Charting outcomes 2016 is out

[3lefts]

Here's the link:

http://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-US-Allopathic-Seniors-2016.pdf


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[Gavanshir]

tldr?

 

[amoeboid]

It's pretty terrifying.

Summary of the data:

935 U.S. Seniors applied to Psychiatry as their first-ranked specialty, and of those 841 matched, and 94 did not. This is a 90% match rate for U.S. Seniors. Compared to some other specialties (I've bolded the specialties with worse match rates):

Anesthesiology: 97%
Child Neurology: 94%
Dermatology: 77%
Diagnostic Radiology: 98%
Emergency Medicine: 91%
Family Medicine: 94%
General Surgery: 83%
Internal Medicine: 98%
Internal Medicine/Pediatrics: 88%
Neurological Surgery: 76%
Neurology: 96%
Obstetrics and Gynecology: 91%
Orthopaedic Surgery: 75%
Otolaryngology: 89%
Pathology: 95%
Pediatrics: 97%
Physical Medicine and Rehabilitation: 89%
Plastic Surgery: 77%
Radiation Oncology 91%
Vascular Surgery: 71%

Mean Step 1 for all specialties: 233. For psychiatry: 224
Mean Step 2 CK for all specialties: 245. For psychiatry: 238

Someone else will have to take a harder look at the DO and IMG data.

 

[PistolPete]

Wow, interesting.

 

[amoeboid]

I took a look at the previous 3 available Charting Outcomes for U.S. seniors for comparison.

2016: 1386 positions. 841 matched, 94 did not match. Match rate: 90%. Step 1: 224. Step 2: 238.
2014: 1374 positions. 669 matched, 26 did not match. Match rate: 96%. Step 1: 220. Step 2: 233.
2011: 1097 positions. 630 matched, 28 did not match. Match rate: 96%. Step 1: 214. Step 2: 225.
2009: 1063 positions. 643 matched, 38 did not match. Match rate: 94%. Step 1: 216. Step 2: 221.

The USMLE creep up isn't a surprise. However, at least compared to the 2014 report, while only a net of 12 more positions were created, U.S. Seniors applying to Psychiatry as a first choice rose from 695 to 935 while the match rate plummeted.

 

[675015]

Wow, interesting.

Well, we did still have

I took a look at the previous 3 available Charting Outcomes for U.S. seniors for comparison.

2016: 1386 positions. 841 matched, 94 did not match. Match rate: 90%. Step 1: 224. Step 2: 238.
2014: 1374 positions. 669 matched, 26 did not match. Match rate: 96%. Step 1: 220. Step 2: 233.
2011: 1097 positions. 630 matched, 28 did not match. Match rate: 96%. Step 1: 214. Step 2: 225.
2009: 1063 positions. 643 matched, 38 did not match. Match rate: 94%. Step 1: 216. Step 2: 221.

The USMLE creep up isn't a surprise. However, at least compared to the 2014 report, while only a net of 12 more positions were created, U.S. Seniors applying to Psychiatry as a first choice rose from 695 to 935 while the match rate plummeted.

Looks like we're still tied for last in regards to AOA applicants...

 

[splik]

I just want to point out that there were 1,386 positions this year (more than in recent years), and 935 US applications. That means 40% of positions were filled by IMGs and DOs and other independent applicants. This about the same as usual (though as more DOs are training, IMGs are becoming a smaller number a little bit) If you can't match as a US medical student, it is because you have massive red flags and/or flagrant personality issues or behavioral problems that manifest on the interview trail. I can tell you my program DNR'd substantially more people than ever before and having interviewed a large number of applicants can say that although there do seem to be more people at the top applying to psych, there were some people who exhibited highly questionable or unprofessional behavior. The sky is not falling. However, I definitely think though on average the pool might be getting weaker, it definitely is getting harder to match into top programs. I believe there are 10 students from harvard applying for psych this year, for example, which is unprecedented in recent years...

If you look at the figures confirming my impression that overall psych is getting more bottom of the barrel applicants - psych was 3rd in competitiveness based on applicants per place (after vascular surgery and neurosurgery) but most of these applicants were not US medical students, and though there were more than enough spots for all allopathic students applying only 90% of them did so. that tells you that those applicants were much weaker than they thought (and thus applied to too few programs, or overreached) or were so terrible as to be unappointable.

