2018 Psychiatry Match Competition

[TexasPhysician]

To help calm the nerves of future applicants, I’ve found some numbers pulled from a program director. I’m rounding for simplicity.

The number of US MD seniors entering Psychiatry increased by about 60 from 2017. Less than 1000 US MD applicants matched into the roughly 1550 spots. That means that DO’s, IMG’s, and re-applicants are still > 1/3 of accepted applicants.

The average US MD is applying to 44 places, so applicants with red flags should probably aim for much more.

---

Members don't see this ad.

 

[WisNeuro]

Oh man, I was hoping this would be some kind of Hunger Games type competition that you were setting up, not merely just commentary on the recent match...

 

[DisorderedDoc417]

To help calm the nerves of future applicants, I’ve found some numbers pulled from a program director. I’m rounding for simplicity.

The number of US MD seniors entering Psychiatry increased by about 60 from 2017. Less than 1000 US MD applicants matched into the roughly 1550 spots. That means that DO’s, IMG’s, and re-applicants are still > 1/3 of accepted applicants.

The average US MD is applying to 44 places, so applicants with red flags should probably aim for much more.

Is the 44 broken up by region at all? That seems amazingly high to me — last year I recall discussions about 30 places and even that seemed high. Of course in some regions and for more competitive applicants seeking top spots it seems quite reasonable.

 

[TexasPhysician]

Is the 44 broken up by region at all? That seems amazingly high to me — last year I recall discussions about 30 places and even that seemed high. Of course in some regions and for more competitive applicants seeking top spots it seems quite reasonable.

It is applications, not interviews, and as an average, some people apply to 100 or so which skews the numbers.

 

[FlowRate]

The number of US MD seniors entering Psychiatry increased by about 60 from 2017.

2017: 1067 US MD Seniors ranked psychiatry programs and 923 matched with psychiatry. ~1400 US MD's applied to psychiatry that year.
2018: 1235 US MD Seniors ranked psychiatry programs and 982 matched with psychiatry.

We don't have the detailed data for this year's match, but last year 914 of those US Seniors ranked psychiatry as their only choice, 68 of those went unmatched.
Unless there was a significant increase in multi-specialty psychiatry applicants, you'd expect the % unmatched who ranked psychiatry first or only to have increased significantly this year.

Because applicants can not interview at all programs and programs can not interview all applicants, I suspect that there's an issue with relative competitiveness of applicants and programs having not properly sorted itself out such that the people who went unmatched this year did so because they didn't interview at traditionally IMG programs and/or IMG programs didn't interview them.

http://www.nrmp.org/wp-content/uploads/2018/03/Advance-Data-Tables-2018.pdf
http://www.nrmp.org/wp-content/uploads/2017/06/Main-Match-Results-and-Data-2017.pdf (Tables 13 and 14)

 

[TexasPhysician]

2017: 1067 US MD Seniors ranked psychiatry programs and 923 matched with psychiatry. ~1400 US MD's applied to psychiatry that year.
2018: 1235 US MD Seniors ranked psychiatry programs and 982 matched with psychiatry.

We don't have the detailed data for this year's match, but last year 914 of those US Seniors ranked psychiatry as their only choice, 68 of those went unmatched.
Unless there was a significant increase in multi-specialty psychiatry applicants, you'd expect the % unmatched who ranked psychiatry first or only to have increased significantly this year.

Because applicants can not interview at all programs and programs can not interview all applicants, I suspect that there's an issue with relative competitiveness of applicants and programs having not properly sorted itself out such that the people who went unmatched this year did so because they didn't interview at traditionally IMG programs and/or IMG programs didn't interview them.

http://www.nrmp.org/wp-content/uploads/2018/03/Advance-Data-Tables-2018.pdf
http://www.nrmp.org/wp-content/uploads/2017/06/Main-Match-Results-and-Data-2017.pdf (Tables 13 and 14)

True. More applied, but only 60 extra entered. Possible solutions are more applications and being realistic about competitiveness.

