What allopathic residencies is an average DO student competitive for?

[songl4a]

.

---

Members don't see this ad.

 

[IslandStyle808]

I feel an MD 245 would have an easier time matching derm than a DO 260 though. I may be wrong

This seems to be the case for ultra-competitive residencies and I can only assume it is a result of MD bias on the part of program directors (as most ultra-competitive residency PDs are MDs). A DO applicant applying for something like Derm/Plastics/Neurosrg needs to not only perform higher on the USMLE, they need to have outstanding everything else.

It is mostly the result of a non-LCME filter being placed on DOs candidates. So no matter what score you get whether it be a 240 or 270, they won't see it. However, there is still a bias, for those programs that do see DO apps, and a DO has to score above an MD student to get similar treatment.

Yet IMO that once a DO student hits around a 250, the score matter far less that what most members on SDN state. So I am in conflict with statements such a DO has to have a 260 to equal a US MD with a 245 (that's me and my opinion so take it with grain of salt).

For instance, I bring up the rad onc example many times where non-stellar board scoring DO students are matching into the field. In the charting outcomes in 2014, there where 6 independent applicants, 4 of which were DO students (which makes it easier to see how DOs match up to US seniors, pg. 7 of NRMP match data). If you assumed that these DOs were all high scorers, then 2 DOs would be scoring between 250-260 and 2 would be scoring in the 230-240 range (charting outcomes pg 270). The average USMLE step I for the field is around 240 and yet DO students with sub-par (<240) scores matched into it. There is a good chance this difference between US MD and US DO score shrinks or matters less as scores increase. Then the other factors such as specific research, auditions w/ LOR from big wigs in the speciality start kicking in more.

Charting outcomes USMLE Step I chart (pg. 270)
http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014-Final.pdf

NRMP match 2014 (PGY-2 radiation oncology match pg. 7)
http://www.nrmp.org/wp-content/uploads/2014/04/Main-Match-Results-and-Data-2014.pdf

Of course with each field YMMV, but with excellent students the bias seems to diminish more for some programs. However, it doesn't mean it eliminates bias at for other programs. There are some residency programs that don't care to take DO students at all for various reasons. Whether it be that they have a lot of excellent MD applicants or a DO student that did not do well during that one MD audition rotation. It may not matter how hard they try in this case.

 

[Petypet]

Matching into competitive specialties in less competitive states/community programs, then relocating after X years/fellowship?

Competitive specialities are competitive for everyone, so even matching ortho in the least desirable location is still challenging.

 

[Dharma]

You've dealt with competition your whole life to this point. You thought this was gonna get any easier? lol

All this means is your life just leveled up... grow a pair and go get what you want.

Not necessary.

Or even a USMLE

I was interviewed at a few programs who mentioned that having the USMLE landed me the interview, one calling it a game-changer. Just an FYI for those thinking coastal programs.

 

[Dharma]

Its more competitive than it was. Truth is the same phenomenon to some (probably lesser) degree is happening with FM. For the first time in decades for example FM in California went completely filled in the match last year. This doesn't mean that either have gotten particularly competitive, just more so than they've been in the past.

Competitive programs and competitive regions as always will be on the more competitive side. This doesn't mean you'll struggle to match at a program that'll give you good training. There are plenty of those around. You don't need a 240 to match a good psych program.

The percentage of USMDs matching into psychiatry is on the climb. This is most definitely an indication of increased competition. The higher that number goes, the more difficult it will become for DOs to match. Contrary to what many would like to believe, most PDs would like their rosters to be filled with USMDs top to bottom.

 

[hallowmann]

The percentage of USMDs matching into psychiatry is on the climb. This is most definitely an indication of increased competition. The higher that number goes, the more difficult it will become for DOs to match. Contrary to what many would like to believe, most PDs would like their rosters to be filled with USMDs top to bottom.

While that certainly says something about this last year's Psych match, and US MD interest in the field, it doesn't necessarily indicate a terrible trend in competitiveness. It seems like a trend right now if you look at the last 4 years (61.4%, 57.2%, 51.8%, 50.1%), but it might very well be the normal variation based on US MD interest that occurs with the match.

What I mean by that is that certainly this last year was on the more competitive side when compared to the recent past, but it doesn't necessarily mean a shifting tide or that things will continue to get worse, just that they are worse right now than they've been in the recent past.