Also this is good news for IMGs and DOs - programs would still rather take exceptional IMGs or decent DOs over a questionable or low functioning personality disorded individual! (I say low functioning, because the high functioning ones tend to end up at top NE programs)

 

[carlosc1dbz]

Just looking at the information without analyzing it closely or understanding aspects of residency application, it looks like most people match into what they want. The truth is that people know what they realistically can apply to based on their scores and connections.

 

[Breaking Free]

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[Breaking Free]

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[Breaking Free]

Very sorry for 3 posts. iPad decided to stall after I hit post and sent it 3 times.

This is a little nerve racking. I really don't know what to make of the data. Because if you look at the breakdowns, you see that the Step 1 score doesn't seem to be highly predictive of who is getting accepted. The 211-220, 221-230, 231-240 all have peculiarly similar unmatched rates.

The numbers are rising for scores, unaccepted US. MD % is rising, and the data doesn't really have very clear correlations for who is successful vs not with respect to what factors are leading to success (besides the fact that more and higher are always at least a little safer).

Seriously, 10%? How the heck are 10% not matching now? Ridiculous given that 3-4 years ago it was less than half that. Why are people not matching? Specifics would help here. Am I supposed to believe that they all have red flags or just applied foolishly? Surely something else is going on? You'll see that the average step 1 of those NOT matching is 214 in 2016 compared to 205 in 2014. The average step 1 of those matching was 224 in 2016 and 220 in 2014. The differences between matching and not matching scores have severely narrowed.

One question that burns in my mind is this: How possible is it that the increasing rate of unmatched U.S. MD's is due to Psychiatry increasingly becoming a backup speciality for those trying for ROADS or any other specialty really? Unmatched data is usually a combination of both those who applied to one specialty only and those who applied to a specialty in addition to another specialty. Matched has a dual-application 1.1 ratio for those who matched and unmatched has a dual-application 1.3 ratio. This means that those who don't match in psych are also more likely to have applied to multiple specialties. Could they just be matching in these other specialties? Somebody who had psych as a backup, but got into another specialty would indeed count as "unmatched" psychiatry in the NRMP data. This clarification is made by the NRMP as well.

I am an MS3 who has wanted to go into psych from day 1. My board scores are not terrible, but they are not great either. I have a thorough CV and have some research, but the data is starting to become less interpretable, and applicants are less able to have comfort in the predictability of things. How does one ensure success nowadays?


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[splik]

see my post above. (not sure why you posted this 3 times)

If you want to match:
1. have a pulse
2. don't only apply to the most competitive programs in the country
3. don't dress as a magician to your interview (I **** you not)
4. don't try and sit in the lap of the program director during the interview (again, true)
5. don't come off as desperate
6. don't spread lies about residents to other residents when on your away rotations (dealt with this complaint)
7. don't get letters from anyone who doesn't say yes when you say "can you write me a strong recommendation letter?" (you'd be amazed how damning with feint praise can be the kiss of death, there is an art to writing thinly veiled criticism)
8. don't give copies of CVs, DVDs of yourself, journals that you've edited, articles that you've written, artwork etc without solicitation (yes someone did give me a DVD of themselves along with a CV of a string of lies)
9. don't get caught in a lie and then try and lie your way out of it (yup, multiple times)
10. don't send a photo of yourself with thank you cards (we know what you look like, it's creepy)
11. don't make racist, xenophobic, or homophobic comments in your interview especially if your interviewer is a racial/sexual minority or foreign (again, sadly does not necessarily stop people from matching)
12. don't do a second look unless there is really something you need to clarify (the more exposure the more likely you are to do something wrong, and it's a nuisance to set up)
13. don't talk about your routine cocaine use (though actually this did appear to stop this person matching)
14. don't talk about your sexploits at the pre-interview dinner
15. don't get drunk at the pre-interview dinner (though again this rarely stops people from matching)
16. don't write a personal statement all about your mental health problems, drug/alcohol addiction, dysfunctional childhood/relationships
17. don't fail step 2 cs
18. don't wait until the last minute to schedule your step 2 exams
19. don't argue with your interviewers
20. don't act like you have the enormous sense of entitlement you believe you have

I know med students are annoyinly neurotic but really when people don't match in psychiatry its usually because of quite flagrant professionalism or other behavioral problems, and/or they did not apply to places witin their reach including safeties.

