorce. Dr. West can be found on instagram at @docbarbiemd. She started a website to help others manage to maintain academic success, while having a family and also enduring some personal challenges along the way. She discuss the many facets of life, as well as, hobbies and interests. Leave a review, subscribe and share with your friends. --- Support this podcast: https://anchor.fm/ninalum/support
Dr. David Flick hosts this episode to talk about preparing for residency applications. He’ll go over the ERAS timeline, the NRMP timeline, why the match process exists, and how to do well in these areas. [0:45] Timelines. ERAS opens around the beginning of June, and the beginning of September is when you can begin to apply. About halfway through September is when those programs receive your application. At the beginning of October, the MSPE is released from your school and goes out to all residency programs. March is when you actually match. The NRMP system opens near the end of September, and you have from then through November to register. Once you start interviewing, you’ll be able to build a rank-order list. In February, you’ll have to certify your list and it can’t be touched afterwards. [4:45] The match process. The NRMP supplies a great video that shows how this process works. The algorithm goes down your rank-order list and tries to pair you with a hospital until it finds a match. If you don’t match in that algorithm, NRMP has a separate program called the Supplemental Offer and Acceptance Program (SOAP). There a video for this process, too. [9:29] Match week. It typically occurs in the second or third week of March. The match itself occurs on the Friday of that week. On the Monday after, you’ll find out if you didn’t match and can then access the SOAP process. You will have access to look at and research the programs, but you cannot contact them directly. You can apply to as many as forty-five and then wait to see if they reach out to you. If you didn’t match in any of the three rounds of SOAP, you’ll then have access to all the unfilled programs that are left. Here, you are allowed to contact programs directly. [15:00] How to do well in match and SOAP. The best way to do well in match is to study the statistics. Your rank-order list must have enough programs on it. For SOAP, timing is everything. You’ll need to be very proactive, and you’ll want to use all forty-five of those slots. Be available to field phone calls, and make sure to brush up on your interview skills.
If you got only rejection letters this application season, you might be thinking your dreams of attending med school are dead. Well, pick yourself up off the ground, soldier, it's not over yet because you can apply again. But don't go throwing good money and time away by reapplying without taking a close, honest look at what your application was missing. Amy A'Hearn, our admissions assistant director, visited to discuss what you should think about when re-evaluating your competitiveness, with the help of Aline Sandouk and Irisa Mahapan. Don't give up...find out what Amy's top recommendations are, and get your dream back on track! Match Week was great for us here at UI as our students did better than the national average for finding a job after med school. But all was not perfect this year, as during the Supplemental Offer and Acceptance Program (SOAP), the servers crashed denying unmatched residency programs and applicants critical time to do the same. In the end, it all worked out...but it was a stressful time for all--but from our viewpoint, especially for SOAPing students! And it isn't the first time, either. Share your stories--anonymously, if you like--of your rejections and how you fixed it! Call us at 347-SHORTCT anytime, visit our Facebook group, or email theshortcoats@gmail.com.
See below for time stamps. Confused about 4th year? This episode is for you! Newly matched 4th year med students Roy Swanson (ophthalmology), Marco Swanson (plastic surgery), and Dana Canfield (obstetrics and gynecology) school Ian on the ins and outs of 4th year of medical school. Show notes can be found here. This is a wide ranging conversation that starts at the end of 3rd year and takes the listener through the completion of 4th year. A complete list of discussion topics for this episode can be found here, but includes: Introductions [2:44] Start 4th year discussion [15:32] Acting internships (+ away rotations) [26:01] Away rotations [1:04:25] Visiting Student Application Service (VSAS) --> now the Visiting Student Learning Opportunities (VSLO) [1:12:47] Letters of recommendation [1:15:05] Electronic Residency Application Service (ERAS) and personal statements [1:38:00] The Step 2s (Clinical Knowledge and Clinical Skills) [2:02:24] Residency interviews [2:34:20] The rank list and the Matching algorithm [3:07:35] The Match and Match week [3:24:49] Supplemental Offer of Acceptance Program (SOAP) aka "the scramble" [3:26:40] Life post-Match [3:33:49] Final comments from the gang [3:43:37] Special thank you to Katie Bedard, MD; Alice Yu, MD; Gary Parizher, MD; Kelly Manger, MD; and Karishma Habbu, MD for their help in formulating the discussion topics. And an extra special thank you to Kristol Das, MD for sitting patiently through a dry run of the interview to identify missing topics and to make sure the 4th Year Episode would flow properly :) Please enjoy with Roy, Marco, and Dana! This episode is sponsored by OnlineMedEd! Use this link to sign up for a free account. Then come back and use this link to get $80 off their annual premium subscription! Check out the TUMS Resources page, which includes a complete list of book recommendations made by guests on this show!
