Advice about applying for residency

[Dr.connect]

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Hey all,

I am new to SDN and my friend advised me to ask my question here. I need some advice please. My ERAS application is ready to go for this years match, however, I ran into a difficulty. I failed my step 2 ck by 3 points, but because I experienced computer problems that cost me time on my exam, I am pending NBMEs decision to void my 1st attempt at CK. However, I am still waiting for their reply, which will take another 3 weeks. I am planning on taking my CK for the second attempt in 2 weeks. My questions is, should I apply now with a failed CK attempt, or should I wait until my scores come out in January after I take my exam in 2 weeks?

I am graduating from AUA in the carribean with a 3.9 GPA and great LOR's, I also have research experience in the field of Psych. I am applying to Psych programs. I dont know if it will be too late to apply once I get my score in January. Please, any advice will help me. I dont want to wait until next year to apply, I want to apply this year and willing to pay the money.

Thank you!

 

[AMEHigh]

It is pretty much too late to apply already. People started sending in applications in September. Most programs have an application deadline of Dec. 1. Did you not know you should apply in September?

 

[Cinclus]

You're looking at applying next year at this point, anyhow. As AMEHigh said, you are very late for this Match cycle.

 

[mimelim]

Hey all,

I am new to SDN and my friend advised me to ask my question here. I need some advice please. My ERAS application is ready to go for this years match, however, I ran into a difficulty. I failed my step 2 ck by 3 points, but because I experienced computer problems that cost me time on my exam, I am pending NBMEs decision to void my 1st attempt at CK. However, I am still waiting for their reply, which will take another 3 weeks. I am planning on taking my CK for the second attempt in 2 weeks. My questions is, should I apply now with a failed CK attempt, or should I wait until my scores come out in January after I take my exam in 2 weeks?

I am graduating from AUA in the carribean with a 3.9 GPA and great LOR's, I also have research experience in the field of Psych. I am applying to Psych programs. I dont know if it will be too late to apply once I get my score in January. Please, any advice will help me. I dont want to wait until next year to apply, I want to apply this year and willing to pay the money.

Thank you!

You are way too late for this cycle. Most programs are already interviewing and virtually all of them stopped taking applications some time ago.

Does any program take applications without a Step 2 score anyway?

Most programs take applications without Step 2 scores. Maybe it is specialty dependent, but it was not unusual for people to not take Step 2 until late in their MS4.

 

[Amygdarya]

Does any program take applications without a Step 2 score anyway?

Yes, quite a few psychiatry programs do (I don't know of other specialties), though even if most programs state they accept applications without Step 2 scores, many of them still prefer seeing them.

In any case, Dr.connect, whether you like it or not, it's way too late to apply now, you should submit your application on September 15th of next year. If you insist an apply this year, 2 things will happen: 1) you will waste your money; 2) when you apply for the second time next year, your unsuccessful first application may count against you (and as someone from a Carribean school you really want to minimize things that count against you, even when applying to a "noncompetitive" specialty like psychiatry, which is not so noncompetitive for Carribean grads). Bottom line: figure out your issue with Step 2 CK, retake it ASAP if necessary, and submit your application on September 15th of next year.

 

[deleted718115]

When you get residency interviews, does it matter if you interview early (Nov) or late (Jan)? In other word, when you get to the interview stage, is it a rolling process?

 

[Cinclus]

When you get residency interviews, does it matter if you interview early (Nov) or late (Jan)? In other word, when you get to the interview stage, is it a rolling process?

It's not rolling. And studies have shown that early vs. late does not really matter. The important thing is getting the interview and not being weird during the interview.

 

[deleted274002]

So, several things:

1. It's way too late to apply now. Most places, even in psychiatry, have filled their interview schedules already and have been full for months.
2. I wouldn't be too confident in the USMLE voiding your scores. Unless Prometric can verify and give this verification in writing that something was wrong with your computer, they aren't going to void your score.
3. As a Caribbean grad and with a failure on Step 2, regardless of whether you pass again in 2 weeks (is that enough time to prepare to increase your score so you would pass?), matching anywhere, even in non-competitive specialties, will be a challenge. With all of the new US medical schools that have opened up sending their students into the residency application trail, applying for residency has become far more competitive in general than most people realize. I'm not saying you shouldn't try, but when you do apply, apply next year on September 15 with a complete file and apply to every psych program in the country.

Good luck.

 

[deleted274002]

You are way too late for this cycle. Most programs are already interviewing and virtually all of them stopped taking applications some time ago.



Most programs take applications without Step 2 scores. Maybe it is specialty dependent, but it was not unusual for people to not take Step 2 until late in their MS4.

This is mostly not true anymore. Unless you're rocking 260+ on Step 1, most programs will want to see Step 2 CK, especially since the USMLE continues to up the minimum passing score. They probably don't care too much about having Step 2 CS scores though.

