2009 Match Stats

[RxBoy]

I think it would be nice to have a match 09 stats thread with discussion. I'll update this as results are made available.

First Set of Stats:

%Unfilled: % of offered spots that did not fill

Overall it looks like most specialties had a very tight fit except for PMNR, Path, and worst being Family. I'm surprised OB only had 6 unmatched spots in the entire country. Anesth seems to be in the middle of the road, no surprises this year.


Updated: 2009 Anesthesia Match Stats:

Updated Stats: Looks like this year had the highest % of Allopathic US Seniors of the total matched. This is usually a sign of increasing competitiveness. The biggest jump was from the 05 to 06 match years, but the 08 to 09 was also significant. Match rate was at 98.1%. Draw your own conclusions but this year seems to of been a little more competitive than previous years.

Next 2009 NRMP report will include other factors like regional stats, program specific stats, % of applicants that matched, ect. Not entirely sure when NRMP will release it.

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[NUGasStud]

I know that applicant stats are not out yet, but I found it interesting that Internal Medicine had a lower unfilled percentage than Anesthesiology...

 

[Colba55o]

Overall it looks like most specialties had a very tight fit except for PMNR, Path, and worst being Family. I'm surprised OB only had 6 unmatched spots in the entire country. Anesth seems to be in the middle of the road, no surprises this year.

These stats are from a "program perspective". Still no stats on matched vs. applicants applied. I think those stats will be more indicative of competitiveness. But if I had to guess, anesthesia will not be that much different than last year... although its a common perception among interviewees.

Anyone know the breakdown of unmatched anesthesia by program? It would be helpful.
I know there were 10 Cat and 16 Advanced unmatched positions.

Could it be that med school class size has been increasing over the past several years, faster than the number of residency spots being offered?
It is funny how internal medicine had such a low unfilled rate; makes you think the tables are turning and primary care is becoming more attractive. That was certainly the trend in my class this year.

 

[RxBoy]

Could it be that med school class size has been increasing over the past several years, faster than the number of residency spots being offered?
It is funny how internal medicine had such a low unfilled rate; makes you think the tables are turning and primary care is becoming more attractive. That was certainly the trend in my class this year.

Well there was def. a statistical difference from last year. Comparing Family, Medicine, and Anesthesia there were actually tighter fits this year than last year for all 3 specialties.

In 2008:
Medicine there were 107 unfilled for 4858 positions = 2.2% unfilled
Family there were 249 unfilled for 2636 positions = 9.4% unfilled
Anesthesia there were 36 unfilled for 1364 positions = 2.6% unfilled

I think this could be due to 1) General increase in # of applicants per residency position 2) Applicants/Programs providing longer rank lists 3) Combination of the two.

 

[RussianJoo]

my school put up the list of unfilled positions.

PGY1 Unfilled Positions:
- Arkansas: 2 out of 14
- Kansas: 1 out of 5
- LSU: 4 out of 4
- Texas Tech: 1 out of 4
- West Virginia: 1 out of 3
- Wisconsin: 1 out of 10
Thus a total of 10 unfilled positions.


PGY2 Unfilled positions:
- U Conn: 3 out of 5
- Yale: 3 out of 19
- U Mass.: 1 out of 5
- Einstein (NYC) : 1 out of 13
- SUNNY Brooklyn: 5 out of 10
- Case Western/Metro Health: 1 out of 7
- Wisconsin: 2 out of 5
For a total of 16 unfilled positions.

And they're probably all gone by now.

 

[peerie]

I am doing FM, and I feel pretty supportive of it. It's not for everyone, but I think I'll like it.

Anyway, I was thinking about the IM question today as I sat with a friend who was scrambling today and looking at the stats. IM gets ALOT of prematches from IMGs and FMGs and so I was wondering if that artificially lowers their match rate.

I interviewed at a lot of FM programs and learned alot about them. None offered prematch spots to anyone. IM regularly does this, maybe as a way to avoid the scramble - which totally stinks no matter what side of the situaiton you are on.

 

[akpete]

my school put up the list of unfilled positions.

