Is this score high enough?

[dr.sartorius]

Long story short: Does anyone with more experience know if a 218 step1 score is solid enough for matching ACGME anesthesia? Especially as a DO applicant?

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[sylvanthus]

Should be fine if everything else is alright. Anesthesia is not that competitive any longer.

 

[chizledfrmstone]

Should be fine if everything else is alright. Anesthesia is not that competitive any longer.

Really?

Can someone tell me why or what terms I should search for an explanation?


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[AlbinoHawk DO]

Really?

Can someone tell me why or what terms I should search for an explanation?


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From what I've heard there is a lot of worry over mid-levels invading the field. Maybe someone with more knowledge can chime in.

 

[chizledfrmstone]

From what I've heard there is a lot of worry over mid-levels invading the field. Maybe someone with more knowledge can chime in.

A family member told me this is the reason he didn't go into Anesthesia... ~15 years ago.

Is the sky falling faster now?


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[AlbinoHawk DO]

A family member told me this is the reason he didn't go into Anesthesia... ~15 years ago.

Is the sky falling faster now?


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I don't know, but from what I've heard the number of CRNA grads is growing by the year and they've already began moving into Pain Medicine, which is a big cash cow for many in anesthesia.

 

[SLC]

The anesthesiologists at my hospital are super territorial these days. Even getting into intense verbal arguments in the OR with partners over who gets to staff certain rooms.

Doesn't seem like a fun situation to be in. They are constantly fighting over who gets the best paying cases.

And there are no CRNA's at this hospital.

 

[NurWollen]

How competitive are critical care fellowships for anesthesiologists, compared to IM CC fellowships?

 

[koan]

Long story short: Does anyone with more experience know if a 218 step1 score is solid enough for matching ACGME anesthesia? Especially as a DO applicant?

I've talked to a few DO residents in anesthesia who got around that score, improved on Step 2 and matched University ACGME programs. There's a lot of gloom and doom on the anesthesia forum but in talking to some senior residents who just graduated last month the job market seems to be improving. They speculated that retirement of baby boomers was accelerating now that their stock portfolios / real estate had recovered somewhat from the recession.

My feeling is that I'd rather do anesthesia for primary care $ than vice versa, so even if reimbursement tanks I'm still pretty certain I will be happy. The CRNA thing is a complicated issue but other fields (esp. primary care) have midlevel encroachment issues as well or bad job markets (radiology, path). You should look into FAER if you want more exposure to anesthesia with some research and a guaranteed publication.

 

[BestDoctorEver]

The anesthesiologists at my hospital are super territorial these days. Even getting into intense verbal arguments in the OR with partners over who gets to staff certain rooms.

Doesn't seem like a fun situation to be in. They are constantly fighting over who gets the best paying cases.

And there are no CRNA's at this hospital.

They got paid per case....

 

[dr.sartorius]

so a 218 is well within range of being able to match ACGME anesthesia? I'm not concerned with the job market etc, i'm asking for a friend.

 

[SLC]

They got paid per case....

That's the way it seems based on the conversation's I've overheard. They more or less bill their own cases.

 

[koan]

so a 218 is well within range of being able to match ACGME anesthesia? I'm not concerned with the job market etc, i'm asking for a friend.

I wouldn't say well within. Charting Outcomes 2011 (most recent data) shows the mean for matched applicants was 226 for allopathic seniors and 229 for independents (DO + IMG) with a standard deviation ~10. Unmatched was 203 and 213, respectively. So your friend is on the low side, but my point was that I have heard improvement on Step 2 can help overcome a below-average Step 1.

 

[dr.sartorius]

I wouldn't say well within. Charting Outcomes 2011 (most recent data) shows the mean for matched applicants was 226 for allopathic seniors and 229 for independents (DO + IMG) with a standard deviation ~10. Unmatched was 203 and 213, respectively. So your friend is on the low side, but my point was that I have heard improvement on Step 2 can help overcome a below-average Step 1.

Thank you!

 

[dr.sartorius]

Bump, anyone else?

 

[a runner]

I wouldn't say well within. Charting Outcomes 2011 (most recent data) shows the mean for matched applicants was 226 for allopathic seniors and 229 for independents (DO + IMG) with a standard deviation ~10. Unmatched was 203 and 213, respectively. So your friend is on the low side, but my point was that I have heard improvement on Step 2 can help overcome a below-average Step 1.