 

[Breaking Free]

Splik, I appreciate your time and thoughtfulness. I often find your posts insightful and quite down to earth. I will continue to monitor this thread, and I will chime back in if it seems that it could possibly be of value to the conversation. I look forward to much wiser people than myself continuing to contribute. Thank you!


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[Liquid8]

3. don't dress as a magician to your interview (I **** you not)

I'd heard of a medical student who once up to the wards in a clown suit, but this has to take the cake. Still laughing out loud!

 

[TheFuture_22]

3. don't dress as a magician to your interview (I **** you not).

This is what I imagine they looked like.

View attachment 209117



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[Salpingo]

tldr?

The big thing I took away from this is that there's a pretty significant bottle-neck with the FMG/IMG/DO crowd. Hopefully, this information will be disseminated, and psychiatry will lose the reputation as being the easiest entry point into American medicine.

I've said this in different threads, but my hope for the future of the field is that we DON'T become a ROAD specialty (first, its just never going to happen, and second, we don't need a bunch of people looking for a cheap meal ticket). We need to recruit some of the quality candidates that are considering primary care specialties because they want meaningful interactions with their patients.

 

[Amygdarya]

Haha, I was wondering how soon after Charting Outcomes release would someone open another "the sky is falling, psychiatry is getting more competitive" thread.

However, I definitely think though on average the pool might be getting weaker, it definitely is getting harder to match into top programs. I believe there are 10 students from harvard applying for psych this year, for example, which is unprecedented in recent years...

Eek to the first statement. Good for psychiatry I guess, sucks for me next year

Though I'd like to point out something that I'm sure you know well: number of students from any school applying into any specialty varies from year to year. For example, out of a little over 100 graduates at my school (not Harvard but top 20 brand name whatever...) 10 matched into psych in 2015 - and it was a glorious match covering the very top programs on both coasts - but only 4 went into psych in 2016 with a very solid bicoastal match outcome (though not quite as spectacular as the year before). This year at least 6 people are applying into psych including 2 MD/PhDs that I know of, so we'll see how it goes. My point is, number of students from any school applying into psych will vary from year to year and is not necessarily evidence of psychiatry getting more competitive.

One question that burns in my mind is this: How possible is it that the increasing rate of unmatched U.S. MD's is due to Psychiatry increasingly becoming a backup speciality for those trying for ROADS or any other specialty really? Unmatched data is usually a combination of both those who applied to one specialty only and those who applied to a specialty in addition to another specialty. Matched has a dual-application 1.1 ratio for those who matched and unmatched has a dual-application 1.3 ratio. This means that those who don't match in psych are also more likely to have applied to multiple specialties. Could they just be matching in these other specialties? Somebody who had psych as a backup, but got into another specialty would indeed count as "unmatched" psychiatry in the NRMP data. This clarification is made by the NRMP as well

I think you're onto something here. In general, I think the vast majority of people interested in psychiatry shouldn't freak out about the 90% match rate, because given still lower range Step scores and high numbers of DOs/IMGs/FMGs matching into psychiatry compared to other specialties, it seems that the non-matched 10% should fall into one of these categories:
1) flagrant professionalism and behavioral issues as splik described;
2) not very competitive applicants only applying to top programs;
3) people applying to psych as backup, matching into their first choice specialty (presumably dermatology) and thus not matching into psych (these are the people with higher Step scores who didn't match into psych)

 

[mimelim]

It's pretty terrifying.

Summary of the data:

935 U.S. Seniors applied to Psychiatry as their first-ranked specialty, and of those 841 matched, and 94 did not. This is a 90% match rate for U.S. Seniors. Compared to some other specialties (I've bolded the specialties with worse match rates):

Anesthesiology: 97%
Child Neurology: 94%
Dermatology: 77%
Diagnostic Radiology: 98%
Emergency Medicine: 91%
Family Medicine: 94%
General Surgery: 83%
Internal Medicine: 98%
Internal Medicine/Pediatrics: 88%
Neurological Surgery: 76%
Neurology: 96%
Obstetrics and Gynecology: 91%
Orthopaedic Surgery: 75%
Otolaryngology: 89%
Pathology: 95%
Pediatrics: 97%
Physical Medicine and Rehabilitation: 89%
Plastic Surgery: 77%
Radiation Oncology 91%
Vascular Surgery: 71%

Mean Step 1 for all specialties: 233. For psychiatry: 224
Mean Step 2 CK for all specialties: 245. For psychiatry: 238

Someone else will have to take a harder look at the DO and IMG data.

