2018 Charting Outcomes of the Match released

[Elessar]

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http://www.nrmp.org/wp-content/uploads/2018/06/Charting-Outcomes-in-the-Match-2018-Seniors.pdf

Thoughts?

 

[Scrubs101]

Wow those research #s are growing faster than average step 1 scores for the competitive specialties.

Also what does a “research experience” encompass, I’ve always been confused about that. Is that just working with different PIs or projects?

 

[hallowmann]

Links to all the new stuff:

Charting Outcomes in the Match for US Allopathic Seniors
http://www.nrmp.org/wp-content/uploads/2018/06/Charting-Outcomes-in-the-Match-2018-Seniors.pdf

Charting Outcomes in the Match for US Osteopathic Seniors
http://www.nrmp.org/wp-content/uploads/2018/06/Charting-Outcomes-in-the-Match-2018-Osteo.pdf

Charting Outcomes in the Match for IMGs
http://www.nrmp.org/wp-content/uploads/2018/07/NRMP-2018-Program-Director-Survey-for-WWW.pdf

2018 NRMP Program Director Survey
http://www.nrmp.org/wp-content/uploads/2018/06/NRMP-2018-Program-Director-Survey-for-WWW.pdf

Wow those research #s are growing faster than average step 1 scores for the competitive specialties.

Also what does a “research experience” encompass, I’ve always been confused about that. Is that just working with different PIs or projects?

Its a field on the ERAS, so there's some flexibility with how it is interpreted by applicants. Generally, its delineated by projects as you mentioned.

 

[Dr. Doctor MD]

This is the weirdest data I've ever seen:

The competitive specialties had very high match rates this year across the board (86% Plastics WOW) and many non competitive specialties dropped quite a lot (OBGYN/GenSurg/Psych)

Psychiatry had a lower match rate than plastic surgery and neurosurgery

General Surgery had a lower match rate than plastic surgery and neurosurgery

Family Medicine had a lower match rate than ENT


I wonder if this is a true change in the numbers or rather different/more criteria in how they include/exclude applicants.

 

[zero0]

Idk what's going on but for the first time in years I'm looking at the charting outcomes and not really seeing a clear correlation between Step1 and match success. It seems like roughly the same proportion of matched/unmatched is in every bracket.

Also, check out anesthesiology. Basically everyone who wanted it got a spot. Even 2/3 of the people who could barely pass boards. EM wasn't too far off either. Makes me wonder why I even bother...

 

[W19]

Well, EM is not getting more competitive. The people who did not match IR have somewhat the same stats with the ones who did... Psych is no longer an IMG specialty. What's happening with gas?

You need a pulse to match into path if you are a US student... No changes in FM/IM. Almost all US students still have a shot at them...

 

[W19]

Wow those research #s are growing faster than average step 1 scores for the competitive specialties.

Also what does a “research experience” encompass, I’ve always been confused about that. Is that just working with different PIs or projects?

These are inflated in my opinion. I worked with a PI during summer b/t MS1---MS2 on a clinical trial, but I did not do anything other than taking VS, drawing bloods and calling patients to remind them about their appointments etc... and I listed it as research experience... A lot of resume padding is happening when it comes to the match...

 

[qrscomplex41]

Is the # of volunteer experiences really that high for many specialties??? Does that include stuff from undergrad? My school has a service requirement, so I have a ton of service hours but these were from 2 long-term "experiences." The number of experiences makes me look below average when I'm probably above average in terms of actual time commitment. 😡🙁

 

[AnatomyGrey12]

Is the # of volunteer experiences really that high for many specialties??? Does that include stuff from undergrad? My school has a service requirement, so I have a ton of service hours but these were from 2 long-term "experiences." The number of experiences makes me look below average when I'm probably above average in terms of actual time commitment. 😡🙁

Your volunteer numbers won’t be what keeps you from a spot in any specialty.

 

[zero0]

Well, EM is not getting more competitive. The people who did not match IR have somewhat the same stats with the ones who did... Psych is no longer an IMG specialty. What's happening with gas?

You need a pulse to match into path if you are a US student... No changes in FM/IM. Almost all US students still have a shot at them...

Idk I guess gas just has too broad of a range in terms of program competitiveness, and plenty of spots to go around, kind of like IM. Then of course there's the fear-mongering...

 

[Taddy Mason]

The psych data is interesting...I hope the “psych is becoming more competitive” naysayers will finally submit to reality. The change in percent matching by rank preference is also interesting, despite the people matching their #1 not really moving.

