residency field ranking

PleaseHelpMe · Feb 20, 2006

Can you guys rankt he hardest residency program to get into starting with the hardest?

For example, pediatrics, derm, surgery, etc

How would you rank these in terms of gaining residency?

Gfunk6 · Feb 20, 2006

In terms of # of US grads who fail to match Integrated Plastics would be far and away the #1 most difficult followed distantly by Derm. Other difficult matches include surgical subspecialties (ENT, Optho, Ortho, Urology) and Rads/RadOnc.

Some specialites, like Neurosurg, have very competitive applicants but also have a high Match rate b/c of self-selection.

pintsized · Feb 20, 2006

Gfunk6 said:
In terms of # of US grads who fail to match Integrated Plastics would be far and away the #1 most difficult followed distantly by Derm. Other difficult matches include surgical subspecialties (ENT, Optho, Ortho, Urology) and Rads/RadOnc.

Some specialites, like Neurosurg, have very competitive applicants but also have a high Match rate b/c of self-selection.

agree

medgator · Feb 20, 2006

PleaseHelpMe said:
Can you guys rankt he hardest residency program to get into starting with the hardest?

For example, pediatrics, derm, surgery, etc

How would you rank these in terms of gaining residency?

Overall, I think Gfunk is on target. My view is this:

Plastics>>> Derm = Rad Onc >>>>>>>> Ortho = Uro = ENT > Neurosurg >>>> Rads >>>>>>>>> Optho >> Anesthesia = Surgery = EM >>>>>>>>>>>>>>>> IM = Peds >>>> Psych = FP = Pathology

deuist · Feb 21, 2006

I've attached two files for you. The first is an alphabetical listing of specialties and their stats about U.S. applicants and matches for 2005, along with the applicants:acceptance and spots:applicants ratios. (I've left out the information for IMG's). I pulled this information off of the AAMC's Careers in Medicine website. You'll notice that I don't have much information for the specialties that match through the San Francisco Match. I had to pull information for neurosurgery et al from scutwork.com.

The second file is my personal listing of how competitive each specialty is. The lower the number, the harder getting a match will be. The method I used to create this ranking was by giving equal weight to the two above-mentioned ratios on a 50-point scale. As you can see, rad/onc, derm, and radiology are the most competitive specialties.

Not ranked are neurosurg, neuro, optho, ENT, plastics, and urology. These programs are not under the NRMP and do not release their information freely on the web---at least that I know of. With the exception of neurology, these specialties are also very difficult to match into (along the lines of derm and rads).

File 1, File 2

daisyduke · Feb 21, 2006

medgator said:
Plastics>>> Derm = Rad Onc >>>>>>>> Ortho = Uro = ENT > Neurosurg >>>> Rads >>>>>>>>> Optho >> Anesthesia = Surgery = EM >>>>>>>>>>>>>>>> IM = Peds >>>> Psych = FP = Pathology

I disagree about anesthesia..... tons of IMG's match into anesthesia every year not to mention many middle of the road AMG's. Why does everyone always insist that anesthesia is so competitive??? Categorical Gen Surg and EM are way more competitive.

fantasty · Feb 21, 2006

I'm not saying I agree with medgator, but just out of curiousity - where would you put neurology and ob/gyn?

beary · Feb 21, 2006

medgator said:
Overall, I think Gfunk is on target. My view is this:

Plastics>>> Derm = Rad Onc >>>>>>>> Ortho = Uro = ENT > Neurosurg >>>> Rads >>>>>>>>> Optho >> Anesthesia = Surgery = EM >>>>>>>>>>>>>>>> IM = Peds >>>> Psych = FP = Pathology

I mostly agree with your list except that path is up there in the gas/surgery/EM group.

medgator · Feb 21, 2006

daisyduke said:
I disagree about anesthesia..... tons of IMG's match into anesthesia every year not to mention many middle of the road AMG's. Why does everyone always insist that anesthesia is so competitive??? Categorical Gen Surg and EM are way more competitive.

That is true.... there are tons of spots to meet the demand for anesthesia. Nonetheless, I think it's one of those fields that is starting to surge in popularity, with higher numbers of applicants each year. Gen surg only had 5 unfilled cat. spots last year, so in that regard, I would agree with you-- EM and gen surg should be a little higher up than anesthesia.