PGY1 Unfilled Positions:
- Arkansas: 2 out of 14
- Kansas: 1 out of 5
- LSU: 4 out of 4
- Texas Tech: 1 out of 4
- West Virginia: 1 out of 3
- Wisconsin: 1 out of 10
Thus a total of 10 unfilled positions.


PGY2 Unfilled positions:
- U Conn: 3 out of 5
- Yale: 3 out of 19
- U Mass.: 1 out of 5
- Einstein (NYC) : 1 out of 13
- SUNNY Brooklyn: 5 out of 10
- Case Western/Metro Health: 1 out of 7
- Wisconsin: 2 out of 5
For a total of 16 unfilled positions.

And they're probably all gone by now.

The PGY2 unfilled should be MCW, not U of Wisc. Wisconsin only does categorical, and MCW certainly had 2 open spots. Just FYI.

 

[DO4lifer]

its kinda weird to see a couple programs go unfilled where i applied, but didn't get an interview.

suckas.

 

[highvoltage]

wow anesthesia didnt do so hot!.

 

[Taurus]

Keep in mind that this list is still preliminary. For example, I know that rads actually had only 5 unfilled spots, not 10. We have to wait to see the final list to make conclusions.

 

[BobA]

Keep in mind that this list is still preliminary. For example, I know that rads actually had only 5 unfilled spots, not 10. We have to wait to see the final list to make conclusions.

Psych actually only had 8 unfilled spots and 4 of them were in Puerto Rico.

Yale C/A, USCD-research track, MSU - were all empty by program choice.

Still, when the final numbers come out I bet there are about 2 spots for every USAMG

 

[DO4lifer]

Psych actually only had 8 unfilled spots and 4 of them were in Puerto Rico.

Yale C/A, USCD-research track, MSU - were all empty by program choice.

Still, when the final numbers come out I bet there are about 2 spots for every USAMG

There are no spots "empty by program choice" that are submitted to NRMP. If they do want to keep those spots open, they are kept separate and aren't sent through the match.
1) This makes sure the spots are open
2) Applicants can end up matching into these spots off the list, and they are contractually bound to give them to these applicants.

 

[RxBoy]

There are no spots "empty by program choice" that are submitted to NRMP. If they do want to keep those spots open, they are kept separate and aren't sent through the match.
1) This makes sure the spots are open
2) Applicants can end up matching into these spots off the list, and they are contractually bound to give them to these applicants.

Agreed.

I don't know why people still believe that nonsense. How could a program even predict it? Lets say you make a list of 30 for 10 spots and want 2 open. If you overestimate, you'll fill w/o those 2 "extra" spots. If you underestimate, you'll fill like 3 spots for 10 positions which would be a nightmare for any program. Plus, I remember a similar question few months back about MGH, UCSF, and Hopkins unfilled positions. Some were saying they purposely do that every year. WHy didn't they do it this year then?

 

[RussianJoo]

The PGY2 unfilled should be MCW, not U of Wisc. Wisconsin only does categorical, and MCW certainly had 2 open spots. Just FYI.

yes you're correct. I am sorry for the confusion.

 

[tranman]

There are no spots "empty by program choice" that are submitted to NRMP. If they do want to keep those spots open, they are kept separate and aren't sent through the match.
1) This makes sure the spots are open
2) Applicants can end up matching into these spots off the list, and they are contractually bound to give them to these applicants.

Wouldn't they essentially just not rank anybody in those slots, effectively keeping the spots open?

 

[pgg]

Wouldn't they essentially just not rank anybody in those slots, effectively keeping the spots open?

No. The way to keep spots available is to not open them up to the match.

If they have 8 spots, and rank 6 people, they'll probably end up with MORE than 2 open spots, because some or all of those 6 people will rank other programs higher and match elsewhere.

 

[Mista Suprane]

Plus, I remember a similar question few months back about MGH, UCSF, and Hopkins unfilled positions. Some were saying they purposely do that every year. WHy didn't they do it this year then?

i think what people were saying about those programs was that they will only rank applicants that they find desirable. they would rather go unfilled as a consequence of making a shorter rank list (potentially leaving spots open) and fill those spots with people from the scramble (those that didn't match a more competitive field), then tack on people to the bottom of the list that they interviewed but don't want.

but i'm not sure this is true either, nor do i think it is the right thing to do. why pass up the person who might be a little less qualified but has a strong desire to do anesthesia for the disgruntled scrambler who may have rocked 99s on his boards but really wanted to do ENT?