Is the # of volunteer experiences really that high for many specialties??? Does that include stuff from undergrad? My school has a service requirement, so I have a ton of service hours but these were from 2 long-term "experiences." The number of experiences makes me look below average when I'm probably above average in terms of actual time commitment. 😡🙁

These numbers are definitely inflated - partially because of people padding resumes and partially because of how things are entered on ERAS.

 

[CECC110]

Is

Idk I guess gas just has too broad of a range in terms of program competitiveness, and plenty of spots to go around, kind of like IM. Then of course there's the fear-mongering...

Original quote implying that its gotten easier? The avg step scores seem similar to previous though..

 

[Psai]

Where are all the ucsf anesthesiology fanboys to tell us that they didn't fill because they were saving spots for the good leftovers in soap

 

[MSTPlease]

Idk what's going on but for the first time in years I'm looking at the charting outcomes and not really seeing a clear correlation between Step1 and match success. It seems like roughly the same proportion of matched/unmatched is in every bracket.

Also, check out anesthesiology. Basically everyone who wanted it got a spot. Even 2/3 of the people who could barely pass boards. EM wasn't too far off either. Makes me wonder why I even bother...

Looking at chart 6 there seems to be a pretty clear correlation

 

[bobjonesbob]

This is the weirdest data I've ever seen:

The competitive specialties had very high match rates this year across the board (86% Plastics WOW) and many non competitive specialties dropped quite a lot (OBGYN/GenSurg/Psych)

Psychiatry had a lower match rate than plastic surgery and neurosurgery

General Surgery had a lower match rate than plastic surgery and neurosurgery

Family Medicine had a lower match rate than ENT


I wonder if this is a true change in the numbers or rather different/more criteria in how they include/exclude applicants.

This is mainly due to self selection and cyclical interest in fields than anything else. People think gen surg and psychiatry aren't that hard to match into so loads of people apply with 210 Step 1 etc. whereas these types of people essentially never apply to plastics and neurosurgery unless they have a phd and / or connections with a program.

 

[Dr. Scribe]

Does the charting outcome for DO students refer to ACGME or AOA residencies?

 

[akinetopsia]

Does the charting outcome for DO students refer to ACGME or AOA residencies?

ACGME. This is the first year there's been a separate Charting Outcomes specific for DO grads, as previously DO grads were lumped in with IMGs, FMGs, "Fifth Pathway" (never really understood that one), etc.

 

[tymont12]

This is mainly due to self selection and cyclical interest in fields than anything else. People think gen surg and psychiatry aren't that hard to match into so loads of people apply with 210 Step 1 etc. whereas these types of people essentially never apply to plastics and neurosurgery unless they have a phd and / or connections with a program.

Yeah, even though Psych's match rate (84.0%) is lower than plastics (85.7%), the applicant pools are completely different. If you look at the 'spread' of people who matched based on their stats, psych is so much more broad than plastics. It seems like the selection process in psych is much more about who the person is as an applicant, rather than the hard number cutoffs of the surgical subs.

 

[AnatomyGrey12]

Does the charting outcome for DO students refer to ACGME or AOA residencies?

Those are all ACGME. There is no report like this for the AOA programs.

 

[zero0]

Looking at chart 6 there seems to be a pretty clear correlation

I'm not so sure. That chart seems to have excluded outliers for some reason.

Using anesthesiology as an example, the unmatched person from the 231-240 bracket wasn't included in the unmatched range on chart 6 at all. I'm willing to bet at least a few of the people from the 221-230 bracket weren't included as well.

Makes me think there's a lot more overlap between matched and unmatched board scores than chart 6 leads us to believe. That might not matter in specialties with high numbers of unmatched, but in anesthesiology where only a few went unmatched (38 out of 1050), excluding even a few outliers seems to be misrepresenting the data.

 

[Taddy Mason]

Yeah, even though Psych's match rate (84.0%) is lower than plastics (85.7%), the applicant pools are completely different. If you look at the 'spread' of people who matched based on their stats, psych is so much more broad than plastics. It seems like the selection process in psych is much more about who the person is as an applicant, rather than the hard number cutoffs of the surgical subs.

Though it is interesting that psych’s match % dropped 5-6% since the last Charting the Outcomes but Step scores were relatively stagnant. Psych also had a larger increase in people applying from top 40 schools, and decreases in those who matched percentage-wise from DO/Carib/foreign schools despite increasing numbers of applicants and matches from those programs. The number of unmatched US MDs also doubled, despite positions offered per applicants remaining the same.

 

[operaman]

One huge caveat to keep in mind:

This is published by the NRMP and only contains their data. This does not pull in ERAS data; it relies on what people self report when submitting their rank list.