 

[mvenus929]

I never did the civilian match, but I find that incredibly bizarre. It seems like programs set themselves up for trouble doing that.

Most programs want to see a passing score prior to rank lists, but not necessarily before they review your application and invite you to interview.

 

[the argus]

With all of the new US medical schools that have opened up sending their students into the residency application trail, applying for residency has become far more competitive in general than most people realize.

Most people don't realize this because it's not true. Since all the new US schools started opening, the percentage of US-IMGs that have matched has stayed basically the same.
http://www.nrmp.org/wp-content/uploads/2015/05/Main-Match-Results-and-Data-2015_final.pdf
http://www.nrmp.org/wp-content/uploads/2013/08/resultsanddata2010.pdf
2015 - 53.1%
2014 - 53.0%
2013 - 52.8%
2012 - 49.1%
2011 - 50.0%
2010 - 47.5%
2009 - 47.8%
2008 - 51.9%
2007 - 50.0%
2006 - 50.6%

I agree that it will be a difficult process for this guy as a Caribbean grad with a step failure, but it has nothing to do with the number of US medical students.

 

[Donald Juan]

I never did the civilian match, but I find that incredibly bizarre. It seems like programs set themselves up for trouble doing that.

I've heard most programs won't rank you without a passing step 2 just to prevent those people who potentially take a spot and fail step 2 and aren't able to start residency, but getting an interview without it is certainly not out of the ordinary.

 

[W19]

I've heard most programs won't rank you without a passing step 2 just to prevent those people who potentially take a spot and fail step 2 and aren't able to start residency, but getting an interview without it is certainly not out of the ordinary.

Does that include CS as well?

 

[Donald Juan]

Does that include CS as well?

I've been told it can affect it, but I'm sure not every residency program rechecks their rank list.

 

[IlDestriero]

When you get residency interviews, does it matter if you interview early (Nov) or late (Jan)? In other word, when you get to the interview stage, is it a rolling process?

As noted above, it's not a rolling admission, you are ranked as you are interviewed. Immediately after the interview applicants go into 3 piles, priority, rank, no rank. At the end of the cycle, the piles are pooled and the rank list is made. So you could be the last one invited on the last day, and still find yourself ranked to match.
The problem the OP has, aside from a very damning failure, is that all the interview spots are probably already filled, so his application wouldn't be considered. Some programs may hold a few late applicant interview spots, but that's something highly competitive programs would do for superstar applicants that changed their mind on careers late in the process, not the OP.

 

[W19]

@SouthernSurgeon I see... I could not understand why so many MS4 I talked to took CS before CK, I guess that might be because of the scheduling aspect of it...

 

[deleted274002]

Most people don't realize this because it's not true. Since all the new US schools started opening, the percentage of US-IMGs that have matched has stayed basically the same.
http://www.nrmp.org/wp-content/uploads/2015/05/Main-Match-Results-and-Data-2015_final.pdf
http://www.nrmp.org/wp-content/uploads/2013/08/resultsanddata2010.pdf
2015 - 53.1%
2014 - 53.0%
2013 - 52.8%
2012 - 49.1%
2011 - 50.0%
2010 - 47.5%
2009 - 47.8%
2008 - 51.9%
2007 - 50.0%
2006 - 50.6%

I agree that it will be a difficult process for this guy as a Caribbean grad with a step failure, but it has nothing to do with the number of US medical students.

Notice how I said in general. The fact that the percentages stay relatively static doesn't tell us what programs these people are matching into. Also that uptick in 2013 could be easily explained by the "All in" policy.

There will always allopathic residencies that cater specifically to Caribbean grads/DOs/FMGs. What happens to the percentage of these people that match to residencies that do not cater Caribbean grads/DOs/FMGs remains to be seen.

 

[IlDestriero]

Notice how I said in general. The fact that the percentages stay relatively static doesn't tell us what programs these people are matching into. Also that uptick in 2013 could be easily explained by the "All in" policy.

There will always allopathic residencies that cater specifically to Caribbean grads/DOs/FMGs. What happens to the percentage of these people that match to residencies that do not cater Caribbean grads/DOs/FMGs remains to be seen.

The all in policy definitely bumped the numbers. Don't expect that to continue. Every new US grad is one FMG not matching going forward.

 

[the argus]

Notice how I said in general. The fact that the percentages stay relatively static doesn't tell us what programs these people are matching into. Also that uptick in 2013 could be easily explained by the "All in" policy.

There will always allopathic residencies that cater specifically to Caribbean grads/DOs/FMGs. What happens to the percentage of these people that match to residencies that do not cater Caribbean grads/DOs/FMGs remains to be seen.

Yes, you said in general. In general, it is not getting harder to match. The fact that the percentages stay relatively static in fact proves that it's not getting harder to match in general.

Arguing about the specific programs people are matching into, which you are doing now, is being more specific, which is the opposite of general.

 

[the argus]

The all in policy definitely bumped the numbers. Don't expect that to continue. Every new US grad is one FMG not matching going forward.