Evidence: 61.4% is on the higher end for psych, but it isn't even a record for the last 10 yrs of psych matches (2010 was 61.4% and 2009 was 61.7%). The truth is that over the last 15 years psych US MD senior filling rate has actually been pretty consistently in a range from 55%-64%. If anything the 2014 (51.8%) and 2013 (50.1%) rates were uncharacteristic lows and possibly outliers that gave an inaccurate depiction of the competitiveness of psych in general.

For reference:
2016 61.4
2015 57.2
2014 51.8
2013 50.1
2012 55.1
2011 58.3
2010 61.4
2009 61.7
2008 55.7
2007 59.9
2006 62.0
2005 63.6
2004 62.8
2003 60.5
2002 58.9

EDIT: I would like to also say that with everything there is simply variation in interest, and that causes these mini-trend changes. Big trend changes also happen, but tend to be dramatic and only recognized after the fact over time. FM for example reached high popularity in the 1990s and early 2000s with US MD filling rates in the high 60s and low 70s, but now is consistently in the 40s. Interestingly psych has actually demonstrated an almost reciprocal change, sitting in the 40s in the 1990s to now being consistently in the 50s and low 60s.

 

[Dharma]

While that certainly says something about this last year's Psych match, and US MD interest in the field, it doesn't necessarily indicate a terrible trend in competitiveness. It seems like a trend right now if you look at the last 4 years (61.4%, 57.2%, 51.8%, 50.1%), but it might very well be the normal variation based on US MD interest that occurs with the match.

What I mean by that is that certainly this last year was on the more competitive side when compared to the recent past, but it doesn't necessarily mean a shifting tide or that things will continue to get worse, just that they are worse right now than they've been in the recent past.

Evidence: 61.4% is on the higher end for psych, but it isn't even a record for the last 10 yrs of psych matches (2010 was 61.4% and 2009 was 61.7%). The truth is that over the last 15 years psych US MD senior filling rate has actually been pretty consistently in a range from 55%-64%. If anything the 2014 (51.8%) and 2013 (50.1%) rates were uncharacteristic lows and possibly outliers that gave an inaccurate depiction of the competitiveness of psych in general.

For reference:
2016 61.4
2015 57.2
2014 51.8
2013 50.1
2012 55.1
2011 58.3
2010 61.4
2009 61.7
2008 55.7
2007 59.9
2006 62.0
2005 63.6
2004 62.8
2003 60.5
2002 58.9

I've seen the numbers in the past but I'm still siding with those who feel that psychiatry will keep ticking upward from here. Applications were through the roof this year and this will continue; many places significantly increased the numbers of interview slots this year (one place I was at doubled spots since 2015). Even from my own n=1 experience, I had very solid application (think high 600s COMLEX and USMLE well above psychiatry for both steps) and went much farther down my ROL than I (or any mentor, colleague, PDs on the trail, etc) expected.

As the number of USMD grads and interest in psychiatry increases, I expect the trend to continue. Word is out that psychiatry is an interesting field with a great lifestyle that offers the potential to practice in multiple settings even during an average day (e.g. morning outpatient, afternoon C&L). Couple that with solid employment prospectives and dwindling stigma amongst both students and the general population and you have a field that is likely to push its way into the middle of the pack. Sure it well never be anywhere near the competitiveness of the (former) ROADs specialities but it won't be dragging along at the depths.

Point being, contrary to what many are saying, psychiatry should no longer be considered an easy match. Treat as such and one may likely find themselves SOAPing.

 

[Petypet]

Even from my own n=1 experience, I had very solid application (think high 600s COMLEX and USMLE well above psychiatry for both steps) and went much farther down my ROL than I (or any mentor, colleague, PDs on the trail, etc) expected.

Isn't that the nature of the match?

 

[hallowmann]

I've seen the numbers in the past but I'm still siding wth those who feel that psychiatry will keep ticking upward from here. Applications were through the roof this year and this will continue; many places significantly increased the numbers of interview slots this year (one place I was at doubled spots since 2015). Even from my own n=1 experience, I had very solid application (think high 600s COMLEX and USMLE well above psychiatry for both steps) and went much farther down my ROL than I (or any mentor, colleague, PDs on the trail, etc) expected.