 

[NeuroendoHolism]

Don't know if it concerns anyone else but I'm pre-med have the scores to do low tier MD and DO but wanna do Jagiellonian not because its cheaper or that I can't scratch the US but because I wanna apply to UK match as well, "6% decrease in IMG's accepted into Psychiatry" That was sorta devastating.

 

[NeuroendoHolism]

Who out there thinks Psychiatry is just going to keep getting more competitive not because of the interest in mental health reason but the lifestyle reason? Pathetic, do what you're good at, no matter what.

 

[Celexa]

Who out there thinks Psychiatry is just going to keep getting more competitive not because of the interest in mental health reason but the lifestyle reason? Pathetic, do what you're good at, no matter what.

I haven't seen any reason to think people are going into psych JUST for lifestyle reasons. No specialty is a lifestyle specialty if you hate what you do. My impression is that as the stigma around mental health subsides slowly, people are more willing to consider psychiatry, and then when they give it serious thought, they realize what a great gig it is.

 

[Psychotic]

The average US MD is applying to 44 places, so applicants with red flags should probably aim for much more.

That is a staggering number. Has that number, like, doubled in the last 4 or 5 years? Because I don't remember anything like that being the case when I applied...damn.

 

[Taddy Mason]

That is a staggering number. Has that number, like, doubled in the last 4 or 5 years? Because I don't remember anything like that being the case when I applied...damn.

Per 2016 Charting the Outcomes the median number of applications for matched applicants was 20, and was 25 for unmatched applicants for psychiatry in 2015.

 

[TexasPhysician]

That is a staggering number. Has that number, like, doubled in the last 4 or 5 years? Because I don't remember anything like that being the case when I applied...damn.

There are certainly some sizeable outliers that skew the number higher. Plus there are more programs added recently.

I think there are a fair number of US MD’s with red flags that apply to 80-100. My anecdotal evidence shows that they have a fairly good match rate due to adding less prestigious locales.

 

[NontradCA]

Who out there thinks Psychiatry is just going to keep getting more competitive not because of the interest in mental health reason but the lifestyle reason? Pathetic, do what you're good at, no matter what.

I don’t even know where to start with this. Pre-med? Being passive aggressive on the psych forums? That profile pic? Thanks for making me cringe at this hour.

 

[raisinbrain]

I don’t even know where to start with this. Pre-med? Being passive aggressive on the psych forums? That profile pic? Thanks for making me cringe at this hour.

I had to expend some effort telling myself not to engage in that sort of a debate. I find it disrespectful to suggest a large percentage of people going into this field are "pathetic" on the basis of their career choices.

Perhaps not everyone has gleaming motivations, but for many, the interest is sincere and multifaceted.

 

[Bartelby]

Per 2016 Charting the Outcomes the median number of applications for matched applicants was 20, and was 25 for unmatched applicants for psychiatry in 2015.

That makes sense, the mean gets skewed by the small but not insignificant group of people applying to a huge number of programs.

 

[uhmocksuhsillen]

With psych getting more competitive...aside from the cost, is there a downside for the avg DO or superstar IMG to apply to 80+ programs?

If the risk is not matching why not go overkill here?

 

[SourceOfDenial]

Crazy how many applications you need/encouraged to send out now. I did 10, and only because that was the same price as 5 or 6. I applied to/went on twice as many interviews for fellowship than residency.

 

[FlowRate]

That is a staggering number. Has that number, like, doubled in the last 4 or 5 years? Because I don't remember anything like that being the case when I applied...damn.

There has been a 30% increase in the number of psych spots; an increase in US MD psych applicants of ~70%; and an increase in # applications per USMD of 50%, all since 2013. (That's a 200% increase in number of US MD applications per psychiatry spot.)