Total US medical school enrollment is not increasing at a rate that will have any significant impact on the number of IMGs that match in the foreseeable future. It is basically increasing the same number per year as the yearly increase in PGY-1 positions through the NRMP (not counting 2012-13 and the all-in policy), which is 500-600 on average.

Will this change in the future, who knows. But the data we have now shows a much slower increase in US medical school 1st year matriculation than what was forecasted years ago.

 

[Law2Doc]

The all in policy definitely bumped the numbers. Don't expect that to continue. Every new US grad is one FMG not matching going forward.

Actually that "uptick" really signaled a net loss. Offshore grads landed a few more spots in the match but a wholesale loss of prematches spots. So on paper if you just look at the "match" things look pretty rosy but in fact if you pair it with the nosedive in prematches spots (of which there used to be a ton) it was really a bloodbath. Not to mention that SOAP is less favorable than the scramble for offshore people and so that loss of spots also isn't reflected in "match" data.

 

[Law2Doc]

... It is basically increasing the same number per year as the yearly increase in PGY-1 positions through the NRMP (not counting 2012-13 and the all-in policy), which is 500-600 on average...

Meh. I know in the region I recently worked we used to have a bunch of offshore grads pre matching at each of the local community hospitals and after the "all in" rule went into effect about 30+ offshore spots got pulled back into the match. Since I seriously doubt this one area represented close to 5% of all prematches nationally, the number of spots lost nationally has to be much much greater than you are selling. There isn't great prematch data out there like there is for the match but I'm betting your numbers are but a fraction.

 

[the argus]

Actually that "uptick" really signaled a net loss. Offshore grads landed a few more spots in the match but a wholesale loss of prematches spots. So on paper if you just look at the "match" things look pretty rosy but in fact if you pair it with the nosedive in prematches spots (of which there used to be a ton) it was really a bloodbath. Not to mention that SOAP is less favorable than the scramble for offshore people and so that loss of spots also isn't reflected in "match" data.

Meh. I know in the region I recently worked we used to have a bunch of offshore grads pre matching at each of the local community hospitals and after the "all in" rule went into effect about 30+ offshore spots got pulled back into the match. Since I seriously doubt this one area represented close to 5% of all prematches nationally, the number of spots lost nationally has to be much much greater than you are selling. There isn't great prematch data out there like there is for the match but I'm betting your numbers are but a fraction.

First off, prematch spots aren't lost. They still exist, they are just now in the match. Just because a place that used to prematch IMGs went into the match doesn't mean that they still don't fill with IMGs. It's just through the match now.

Where is your data showing it was a "bloodbath" and that IMGs lost spots due to the all-in policy. I'll help you out. There is no such data because what you are claiming just isn't true.

From 2012 to 2013, there was an increase from 24,006 PGY1 positions in the match to 26,138 due to the all in policy. This is an increase of 2,132, ~500 of which can be explained by just general PGY-1 yearly increases. That leaves ~1600 spots that were previously prematch.

In 2012, 4,870 IMGs (US and foreign) matched through the NRMP. In 2013, that number was 6,247, an increase of 1,377 from the year before.

1st year USMD matriculation in 2008 (matched in 2012) was 18,036, while in 2009 (matched in 2013) it was 18,390, an increase of 354. In 2012, 15,712 USMDs matched. In 2013, 16,390 USMDs matched. That's an increase of 678, but the matriculation numbers only increased 354 between those years. Where did those other ~300 spots come from? Could it be maybe the remaining ~300 previously prematch spots that were left over after subtracting the new IMG matches? USMDs also prematched prior to 2013, just not in as high of numbers as IMGs.

US medical school matriculation numbers (MD + DO) did not change substantially from 2008 to 2009 (2012 to 2013 match). There wasn't some magical new cohort of US medical graduates ready to take spots that were previously filled by IMGs. From 2008 to 2009, US medical school enrollment (MD+DO) increased by a total of 668, which is just enough to cover the general yearly increase of ~500 PGY-1 positions.

There was no "bloodbath" following the institution of the all-in policy. The same number of IMGs entered first year GME as the previous year, many more just entered it through the NRMP rather than prematching.

 

[Law2Doc]

First off, prematch spots aren't lost. They still exist, they are just now in the match. Just because a place that used to prematch IMGs went into the match doesn't mean that they still don't fill with IMGs. It's just through the match now.

Where is your data showing it was a "bloodbath" and that IMGs lost spots due to the all-in policy. I'll help you out. There is no such data because what you are claiming just isn't true.

From 2012 to 2013, there was an increase from 24,006 PGY1 positions in the match to 26,138 due to the all in policy. This is an increase of 2,132, ~500 of which can be explained by just general PGY-1 yearly increases. That leaves ~1600 spots that were previously prematch.

In 2012, 4,870 IMGs (US and foreign) matched through the NRMP. In 2013, that number was 6,247, an increase of 1,377 from the year before.