I would say 218 is well within the range. Even in 2011 when anesthesiology was more competitive than it is now and less DO's matched into it, 218 was well within range.

You're looking at the numbers wrong. Instead of looking at the mean scores for matched and unmatched applicants, look at the percent of applicants who matched within each score range. Unfortunately DO's show up as "score unknown" in charting the outcomes, but we can assume that DO's numbers are more closely related to US seniors than IMG's. US seniors with a step 1 between 211-220 matched at a 99.1% rate. 233 out of 235. I would say DO's in that range do pretty well too, especially now.

 

[koan]

^ This is a very good point. But there is data for independent applicants with scores between 211-220, and 15 matched / 20 didn't (43%). The group represented by "score unknown" (117 matched, 50 unmatched) may be students who only took COMLEX; they would still show up as having applied and either matched or not, but their USMLE score would be "unknown". I think the score breakdown data shows pretty clearly that it's harder for DO / IMG to match at every score bracket. I doubt all of those unmatched students are IMG.

Overall though I agree with @a runner that DOs are definitely matching in that score range, and below. Like I said, I personally know of a few examples of this. Everyone agrees that anesthesia is less competitive than it used to be, and there are many ways to boost an application with a low Step 1 (e.g. improve Step 2, away rotation, research, good LORs, etc.)

 

[sazerac]

Really?

Can someone tell me why or what terms I should search for an explanation?


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The reimbursement model for Gas is changing too. The old system was to work like a dog for a few years as an attending and then make partner in a small firm, making big bucks as an owner.

The model now is to work like a dog but then the partners sell their partnership to a national corporation before you become partner yourself. They make out like bandits and you look like a fool.

The other reimbursement model is to just work for one of these national corporations as a wage employee, getting paid modestly while the out-of-state corporate owners make big bucks on your labor.

Medical students are voting with their Rank Order Lists. Anesthesia doesn't even fill in the match anymore. It is amusing to follow the Gas forum in March and see who applied to competitive specialties, failed to match, and then get stuck in Gas during the SOAP process. Talk about an unexpected last-minute career change!

 

[meliora27]

The reimbursement model for Gas is changing too. The old system was to work like a dog for a few years as an attending and then make partner in a small firm, making big bucks as an owner.

The model now is to work like a dog but then the partners sell their partnership to a national corporation before you become partner yourself. They make out like bandits and you look like a fool.

On an EM rotation, the attendings told similar stories about their field. Big national companies like EmCare, Apollo, Team Health are cornering the EM market.

Radiologists talk about the same thing vis a vis huge companies like Sheridan that corner the market.

I presented at an Anesthesiology conference and I was talking with someone who turned out to be a Sheridan recruiter, apparently they staff Radiology/Anesthesiology/Neonatology/EM. And just today, I saw that AmSurg (AMSG on the Nasdaq) completed their acquisition of Sheridan for $2.3 BILLION

The world is a changin'...

 

[a runner]

^ This is a very good point. But there is data for independent applicants with scores between 211-220, and 15 matched / 20 didn't (43%). The group represented by "score unknown" (117 matched, 50 unmatched) may be students who only took COMLEX; they would still show up as having applied and either matched or not, but their USMLE score would be "unknown". I think the score breakdown data shows pretty clearly that it's harder for DO / IMG to match at every score bracket. I doubt all of those unmatched students are IMG.

Overall though I agree with @a runner that DOs are definitely matching in that score range, and below. Like I said, I personally know of a few examples of this. Everyone agrees that anesthesia is less competitive than it used to be, and there are many ways to boost an application with a low Step 1 (e.g. improve Step 2, away rotation, research, good LORs, etc.)

Pg. 6 (pg. 10 of the pdf) of charting the outcomes 2011 says that "USMLE step 1 scores are not available for most osteopathic medical school graduates included in the independent applicant group." I've actually went through most of the specialties to see if the # of DO's matching to each specialty in the Main Report correlates to the # of independent applicants that matched with no score reported and I haven't seen an example of it not correlating within 1-3% error. For example, anesthesia shows 117 matched with "score unknown" and the Main Report says 118 DO's matched. Pretty darn close. It's the most reliable way we have to see what % of DO's that applied in each specialty matched for any year a charting outcomes was published.

Good point on bringing up the group represented by score unknown... ~50 DO's likely didn't match that year. That's pretty significant. Hopefully (and most likely) that # has gone down considerably since then. In that case anesthesia was more competitive that year for DO's than I would have thought.