So does that mean we are winning?

 

[amoeboid]

So does that mean we are winning?

Yes, you win!

 

[splik]

I'd heard of a medical student who once up to the wards in a clown suit, but this has to take the cake. Still laughing out loud!

out of curiosity I did look them up and they didn't match! guess they weren't able to pull a psychiatry residency spot out of a hat!

 

[Drrrrrr. Celty]

So what's the spike in psychiatry due to? Will it go down within the coming years?

Is the field moving towards being either closed to DOs and IMGs or what?

I mean the DO match showed that to have a 90% match rate it was advised that you have over 10 ranks. How hard is it to interview at 10 or more places?

DOs were shown to need around a 530 ( The avg comlex) to match with 80% success. But it seemed like COMLEX 2 scores were more linked to success. Does the field prefer the clinical exam over the step 1/level 1?

With 200 DOs applying to psych and 900 MDs. How much wiggle room is there left in the field?

 

[Merovinge]

So what's the spike in psychiatry due to? Will it go down within the coming years?

Is the field moving towards being either closed to DOs and IMGs or what?

I mean the DO match showed that to have a 90% match rate it was advised that you have over 10 ranks. How hard is it to interview at 10 or more places?

DOs were shown to need around a 530 ( The avg comlex) to match with 80% success. But it seemed like COMLEX 2 scores were more linked to success. Does the field prefer the clinical exam over the step 1/level 1?

With 200 DOs applying to psych and 900 MDs. How much wiggle room is there left in the field?

DO's are still fine in psychiatry and should be going forward. Probably the best psychiatrist I have ever had the privilege of learning from was a DO and they are on faculty at very prestigious hospitals.

I will say that never understood why you guys take COMLEX though if you know you want to apply to traditional MD residencies. It would make sense to me to show you are equal by taking the same test and being put on the same curve. It feels like applying to college with QATs instead of ACTs or SATs (note that QATs is completely made up).

 

[Dharma]

So what's the spike in psychiatry due to? Will it go down within the coming years?

Is the field moving towards being either closed to DOs and IMGs or what?

I mean the DO match showed that to have a 90% match rate it was advised that you have over 10 ranks. How hard is it to interview at 10 or more places?

DOs were shown to need around a 530 ( The avg comlex) to match with 80% success. But it seemed like COMLEX 2 scores were more linked to success. Does the field prefer the clinical exam over the step 1/level 1?

With 200 DOs applying to psych and 900 MDs. How much wiggle room is there left in the field?

Don't stress too much. No one has the answers. I know plenty of DO's who matched at solid programs this past year with the stats you mentioned above (a few with lower boards). It does look like psychiatry is becoming more competitive (although I'm not 100% sold on the idea that it's going to become as popular as some feel it will be) but like someone else mentioned earlier, the sky is not falling.

Your job: Take care of what is within your control. Do well on the boards and on the wards. Land solid LORs. Apply and attend interview utilizing the rule of 1/3s.

 

[Merovinge]

We have to take COMLEX to get licensed bar I think a few states. and I think every DO school has it as a requirement for graduation. I agree that ideally every osteopathic student should take step 1 and 2, but taking step two, which seems to be less highly weighted than step 1, is a pain both due to cost and scheduling with our other tests and rotations. Even taking step one is a pain as we only have so long to study, it's expensive, exhausting, and has a different focus on material than COMLEX. Best to just get rid of COMLEX imo

That's a great explanation! I didn't realize you needed COMLEX for the license. Definitely should be removed but I'm sure whoever charges 4 figures per exam is not going to give it up easily.

 

[Drrrrrr. Celty]

That's a great explanation! I didn't realize you needed COMLEX for the license. Definitely should be removed but I'm sure whoever charges 4 figures per exam is not going to give it up easily.

If I could just take the USMLE I'd be happy to lol.

 

[notdeadyet]

My read of Charting Outcomes is consistent with recent trends.