1st year USMD matriculation in 2008 (matched in 2012) was 18,036, while in 2009 (matched in 2013) it was 18,390, an increase of 354. In 2012, 15,712 USMDs matched. In 2013, 16,390 USMDs matched. That's an increase of 678, but the matriculation numbers only increased 354 between those years. Where did those other ~300 spots come from? Could it be maybe the remaining ~300 previously prematch spots that were left over after subtracting the new IMG matches? USMDs also prematched prior to 2013, just not in as high of numbers as IMGs.

US medical school matriculation numbers (MD + DO) did not change substantially from 2008 to 2009 (2012 to 2013 match). There wasn't some magical new cohort of US medical graduates ready to take spots that were previously filled by IMGs. From 2008 to 2009, US medical school enrollment (MD+DO) increased by a total of 668, which is just enough to cover the general yearly increase of ~500 PGY-1 positions.

There was no "bloodbath" following the institution of the all-in policy. The same number of IMGs entered first year GME as the previous year, many more just entered it through the NRMP rather than prematching.

Again to buy your argument I need to buy your numbers on how many people used to get spots in the prematch. Which I don't and I think you are pointing to differences in March numbers to estimate prematch numbers, which is flawed. No those spots didn't all get "lost" but many did not in fact get filled by the same IMGs in the match, and some of them found there way to SOAP, which too was beneficial to US grads. US grads have been 93-94% of the match every year for the last decade. The additional 5-6% get spots in SOAP, which again is beneficial to US grads now because it deemphasizes the race to the phones and fax, and emphasizes the US CV. If match numbers bump up because of all in, and US applicants still get that same 93-94% of the match (which they did) then offshore is losing ground. Prematch and SOAP numbers are guesses, by you and everyone, but they were the numbers that make more of a difference to IMGs. Match data is missing the Forrest for the trees.

 

[IlDestriero]

They'll probably wash out more people to buff the numbers. That's for profit thinking. Think like a business professional.

 

[the argus]

Again to buy your argument I need to buy your numbers on how many people used to get spots in the prematch. Which I don't and I think you are pointing to differences in March numbers to estimate prematch numbers, which is flawed. No those spots didn't all get "lost" but many did not in fact get filled by the same IMGs in the match, and some of them found there way to SOAP, which too was beneficial to US grads. US grads have been 93-94% of the match every year for the last decade. The additional 5-6% get spots in SOAP, which again is beneficial to US grads now because it deemphasizes the race to the phones and fax, and emphasizes the US CV. If match numbers bump up because of all in, and US applicants still get that same 93-94% of the match (which they did) then offshore is losing ground. Prematch and SOAP numbers are guesses, by you and everyone, but they were the numbers that make more of a difference to IMGs. Match data is missing the Forrest for the trees.

Forget match numbers if you like, just look at first year matriculation numbers. As I mentioned, there were only 668 more US grads from 2012 to 2013. IMGs could not have possibly lost many positions, there was simply not anyone else to fill them. There is an ~500-600 increase in PGY-1 positions every year, which basically covers the yearly increase in US grads.

Your whole argument is based on the assumption that there's some cohort of additional US grads to take the spots that were previously filled by IMGs. There isn't. 1st year matriculation numbers are widely available for USMD and DO schools, and they have not been increasing at a rate that would significantly affect the number of IMGs getting PGY-1 positions.

This whole idea of a "bloodbath" is contingent on there being additional US grads to fill those positions, which wasn't the case and still isn't.

It's obvious you are convinced there is some massive decrease in the number of IMGs getting residency positions over the last few years. That's fine you are allowed to believe whatever you want to believe. Even if you think the match numbers are inconclusive, there is no arguing about total 1st year US medical school enrollment (USMD +DO). Despite the rhetoric being thrown around over the past 5 years or so, 1st year US medical school enrollment has not increased that dramatically. The number of IMGs getting PGY-1 positions hasn't decreased because there is simply no one else to fill the positions. The percentage of PGY-1 positions being filled by IMGs may be decreasing slightly, as most new PGY-1 positions are filled by new US grads. But the absolute number of IMGs getting positions hasn't decreased, and can't due to simple arithmetic.

 

[Law2Doc]

Forget match numbers if you like, just look at first year matriculation numbers. As I mentioned, there were only 668 more US grads from 2012 to 2013. IMGs could not have possibly lost many positions, there was simply not anyone else to fill them. There is an ~500-600 increase in PGY-1 positions every year, which basically covers the yearly increase in US grads.

Your whole argument is based on the assumption that there's some cohort of additional US grads to take the spots that were previously filled by IMGs. There isn't. 1st year matriculation numbers are widely available for USMD and DO schools, and they have not been increasing at a rate that would significantly affect the number of IMGs getting PGY-1 positions.

This whole idea of a "bloodbath" is contingent on there being additional US grads to fill those positions, which wasn't the case and still isn't.