The % of spots filled by US MD's is a one potential measure of competitiveness. In 2017, 66% of spots in psych were filled by US MD's. In comparison, the highs tend to be radiation oncology, ortho, plastics, and derm with 90%-95% on average (although rad onc was 100% in 2017). Mid-competitiveness fields include Diagnostic Radiology (60%), Anesthesia (66%), Emergency Med (78%), and Peds (67%.) Family med, Internal med, Neuro, and Path were 35-50%.

 

[MacDonaldTriad]

Don't know if it concerns anyone else but I'm pre-med have the scores to do low tier MD and DO but wanna do Jagiellonian not because its cheaper or that I can't scratch the US but because I wanna apply to UK match as well, "6% decrease in IMG's accepted into Psychiatry" That was sorta devastating.

What makes you think the UK will want wankers like you? There may be some psych applicants that are going into psych because it is the only place they can license, but we have shed most of these lately. I suggest you look into pathology.

 

[NeuroendoHolism]

What makes you think the UK will want wankers like you? There may be some psych applicants that are going into psych because it is the only place they can license, but we have shed most of these lately. I suggest you look into pathology.

The only place they can match, and the other person admitted to the lifestyle reason, I call BS on it

 

[NeuroendoHolism]

I don’t even know where to start with this. Pre-med? Being passive aggressive on the psych forums? That profile pic? Thanks for making me cringe at this hour.

I’m not being passive aggressive I’m calling BS at the match results I’m pissed lifestyle and only place they match is no decent reason to take that residency away from a kid who’s been interested in psych from day one.

 

[NeuroendoHolism]

I haven't seen any reason to think people are going into psych JUST for lifestyle reasons. No specialty is a lifestyle specialty if you hate what you do. My impression is that as the stigma around mental health subsides slowly, people are more willing to consider psychiatry, and then when they give it serious thought, they realize what a great gig it is.

That’s the morally gilded version but sure I can agree I don’t have evidence for my statement either other than sdn forums and all the articles on the ROAD E.

 

[NeuroendoHolism]

What makes you think the UK will want wankers like you? There may be some psych applicants that are going into psych because it is the only place they can license, but we have shed most of these lately. I suggest you look into pathology.

Ya know i have no idea but I wanna get out of the US.

 

[NontradCA]

I’m not being passive aggressive I’m calling BS at the match results I’m pissed lifestyle and only place they match is no decent reason to take that residency away from a kid who’s been interested in psych from day one.

If you have never done the match process, why do you think you’re entitled to be pissed at the results? Why do you think you’re entitled to judge the reasons someone goes into psychiatry? You’re an outsider whose speaking about things you know nothing about. Your post is absolutely absurd.

 

[MacDonaldTriad]

You caught us. Only lazy losers would consider psych, real men only consider surgery. The depressing thing is that you haven't even started medical training and you are already buying this BS. I would be hard pressed to name one professor of psychiatry who wouldn't do it over again exactly the same way, and that isn't because it is easy.

 

[MacDonaldTriad]

Ya know i have no idea but I wanna get out of the US.

 

[Mad Jack]

Don't know if it concerns anyone else but I'm pre-med have the scores to do low tier MD and DO but wanna do Jagiellonian not because its cheaper or that I can't scratch the US but because I wanna apply to UK match as well, "6% decrease in IMG's accepted into Psychiatry" That was sorta devastating.

The only place they can match, and the other person admitted to the lifestyle reason, I call BS on it

Who out there thinks Psychiatry is just going to keep getting more competitive not because of the interest in mental health reason but the lifestyle reason? Pathetic, do what you're good at, no matter what.

Ya know i have no idea but I wanna get out of the US.

If you want to train in the US, go to a US school. The UK will likely want nothing to do with you as a US citizen grad regardless of where you train. Psych will continue to get more competitive for the foreseeable future. You have no right to judge anyone (nor do I) for choosing a field that they have earned a place in, particularly when you have earned a place in exactly nothing so far.