As the number of USMD grads and interest in psychiatry increases, I expect the trend to continue. Word is out that psychiatry is an interesting field with a great lifestyle that offers the potential to practice in multiple settings even during an average day (e.g. morning outpatient, afternoon C&L). Couple that with solid employment prospectives and dwindling stigma amongst both students and the general population and you have a field that is likely to push its way into the middle of the pack. Sure it well never be anywhere near the competitiveness of the (former) ROADs specialities but it won't be dragging along at the depths.

Point being, contrary to what many are saying, psychiatry should no longer be considered an easy match. Treat as such and one may likely find themselves SOAPing.

Its certainly possible. Only time will tell. Its one of the reasons I recommend applying broadly in general.

 

[Dharma]

Isn't that the nature of the match?

Tis. That said, I still feel pretty darn lucky to have matched at an awesome program (actually my favorite although I dropped them lower on my ROL for family reasons). It was a much tougher season for many others.

I'm glad I'm done with the match thing. Me thinks these upcoming years gonna start looking a bit nasty. Yes, doom and gloom kids. Get your game down tight and don't set unrealistic expectations (but do aim high).

 

[Dharma]

Good discussion regarding competitiveness on the psychiatry forums. This poster is one of the more respected heads on the forum: http://forums.studentdoctor.net/thr...more-competitive.1125203/page-2#post-17737294

Another good one (although the whole thread is pretty good for those interested): http://forums.studentdoctor.net/thr...more-competitive.1125203/page-2#post-17735081

 

[DetectiveAlonzo]

Tis. That said, I still feel pretty darn luck to have matched at an awesome program (actually my favorite although I dropped them lower on my ROL for family reasons). It was a much tougher season for many others.

I'm glad I'm done with the match thing. Me thinks these upcoming years gonna start looking a bit nasty. Yes, doom and gloom kids. Get your game down tight and don't set unrealistic expectations (but do aim high).

But on SDN... isn't everything all doom and gloom?

 

[Petypet]

Yes, doom and gloom kids.

There's still like 1000 unfilled ACGME spots and I thought close to 1000 unfilled AOA spots. Hardly doom and gloom.

 

[Dharma]

There's still like 1000 unfilled ACGME spots and I thought close to 1000 unfilled AOA spots. Hardly doom and gloom.

North Dakota IS beautiful this time of the year.


I was exaggerating (a bit). A little fear is good for the kids. Lights a fire under the arse.

So here's some heat for the future wannabe psychiatrists: There were 11 unfilled psychiatry spots before SOAP this year, with many fighting over those left-over few scraps. That's kinda slim pickings.

 

[Drrrrrr. Celty]

North Dakota IS beautiful this time of the year.


I was exaggerating (a bit). A little fear is good for the kids. Lights a fire under the arse.

So here's some heat for the future wannabe psychiatrists: There were 11 unfilled psychiatry spots before SOAP this year, with many fighting over those left-over few scraps. That's kinda slim pickings.

Well, hopefully it's just IMGs who feel the crunch for now.

 

[pattr]

Courtesy of cliquesh:

I think you're being factious, but it case you aren't...

It's realistic, as a DO, to match at:

A top tier pyschiatry, family medicine, anesthesia, PM&R or pathology program.

A mid-tier internal medicine, neurology, pediatric, Ob/gyn or emergency medicine program

A mid to low tier general surgery or radiology program.

It's also realistic to match AOA orthopedics and general surgery, as well as emergency medicine, family medicine, pediatrics, internal medicine, psych and Ob/gyn.

It's unrealistic to match Acgme orthopedics, neurosurgery, urology, ENT, derm, radiation oncology and plastic surgery. Opthamology may or may not be unrealistic (not enough data to determine).

It's unrealistic to match aoa surgical subspecialities, except for aoa general surgery and orthopedics, because there are so few spots ( 14 neurosurgery, 24 ENT, 17 urology, and 15 opthamology). This is in contrast to the 135 general surgery spots and 100 orthopedic spots offered last year.

Similar there are few AOA anesthesia, radiology, and derm spots (about 30 for each speciality). However, acgme anesthesia is very DO friendly and acgme radiology is pretty DO friendly. AOA derm is weird because you don't apply as a 4th year, you apply as an intern, so I don't know how realistic aoa derm is.