Anyone who did not get any interviews in a field and did not rank any programs would not be captured in this report, though arguably that’s a small minority since most people at least rank their home program. For the surgical subs though, people with low scores and no interviews are not captured in the percentages.

 

[Elessar]

I'm not so sure. That chart seems to have excluded outliers for some reason.

Using anesthesiology as an example, the unmatched person from the 231-240 bracket wasn't included in the unmatched range on chart 6 at all. I'm willing to bet at least a few of the people from the 221-230 bracket weren't included as well.

Makes me think there's a lot more overlap between matched and unmatched board scores than chart 6 leads us to believe. That might not matter in specialties with high numbers of unmatched, but in anesthesiology where only a few went unmatched (38 out of 1050), excluding even a few outliers seems to be misrepresenting the data.

The brackets mark the IQR (25th percentile to 75th percentile). Remember “box and whisker plots”?? Showing the entire range from min to max would be statistically useless...

 

[mymembernames]

So it seems like all this hype that EM is more competitive is BS?

 

[Wolf3D]

So it seems like all this hype that EM is more competitive is BS?

With the proliferation of EM programs, both academic and community (but particularly the latter), it's going the way of IM and gas. Competitive on the national level? No. Competitive to get into programs with a track record of success in desirable areas? Yes. Getting into any ol' EM program in middle America isn't hard. Doing the reputable programs like Cincy, Carolinas, Highland, Denver? You bet there's a fair amount of competition for those.

 

[MSTPlease]

I'm not so sure. That chart seems to have excluded outliers for some reason.

Using anesthesiology as an example, the unmatched person from the 231-240 bracket wasn't included in the unmatched range on chart 6 at all. I'm willing to bet at least a few of the people from the 221-230 bracket weren't included as well.

Makes me think there's a lot more overlap between matched and unmatched board scores than chart 6 leads us to believe. That might not matter in specialties with high numbers of unmatched, but in anesthesiology where only a few went unmatched (38 out of 1050), excluding even a few outliers seems to be misrepresenting the data.

As already stated, box and whisker plots frequently exclude outliers (because they are exactly that - outliers) and are not "misrepresenting the data" if it's stated that they are only showing 25th, 50th, and 75th percentiles (as is the case for chart 6). An overlap between groups does not negate a statistically significant correlation. Yes, in smaller groups, you need a larger difference but when 75th percentile of the unmatched gas applicants have a step 1 score lower than the 25th percentile of matched applicants, the correlation between step score and matching is probably significant given the size of the groups. If you want to see every person included, go to Chart AN-3 and Graph AN-2. It's hard to see in chart AN-3 because the unmatched numbers are so small but the distribution is clearly shifted significantly to the left compared to the matched group. When you have those small numbers, the fact that you have 8 in the 231-240 group and only 5 in the 221-230 group doesn't weaken the argument that there's a correlation (especially when you're talking about 8/222 aka 3.6% and 5/135 aka 3.7% so the trend of decreasing match rate is still there). In graph AN-2 you can see a clear trend of increasing percentage of matches with increasing step 1 score.

 

[hallowmann]

ACGME. This is the first year there's been a separate Charting Outcomes specific for DO grads, as previously DO grads were lumped in with IMGs, FMGs, "Fifth Pathway" (never really understood that one), etc.

Its actually the second time. They did it in 2016 too.

Those are all ACGME. There is no report like this for the AOA programs.

Yeah, unfortunately there hasn't been one since 2012. I thought they would do one in 2014 or 2015, but it never happened, and now with the merger it almost seems pointless.

Though it is interesting that psych’s match % dropped 5-6% since the last Charting the Outcomes but Step scores were relatively stagnant. Psych also had a larger increase in people applying from top 40 schools, and decreases in those who matched percentage-wise from DO/Carib/foreign schools despite increasing numbers of applicants and matches from those programs. The number of unmatched US MDs also doubled, despite positions offered per applicants remaining the same.

In general, more US MDs, including more competitive ones, are applying Psych most likely because of interest, demand and lifestyle.

 

[libertyyne]

Its actually the second time. They did it in 2016 too.



Yeah, unfortunately there hasn't been one since 2012. I thought they would do one in 2014 or 2015, but it never happened, and now with the merger it almost seems pointless.



In general, more US MDs, including more competitive ones, are applying Psych most likely because of interest, demand and lifestyle.

if more competitive ones were applying wouldnt the step 1 medians /means increase?

 

[hallowmann]

if more competitive ones were applying wouldnt the step 1 medians /means increase?

I guess it depends on what you mean by "more competitive ones". In psychiatry there is a lot more that makes someone competitive than just Step 1 score.