 

[Monocles]

View attachment 230696
If you want to train in the US, go to a US school. The UK will likely want nothing to do with you as a US citizen grad regardless of where you train. Psych will continue to get more competitive for the foreseeable future. You have no right to judge anyone (nor do I) for choosing a field that they have earned a place in, particularly when you have earned a place in exactly nothing so far.

unrelated but what is that meme from?

 

[Mad Jack]

unrelated but what is that meme from?

Just a random reaction from Reddit, based on any number of heresy memes, usually involving characters from Warhammer 40k or knights looking disgusted/horrified

 

[waddledees]

There has been a 30% increase in the number of psych spots; an increase in US MD psych applicants of ~70%; and an increase in # applications per USMD of 50%, all since 2013. (That's a 200% increase in number of US MD applications per psychiatry spot.)

The % of spots filled by US MD's is a one potential measure of competitiveness. In 2017, 66% of spots in psych were filled by US MD's. In comparison, the highs tend to be radiation oncology, ortho, plastics, and derm with 90%-95% on average (although rad onc was 100% in 2017). Mid-competitiveness fields include Diagnostic Radiology (60%), Anesthesia (66%), Emergency Med (78%), and Peds (67%.) Family med, Internal med, Neuro, and Path were 35-50%.

The % filled by US MDs waxes and wanes. By this metric alone, this year's competitiveness doesn't compare to 1986's 69.8% match rate. US MD % fill rates were lower in 2011-2014, and now the rates are returning to 2009-2010 and 2002-2007 numbers. Obviously many confounding factors, including the disappearance of out of match spots.

% Filled by US MD
1978: 50%
1979: 46%
1980: 44%
1981: 53%
1982: 58.7%
1983: 57%
1984: 57%
1985: 66.5%
1986: 69.8%
1987: 68.4 [Fluoxetine approved]
1988: 67.9%
1989: 65.9%
1990: 58.5%
1991: 58.3%
1992: 48.6%
1993: [risperidone approved]
1996: 48.9%
1997: 49.9%
1998: 46.7%
1999: 53.1%
2000: 51%
2002: 58.9%
2003: 60.5%
2004: 62.87%
2005: 63.6%
2006: 62%
2007: 59.9%
2008: 55.7%
2009: 61.7%
2010: 61.4%
2011: 58.3%
2012: 55.1%
2013: 52.5%
2014: 51.8%
2015: 57.2%
2016: 61.4%
2017: 61.7%
2018: 63.1%

 

[NickNaylor]

Just a random reaction from Reddit, based on any number of heresy memes, usually involving characters from Warhammer 40k or knights looking disgusted/horrified

I like it.

 

[Mad Jack]

The % filled by US MDs waxes and wanes. By this metric alone, this year's competitiveness doesn't compare to 1986's 69.8% match rate. US MD % fill rates were lower in 2011-2014, and now the rates are returning to 2009-2010 and 2002-2007 numbers. Obviously many confounding factors, including the disappearance of out of match spots.

% Filled by US MD
1978: 50%
1979: 46%
1980: 44%
1981: 53%
1982: 58.7%
1983: 57%
1984: 57%
1985: 66.5%
1986: 69.8%
1987: 68.4 [Fluoxetine approved]
1988: 67.9%
1989: 65.9%
1990: 58.5%
1991: 58.3%
1992: 48.6%
1993: [risperidone approved]
1996: 48.9%
1997: 49.9%
1998: 46.7%
1999: 53.1%
2000: 51%
2002: 58.9%
2003: 60.5%
2004: 62.87%
2005: 63.6%
2006: 62%
2007: 59.9%
2008: 55.7%
2009: 61.7%
2010: 61.4%
2011: 58.3%
2012: 55.1%
2013: 52.5%
2014: 51.8%
2015: 57.2%
2016: 61.4%
2017: 61.7%
2018: 63.1%

My bet is if we excluded a number of positions equal to former prematch positions, this would be one of the most competitive years, if not the most, in psych history. Those being added via the all-in policy has made things look less competitive than they would otherwise.