I kinda gave a rough guide on what I noticed during med school and matching. The equal signs should probably represent fields within the same tier I guess.

I'd probably put neurology on the same footing as psych and path-- really not competitive at all, maybe as competitive as IM.

OB/GYN used to be a lot more competitive back in the day, but it has fallen out of favor over the past few years, from what I can tell. I don't know where I would put it, but it is certainly less competitive than Categorical Gen Surg, and probably less competitive than anesthesia.... anyone else have an idea?

TheOneTwo · Feb 21, 2006

I think a lot of this is very skewed. The question of how possible it is to find a spot is different from how possible it is to find a good/academic/university-based/reputable spot. There are certain programs in IM and other "non-competitive" fields that are as hard to get into as any radiology, ortho, or other majorly competitive spot. Part of the issue is that for many majorly competitive programs, most spots tend to be in university centers while less competitive ones have many many non-competitive community-based programs and it seems like the more "non-competitive" we consider a field, the more programs tend to be available with some exceptions on both sides.

All I'm saying is you also have to ask yourself what you want out of it. For example, if you want to end up at a top 10 program in your field, certain fields become exponentially harder to match (like IM) while others may still be possible (I'm not sure but I think neurology and maybe a couple of others).

medgator · Feb 21, 2006

TheOneTwo said:
I think a lot of this is very skewed. The question of how possible it is to find a spot is different from how possible it is to find a good/academic/university-based/reputable spot. There are certain programs in IM and other "non-competitive" fields that are as hard to get into as any radiology, ortho, or other majorly competitive spot. Part of the issue is that for many majorly competitive programs, most spots tend to be in university centers while less competitive ones have many many non-competitive community-based programs and it seems like the more "non-competitive" we consider a field, the more programs tend to be available with some exceptions on both sides.

All I'm saying is you also have to ask yourself what you want out of it. For example, if you want to end up at a top 10 program in your field, certain fields become exponentially harder to match (like IM) while others may still be possible (I'm not sure but I think neurology and maybe a couple of others).

Good point. I guess the original question should have been: Keeping all things equal, which fields are the most competitive to match into?

There may be people matching into mid-tier rad onc programs who have the same aptitude as a person doing IM at MGH.

deuist · Feb 21, 2006

From the Excel charts:

Rank Specialty
1 Radiation Oncology (PGY-1)
2 Dermatology (PGY-1)
3 Radiology (PGY-1)
4 Physical Medicine (PGY-1)
5 Emergency Medicine (PGY-2)
6 Anesthesiology (PGY-1)
7 Dermatology (PGY-2)
8 Anesthesiology (PGY-2)
9 Radiation Oncology (PGY-2)
10 Orthopaedic Surgery
11 Physical Medicine (PGY-2)
12 Emergency Medicine (PGY-1)
13 Radiology (PGY-2)
14 Surgery
15 Pediatrics
16 Pathology
17 Psychiatry
18 Internal Medicine
19 Ob/Gyn
20 Thoracic Surgery
21 Family Medicine
22 Medical Genetics
23 Preventive Medicine

I did not rank neuro, neurosurg, ENT, optho, plastics and urology for the reasons I gave earlier.

Gfunk6 · Feb 21, 2006

Deutist, I would be curious what would happened if you consolidated the PGY-1 and PGY-2 numbers for these specialities. In some cases (e.g. RadOnc PGY-1) the n is probably too low for statistical significance.

toxic-megacolon · Feb 21, 2006

beary said:
I mostly agree with your list except that path is up there in the gas/surgery/EM group.