I mean sure, if you're looking at only Step 1 scores, you could argue that the difference of some more competitive US MD applicants isn't large enough to shift the entire mean of 1000 applicants on a score, but...

now that you say that, maybe we should look at the averages on the Charting Outcomes for Psychiatry:

US MD seniors matched and unmatched in Psychiatry Step 1 means
2018: 226 and 215
2016: 224 and 214
2014: 220 and 205
2011: 214 and 198

Seems like a pretty clear and quick trend up to me.

 

[libertyyne]

I guess it depends on what you mean by "more competitive ones". In psychiatry there is a lot more that makes someone competitive than just Step 1 score.

I mean sure, if you're looking at only Step 1 scores, you could argue that the difference of some more competitive US MD applicants isn't large enough to shift the entire mean of 1000 applicants on a score, but...

now that you say that, maybe we should look at the averages on the Charting Outcomes for Psychiatry:

US MD seniors matched and unmatched Psychiatry Step 1 means
2018: 226 and 215
2016: 224 and 214
2014: 220 and 205
2011: 214 and 198

Seems like a pretty clear and quick trend up to me.

When the mean match score for psychiatry is below the mean unmatched score of all US seniors , are you seriously going to say it is competitive?

Do you also consider child neurology , , peds, pm&r and pathology to be competitive because they have higher means compared to psych.

 

[hallowmann]

When the mean match score for psychiatry is below the mean unmatched score of all US seniors , are you seriously going to say it is competitive?

Let's recap:

I said "more US MDs, including more competitive ones, are applying Psych", you then replied "if more competitive ones were applying wouldnt the step 1 medians /means increase?" To that I showed data that means for US MDs applying/matching Psychiatry have actually been increasing, to which you replied "When the mean match score for psychiatry is below the mean unmatched score of all US seniors , are you seriously going to say it is competitive?", which is funny because I never said "it is competitive," (that's just a straw man you chose). Again, what I said was "more US MDs, including more competitive ones, are applying Psych," which I think I've demonstrated is absolutely true.

Its OK. You can just say, "oh, wow, you're right, I didn't realize that." No one will think less of you.

EDIT: Actually you know what, I took your post for granted. Looking past the straw man, you are actually also just wrong in terms of data here. The US MD unmatched mean Step 1 score is 224, while the US MD matched in Psychiatry mean Step 1 score is 226, and from what I hear 226 is actually greater than 224.

 

[libertyyne]

Let's recap:

I said "more US MDs, including more competitive ones, are applying Psych", you then replied "if more competitive ones were applying wouldnt the step 1 medians /means increase?" To that I showed data that means for US MDs applying/matching Psychiatry have actually been increasing, to which you replied "When the mean match score for psychiatry is below the mean unmatched score of all US seniors , are you seriously going to say it is competitive?", which is funny because I never said "it is competitive," (that's just a straw man you chose). Again, what I said was "more US MDs, including more competitive ones, are applying Psych," which I think I've demonstrated is absolutely true.

Its OK. You can just say, "oh, wow, you're right, I didn't realize that." No one will think less of you.

You are comparing multi year means. The average step score is also increasing. You know, could just be background noise.

 

[hallowmann]

You are comparing multi year means. The average step score is also increasing. You know, could just be background noise.

Yeah, except its going up faster than the rate of mean increase for Step 1. To give you an idea, again per Charting Outcomes, US MD mean matched Step 1 score was 226 in 2011 and is 233 in 2018 (increase of 7), and in that same time the means for US MDs matching Psychiatry has increased by 12, which is a change that is 70% greater than the change in US MD Step 1 averages.

Also, let's not forget that using Step 1 means increasing over time for matching in Psychiatry was the metric you suggested for measuring competitiveness, not mine.

Again, seriously, its OK to just say you didn't know that data and are wrong on this one. You're going to learn to be wrong quite often in your medical career, especially during residency. Its not a character flaw to be wrong/make a mistake, its actually just being human.

 

[libertyyne]

Yeah, except its going up faster than the rate of mean increase for Step 1. To give you an idea, again per Charting Outcomes, US MD mean matched Step 1 score was 226 in 2011 and is 233 in 2018 (increase of 7), and in that same time the means for US MDs matching Psychiatry has increased by 12, which is a change that is 70% greater than the change in US MD Step 1 averages.

Also, let's not forget that using Step 1 means increasing over time for matching in Psychiatry was the metric you suggested for measuring competitiveness, not mine.

Again, seriously, its OK to just say you didn't know that data and are wrong on this one. You're going to learn to be wrong quite often in your medical career, especially during residency. Its not a character flaw to be wrong/make a mistake, its actually just being human.

thanks for pointing out my character flaws, I am still not convinced that your statement " more competitive" students are going into psych. a one point increase over two years. Isnt it convienent that you would choose that time frame compared to just comparing it to last charting outcomes? Its ok for you to admit that you were wrong too, you know.