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)
Session 14 Today, we break down the match data, compensation surveys, and lifestyle reports for Emergency Medicine. If you’re interested in EM, this is a must listen. I also talked about dove into match data back in session 11 specifically on Anesthesiology and now I'm going to dive into Emergency Medicine. If you follow the NRMP results, Anesthesiology is first in the alphabetical order, followed by Child Neurology and then third, Dermatology. However, these two are relatively smaller so I'll reserve a separate discussion on the smaller programs at a later date. For now, let's focus on Emergency Medicine, which is a very popular specialty these days. [02:05] Emergency Medicine at a Glance Back in Session 2, I was able to talk to an Emergency Medicine physician and learned that because of the shift work and the amount of work, it has become popular. What is considered full-time for an Emergency Medicine physician is about 15-16 shifts a month. That is equivalent to three business weeks (Monday through Friday, five days times three) which means an extra whole week off per month. Of course shift work comes with some negatives which were also mentioned in that episode. [03:10] NRMP Match Data for 2016 First, check out this 120-page PDF document called, Main Match Results and Data for 2016. Looking at Table 1 (page 12 of 120) for this NRMP match data, Emergency Medicine has 174 programs, which means it has 55 more programs compared to Anesthesia with 119 programs. Of those 174 programs, there are 1,895 spots and this works out to almost eleven spots per program. It is a very competitive and a very, very wanted specialty that out of those 174 programs, only one program went unfilled. Number of applicants: 2,476 Number of available spots: 1,895 Number of applicants that matched: 1,894 Number unfilled: 1 Number of U.S. Seniors that matched: 1,486 (78.5%) As compared with Anesthesiology, 72% of those that matched were U.S. Seniors. Hence, Emergency Medicine is matching more U.S.-based Seniors going into Emergency Medicine. This possible means that there are less international students applying for Emergency Medicine and less students who didn't match right away. Looking at the total number of matches which is 1,894 (out of 1,895 positions offered), there was one spot in one program that went unfilled. This suggests how very competitive the specialty is with 99% were filled for Emergency Medicine. [06:18] Emergency Medicine and PGY1 Positions Last time, when I talked about Anesthesiology, Table 1 has PGY1 positions, PGY2 positions, and physician positions. Emergency Medicine, however, only has PGY1 positions listed in Table 1.0, which means that you don't go to do an internship separate from your Emergency Medicine residency because it's all built into the one main residency. It can be very confusing considering that different specialties have different terminologies. As with Emergency Medicine, it does not have other internship outside the program so there are are no PGY2 positions or physician positions available to apply to. [07:35] Applicant Types in Emergency Medicine Table 2 (page 16 of 120) of the 2016 NRMP match data breaks down the specialty and applicant type. For Emergency Medicine: Number of filled positions: 1,894 % of U.S. Seniors that filled: 78.5% Number of (non-Senior) U.S. Grad: 73 (almost 4%) - U.S. Grad means that you either took time off between trying to match and graduating from medical school. It's either you didn't try to match during your senior year of medical school or you didn't match and you took some time off and strengthened your application and reapplied and now are getting in. Number of Osteopathic students matching into EM: 224 (almost 12%) - These are osteopathic students that went outside of their AOA match, or national match, and applied through these MD programs instead of to DO Emergency Medicine programs. Number of Canadians: 1 Number of U.S. International medical graduates: 87 Number of non-U.S. international medical graduates: 23 (These are non-U.S. citizens that graduated from an international medical school) Number of unfilled spot: 1 Comparing it with Family Medicine, which you may assume as a primary care specialty to have a large percentage of availability for international medical grads, they had 382 international medical grads out of 3,083 spots, equivalent to 12% more or less. [11:20] Emergency Medicine as a Relatively New Specialty We learned from the Specialty Stories Podcast session 2 where we interviewed a community-based EM physician, that Emergency Medicine is still a relatively new specialty. Table 3 (Page 20) of the NRMP match data for 2016 shows the positions offered from 2012 to 2016. And Emergency Medicine (outside of the primary care specialties) is the fastest growing specialty out of all of the more sub-specialties. If you're interested in Emergency Medicine, that means there are more and more spots available every year which is a good thing. 