It's obvious you are convinced there is some massive decrease in the number of IMGs getting residency positions over the last few years. That's fine you are allowed to believe whatever you want to believe. Even if you think the match numbers are inconclusive, there is no arguing about total 1st year US medical school enrollment (USMD +DO). Despite the rhetoric being thrown around over the past 5 years or so, 1st year US medical school enrollment has not increased that dramatically. The number of IMGs getting PGY-1 positions hasn't decreased because there is simply no one else to fill the positions. The percentage of PGY-1 positions being filled by IMGs may be decreasing slightly, as most new PGY-1 positions are filled by new US grads. But the absolute number of IMGs getting positions hasn't decreased, and can't due to simple arithmetic.

First year enrollment being matched to increase in residency spots for fourth years doesn't work. You are three years off in matching people to spots. Saying first year class increased by 600 spots in the same year the residency spots increased by 500 ( which I think is a false statistic BTW) still isn't marrying the appropriate years.

Again since I don't buy your numbers you aren't going to convince me on your point.

 

[the argus]

First year enrollment being matched to increase in residency spots for fourth years doesn't work. You are three years off in matching people to spots. Saying first year class increased by 600 spots in the same year the residency spots increased by 500 ( which I think is a false statistic BTW) still isn't marrying the appropriate years.

Again since I don't buy your numbers you aren't going to convince me on your point.

Here you go, you can't not buy these numbers as they are directly from the ACGME.
https://www.acgme.org/acgmeweb/tabid/259/Publications/GraduateMedicalEducationDataResourceBook.aspx

download the most recent GME Data Resource Book from 2013-2014. One year old but the best we can do. Go to page 6, "Number of residents entering the pipeline, by medical school type and academic year." Pipeline Programs are defined as programs within specialties that lead to initial board certification, i.e. first year categorical positions (prelims are excluded, whether or not they have advanced positions). From 2004 to 2013, there has been >6,600 IMGs entering categorical positions, with a gradual increase to a peak of 7,144 in 2009. From 2012 to 2013 (i.e. implementation of all-in policy), the number went from 6,988 to 6,693, a decrease of 295, or ~4%.

I don't know what your definition of bloodbath is, but a decrease of ~4% probably wouldn't qualify for most people.

So again, the data shows that the number of IMGs matching to categorical PGY-1 positions is basically staying the same with some minor variability. It also dropped ~250 positions, ~3%, from 2009 to 2010, but then increased again from 2010 to 2012.

Maybe the day will come when the US medical education system produces enough graduates to the point where the number of IMGs matching decreases significantly. Who knows, but it certainly hasn't happened yet.

 

[Psai]

There are many MD and DO schools opening and some existing schools are increasing class size. The number of applications per applicant is increasing and subjectively, everyone thinks it is harder to match than before.

 

[the argus]

There are many MD and DO schools opening and some existing schools are increasing class size. The number of applications per applicant is increasing and subjectively, everyone thinks it is harder to match than before.

I'm not disputing that more medical schools are opening, and how people subjectively feel about difficulty to match really means nothing. The data shows that it's not any more difficult to match currently than it has been over the past 10 years. It's just not. We may get to the point where IMGs are squeezed out of GME positions, but it hasn't happened yet and won't happen in the next 5 years either. I was specifically taking issue with the post by Law2Doc who claimed that IMGs are matching much less and that after the all-in policy in 2013 it was a "bloodbath" for IMGs. That's just patently false.

 

[Psai]

I'm not disputing that more medical schools are opening, and how people subjectively feel about difficulty to match really means nothing. The data shows that it's not any more difficult to match currently than it has been over the past 10 years. It's just not. We may get to the point where IMGs are squeezed out of GME positions, but it hasn't happened yet and won't happen in the next 5 years either. I was specifically taking issue with the post by Law2Doc who claimed that IMGs are matching much less and that after the all-in policy in 2013 it was a "bloodbath" for IMGs. That's just patently false.

http://www.nrmp.org/wp-content/uploads/2015/05/Main-Match-Results-and-Data-2015_final.pdf

page v shows that applicants increased by about 10k in the past 10 years while positions increased by 6k. 15k us seniors in 2005 and 18k in 2015

page 48 shows a slight bump in number of people soaping from last year. 13,657 people who didn't get any spot in the match sounds like a lot to me. People are applying to more programs and interviewing at more programs. What are you basing your views on? "The data shows". What data? All you did was share your opinion.

My understanding is that there are 16 new MD schools and 15 new DO schools that have opened or will open in the past few years. There are several schools that are increasing their class size. This means that there will be even more competition for spots. Everyone who is not a us grad will be shut out.