 

[DO4lifer]

Wouldn't they essentially just not rank anybody in those slots, effectively keeping the spots open?

say program A has 10 spots. They want to hold 2 spots for out of the match contracts. They submit 8 spots to NRMP to run through the match. They rank 25 people, and fill 7 of the 8 spots. One spot is unmatched and will be scrambled into by either NRMP people or out of match people.

If the program submitted 10 spots, and ranked 30 people, and filled the 10 spots, they wouldn't have those 2 spots available. There is no way to keep 2 spots open unless you do not submit them to NRMP.

 

[puraj83]

any ideas why yale might have had a couple open spots?

 

[Spacedman]

any ideas why yale might have had a couple open spots?

...because they didn't rank enough people who wanted to live in new haven.

 

[RxBoy]

Updated OP

 

[ryanjmy]

Updated: 2009 Anesthesia Match Stats:

The last column in the chart would make more sense if 2006 had a percent of 77 or so. I wonder if it is just an outlier. There is a lot of subjective evidence that anesthesia has gotten a more competitive over the years. I think the data will eventually confirm this. The steps score data will be the best indication, but it looks like the NRMP is a couple years behind on publishing that data.

I could see how an M3 in 2008 talking to a CA-2 (class of 05) might get a false impression of how competitive they are. I know my advisor was a little surprised that I did not get an interview at couple of place that I applied to.

 

[RxBoy]

The last column in the chart would make more sense if 2006 had a percent of 77 or so. I wonder if it is just an outlier. There is a lot of subjective evidence that anesthesia has gotten a more competitive over the years. I think the data will eventually confirm this. The steps score data will be the best indication, but it looks like the NRMP is a couple years behind on publishing that data.

I could see how an M3 in 2008 talking to a CA-2 (class of 05) might get a false impression of how competitive they are. I know my advisor was a little surprised that I did not get an interview at couple of place that I applied to.

I personally think 06 had a spike and it kind of plateaued near that level in 07 and 08. This year there was another smaller, but still significant spike. Predicting next year is like predicting stocks... no one really knows what will happen. Could spike again, could plateau, or could even plummet after the health reforms. But one thing is certain, it was a lot tougher for non US allopathic seniors to match this year. Those that did should be very proud.

 

[RxBoy]

1996's Match Rate was 33%!!!!

(Updated my figure in the OP to include 2000 and 1996)

 

[morpheus md]

i think what people were saying about those programs was that they will only rank applicants that they find desirable. they would rather go unfilled as a consequence of making a shorter rank list (potentially leaving spots open) and fill those spots with people from the scramble (those that didn't match a more competitive field), then tack on people to the bottom of the list that they interviewed but don't want.

but i'm not sure this is true either, nor do i think it is the right thing to do. why pass up the person who might be a little less qualified but has a strong desire to do anesthesia for the disgruntled scrambler who may have rocked 99s on his boards but really wanted to do ENT?

The usual case is that those spots go to people that have actually started residency in another field, and sometimes completed a residency in another field, and switched electively into anesthesia. At Hopkins we have recently had people from Emed, GS, Neurosurg and Plastics take those spots, some of them ending up being among the best gas residents eventually.

 

[morpheus md]

1996's Match Rate was 33%!!!!