2012 - 1,668 spots 2013 - 1,743 spots 2014 - 1,786 spots 2015 - 1,821 spots 2016 - 1,895 spots It's growing relatively consistently between 6.5% to 7% year over year. Now if you look at some of these other ones, the primary care specialties, family medicine growing 11.5% every year which is huge but expected for primary care specialty. Pediatrics almost 10% every year. But Emergency Medicine as a specialty outside of primary care is the fastest growing which is pretty awesome. [13:20] Osteopathic Students in Emergency Medicine The national matching service which is the DO matching service, their program has a 2016 program stat. If you Google ‘national match DO 2016,' I'm looking at a very different amount of data compared to the NRMP. While, the NRMP is 120-paged report, this specific list is just a one-paged website showing that Emergency Medicine for osteopathic students had 58 programs and 307 positions. NRMP has 174 programs and 1,895 positions. So a lot more MD programs which makes sense I think historically. Obviously there are more MD programs throughout the country since DOs are still relatively new in the grand scheme of things (Emergency Medicine is a newer specialty but still DOs being a newer breed of doctors). So they just have less of a footprint which is neither good nor bad but it's just what it is. So 58 programs, 307 positions available, and five of those positions went unmatched in the Emergency Medicine for osteopathic students in their matching in 2016. [15:20] U.S. Applicants & PGY-1 Positions Going back to the NRMP match data for 2016, Table 7 (Page 30 of 120), shows the number of positions offered and filled by US seniors and all applicants between 2012 and 2016. And so doing some quick math, the number of US students that are filling these spots for Emergency Medicine has basically stayed the same, around 78% to 80% every year, which is pretty good. It means U.S. applicants are staying very competitive for these programs. Table 9 (Page 37 of 120) of the NRMP match data for 2016 shows all applicants matched to PGY-1 positions by specialty from 2012 to 2016. Emergency Medicine being one of the fastest growing specialties out there or has been the fastest growing outside of the primary care specialties, applicants and students that matched made up the most out of any of the specialties, again outside of the primary care specialties. They made up about 7% every year since 2012, with the 2016 match data showing 7.1% of all students matching into a PGY-1 position, or matching into Internal Medicine. Now just for numbers here, 11.5% matched into family medicine, almost 26% matched into Internal Medicine, 6.8% matched into a PGY-1 only spot for Internal Medicine, and Pediatrics was 10%. So all of these big primary care specialties are 11.5%, 10%. Internal Medicine is huge at 26%. But Emergency Medicine has the largest number of students matching into it outside of the primary care specialties. Looking at Table 11 (Page 39 of 120) shows the osteopathic students matching into PGY-1 spots for these DO programs and Emergency Medicine is the highest outside of the primary care specialties at 9.3%. So 9.3% of all osteopathic students matching into an MD position matched into Emergency Medicine. [18:15] Emergency Medicine as Only Specialty Choice Figure 6 (Page 45 of 120) in the NRMP match data talks about the percentages of unmatched US seniors and independent applicants who ranked each specialty as their only choice. Emergency Medicine had 11.3% unmatched number and almost 6% of U.S. seniors that were applying for Emergency Medicine as their only specialty choice did not match. However, that data alone doesn't tell you enough actually. Here are comparisons of U.S. Seniors unmatched for other specialties: 8.7% of U.S. seniors unmatched for Psychiatry 20% for