Sent from my iPhone using SDN mobile

 

[DetectiveAlonzo]

Once again... guys.... this is SDN.

Don't forget that.

lolz

 

[FourniersGreenGang]

All this being said, I wonder how much this will change with the merger. The fact of the matter is that the top DO students interested in neurosurgery, ENT, ortho, etc. Largely have not entered the ACGME match for these programs in the past due to the justified fear of not matching and being SOL with the AOA match. I guess we will find out in 2020!

 

[IsWhat]

North Dakota IS beautiful this time of the year.


I was exaggerating (a bit). A little fear is good for the kids. Lights a fire under the arse.

So here's some heat for the future wannabe psychiatrists: There were 11 unfilled psychiatry spots before SOAP this year, with many fighting over those left-over few scraps. That's kinda slim pickings.

I may be wrong, but psychiatry has a few barriers other specialties don't have. The way med school is set up - choosing psychiatry is kind of like going to flight school in the Air Force only to choose to be a flight controller. It can be a hard leap of faith for even the most pro-psychiatry students, because you will be giving up a larger portion of medicine - barring a fellowship post residency. So it's hard to believe psychiatry will ever be "truly" competetive.

 

[Yadster101]

North Dakota IS beautiful this time of the year.


I was exaggerating (a bit). A little fear is good for the kids. Lights a fire under the arse.

So here's some heat for the future wannabe psychiatrists: There were 11 unfilled psychiatry spots before SOAP this year, with many fighting over those left-over few scraps. That's kinda slim pickings.

I know we're considering 225 to be a low step but that's still a damn good score. Being an "average DO student" is not easy. So what happens to the below average DO students? The kids getting low comlex/step? Can they even get into FM?

I'm aiming for FM out of genuine interest but I know it's not competitive. Scary to think that kids with lower scores may not even match.

 

[NontradCA]

I feel an MD 245 would have an easier time matching derm than a DO 260 though. I may be wrong

How many DOs are getting 260 USMLE? Like one per class/school. If that. How many DOs match ACGME derm a year? Ask yourself these things before you spout out random ****.

 

[NontradCA]

I know we're considering 225 to be a low step but that's still a damn good score. Being an "average DO student" is not easy. So what happens to the below average DO students? The kids getting low comlex/step? Can they even get into FM?

I'm aiming for FM out of genuine interest but I know it's not competitive. Scary to think that kids with lower scores may not even match.

Cmon man. Don't listen to idiots on the internet. Just look at the data.

 

[DetectiveAlonzo]

Listen to @NontradCA

He's another SDN OG around these parts.

 

[hallowmann]

I know we're considering 225 to be a low step but that's still a damn good score. Being an "average DO student" is not easy. So what happens to the below average DO students? The kids getting low comlex/step? Can they even get into FM?

I'm aiming for FM out of genuine interest but I know it's not competitive. Scary to think that kids with lower scores may not even match.

FM is also a lot more about being personable and other aspects of your app (social service, volunteering, etc.), more so than say IM. I know people with <500 COMLEXs that aren't having an issue matching. They also happen to make good impressions and have good clinical scores though. Its the ones with 1-2 board failures and maybe poor social skills that seem to struggle.

 

[Dharma]

I may be wrong, but psychiatry has a few barriers other specialties don't have. The way med school is set up - choosing psychiatry is kind of like going to flight school in the Air Force only to choose to be a flight controller. It can be a hard leap of faith for even the most pro-psychiatry students, because you will be giving up a larger portion of medicine - barring a fellowship post residency. So it's hard to believe psychiatry will ever be "truly" competetive.

It won't be ROADs by any means but it will be a more difficult match than FM, IM, peds, path, and others (barring the academic powerhouses of course).

Don't necessarily agree with the analogy but I get what you're saying.

 

[Dharma]

I know we're considering 225 to be a low step but that's still a damn good score. Being an "average DO student" is not easy. So what happens to the below average DO students? The kids getting low comlex/step? Can they even get into FM?

I'm aiming for FM out of genuine interest but I know it's not competitive. Scary to think that kids with lower scores may not even match.

I wouldn't worry about FM. My comments have been about what I've seen in the last 2 years, including my own interview/match experience, in psychiatry.