(Updated my figure in the OP to include 2000 and 1996)

Numb and Number: Once a Hot Specialty, Anesthesiology Cools As Insurers Scale Back --- Health-Care Workers Find Fewer Jobs, Lower Pay In Era of Cost-Cutting --- Working Harder for $100,000

By George Anders, The Wall Street Journal
Mar 17, 1995


Copyright Dow Jones & Company Inc Mar 17, 1995
Patrick Kwan has as bright a resume as a young doctor could want, including four years of advanced training in anesthesiology. So when he entered the job market last spring, he expected to be showered with lucrative offers. What happened instead was a painful experience.
After six months of looking, Dr. Kwan got just one full-time offer, to join a group practice at $120,000 a year. He turned it down because the pay was less than half what other partners were making and because the job didn't make use of his subspecialty: anesthesia for cardiac surgery. He thought something better would come along. It hasn't.
Today, the 33-year-old Dr. Kwan is a migrant medical worker, driving his 1989 Mazda across Northern California so he can perform brief, fill-in stints in anesthesia at 10 different hospitals. On Christmas Day, he put in 12 hours at a big Berkeley hospital. At other times, he has spent nights or weekends at rural hospitals. "I can't afford to be choosy," he says. "I'll take whatever is available."........

Credit: Staff Reporter of The Wall Street Journal

 

[RxBoy]

Numb and Number: Once a Hot Specialty, Anesthesiology Cools As Insurers Scale Back --- Health-Care Workers Find Fewer Jobs, Lower Pay In Era of Cost-Cutting --- Working Harder for $100,000

By George Anders, The Wall Street Journal
Mar 17, 1995


Copyright Dow Jones & Company Inc Mar 17, 1995
Patrick Kwan has as bright a resume as a young doctor could want, including four years of advanced training in anesthesiology. So when he entered the job market last spring, he expected to be showered with lucrative offers. What happened instead was a painful experience.
After six months of looking, Dr. Kwan got just one full-time offer, to join a group practice at $120,000 a year. He turned it down because the pay was less than half what other partners were making and because the job didn't make use of his subspecialty: anesthesia for cardiac surgery. He thought something better would come along. It hasn't.
Today, the 33-year-old Dr. Kwan is a migrant medical worker, driving his 1989 Mazda across Northern California so he can perform brief, fill-in stints in anesthesia at 10 different hospitals. On Christmas Day, he put in 12 hours at a big Berkeley hospital. At other times, he has spent nights or weekends at rural hospitals. "I can't afford to be choosy," he says. "I'll take whatever is available."........

Credit: Staff Reporter of The Wall Street Journal

Thanks for that article.

Never been so terrified of the phrase, "specialties are cyclic"

This also sheds some light why so many old timer medicine docs look down at me every time I say I'm going into anesthesia. The newer ones praise me.

 

[morpheus md]

Thanks for that article.

Never been so terrified of the phrase, "specialties are cyclic"

This also sheds some light why so many old timer medicine docs look down at me every time I say I'm going into anesthesia. The newer ones praise me.

The rest of that article would really curl your hair....more than any other single thing, this article was response for the crash in applicants to Anesthesia in the mid 1990's...a fear of extinction that never happened (yet?), many residencies closing their doors, a resultant shortage of anesthesiologists, and later a boom in salaries for anesthesiologists and CRNAs...

Numb and Number: Once a Hot Specialty, Anesthesiology Cools As Insurers Scale Back --- Health-Care Workers Find Fewer Jobs, Lower Pay In Era of Cost-Cutting --- Working Harder for $100,000