Neurosurgery 5% for Family Medicine 20.8% for Orthopedic Surgery So 6% of unmatched U.S. Seniors isn't very high and when you look at these you just have to question how competitive were these students for Emergency Medicine if they weren't matching? [19:58] SOAP Data Table 18 (Page 55 of 120) of the NRMP match data shows the SOAP data for 2015 and 2016. SOAP stands for the Supplemental Offer and Acceptance Program through the NRMP. These are for students that did not match, they find out before the actual match date, and they are given time to talk to programs that have some spots and hopefully match after they find out they didn't match to begin with. For 2016, Emergency Medicine did not participate in the SOAP. And that kind of makes sense because there was only one spot unfilled. [21:00] Charting the Outcomes - Emergency Medicine Switching over to the NRMP Charting Outcomes Report, which is another great 211-paged report. Chart 3 (page 10 of 211) shows the rates of U.S. allopathic Seniors. 91% of US allopathic seniors matched into their preferred specialty. Chart 4 (Page 12 of 211) shows the median number of contiguous ranks of US allopathic seniors. So when you make your rank list, you're ranking the programs that you interviewed at or applied to, and you rank all of the programs that you want to go to in order of how you want to go to them. The median number of contiguous ranks of those that matched for Emergency Medicine was 12. Those that did not match was 4. So these students that did not match were very, very selective with who they ranked. They were probably hoping to only match in a very specific part of the country or to a couple very specific programs. When you do that, the less schools that you apply to, the more strict you are with your availability to apply to a larger number of schools. This is going to limit your chances getting into medical school. That's exactly what happened here with students applying to Emergency Medicine is they didn't apply and they didn't match to enough programs. Again, 12 compared to 4 contiguous rank numbers. [24:23] Charting the Outcomes - Step 1 and Step 2 CK Scores Chart 6 (Page 14 of 211) in Charting the Outcomes shows the Step 1 Scores of U.S. Allopathic Seniors. For osteopathic medical students, they take the COMLEX Level 1. Osteopathic students can take the USMLE but we're focusing here on U.S. allopathic seniors. Those that matched into Emergency Medicine scored between 225 roughly and 245 which are great scores, and those that did not match scored in roughly 205 to 235. Their scores were much lower on the bottom end, and only went up to about the middle of the road for those that did match. So Step 1 scores mean a great deal for your ability to match. Just like a great MCAT score, it opens up a lot of doors. Looking at Chart 7 (Page 15 of 211) shows the Step 2 CK scores, Emergency Medicine, they were between 238 roughly and 255, and those that did not match were 224-ish to 242-ish. So again, lower obviously Step 2 scores. [25:54] Importance of Research, Abstracts, and Publications Looking at Chart 8 (Page 16 of 211) for the charting the outcomes NRMP match data, research didn't seem to play a huge part in those that matched and did not match. The Mean Number of Research Experience for U.S. Allopathic Seniors was 2.4 for those that matched and only 2.2 for those that did not match. Though research that actually led to something seems to be more important. The Mean Number of Abstracts, Presentations, and Publications (Chart 9 - Page 17 of 211) for those that matched in Emergency Medicine, they had 3.3 and those that did not match had 2.2. [26:39] AOA Data Chart 12 (Page 20 of 211) shows the AOA Data, referring to the Alpha Omega Alpha which is the medical Honor Society. 