 

[OldPsychDoc]

The % filled by US MDs waxes and wanes. By this metric alone, this year's competitiveness doesn't compare to 1986's 69.8% match rate. US MD % fill rates were lower in 2011-2014, and now the rates are returning to 2009-2010 and 2002-2007 numbers. Obviously many confounding factors, including the disappearance of out of match spots.

I think that to understand the competition these past 2 years, you also need to include US DO grads (which aren't included in the US MD grads numbers). Their numbers have rocketed, and they've almost totally eclipsed the Caribbean and FMG applicants.

 

[Stagg737]

With psych getting more competitive...aside from the cost, is there a downside for the avg DO or superstar IMG to apply to 80+ programs?

If the risk is not matching why not go overkill here?

That was my thought process when I sent out ~75 applications. I knew I wasn't the best applicant, so I sent an application to literally every program I thought I had a shot at that my wife and I could tolerate living. I was fortunate to match at the program I had wanted to go to from the start, but increasing my odds and having a little more comfort was completely worth the extra $1,000 or so spend during the cycle.

I’m not being passive aggressive I’m calling BS at the match results I’m pissed lifestyle and only place they match is no decent reason to take that residency away from a kid who’s been interested in psych from day one.

This is a completely baseless statement and you have no idea what you're talking about. Some people just want to be physicians and are willing to go anywhere and enter any field to make that dream come true. That does not make their reason for entering psych any less valid than yours. Does it suck that someone who only chose psych as a back-up sometimes matches over someone who wanted psych from the start? Of course it does. But it's not that person's fault that they were a better applicant than the person interested in psych as their first choice who didn't get the spot. Medicine is competitive, the sooner you learn that the better off you'll be.

Ya know i have no idea but I wanna get out of the US.

Then why are you pissed about the match results? If you don't want to be in the U.S., then don't complain about how the system sucks when you know nothing about how the system works like an entitled little crybaby. Medicine here is competitive, if you don't like the risk or can't handle the heat then cut your losses early, because it only gets harder the further along you go.

 

[uhmocksuhsillen]

That was my thought process when I sent out ~75 applications. I knew I wasn't the best applicant, so I sent an application to literally every program I thought I had a shot at that my wife and I could tolerate living. I was fortunate to match at the program I had wanted to go to from the start, but increasing my odds and having a little more comfort was completely worth the extra $1,000 or so spend during the cycle..

Mind sharing how many interviews you ended up with from all those apps? Any ballpark on your stats?

 

[NontradCA]

Current third year here. Can someone shed some light on how much money it takes to apply to 44 places? And in your opinion, how many interviews is enough?

Fees for ERAS Residency Applications

Would need more info to give a ballpark answer to second question. You can use statistics and look at the correlation between number of ranks and match and USMLE scores and match to get an idea.

 

[MacDonaldTriad]

If I were in charge, the first 10 would be $200, the next 5 would be $500, and $1000 for every application after 15. The outcome would be the same and we would all save a lot of time and money. I would also be able to interview almost everyone who applies to our program. Applicants would have a much higher chance at getting into places they interview at and they wouldn't have to fly all over the place. Win win.

 

[zyxab]

The % filled by US MDs waxes and wanes. By this metric alone, this year's competitiveness doesn't compare to 1986's 69.8% match rate. US MD % fill rates were lower in 2011-2014, and now the rates are returning to 2009-2010 and 2002-2007 numbers. Obviously many confounding factors, including the disappearance of out of match spots.