I've noticed that the people who push the idea that anesthesiology is competitive are usually anesthesiologists/anesthesiology residents. At my institution, there are 10 PGY1s. 3 of them scrambled in. 3 are FMG. 3 are DO. One is US Allopathic grad who went to the same institution for medschool. They sit around talking about how competitive anesthesia is with a straight face. 😕

toxic-megacolon · Feb 21, 2006

Check the last post on this thread for my (humble) opinion.

http://forums.studentdoctor.net/showthread.php?t=248682

fishmonger69 · Feb 21, 2006

deuist said:
From the Excel charts:

Rank Specialty
1 Radiation Oncology (PGY-1)
2 Dermatology (PGY-1)
3 Radiology (PGY-1)
4 Physical Medicine (PGY-1)
5 Emergency Medicine (PGY-2)
6 Anesthesiology (PGY-1)
7 Dermatology (PGY-2)
8 Anesthesiology (PGY-2)
9 Radiation Oncology (PGY-2)
10 Orthopaedic Surgery
11 Physical Medicine (PGY-2)
12 Emergency Medicine (PGY-1)
13 Radiology (PGY-2)
14 Surgery
15 Pediatrics
16 Pathology
17 Psychiatry
18 Internal Medicine
19 Ob/Gyn
20 Thoracic Surgery
21 Family Medicine
22 Medical Genetics
23 Preventive Medicine

I did not rank neuro, neurosurg, ENT, optho, plastics and urology for the reasons I gave earlier.

nothing screams 'flawed' more than surgery ranking only one spot higher than pediatrics on the 'competitiveness' scale. i use the number of ranks/position as a better judge of competitiveness, which means :

rad onc > plastics > derm > radiology > ortho = uro = ent > g.surg > EM > anesthesia etc

http://www.nrmp.org/res_match/tables/table10ab_05.pdf

fishmonger69 · Feb 21, 2006

toxic-megacolon said:
Check the last post on this thread for my (humble) opinion.

http://forums.studentdoctor.net/showthread.php?t=248682

i'd agree with your opinion

toxic-megacolon · Feb 21, 2006

fishmonger69 said:
nothing screams 'flawed' more than surgery ranking only one spot higher than pediatrics on the 'competitiveness' scale.

Except maybe Physical Medicine ranking higher than Orthopedics!?! (PGY 1 or not)

deuist · Feb 21, 2006

toxic-megacolon said:
Except maybe Physical Medicine ranking higher than Orthopedics!?! (PGY 1 or not)

You are certainly welcome to disagree with my weighting of the numbers. However, given that 560 American applicants that apply to ortho match for the 716 that apply (meaning that 78% match) compared to physical medicine's 16% match for PGY-1 and 65% for PGY-2, I'd say that PMR is more competitive.

PMR does have more spots than it does applicants for PGY-2. The low match rate could be explained if applicants were using PMR as a back-up specialty and matched into more competitive fields.

As with any ranking system, there are different ways to interpret the numbers.

medgator · Feb 21, 2006

deuist said:
You are certainly welcome to disagree with my weighting of the numbers. However, given that 560 American applicants that apply to ortho match for the 716 that apply (meaning that 78% match) compared to physical medicine's 16% match for PGY-1 and 65% for PGY-2, I'd say that PMR is more competitive.

PMR does have more spots than it does applicants for PGY-2. The low match rate could be explained if applicants were using PMR as a back-up specialty and matched into more competitive fields.

As with any ranking system, there are different ways to interpret the numbers.

I would point out that the quality of applicant with regard to board scores and class ranking differs significantly between ortho and PMR. In that regard, ortho is much more competitive out of the two fields. There is some self-selecting that occurs before people decide to apply to ortho as well.

Also, doesnt PMR start at the PGY-2 level anyways? What are the PGY-1 spots for?

medgator · Feb 21, 2006

beary said:
I mostly agree with your list except that path is up there in the gas/surgery/EM group.

Most people I've talked to say path and neuro are really not competitive at all. We had one person who wanted to do it in my class, and being an average student, got interviews at top-notch places.

Finally M3 · Feb 22, 2006

medgator said:
I would point out that the quality of applicant with regard to board scores and class ranking differs significantly between ortho and PMR. In that regard, ortho is much more competitive out of the two fields. There is some self-selecting that occurs before people decide to apply to ortho as well.

Also, doesnt PMR start at the PGY-2 level anyways? What are the PGY-1 spots for?

Your list is nice, but I agree with the other posters that PM&R isn't up there with ortho. Your statistics with the PGY1's are flawed, and besides, only represent a small chunk of the spots when combined with the PGY2 programs.