13% of U.S.seniors that matched were AOA for Emergency Medicine and 1% of those that did not match were AOA. AOA seems to play a little bit of a role in matching to Emergency Medicine. It's usually the case with the more competitive specialties. The AOA seems to play a role, though is it really the AOA that plays a role, or just the fact that you have great grades? Obviously, having great grades leading to the ability to do well on your board scores. [27:31] Step 1 and 2 Scores and Distinct Specialties Table EM-1 (Page 60 of 211) in Charting the Outcomes Report shows all of the raw numbers. Mean USMLE Step 1 score: 233 for those that matched and 220 for those that did not match Mean USMLE Step 2 score: 245 for those that matched and 232 for those that did not match Chart EM-1 (Page 61 of 211) has the number of distinct specialties ranked by U.S. allopathic seniors. For US allopathic seniors that only ranked Emergency Medicine, 1,269 matched, 72 did not. That's 5.4% roughly of those that only listed Emergency Medicine did not match. The second column here in chart EM-1 shows that 88 students (column number two is if you had two programs or two specialties that you're ranking for). And so for students that aren't 100% in on Emergency Medicine, 88 of those matched and 40 did not. So if you look at that number, it's 31% of those that ranked two programs here did not match compared to 5% for those that are only ranking one. You need to make up your mind because you're obviously not selling the programs that you're interviewing at that you're dedicated to going to whatever specialty that you're interviewing at for that day. [30:43] Medscape Lifestyle Report 2017 Diving into the Medscape Survey Data for Emergency Medicine, and looking at the newest Medscape Lifestyle Report for 2017, Emergency Medicine. Slide 2 shows that 59% (at the highest) of Emergency Medicine physicians are stating they are burned out. What's interesting though is on the next slide, when it asks about the severity of burnout, Emergency Medicine is way down the list at 4.2. So it's a scale from one to seven, Urology is at 4.6 at the highest, Infectious Disease is the lowest on this list at 3.9, Emergency Medicine is 4.2. So they're burned out but not the highest which is interesting. Not surprising for Emergency Medicine given that it's shift work, is that they are almost very close to the top, specifically, fifth on the list for which physicians are happiest. It looks like it's mostly based on outside of work. Urology is 76% are happiest outside of work, Emergency Medicine is 71% are happiest outside of work, and Emergency Medicine is 28% happiest at work. So there's a big discrepancy there, and obviously with shift work you have a lot of time outside of work which is great, and so Emergency Medicine physicians are loving that time, but they're getting burnt out at work. [32:26] Medscape Physician Compensation Report 2016 Switching one more time to the Medscape Physician Compensation Report for 2016. How much do physicians earn overall? Orthopedics at the very top just to give you some understanding of where we're at. Pediatrics at the bottom. Ortho at $443,000, Pediatrics at $204,000, and Emergency Medicine is almost in the middle at $322,000 a year. What's interesting in this compensation report is that they have a list here for which specialties have the most female physicians and Emergency Medicine is on the lower end of the list at 19%. OB-GYN unsurprisingly is 55%, Pediatrics, again unsurprisingly 53%. Emergency Medicine is 19%. We need some more female physicians in Emergency Medicine. So if you are a female, go for it. For physicians that feel fairly compensated, Emergency Medicine is top three at 60%. Dermatology 66%, Pathology 63%, Emergency Medicine right there at the top at 60%. What's interesting looking at Slide 17 here, Emergency Medicine has the fifth highest satisfaction overall for physicians at 57%. 60% being satisfied with their income, 66% would choose medicine again which is at the higher end, but only 44% would choose Emergency Medicine again. Now I have a hypothesis about this. I don't think it's Emergency Medicine necessarily that is causing this 44% that would choose this specialty again. Looking back, speaking to an Emergency Medicine physician back in Session 2, he talked about how Emergency Medicine doctors need to know a lot about a lot and I have a feeling that a lot of people go into Emergency Medicine because they haven't found that one thing that lights them up every day all day. And when they're practicing Emergency Medicine, at some point they realize what that thing is, and then they wish their whole time was spent doing that one thing, but they're ‘stuck' in Emergency Medicine. So although Emergency Medicine is nowhere near the bottom, it's still one of the lowest ones. You have Pulmonary Medicine which is kind of surprising at 37%. OB-GYN 41%. Unsurprisingly Internal Medicine is at 25% which is too bad. Links: NRMP Main Match Data for 2016 Charting Outcomes in the Match for U.S. Allopathic Seniors National Match DO 2016 Medscape Lifestyle Report 2017 Medscape Compensation Report 2016 Send me an email at ryan@medicalschoolhq.net MedEd Media Network Specialty Stories Podcast session 11 Specialty Stories Podcast session 2 Facebook Medical School Headquarters Hangout Page