 

[hallowmann]

thanks for pointing out my character flaws, I am still not convinced that your statement " more competitive" students are going into psych. a one point increase over two years. Isnt it convienent that you would choose that time frame compared to just comparing it to last charting outcomes? Its ok for you to admit that you were wrong too, you know.

Actually if you reread my post, I was saying being wrong is not a character flaw, its the human condition. Again, you will be (as I have been and as every doctor out there was) wrong many times in residency, its OK to admit it, its not a measure of who you are as a person. That's pretty much saying the opposite, but take it however you want.

Also, what exactly are we arguing about? Are you upset I used 2011 compared to 2018? I used it because 1-2 yrs is generally not as useful for measuring trends on annual data, actual ranges are more helpful.

But you know what, lets play your game. I mean all the data is publicly available, so you could always look into this yourself, but I might as well make it easy.

US MD mean Step 1 matched Total / matched Psychiatry
2018: 233 / 226 (increase of 0 vs 2)
2016: 233 / 224 (increase of 3 vs 4)
2014: 230 / 220 (increase of 4 vs 6)
2011: 226 / 214

Again, every data point demonstrates a faster rate of increase among US MDs matching Psychiatry than among US MDs matching overall.

Also, to be clear, when the data I present is contradicted, I will gladly admit my being wrong. In this one rare case, I am not wrong. Or maybe I am, I just haven't seen something to demonstrate it yet.

 

[Taddy Mason]

thanks for pointing out my character flaws, I am still not convinced that your statement " more competitive" students are going into psych. a one point increase over two years. Isnt it convienent that you would choose that time frame compared to just comparing it to last charting outcomes? Its ok for you to admit that you were wrong too, you know.

I think this argument stemmed somewhat from @hallowmann ’s response to my post where I noted that it was interesting that while the number of US MD applicants per spots stayed relatively the same for psych the number of unmatched US MDs doubled, with the percentage of DOs and IMGs staying the same or decreasing despite the total of number of applicants from those schools increasing. Step scores for psych have increased fairly rapidly over the past seven years, albeit the increase in the past 2 years wasn’t that great. Psych also had probably the largest increase in applicants from top 40 schools. So, yes psych is becoming more competitive (likely due to factors not well captured by Charting the Outcomes), but using Step 1 as a primary metric to gauge the competitiveness of psych is rather misleading. Somewhat similar effect as to the self-selection bias you see with surg subspecialties with higher match percentages than other fields.

 

[hallowmann]

I think this argument stemmed somewhat from @hallowmann ’s response to my post where I noted that it was interesting that while the number of US MD applicants per spots stayed relatively the same for psych the number of unmatched US MDs doubled, with the percentage of DOs and IMGs staying the same or decreasing despite the total of number of applicants from those schools increasing. Step scores for psych have increased fairly rapidly over the past seven years, albeit the increase in the past 2 years wasn’t that great. Psych also had probably the largest increase in applicants from top 40 schools. So, yes psych is becoming more competitive (likely do to factors not well captured by Charting the Outcomes), but using Step 1 as a primary metric to gauge the competitiveness of psych is rather misleading. Somewhat similar effect as to the self-selection bias you see with surg subspecialties with higher match percentages than other fields.

Thank you. I'm sorry, I think I got a little sidetracked/into the weeds on this. What you described is absolutely my point, and you said it far more effectively and efficiently than I did.

 

[Taddy Mason]

Thank you. I'm sorry, I think I got a little sidetracked/into the weeds on this. What you described is absolutely my point, and you said it far more effectively and efficiently than I did.

Haha - I’ve been guilty of that plenty of times on here. I think a big thing to take away from all of this though is that, while yes Step 1 is important, there are a lot of other factors at play, many of which are not well captured by Charting the Outcomes for ALL specialties; thus Step 1 really should not be used as the be all end all metric to gauge competitiveness.

 

[libertyyne]

Actually if you reread my post, I was saying being wrong is not a character flaw, its the human condition. Again, you will be (as I have been and as every doctor out there was) wrong many times in residency, its OK to admit it, its not a measure of who you are as a person. That's pretty much saying the opposite, but take it however you want.

Also, what exactly are we arguing about? Are you upset I used 2011 compared to 2018? I used it because 1-2 yrs is generally not as useful for measuring trends on annual data, actual ranges are more helpful.

But you know what, lets play your game. I mean all the data is publicly available, so you could always look into this yourself, but I might as well make it easy.