1. Stats of folks going into psychiatry (as an average) continues to climb.
2. Stats of folks going into almost all fields in medicine continues to climb.
3. Psychiatry is not getting more competitive when compared to other fields, and in fact it remains as a specialty one of the easiest fields to match into.

No big surprises that I can see in Charting Outcomes this year. Looking at total number of applicants and number of unmatched applicants is really less revealing when you're looking at something like psychiatry (which is the go-to specialty for folks who barely graduated, have a series of big red flags, or IMGs hoping for an easy match).

 

[Drrrrrr. Celty]

Don't stress too much. No one has the answers. I know plenty of DO's who matched at solid programs this past year with the stats you mentioned above (a few with lower boards). It does look like psychiatry is becoming more competitive (although I'm not 100% sold on the idea that it's going to become as popular as some feel it will be) but like someone else mentioned earlier, the sky is not falling.

Your job: Take care of what is within your control. Do well on the boards and on the wards. Land solid LORs. Apply and attend interview utilizing the rule of 1/3s.

What should I get if my goal is to match Psych in the Midatlantic region i.e PA, MD, VA, DC? I know asking for a specific usmle score is pedantic, but what should my minimal goal be to be competitve or even bother with usmle? I'm middle of my class and I generally get the majority of pathophysiology, so I doubt I'll be breaking any records or really above 230.

 

[PistolPete]

The COMLEX is a terrible exam but until the old guard of FP DO's who control the AOA die off it won't go anywhere anytime soon. The main accomplishment we can revel in for now is a merger between AOA and ACGME residencies.

 

[clausewitz2]

What should I get if my goal is to match Psych in the Midatlantic region i.e PA, MD, VA, DC? I know asking for a specific usmle score is pedantic, but what should my minimal goal be to be competitve or even bother with usmle? I'm middle of my class and I generally get the majority of pathophysiology, so I doubt I'll be breaking any records or really above 230.

There is a very wide spread of programs in the area you mention. Shepard-Pratt is in a very different league than, say, Allegheny Health Network. You looking just for academic, or are you okay with a community shop?

 

[Drrrrrr. Celty]

There is a very wide spread of programs in the area you mention. Shepard-Pratt is in a very different league than, say, Allegheny Health Network. You looking just for academic, or are you okay with a community shop?

As long as I get a decent education and am not at a sweatshop I'll be happy. How competitive is Shepard-Pratt though? I've been told by some posters that it accepts COMLEX. Is it DO friendly?

 

[Dharma]

As long as I get a decent education and am not at a sweatshop I'll be happy. How competitive is Shepard-Pratt though? I've been told by some posters that it accepts COMLEX. Is it DO friendly?

Shepard-Pratt has its fair share of DOs. Most definitely DO friendly.

 

[Mad Jack]

Damn, I'm starting to worry a bit as a DO applying to psych down the road. What can I do to boost my chances? I've got a Step 1 in the mid 220s, one strong letter from a guy that is pretty well known in the area, a serious love of the field, and a year to prepare. I'm going to take Step 2, because why not, but what else can I do? I'm really looking for a program with decent psychosomatic training, don't care if it's university or community, but I'd settle for a sweatshop in NoDak if that's what it took.

 

[sazerac]

Damn, I'm starting to worry a bit as a DO applying to psych down the road. What can I do to boost my chances? I've got a Step 1 in the mid 220s, one strong letter from a guy that is pretty well known in the area, a serious love of the field, and a year to prepare. I'm going to take Step 2, because why not, but what else can I do? I'm really looking for a program with decent psychosomatic training, don't care if it's university or community, but I'd settle for a sweatshop in NoDak if that's what it took.

That mid 220s in Step 1 will help a lot, according to the FREIDA data on psych programs.

According to FREIDA, a huge number of psych programs:

1. Only interview Step1=220 or more
2. Their current resident Step1 scores have an average of 201-220

This leads me to one of three conclusions:

a. A huge number of psych residencies have a resident pool that amazingly scored exactly 220, no more no less
b. Psych really is getting more competitive, since most of today's psych residents couldn't even score an interview at their own program for the 2017 match
c. FREIDA program data isn't very reliable

 

[Breaking Free]

Damn, I'm starting to worry a bit as a DO applying to psych down the road. What can I do to boost my chances? I've got a Step 1 in the mid 220s, one strong letter from a guy that is pretty well known in the area, a serious love of the field, and a year to prepare. I'm going to take Step 2, because why not, but what else can I do? I'm really looking for a program with decent psychosomatic training, don't care if it's university or community, but I'd settle for a sweatshop in NoDak if that's what it took.