Session 59 In this episode, Ryan takes a question directly from the OldPreMeds.org forums and delivers the answer right here to you. This week’s question is an interesting one:choosing which schools to apply to. OldPreMeds Question of the Week: “I was looking into residency match rates of DO versus MD programs using the school website and comparing them to an NRMP. I noticed that the 2016 data for DO match rate was 80.3% versus 93.8% for MD. When I look at the data from DO schools like Western and Touro I find reports of 90% to 100% match rates. Is the difference because of the schools and the 80.3% looks at all DO programs? Should one look at the individual school match rate instead of the overall match rate when choosing a program? If anyone has information about the discrepancies please let me know”. (2:00) Questioning the data I dug into this a little bit to figure out where this person was getting their data. I pulled up the information from the American Osteopathic Association Intern and Residency Registration Program match data; this is the matching system for DO students. I also looked at the National Resident Matching Program (NRMP) that matches for MD residencies. So just to backtrack and give you a little information: two different tracks, DO and MD. A DO is doctor of osteopathic medicine, MD is a medical doctor, just two different types of medical school. You both end up being physicians at the end of the day; there's really no difference and actually, their residency programs are merging. Not a lot of information has come out on how that's going to happen, but I believe the year is 2020 when that happens. Therefore, much of this information, by the time you start medical school and as you're listening to this, perhaps won’t matter because much of it will have changed. However, I still wanted to reply to this question because I thought it was a good one. Here’s my take on this question: (3:20) Match Rates This student is claiming the 2016 data for DO match rate was 80.3%. However, when I bring up the 2016 match data, I see an unmatch rate of 13% - which is a match rate of 87%. So I'm not sure where this student was coming up with 80.3%. If you just look up DO match rates for 2016, the website comes up and it's the match data for the DO applications and has a list of every school. The highest school on here, the highest non-match school is at 28.6%, so that's a match rate of 71.4% which isn't very good at all. That school is Touro University in Nevada (TUNCOM) There are several different Touro schools and that is the worst one by far. The next closest one on here isn't far behind at 26.9% non-match, and that one is William Carey University College of Osteopathic Medicine in Mississippi. (5:15) Matching vs. Unmatched Percentage matched vs. Percentage Unmatched. The way that the AOA lists this, is they have percentage matched, percentage non-matched, and then percentage of non-participants. When you look at percentage matched, it's only 40.9% and you might think, 'Wow that's crazy, how come nobody's matching?' But then when you combine that with non-participants, DO students that are matching outside of the DO residency matching program (as a DO student you can match through the MD matching program and you're counted as a non-participant). When you look at the percentage matched at 40.9% and the percentage non-matched at 46.1%, the result is 87%, which is obviously the leftover from the non-match of 13%. So 87% of DO students are matching. (6:35) Is every spot getting filled? Not every prelim spot is getting filled. Now here's something to think about when it comes to residency matching. When I looked at the NRMP match data, they have the total match of 96.3% of all US spots filled. So not every residency spot is getting filled, which is not good. And when you look at it, you have several different types of programs that are more than likely not getting close to getting filled, and those are prelim spots. If I look at surgery prelim- and a prelim is a PGY1 year only. It's basically saying, 'Hey come to our prelim spot, and try out for our residency.' It is basically if you didn't