US MD mean Step 1 matched Total / matched Psychiatry
2018: 233 / 226 (increase of 0 vs 2)
2016: 233 / 224 (increase of 3 vs 4)
2014: 230 / 220 (increase of 4 vs 6)
2011: 226 / 214

Again, every data point demonstrates a faster rate of increase among US MDs matching Psychiatry than among US MDs matching overall. I really think we're done here.

Interesting you didnt include 2009 data since it probably didnt help prove your point.
2009: 225/216.

There was a large increase in 2007, but I dont have the national mean for that time.

This graph shows the point I am trying to make. There isnt a 2018 chart yet, but I wouldnt hold my breath for it showing anything more drastic.

Psych remains a specialty with lower STEP scores compared to the mean, so if the average joe starts applying to pysch with average scores that means their step rises. Thats the point. If you define more competitive as the mean score then yes. But i dont think many people would define more competitive applicants as that.

I think this argument stemmed somewhat from @hallowmann ’s response to my post where I noted that it was interesting that while the number of US MD applicants per spots stayed relatively the same for psych the number of unmatched US MDs doubled, with the percentage of DOs and IMGs staying the same or decreasing despite the total of number of applicants from those schools increasing. Step scores for psych have increased fairly rapidly over the past seven years, albeit the increase in the past 2 years wasn’t that great. Psych also had probably the largest increase in applicants from top 40 schools. So, yes psych is becoming more competitive (likely do to factors not well captured by Charting the Outcomes), but using Step 1 as a primary metric to gauge the competitiveness of psych is rather misleading. Somewhat similar effect as to the self-selection bias you see with surg subspecialties with higher match percentages than other fields.

I do not know what the reason for the higher rate of unmatched US seniors was. My theory is that a lot of them got caught with their pants around their ankles when they did not interview and rank broadly. I would disagree with the premise that step score does not capture an aspect of competitiveness. I also think in fields where step truely doesnt matter there very small difference between matched an unmatched means like child neurology or vascular surgery. I guess if your argument regarding a rapid increase in pysch's competititveness wouldnt we see a gradual increase in unmatched US seniors compared to an large number in last match without a corresponding step increase.

 

[Taddy Mason]

Interesting you didnt include 2009 data since it probably didnt help prove your point.
2009: 225/216.

There was a large increase in 2007, but I dont have the national mean for that time.

This graph shows the point I am trying to make. There isnt a 2018 chart yet, but I wouldnt hold my breath for it showing anything more drastic.

Psych remains a specialty with lower STEP scores compared to the mean, so if the average joe starts applying to pysch with average scores that means their step rises. Thats the point. If you define more competitive as the mean score then yes. But i dont think many people would define more competitive applicants as that.

View attachment 236656

I do not know what the reason for the higher rate of unmatched US seniors was. My theory is that a lot of them got caught with their pants around their ankles when they did not interview and rank broadly. I would disagree with the premise that step score does not capture an aspect of competitiveness.

As someone who recently went through the interview process (specifically for psych) I would strongly disagree.

Edit - Never have I said that Step 1 score isn’t at least some metric of competitiveness. The degree to its usefulness amongst other factors in regards to derermining “competitiveness” varies per specialty. Which is why lumping specialties together as “uncompetitive” via Step 1 scores is misleading.

 

[hallowmann]

Interesting you didnt include 2009 data since it probably didnt help prove your point.
2009: 225/216.

There was a large increase in 2007, but I dont have the national mean for that time.

This graph shows the point I am trying to make. There isnt a 2018 chart yet, but I wouldnt hold my breath for it showing anything more drastic.

Psych remains a specialty with lower STEP scores compared to the mean, so if the average joe starts applying to pysch with average scores that means their step rises. Thats the point. If you define more competitive as the mean score then yes. But i dont think many people would define more competitive applicants as that.

View attachment 236656

I do not know what the reason for the higher rate of unmatched US seniors was. My theory is that a lot of them got caught with their pants around their ankles when they did not interview and rank broadly. I would disagree with the premise that step score does not capture an aspect of competitiveness.

Actually, I didn't even bother checking 2009 and didn't know the numbers until you posted it. I started at 2011, because that was what I looked at for this post. I thinks its funny that in the face of a 7 yr trend, you look back before it and say, "see its not a 9-yr trend". You're absolutely right, specifically for the time between 2009 and 2011 psychiatry mean matched Step 1 scores did go down by 2 and the mean matched overall scores went up by one. You win.