By George Anders, The Wall Street Journal
Mar 17, 1995





"....Market realities are finally starting to hit the health-care profession. Competition is restraining the rapid escalation of medical costs, a trend that economists generally applaud. This new austerity comes with a price, however: a slowdown in the once-booming medical labor market.
For most of the past decade, health care has provided some of the most bountiful, diverse job prospects in the entire economy. People with a high-school education or less have found thousands of clerical and maintenance jobs at hospitals. Those with more training have found jobs commanding $40,000 to $80,000 a year in such fields as nursing and pharmaceutical sales. Young doctors who picked the right specialties have been bombarded with chances to earn $200,000 or more.
Now, though, the job picture is dimming. Health-maintenance organizations and other cost-minded insurers are pressing doctors and hospitals to be more efficient. Medical prices for the past 12 months climbed just 4.9%, one of the lowest rates in 20 years. As medical providers scramble to cut costs and skip services they judge unnecessary, they are loath to add to their payrolls.
Labor Department data show the health sector created 388,000 jobs in the peak year of 1990, one-quarter of the U.S. economy's total growth in nonfarm employment. Last year, new health jobs totaled just 254,000, accounting for less than 10% of all new jobs.
Community hospitals provided a steady source of new jobs in the early 1990s, says Mark Pauly, a professor of health-care systems at the University of Pennsylvania's Wharton School. But "now patients aren't showing up to be admitted as often, and when they do come, they don't stay as long. Hospital employment in many places is dropping."
Bleak job prospects aren't gripping all areas of health care. Many treatments are being switched to cheaper settings, such as home care, where jobs are plentiful. And some regions, such as the Midwest and South, appear to be doing better than either the East or West coasts.
Nonetheless, major parts of the health-care work force are shrinking. Some 83,000 jobs for orderlies and nurses' aides disappeared last year. Jobs for physical therapists dropped 7.8%.
In the pharmaceutical industry, total U.S. employment fell 3.1% in the first six months of 1994, with nearly half of that decline in marketing. Bigger cuts are likely this year, because of consolidations brought on by drug-company mergers, says a spokesman for the Pharmaceutical Research & Manufacturers' Association.
Even in nursing -- a field that has long faced a worker shortage -- the outlook is changing. Most of the growth in nursing jobs last year was in outpatient care, which is more likely to offer part-time work and lower pay. Nursing schools say graduates are having a tougher time finding work in desired locations. "Getting a job depends on how willing people are to move to another area," says Janet Rogers, dean of the University of San Diego's school of nursing.
Some experts think more retrenchment is imminent. The New York consulting firm APM Inc. recently analyzed per-member outlays by some of the most aggressive HMOs and managed-care companies, to see what would happen if other health insurers adopted similar budgets.
APM's conclusions: spending cuts of 50% or greater could lie ahead for services in several medical fields, including psychiatry, radiology and plastic surgery. "We're talking about some very big numbers," says James Kagan, a managing director at APM. Other consultants say cutbacks will eliminate not just physicians' jobs, but also a wide range of technicians, office managers and aides.
A close look at anesthesiology provides a case study of how job prospects -- even in a high-paying specialty -- can rapidly sour.
For most of the past 15 years, anesthesiology has been a booming field, thanks to growing surgery volumes and insurers' willingness to reimburse most bills in full. The average anesthesiologist earned $131,900 in 1982, according to the American Medical Association. By 1992 that figure had jumped 73%, to $228,500.
Teaching hospitals scrambled to train enough young doctors in this popular specialty. Newly minted M.D.'s headed into two-year or three-year residency programs, picking up the skills they needed to become full-time anesthesiologists. By the end of 1993, the U.S. had 29,800 anesthesiologists, nearly double the total in 1980.
"I taught a lot of residents in the 1980s who were smirking at me and my minuscule academic salary," recalls Philip Boysen, chairman of the anesthesiology department at the University of North Carolina, Chapel Hill. "They were very goal-directed, and their goal was to get into private practice and make a lot of money."
In the past few years, however, market forces have put the squeeze on anesthesia, starting with a moderation in surgery volume. Widely quoted studies by Rand Corp., a Santa Monica, Calif., research group, have suggested that at least one-third of some common procedures -- such as hysterectomies, insertion of middle-ear tubes and angioplasties -- are either inappropriate or of uncertain benefit.
HMOs and other managed-care plans have responded by nudging down surgery and hospitalization rates for their members. One of the most efficient West Coast group practices, Mullikin Medical Centers, Long Beach, Calif., now incurs only about 170 hospital days a year for each 1,000 of its members under age 65. That is barely half the national average -- but many health plans around the country say they want to emulate Mullikin's lower hospital usage.