match anywhere else, then a prelim spot you can hopefully come into our program after you do well your prelim year. If you look at surgery prelim according to NRMP, it only filled 64.4%. There were a lot of spots available. (8:00) Know yourself, and your competition If you’re not matching, you are probably trying to match into a very competitive program that you aren't qualified to match in. What does this all mean? It means that a lot of people that aren't matching are probably trying to match into a very competitive program that they aren't qualified to match in. It's very similar to trying to get accepted to Harvard, Yale, and Wash U medical schools when you have a 3.0 GPA and a 500 on the MCAT. You're dreaming a little bit too big, but it also could be that that year that you're applying for something is a very competitive year and a lot of people are trying to match into it and you just didn't make the cut. Typically, the students that go through the Supplemental Offer and Acceptance Program (SOAP, formerly called Scramble) get notified during the time period before the match and are notified that you did not match. You then enter this SOAP program and you find residencies that didn't fill, and a lot of them are going to be PGY1 only spots. Some of them may be internal medicine spots and you wanted to do something else besides internal medicine. However, there are these other spots, and if you want to match into one of those programs you can go do that. There's a whole separate system outside of the normal match program to allow students that didn't match to get into a program so that they can continue their post-graduate training, which is necessary if you want to be a doctor here in the US. (9:38) Know when to ask questions, and which ones to ask My personal belief? You shouldn't look at residency matching rates for choosing which schools to apply to, with one exception. Look at those huge outliers like Touro Nevada, like William Carey University, and ask yourself: Why is their match rate so low? Are they a brand new school and they're just getting ramped up Perhaps their first round of students that they let in weren't the best students? Are they just getting their curriculum under control? Are they under some sort of probation because their curriculum isn't training students well enough? Then call the school and say, 'Hey I noticed your residency match rates are pretty terrible,' and find out from them what they have to say. If it's a school that you're interested in going to because the location is perfect for you, consider it. (10:45) Past performance does not predict future performance. It's like the stock market: it doesn't matter what the stock market did yesterday, it's not going to determine what it does tomorrow. It's a good predictor, it's a good kind of rule of thumb to think about it, but things change, people change, professors change, and you - the person that is actually learning and studying and figuring this all out, is one of the biggest variables to all of this. So if you are motivated, if you are driven, if you are determined to get whatever residency spot you want, then you will probably do well. You cannot rely on the school to help you match somewhere. The school is there to help support you, but you need the drive and motivation to do it yourself. (11:32) My Bottom line When it comes to residency matching and picking schools, look at those huge outliers, but outside of that I wouldn't look at residency programs to determine where you want to go to school. Locations, curriculum and many other factors come into play. Resources Mentioned on this Episode: http://www.oldpremeds.org American Osteopathic Association Intern and Residency Registration Program https://medicalschoolhq.net/pmy-215-why-do-you-want-to-be-a-doctor-you-need-to-know-this/ Touro University Nevada Supplemental Offer and Acceptance Program William Carey University College of Osteopathic Medicine
A Google Hangout video discussion from the EM Match Advice series, hosted by Dr. Mike Gisondi. This episode focuses on what happens if one does not match into any EM residency programs. What are the logistics behind the Supplemental Offer and Acceptance Program (SOAP)? Joined by expert panelists: Dr. Dan Egan (St. Luke's-Roosevelt), Dr. Tiffany Murano (Rutgers), and Dr. Mary Westergaard (Wisconsin). http://www.aliem.com/em-match-advice-what-if-i-dont-match-what-is-the-soap/