 

[the argus]

http://www.nrmp.org/wp-content/uploads/2015/05/Main-Match-Results-and-Data-2015_final.pdf

page v shows that applicants increased by about 10k in the past 10 years while positions increased by 6k. 15k us seniors in 2005 and 18k in 2015

page 48 shows a slight bump in number of people soaping from last year. 13,657 people who didn't get any spot in the match sounds like a lot to me. People are applying to more programs and interviewing at more programs. What are you basing your views on? "The data shows". What data? All you did was share your opinion.

My understanding is that there are 16 new MD schools and 15 new DO schools that have opened or will open in the past few years. There are several schools that are increasing their class size. This means that there will be even more competition for spots. Everyone who is not a us grad will be shut out.

Since 2000, 71-78% of total applicants to the NRMP have matched, and the most recent years are ~75%. In terms of absolute numbers, there are more total positions, more people are applying, more people are matching, and along with that more people are also not matching. But the percentage of people matching and not matching is staying basically the same. Therefore it's not getting harder to match.
http://www.nrmp.org/wp-content/uploads/2015/05/Main-Match-Results-and-Data-2015_final.pdf
http://www.nrmp.org/wp-content/uploads/2013/08/resultsanddata2010.pdf
http://www.nrmp.org/wp-content/uploads/2013/08/resultsanddata2005.pdf

Percent of total applicants that matched per year
2000 - 73.4%
2001 - 76.5%
2002 - 78.6%
2003 - 78.5%
2004 - 76.8%
2005 - 78.0%
2006 - 75.1%
2007 - 73.4%
2008 - 72.9%
2009 - 71.4%
2010 - 71.2%
2011 - 73.2%
2012 - 73.1%
2013 - 73.5%
2014 - 75.0%
2015 - 75.2%

Again, I'm not arguing that in the future IMGs won't get pushed out if the stated AMG expansion plans come to fruition. I'm only saying it hasn't happened yet, and will not happen in the immediate future either. That's all.

 

[Psai]

So if mcdonalds gets a million apps for 10k jobs and Harvard need school gets 10k apps for 100 spots, they're both equally competitive as 1% of the applicants get a job amirite? Average step 1 scores are increasing at a steady rate and more people are applying to more places. You can't look at the results and assume that it means that the process is unchanged. It takes 4 years for a medical school to start graduating people and sending them into residency. These new graduates will start filling up spots soon.

The all in policy was implemented in 2013. So that helps explain the little bump in spots and matches since then. Looking before 2013, there's a slow but steady decrease. If you don't think that imgs will get squeezed out, you are lying to yourself and all prospective medical graduates

 

[the argus]

We are not comparing fast food vs medical school, we are comparing applying to residency vs applying to residency. Of course the process changes, but if the process changes for everyone, that doesn't mean it is more competitive, it just means that the process has changed. It might make it more of a pain in the ass, but it doesn't make it more competitive.

And you can make predictions about the future if you want to, just know that it doesn't mean anything. 5 years ago people were saying IMGs would be squeezed out by 2015, and we know how well that panned out. >6,300 IMGs matched this year. I'll believe IMGs will be squeezed out the year that US medical school enrollment begins to approach the total number of PGY-1 positions. It hasn't even remotely come close yet with the most recent matriculation data available from 2014.

 

[Dave89]

As noted above, it's not a rolling admission, you are ranked as you are interviewed. Immediately after the interview applicants go into 3 piles, priority, rank, no rank. At the end of the cycle, the piles are pooled and the rank list is made. So you could be the last one invited on the last day, and still find yourself ranked to match.
The problem the OP has, aside from a very damning failure, is that all the interview spots are probably already filled, so his application wouldn't be considered. Some programs may hold a few late applicant interview spots, but that's something highly competitive programs would do for superstar applicants that changed their mind on careers late in the process, not the OP.

I've known since my first interview that the ranking happens in the room in those intervals between interviews, but when (if ever) are factors such as USMLE score updates, publications, etc. considered if submitted after interviewing?

 

[Psai]

Number of residency spots 2005: 24,012
Number of residency spots 2014: 26,678

US MD grads 2005: 15,760; 93.7% matched
US MD grads 2014: 18,078; 94.4% matched

DO grads 2005: 2,756; 68.6% matched
DO grads 2014: 5,263; 77.7% matched

US foreign grads 2005: 2,091 active applicants; 54.7% matched with 1,416 pulling out of the match
US foreign grads 2014: 5,133 active applicants; 53% matched with 1,819 pulling out of the match

Non US foreign grads 2005: 5,554 active applicants; 55.6% matched with 3,389 pulling out of the match
Non US foreign grads 2014: 7,334 active applicants; 49.5% matched with 2,558 pulling out of the match

2005: 0.85 positions per active applicants
2014: 0.78 positions per active applicant

I don't know how else to tell you this. The match is much more competitive than before and it will continue to become more competitive. Congress is unwilling to increase the funding for residency spots. The number of medical graduates is increasing at a faster rate than the number of residency spots.

http://www.nrmp.org/wp-content/uploads/2013/08/resultsanddata2005.pdf
http://www.nrmp.org/wp-content/uploads/2014/04/Main-Match-Results-and-Data-2014.pdf

 

[Danglebells]

Hey all,

I am new to SDN and my friend advised me to ask my question here. I need some advice please. My ERAS application is ready to go for this years match, however, I ran into a difficulty. I failed my step 2 ck by 3 points, but because I experienced computer problems that cost me time on my exam, I am pending NBMEs decision to void my 1st attempt at CK. However, I am still waiting for their reply, which will take another 3 weeks. I am planning on taking my CK for the second attempt in 2 weeks. My questions is, should I apply now with a failed CK attempt, or should I wait until my scores come out in January after I take my exam in 2 weeks?