Like I said before, the data speaks for itself. You can try and change the argument/discussion from post to post as much as you want. I never said that throughout all of time and history, psychiatry has always been increasing in competitiveness, simply that it is doing so currently. Nor did I say that psychiatry is "competitive" (whatever the hell that means), but simply that the US MD applicants applying to it are "more competitive" than they were before.

Also, again, you were the one that defined "more competitive" as "step 1 medians / means" increasing. Again, the data speaks for itself.

 

[libertyyne]

Actually, I didn't even bother checking 2009 and didn't know the numbers until you posted it. I started at 2011, because that was what I looked at for this post. I thinks its funny that in the face of a 7 yr trend, you look back before it and say, "see its not a 9-yr trend". You're absolutely right, specifically for the time between 2009 and 2011 psychiatry mean matched Step 1 scores did go down by 2 and the mean matched overall scores went up by one. You win.

Like I said before, the data speaks for itself. You can try and change the argument/discussion from post to post as much as you want. I never said that throughout all of time and history, psychiatry has always been increasing in competitiveness, simply that it is doing so currently.

you can win! I dont care. You dont have to take it personally. I just wanted to get some analysis on what happened in psych.

I was just saying compared to last charting outcomes, not 7 years or 9 years or long term trends, the score went up but not by the amount of unmatched seniors. If the immediate trend you are stating were true , the number of unmatched seniors would be going up directly related to the increase in step score compared to the national average increases. However it seems like scores didnt increase by much yet number of unmatched seniors went up drastically. Now people ususally say " other selection factors" at this point. But that doesnt make sense considering fields that truely do that dont have large discrepancies between matched and unmatched step scores.

Edit to address your edit: "More competitive" in my mind would mean compared to the average medical student. If you truely think that more competitive means average person applying to below average step 1 field , then sure you can interpret it as an increase, i dont think many other people would do so. If the number/proportion of applicants to psych in the 230-270 range jumped i would agree with you .

I am unsure on how to interpret the folllowing chart.

 

[hallowmann]

you can win! I dont care. You dont have to take it personally. I just wanted to get some analysis on what happened in psych.

I was just saying compared to last charting outcomes the score went up but not by the amount of unmatched seniors. If the trend you are stating were true , the number of unmatched seniors would be going up directly related to the increase in step score compared to the national average increases. However it seems like scores didnt increase by much yet number of unmatched seniors went up drastically. Now people ususally say " other selection factors" at this point. But that doesnt make sense considering fields that truely do that dont have large discrepancies between matched and unmatched step scores.

I am unsure on how to interpret the folllowing chart.
View attachment 236657

Nothing taken personally. No, at this point I feel that I certainly haven't won given the amount of time I spent discussing a topic I have very little invested in.

Also, if you are actually curious, there's a thread in Psych discussing it right now. New Charting Outcomes Shows Increased Psychiatry Competitiveness. That should be more useful given that PDs and attendings are on that forum and can give insight as well. Also, I would point to this post that points out data you haven't mentioned.

 

[Taddy Mason]

I do not know what the reason for the higher rate of unmatched US seniors was. My theory is that a lot of them got caught with their pants around their ankles when they did not interview and rank broadly. I would disagree with the premise that step score does not capture an aspect of competitiveness. I also think in fields where step truely doesnt matter there very small difference between matched an unmatched means like child neurology or vascular surgery. I guess if your argument regarding a rapid increase in pysch's competititveness wouldnt we see a gradual increase in unmatched US seniors compared to an large number in last match without a corresponding step increase.

That twice as many “got caught with their pants around their ankles” while possible, is a bit absurd/on the extreme end of possibilities. All I’m getting at is that that data trends for psych are rather interesting, particularly in light of the minimal change in Step scores, despite the more “drastic” (relative to) changes in other data points. Beings we don’t have access to their data set and the metrics which aren’t captured (and honestly would be harder to objectively capture) it’s merely conjecture. But based on this data along with my own personal experience and the anecdotal experiences of classmates, friends from other schools, people encountered on the interview trail, and people on SDN and Reddit I would say psych is becoming more competitive, but using Step as a primary metric of competitiveness has its limitations in regards to reliability. Also, not trying to pull rank, as I have 3 more days until I actually start my first shift as an intern, but when you go through the application/interview/match process you’ll better appreciate how messy interpretating some of these metrics can become.

 

[Taddy Mason]

@libertyyne your fall back is that Step 1 is the ultimate metric. We’re providing things found in Charting the Outcomes and from personal experience that suggest otherwise. Yes, Step 1 is important, but it’s importance as to what constitutes “competitive” varies by specialty. Again, at risk of sounding like a broken record, it’s not the be all end all. Again, I think you’ll appreciate this more once you go through the residency application and interview process.