I'm like you. I'm just too passionate about it to not do it. I'll go to the most malignant program, sewing together Nikes and making iPhones if I have to.

I doubt that will happen to either of us, and I am starting to think that psych is not getting abnormally more competitive, just that more people are "settling" for it--either because ROADS dreams are gone or there are huge red flags like board failures. I can see this at my own school where students out of the blue, who actually seem quite apathetic, who expressed wanting to do other fields before, decided they wanted to do psych all of a sudden. I'm not sure why Psych is the go-to field to settle for either, but I have had faculty express this sentiment to me during my mentorship meetings. While these unexpected applicants deserve to be a part of the field if they have a sincere passion to serve the mentally ill, my hope is that residencies stay holistic and don't start overemphasizing numbers at the cost of the other parts of an applicant. I'm similar to you with long-term demonstrated interest and passion with what historically has been a fine board score (unfortunately not the greatest standardized test taker despite being in top 1/3 of my Med school class). My CV is built for psych and shows my commitment since day 1 of MS1, and I hope that this is still easily detected and highly valued by residency programs--before a computer just filters me. The 2016 NRMP Program Director Survey still says that 74% of programs use Step 1 as a "Yes, PASS only." With rising board scores and exponentially increasing applicant #'s (nearly 1000 per program), I wonder how this is feasible in reality. This is the problem with psych residency right now for applicants. There are lots of strange variables that do not make sense at face value, or at least how the NRMP reports the data.


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[TheFuture_22]

Damn, I'm starting to worry a bit as a DO applying to psych down the road. What can I do to boost my chances? I've got a Step 1 in the mid 220s, one strong letter from a guy that is pretty well known in the area, a serious love of the field, and a year to prepare. I'm going to take Step 2, because why not, but what else can I do? I'm really looking for a program with decent psychosomatic training, don't care if it's university or community, but I'd settle for a sweatshop in NoDak if that's what it took.

I think you will be fine. I'm a DO applying with similar stats to yours (your step score is a bit higher actually), and I am doing pretty well his far getting interviews. 7 invites thus far at fairly solid programs, applied to 55.


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[Drrrrrr. Celty]

I think you will be fine. I'm a DO applying with similar stats to yours (your step score is a bit higher actually), and I am doing pretty well his far getting interviews. 7 invites thus far at fairly solid programs, applied to 55.


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How many iis are you expecting?


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[TheFuture_22]

I only want to go on 15 tops, so that's what I was originally expecting. Now it looks like I may have to turn down a few if they keep coming in like they are. Good problem to have I guess, so I won't complain if it happens.


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[FlowRate]

I believe there are 10 students from harvard applying for psych this year, for example, which is unprecedented in recent years...

11 last year. (But that was also > average.)

 

[TheaterOfTheme]

I only want to go on 15 tops, so that's what I was originally expecting. Now it looks like I may have to turn down a few if they keep coming in like they are. Good problem to have I guess, so I won't complain if it happens.


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Did you have significant amount of research/psych related ECs?

 

[Merovinge]

That mid 220s in Step 1 will help a lot, according to the FREIDA data on psych programs.

According to FREIDA, a huge number of psych programs:

1. Only interview Step1=220 or more
2. Their current resident Step1 scores have an average of 201-220

This leads me to one of three conclusions:

a. A huge number of psych residencies have a resident pool that amazingly scored exactly 220, no more no less
b. Psych really is getting more competitive, since most of today's psych residents couldn't even score an interview at their own program for the 2017 match
c. FREIDA program data isn't very reliable

B is pretty applicable to me, I would not be competitive now at the residency I graduated from. I think others also fall into this boat.

Completely independently I am stealing your avatar pic, is is freaking amazing.

 

[TheFuture_22]

Did you have significant amount of research/psych related ECs?

No research, No psych related ECs per say. By my own evaluation I would say my application was pretty much average for psychiatry overall. Other DOs in the interview thread seem to be doing well as well. I don't think psych is as DO unfriendly as some people have been making it out to be recently.


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