Difference between PGY1 v. 2 is integrated internship v. do your internship somewhere else.

Competition-wise, I think we're (PMR) nearer to anesthesia & EM.

Also not fully represented is surgery- much more competitive than your rankings. Your taking into account the prelim surg AND the categorical surg. No-one wants to do prelim surg. Categorical only has a handful of unmatched spots every year.

medgator · Feb 22, 2006

Finally M3 said:
Your list is nice, but I agree with the other posters that PM&R isn't up there with ortho. Your statistics with the PGY1's are flawed, and besides, only represent a small chunk of the spots when combined with the PGY2 programs.

Difference between PGY1 v. 2 is integrated internship v. do your internship somewhere else.

Competition-wise, I think we're (PMR) nearer to anesthesia & EM.

Also not fully represented is surgery- much more competitive than your rankings. Your taking into account the prelim surg AND the categorical surg. No-one wants to do prelim surg. Categorical only has a handful of unmatched spots every year.

I don't think that's my list you are talking about.... I would definitely put PMR below surgery, and way below ortho. Like I said before, surg is def. competitive as evidenced by the fact that were only 5 unfilled spots last year (interestingly, radiology had ~40 spots unfilled at the time of the scramble). As for prelim surg spots, there were TONS of open ones all over after that match, even at big name places like UCSF.

deuist · Feb 22, 2006

Finally M3 said:
Your statistics with the PGY1's are flawed,

How are they flawed? They came straight from the AAMC. You could make the argument that self-selection could make a hard specialty look less competitive. Again, that's the problem with any ranking system. Like the med school rankings, I think that people are using the list too literally. Is there really a difference between #8 and #12?

Finally M3 · Feb 22, 2006

medgator said:
I don't think that's my list you are talking about.... I would definitely put PMR below surgery, and way below ortho. Like I said before, surg is def. competitive as evidenced by the fact that were only 5 unfilled spots last year (interestingly, radiology had ~40 spots unfilled at the time of the scramble). As for prelim surg spots, there were TONS of open ones all over after that match, even at big name places like UCSF.

Sorry, the list I was referring to was the OPs. I just hit reply on your's re; the question of diff. between PGY1 and PGY2 progs.

Finally M3 · Feb 22, 2006

deuist said:
How are they flawed? They came straight from the AAMC. You could make the argument that self-selection could make a hard specialty look less competitive. Again, that's the problem with any ranking system. Like the med school rankings, I think that people are using the list too literally. Is there really a difference between #8 and #12?

I think my problem with your rankings is that you're treating the PGY1 & 2s of all specialties as if they have seperate application pools. People apply to both types of programs, not one or the other. Notmatching as a PGY1 in PMR doesn't mean you didn't match at all (which those competitiveness % (# of match/ # of applicants), but rather you probably matched in a PGY2 spot.

If you look at all the specialties that offer both PGY1s and PGY2s, you can see that due to this bias, it seems the PGY1 spots of relatively noncompetitive fields (I'll cheerfully admit PMR) is more competitive than an Ortho or Radonc spot. Same is true for Anesthesia.

I'm not bagging your PGY2 list, because it does give a nice estimate of 'competitiveness'. I'm just saying the PGY1 stats may be a bit misleading 😀

Plastikos · Jun 13, 2006

deuist said:
How are they flawed? They came straight from the AAMC. You could make the argument that self-selection could make a hard specialty look less competitive. Again, that's the problem with any ranking system. Like the med school rankings, I think that people are using the list too literally. Is there really a difference between #8 and #12?

You should be able to find the data for almost all of the specialties except for neurosurg/uro, they all use NRMP. I also recall shortly after the match having a similar discussion with links to a ERAS/AAMC site that had stats for everyone, including AMG/IMG/apps/spots/AOA etc....Someone with more motivation should be able to find it or recall it.

Koil Gugliemi · Jun 13, 2006

You guys are really splitting hairs here. which goes where in the list is pure conjecture. AND there are lots of exceptions for people who know people etc., AND it changes dramatically year to year.

Most specialties are in the "moderate" category. Primary care are less competitive. rad-onc is nuts.

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