I am graduating from AUA in the carribean with a 3.9 GPA and great LOR's, I also have research experience in the field of Psych. I am applying to Psych programs. I dont know if it will be too late to apply once I get my score in January. Please, any advice will help me. I dont want to wait until next year to apply, I want to apply this year and willing to pay the money.

Thank you!

You need to apply ASAP


Yes its late, but if you get your application out to a very very broad number of psych programs (think 100+) you might be able to get some interviews. Plus if you don't, you might be able to scramble in to a program that you have applied to.

The advice above that you are applying too late is unfortunately true. Do not expect to get more than a couple interviews, if any. That being said, if you don't apply anywhere this cycle you have a 0% chance of matching this year, and a severely decreased chance of matching next year.

At least if you apply, you will have some chance of matching this cycle.

Honestly if you are an IMG with a step failure who is 1 year post graduation, a lot of programs wont open your application. Its really not fair, but Im afraid that they wont even look twice to see that you might have a legitimate reason for the failure.

 

[Danglebells]

And @theargus is right. I have been reading SDN for over a decade before I made an account, and the whole "IMGs are going to be squeezed out" thing has been predicted for at least the past 10 years, and it simply isn't happening. Look at the numbers, its all there.

Edit: and the osteopathic 77% match rate is because by matching into an osteopathic residency, the applicant withdraws from the ACGME match. Table 4 in the second link shows that it accounts for 23.7% of the osteopathic applicants.

 

[Psai]

Look at the numbers? You mean all of the ones I posted? the ones that support my view?

 

[nOchemallday]

Look at the numbers? You mean all of the ones I posted? the ones that support my view?

Number of residency spots 2005: 24,012
Number of residency spots 2014: 26,678

US MD grads 2005: 15,760; 93.7% matched
US MD grads 2014: 18,078; 94.4% matched

DO grads 2005: 2,756; 68.6% matched
DO grads 2014: 5,263; 77.7% matched

US foreign grads 2005: 2,091 active applicants; 54.7% matched with 1,416 pulling out of the match
US foreign grads 2014: 5,133 active applicants; 53% matched with 1,819 pulling out of the match

Non US foreign grads 2005: 5,554 active applicants; 55.6% matched with 3,389 pulling out of the match
Non US foreign grads 2014: 7,334 active applicants; 49.5% matched with 2,558 pulling out of the match

2005: 0.85 positions per active applicants
2014: 0.78 positions per active applicant

I don't know how else to tell you this. The match is much more competitive than before and it will continue to become more competitive. Congress is unwilling to increase the funding for residency spots. The number of medical graduates is increasing at a faster rate than the number of residency spots.

http://www.nrmp.org/wp-content/uploads/2013/08/resultsanddata2005.pdf
http://www.nrmp.org/wp-content/uploads/2014/04/Main-Match-Results-and-Data-2014.pdf

Several things:
1. All of the US/Non-US FMG data is correct and all of the percentages are correct, but something has to be wrong with the MD/DO data you posed. Just look at your 2014 data: Number of active applicants * % matched adds up to 27,506 which is more than the available spots (26,678).

2. You've decided to count PGY1 + PGY2 positions in your 2005 data (PGY-1 only total spots: 21,454), but count just PGY1 in the 2014 data (total spots: 26,678)

3. The ratios are correct, but I think there's a second half to the story. You say "the number of medical graduates is increasing at a faster rate than the number of residency spots." If you look at the ratio of PGY1 spots:total applicants instead of just PGY1:active applicants you get the following.
In 2005 (Table 2) total applicants (active + withdrew) is 31,862. Total PGY1 spots (Table 1): 21,454. Ratio: 0.673
In 2014 (Table 4) total applicants (active + withdrew) is 40,394. Total PGY1 spots (Table 3): 26,678. Ratio: 0.660

So what we really see is that the number of US/Non-US FMGs withdrawing has gone down. This is also supported purely by the numbers of withdrawals you listed. And if you look at the match rates:
In 2005 (Table 2) there were 25,348 active applicants. Only 19,760 (78%) matched.
In 2014 (Table 4) there were 34,270 active applicants. Of them, 25,687 (75%) matched.
My interpretation is that people who have a snowball's chance in hell are wasting their time and money still actively applying instead of withdrawing.