% Filled by US MD
1978: 50%
1979: 46%
1980: 44%
1981: 53%
1982: 58.7%
1983: 57%
1984: 57%
1985: 66.5%
1986: 69.8%
1987: 68.4 [Fluoxetine approved]
1988: 67.9%
1989: 65.9%
1990: 58.5%
1991: 58.3%
1992: 48.6%
1993: [risperidone approved]
1996: 48.9%
1997: 49.9%
1998: 46.7%
1999: 53.1%
2000: 51%
2002: 58.9%
2003: 60.5%
2004: 62.87%
2005: 63.6%
2006: 62%
2007: 59.9%
2008: 55.7%
2009: 61.7%
2010: 61.4%
2011: 58.3%
2012: 55.1%
2013: 52.5%
2014: 51.8%
2015: 57.2%
2016: 61.4%
2017: 61.7%
2018: 63.1%

Great post.

 

[SaintMartha]

Do you guys think applying for a child psych fellowship in two years will be as competitive as the match has been this year for general residency?

 

[ksharp33]

Do you guys think applying for a child psych fellowship in two years will be as competitive as the match has been this year for general residency?

Nope. There were 100 unfilled spots in child this past match. Only about half the programs even filled. Child psych is very uncompetitive.

 

[SaintMartha]

Yes that is what I heard. But i was curious because the same people that applied to general psych residency with me this year will apply for child psych fellowship with me in two years...just extremely nervous after this years match lol

 

[MacDonaldTriad]

The child psych slots are growing quickly and demand isn't. Things might be changing, but that would be an unbelievable change.

 

[psychm]

Who out there thinks Psychiatry is just going to keep getting more competitive not because of the interest in mental health reason but the lifestyle reason? Pathetic, do what you're good at, no matter what.

It is definitely a major part. How much, I'm not sure, but it does not hurt psychiatry to draw more and more competitive applicants. A passion for psychiatry is important but motivated, hard working, dedicated people are welcome. If anyone in medicine should know about the importance of things like lifestyle, family, and overall work life balance, it should be psychiatrists.

 

[Sporadicus]

The % filled by US MDs waxes and wanes. By this metric alone, this year's competitiveness doesn't compare to 1986's 69.8% match rate. US MD % fill rates were lower in 2011-2014, and now the rates are returning to 2009-2010 and 2002-2007 numbers. Obviously many confounding factors, including the disappearance of out of match spots.

% Filled by US MD
1978: 50%
1979: 46%
1980: 44%
1981: 53%
1982: 58.7%
1983: 57%
1984: 57%
1985: 66.5%
1986: 69.8%
1987: 68.4 [Fluoxetine approved]
1988: 67.9%
1989: 65.9%
1990: 58.5%
1991: 58.3%
1992: 48.6%
1993: [risperidone approved]
1996: 48.9%
1997: 49.9%
1998: 46.7%
1999: 53.1%
2000: 51%
2002: 58.9%
2003: 60.5%
2004: 62.87%
2005: 63.6%
2006: 62%
2007: 59.9%
2008: 55.7%
2009: 61.7%
2010: 61.4%
2011: 58.3%
2012: 55.1%
2013: 52.5%
2014: 51.8%
2015: 57.2%
2016: 61.4%
2017: 61.7%
2018: 63.1%

Yep the all in policy started in the 2013 match when a couple hundred previously "reserved" spots were added to NRMP. Psych had a very high % of out of match spots relative to other specialties so on paper appeared to lose some thunder (assuming %USMD as proxy for competitiveness) but significantly more USMDs have applied every year. Our share of the graduating class has increased from 4.2% to 5.3% in just 4 years! No other specialty has had that sort of movement except maybe radiology (in the other direction).

Sorry to DO/IMG/FMG applicants, but I don't think sub 60% will happen again for the foreseeable future...even so, 30-40% of 1500 spots means that matching is still quite doable, though you definitely will have to work harder than other people in your same position did a few years back.

And for the USMDs who were looking to psych "from day 1," you are now competing with a small but growing pool of lifestyle seeking gunners. It sucks, but if you are truly passionate about your specialty, you will be that much more motivated to make your application as strong as it can be. Programs will all say that "training residents who are passionate about psychiatry" is priority #1, but realistically getting interns who will be able to handle the workload is and always will be priority #1. Gunners can do the work but they don't really care, so make it an easy choice!