For anesthesiologists, lower-than-expected growth in surgery means less business. "We can't exactly hang out a shingle saying: `Anesthesia for Sale,'" observes Jonathan Roth, chairman of the anesthesiology department at Albert Einstein Medical Center in Philadelphia. "We're dependent on the volume of surgery in hospitals." When managed-care plans move into a market, other anesthesiologists contend, surgery frequencies can drop 20%.
Charges for anesthesia services, meanwhile, are tumbling in many areas. Some managed-care plans are pressing anesthesiologists for discounts of as much as 30% from quoted rates. Other health plans are offering only a flat stipend of, say, 75 cents per member per month, which is meant to cover all anesthesia needs. And the federal government's Medicare program for the elderly, which traditionally has been a big source of anesthesiologists' income, has lately grown much stingier.
Since last year, Medicare has slashed its payments to "care teams" of doctors and nurses who jointly provide anesthesia in surgery. Typically, one anesthesiologist can supervise several nurse anesthetists working simultaneously in two or three different rooms. Under the old rules, anesthesiologists with enough "care teams" in action could earn much more than their usual solo billing rates. But Medicare's new rules largely prevent that.
In addition, some hospitals are making much greater use of nurse anesthetists, who typically earn $80,000 a year, less than half their physician counterparts. That switch -- and its accompanying cost saving -- is becoming especially popular as more operations can be performed quickly in an outpatient setting, without the need for an overnight hospital stay.
A recent survey by Abt Associates, a Bethesda, Md., consulting firm, looked at four different ways that hospitals could mix doctors and nurses in anesthesia units. The study noted that for many procedures, nurses could be used in place of better-trained, better-paid doctors. In the most nurse-intensive scenario, Abt concluded, the U.S. already has twice as many doctors in anesthesia as it needs.
"Managed care has kicked our feet out from under us," says Fredrick Orkin, an anesthesiology professor at Dartmouth-Hitchcock Medical Center in Lebanon, N.H. "We've been producing new anesthesiologists at a rapid and accelerating rate. It had to reach the point where there no longer would be any jobs."
Michael Borello, a third-year Dartmouth resident in anesthesiology, says he will avoid the job market for another year by starting a one-year advanced fellowship this summer in pain management. He hopes the additional training in a subspecialty will help his prospects. "For residents who aren't going the fellowship route, things are very difficult."
The same glum tone surfaces at Boston University. "Technology made this a very attractive specialty, but now we've almost saturated the market," says Marcelle Willock, head of BU's anesthesiology department. One of her top trainees, Blaine Zaid, says: "I've contacted 20-some hospitals, and the basic message I'm getting is that there are almost no jobs available."
At the University of California, San Francisco, anesthesiology department chairman Ronald Miller once assumed his third-year residents could find jobs without his help. Not anymore. "I wrote 700 letters of recommendation this year," Dr. Miller says. That has helped many of his 22 residents land jobs, he says, but often at much lower pay than usual.
Dr. Kwan, who did his residency and an advanced fellowship at UCSF, says he earns about $100,000 a year, shuttling from one temporary job to another. Against that income, though, he must pay for malpractice insurance, as well as various fees to join the staffs of hospitals where he works.
"This whole experience has been very educational for me," Dr. Kwan says. "It's just a question of how much longer I can take it. I'm still living in the same apartment I had at UCSF. I'm still cooking meals for myself to save money."
Top officials at teaching hospitals are starting to shrink their anesthesiology teaching programs, so that the supply of new specialists will be more in line with reduced demand. But many hospitals aren't cutting fast enough, says Dartmouth's Dr. Orkin, in part because residents represent a cheap source of labor.
The biggest corrective measures may come from medical students themselves. With loans that sometimes top $100,000, medical students go to great lengths to gather information about what specialties offer the most lucrative and dependable careers. Anesthesia currently is regarded as a very bad choice.
Many teaching hospitals say that U.S. students' applications for anesthesiology residencies are down 30% to 50% this year. Foreign medical graduates may pick up some of the slack. Even so, many training slots in anesthesia are likely to go empty next year, for lack of applicants.
Even some residents who are part-way through anesthesiology training are dropping out -- and starting over in other fields. At University of North Carolina, for example, four anesthesia residents quit this past autumn, preferring to begin a new training track in family practice or emergency medicine. "They gave up on the field," says UNC's Dr. Boysen. "They believed that it was too much work for not enough payoff."

Credit: Staff Reporter of The Wall Street Journal

 

[seamonkey]

That article is amazing. You could just change a few dates and it starts to look like what some people around here are predicting.