I think the best argument one could make to say that FMGs will feel a squeeze is to look at the efficiency of the match. Even though the match rate has not changed significantly over the past decade (78% to 75%), the efficiency of the match has improved. Ratio of PGY1 matches: PGY1 positions. 2005: 0.921; 2014: 0.963. Obviously there will reach a limit to how efficient the match will fill positions and after it has, FMGs may more readily feel the squeeze. But that's purely speculation at this point.

EDIT: colon P makes a smiley face in 😛GY1

 

[Danglebells]

Lol that 1% squeeze

 

[Psai]

Several things:
1. All of the US/Non-US FMG data is correct and all of the percentages are correct, but something has to be wrong with the MD/DO data you posed. Just look at your 2014 data: Number of active applicants * % matched adds up to 27,506 which is more than the available spots (26,678).

2. You've decided to count PGY1 + PGY2 positions in your 2005 data (PGY-1 only total spots: 21,454), but count just PGY1 in the 2014 data (total spots: 26,678)

3. The ratios are correct, but I think there's a second half to the story. You say "the number of medical graduates is increasing at a faster rate than the number of residency spots." If you look at the ratio of PGY1 spots:total applicants instead of just PGY1:active applicants you get the following.
In 2005 (Table 2) total applicants (active + withdrew) is 31,862. Total PGY1 spots (Table 1): 21,454. Ratio: 0.673
In 2014 (Table 4) total applicants (active + withdrew) is 40,394. Total PGY1 spots (Table 3): 26,678. Ratio: 0.660

So what we really see is that the number of US/Non-US FMGs withdrawing has gone down. This is also supported purely by the numbers of withdrawals you listed. And if you look at the match rates:
In 2005 (Table 2) there were 25,348 active applicants. Only 19,760 (78%) matched.
In 2014 (Table 4) there were 34,270 active applicants. Of them, 25,687 (75%) matched.
My interpretation is that people who have a snowball's chance in hell are wasting their time and money still actively applying instead of withdrawing.

I think the best argument one could make to say that FMGs will feel a squeeze is to look at the efficiency of the match. Even though the match rate has not changed significantly over the past decade (78% to 75%), the efficiency of the match has improved. Ratio of PGY1 matches: PGY1 positions. 2005: 0.921; 2014: 0.963. Obviously there will reach a limit to how efficient the match will fill positions and after it has, FMGs may more readily feel the squeeze. But that's purely speculation at this point.

EDIT: colon P makes a smiley face in 😛GY1

Good point, I made a mistake in including the number of total DO and MD applicants who aren't all active applicants which made a huge difference because the number of do applicants to the match is about half the number of total do graduates. I also left out us grads (not seniors), canadians and fifth pathway.

I think the all in rule helped increase the efficiency of the match as the number of positions outside of the match greatly decreased.

 

[NotAProgDirector]

Sounds like you've solved the match math numbers. My bottom line is that, at present, the overall situation remains stable. You can clearly see the increase in allo students 2013-2015 as predicted by medical school class size increases / new schools. But the slots also increased at about the same rate, for reasons that are unclear. All-in brought more spots into the match, but also decreased pre-match contracts which decreases the withdrawal rate of the IMG's.

Whether these trends will continue or not is unclear. It's hard to tell how many new schools are still ramping up, whether allo spots will continue to increase, etc. We also have all of the DO spots in the AOA match which we are not including, and the SF match (which is small). And we're looking at PGY-1 positions, and know that prelim spots don't lead to board certification, and ignoring PGY-2 spots. So there's still lots of wiggle room.

There may be an IMG squeeze in the future. Or maybe not, it's hard to tell. I was much more worried about it several years ago, but I think we've seen most of the allo expansion now. Time will tell.

 

[NotAProgDirector]

I've known since my first interview that the ranking happens in the room in those intervals between interviews, but when (if ever) are factors such as USMLE score updates, publications, etc. considered if submitted after interviewing?

I think this is going to depend on program size. For small programs who don't interview a huge number of candidates, I expect that all ranking happens at the end. If you only have 20 people to put on your list, it's easy enough to have a lunch/evening meeting where you put everyone up on a screen and decide where people are going to be ranked. In that case, any late-breaking information is simply included in the ranking process.

In a bigger program (like mine), we rank as we go. It would be ridiculous to create a rank list from scratch on 200+ people. When we score people, we don't pick "#124" or "#5". Instead we score people by quartile -- 1st, 2nd, 3rd, 4th, and bottom-of-list/consider-not-ranking, and unrankable. So then I sort the list by these scores. Then, I take any new information (and the information I have) and re-jigger the list. A late-breaking Step 2 that is much better than Step 1 might bump someone from one category to the next (and vice versa). Any information is used to sort people within their quartiles. I focus on the part of the list where we tend to get our last match, since that's what matters in the end.

Other programs may do things differently.