 

[libertyyne]

@libertyyne your fall back is that Step 1 is the ultimate metric. We’re providing things found in Charting the Outcomes and from personal experience that suggest otherwise. Yes, Step 1 is important, but it’s importance as to what constitutes “competitive” varies by specialty. Again, at risk of sounding like a broken record, it’s not the be all end all. Again, I think you’ll appreciate this more once you go through the residency application and interview process.

i dont disagree with you that step 1 is only one aspect of competitiveness. I am mortified of the process of getting a residency myself even if it is in something like FM. The point is that usually , specialties that are desirable or "competitive" compared to the mean tend to have their step scores reflect that. I dont know why so many psych hopefuls failed to match, but a majority of those not matching had step scores below 220 with 60 or so being below 210. If psych didnt care about that number the ratio of matched to unmatched wouldnt vary with step score and you would expect a flat percent of people being unmatched across all categories of passing scores. My hypothesis that people didnt apply broadly enough considering the contiguous rank numbers are lower for psych compared to similarly fields in terms of step medians like family medicine, child psych. Is it that psych doesnt offer as many interviews? Is it that psych applicants go to fewer interviews compared to their peers in other similar competitive fields? There were also more soap positions available compared to the previous two years. To me all of this says mismatch of personal competitiveness and programs that people applied to. I am open to being proven wrong. Let me ask you a question , what do you think people were making match decisions on?

 

[libertyyne]

Another interesting data point is IMGs and FMGs

They matched with lower Step scores compared to US counterparts. This could be interpreted along the same lines that US grads were applying to programs in desirable locations without an idea about their own competitiveness especially grads with <220. Or IMGS and FMGs have some holistic quality to them that psych programs perfer which seems kinda outlandish.

 

[Taddy Mason]

i dont disagree with you that step 1 is only one aspect of competitiveness. I am mortified of the process of getting a residency myself even if it is in something like FM. The point is that usually , specialties that are desirable or "competitive" compared to the mean tend to have their step scores reflect that. I dont know why so many psych hopefuls failed to match, but a majority of those not matching had step scores below 220 with 60 or so being below 210. If psych didnt care about that number the ratio of matched to unmatched wouldnt vary with step score and you would expect a flat percent of people being unmatched across all categories of passing scores. My hypothesis that people didnt apply broadly enough considering the contiguous rank numbers are lower for psych compared to similarly fields in terms of step medians like family medicine, child psych. Is it that psych doesnt offer as many interviews? Is it that psych applicants go to fewer interviews compared to their peers in other similar competitive fields? There were also more soap positions available compared to the previous two years. To me all of this says mismatch of personal competitiveness and programs that people applied to. I am open to being proven wrong. Let me ask you a question , what do you think people were making match decisions on?

Half of those SOAP positions came from a new program that didn’t participate in the match, but participated in SOAP. Take that into account and there’s relatively little change in the positions available in SOAP. Again, you’re putting all the weight on Step 1 (e.g., lumping different specialties together as being “equally” competitive solely by Step 1 - which is misleading and basically comparing apples to oranges). That’s why I keep bringing up the other trends in psych specific data that stand out relative to other specialties. You’re missing the forest for the trees (or a tree...).

Edit - Also, I don’t get why you keep bringing up the number of ranks. Average across all specialties for matched applicants was 12.3 and average for psych was 10, while the averages for unmatched were 5.3 overall and 5.8 for psych (also, these numbers are basically unchanged compared to the 2016 data). One, that’s really not a big difference, and doesn’t support your argument that the number of unmatched US MDs doubled for psych because they didn’t rank enough programs. Two, 9-11 ranks is usually considered adequate for psych and the 2018 (and 2016) data support this. Going off number of ranks as the only metric suggests a > 90% chance of matching for psych.

 

[Cognovi]

I am unsure on how to interpret the folllowing chart.
View attachment 236657

Students who match rank more programs than students who did not match, in every specialty. Ranking more programs may increase your chance of matching. Being able to rank more programs is a marker of competitiveness--strong applicants will obtain more interview invitations and have more programs to rank. It is not advisable to NOT rank programs that you could rank. You should rank all programs for which you are eligible and willing to attend. Applications in some specialties rank more programs than in other specialties.

 

[shortcoatdream15]

I think it’s pretty clear that more people are becoming interested in psych, so the field is getting more competitive, however, step scores for psych aren’t rising proportionately because psych residencies simply don’t care about step as much as other specialties. It’s pretty well established on this forum that psych programs care about demonstrated commitment/interest in psych as much as [if not more than] step scores.

The reason why so many psych hopefuls failed to match is because they didn’t show demonstrated commitment and interest to the field. It’s that simple