Can I get whatever location I want for residency if...

[charger246]

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Can I get whatever location I want for residency if I am not selective/do not care about which specialty I match into?

Long story short, I didn't get into any of my local schools but got into out of state schools. It's pretty far away, but looking at the match list the school historically matches around 10-14 students out of ~230 per year back at my home state.

My main priority is getting back to my home state for residency, so are the chances of this good assuming my only factor when picking residency/specialty is location? (It's an East coast school and I'm from the Midwest, also thinking that there won't be too many people from my Midwest home state attending this school who want to go back there for residency, not sure if that will help me too...)

 

[costales]

Probably. It still depends on your competitiveness for those spots when you apply.

 

[babdoc]

It also depends on what state you're wanting to go back to and how many residency spots there are in said state. I would caution you in just wanting to get back no matter what the specialty is. Medical training is a marathon, and you only get (usually) one go at it. It is difficult to go back and switch specialties. It's generally better to do something you like rather than just going where you want. You'll be able to move back after you are done with residency if you don't get into a program in your home state.

 

[cabinbuilder]

Can I get whatever location I want for residency if I am not selective/do not care about which specialty I match into?

Long story short, I didn't get into any of my local schools but got into out of state schools. It's pretty far away, but looking at the match list the school historically matches around 10-14 students out of ~230 per year back at my home state.

My main priority is getting back to my home state for residency, so are the chances of this good assuming my only factor when picking residency/specialty is location? (It's an East coast school and I'm from the Midwest, also thinking that there won't be too many people from my Midwest home state attending this school who want to go back there for residency, not sure if that will help me too...)

You should absolutely care what your specialty is because misery does not make for a happy doctor. Your goal for residency choice is 1) specialty that you love 2) good training there because once you are out it's hard to pick up new skills. Once you are done, then move back home if you didn't match there in the first place. Need to understand that getting into a residency is almost as hard as getting into medical school.

 

[charger246]

You should absolutely care what your specialty is because misery does not make for a happy doctor. Your goal for residency choice is 1) specialty that you love 2) good training there because once you are out it's hard to pick up new skills. Once you are done, then move back home if you didn't match there in the first place. Need to understand that getting into a residency is almost as hard as getting into medical school.

No it's not. That may be your goal for residency, but it's not mine. I don't like pediatrics or family practice, but if it's the only specialties that will get me back to my home state, then I'll do it.

 

[cabinbuilder]

No it's not. That may be your goal for residency, but it's not mine. I don't like pediatrics or family practice, but if it's the only specialties that will get me back to my home state, then I'll do it.

I'm already an Attending. Your logic is going to make you one miserable doctor. Good luck.

 

[SLC]

No it's not. That may be your goal for residency, but it's not mine. I don't like pediatrics or family practice, but if it's the only specialties that will get me back to my home state, then I'll do it.

If I had to become a psychiatrist to get back to my home state; then I'd be looking for the best things about other states.

Take it from someone a little further along than you (and you've already had that above too); going through with this plan will not end well. Pick a specialty based on what you want to do in your career, not where you want to do residency. It will be awesome if you can do both; but if you have to pick one, pick the specialty of choice every single time.

 

[AlbinoHawk DO]

You're so naive that I don't know if I should be laughing at you or feel sad for you.

 

[MLT2MT2DO]

No it's not. That may be your goal for residency, but it's not mine. I don't like pediatrics or family practice, but if it's the only specialties that will get me back to my home state, then I'll do it.

In that case why bother with medical school? The quickest way to get back home would be to go apply to your local Jiffy Lube and forgo your acceptance.

 

[charger246]

I'm laughing at Albinohawk for how pathetically naive he is. If anyone can answer my questions it would be appreciated.

 

[charger246]

In that case why bother with medical school? The quickest way to get back home would be to go apply to your local Jiffy Lube and forgo your acceptance.

I don't know... some people have lives outside of freaking medicine and a desire to stay close to family.

 

[JimmyB123]

In that case why bother with medical school? The quickest way to get back home would be to go apply to your local Jiffy Lube and forgo your acceptance.

You'd be surprised how many people have a huge desire to stay close to home, loved ones, family, etc. Its not really an absurd thing.

 

[SLC]

I'm laughing at Albinohawk for how pathetically naive he is. If anyone can answer my questions it would be appreciated.

You've recoeved plenty of good (and correct) answers. The fact that you don't seem to like them is on you.

I mean if staying close to mom and dad is so incredibly important that you'd do any residency it took to make it happen, then why even go away to med-school in the first place. I think that's the most obvious question you should be asking yourself.

 

[TopTomato]

I'm laughing at Albinohawk for how pathetically naive he is. If anyone can answer my questions it would be appreciated.

I find it ironic that you're calling somebody else naive yet you seem rather uniformed about the whole matching process. Your question was already answered as stated above. Take what you will from what the previous posters had to say

 

[costales]

OP: You haven't started med school and you're asking people "Can I get whatever location I want...". The most correct answer is nobody knows. Furthermore, it's not uncommon for people to change their likes and dislikes during 3rd year, so you might want to keep that in mind as well.

 

[hallowmann]

I don't know... some people have lives outside of freaking medicine and a desire to stay close to family.

Yeah, but very few people are willing to put the work in that med school requires while simultaneously not caring at all about what specialty they go into and the quality of the training they get. Only you can answer that question about whether you can get into your home state. It depends on the number of residencies there and the competitiveness of those residencies. Generally speaking, the midwest is less competitive than the coasts, so that's a good sign.

That said, you are naive if you think after spending upwards of $200k and losing 4 yrs of your life to med school that it won't matter what you go into for the rest of your life. Residency isn't pleasant either, and it's even more unpleasant if you don't like what you're doing. If you really want to stay home and don't care what you do, why not apply to PA school or a nursing school in your home state. Whatever reasons you have for not doing so are going to be the same reasons you'd have for wanting a specific residency.

You'd be surprised how many people have a huge desire to stay close to home, loved ones, family, etc. Its not really an absurd thing.

It is. I completely get the wanting to stay close to home, it's pretty much the main reason I chose my school, and it's basically the number one reason med students choose their school. That said, very few, if anyone, picks residency on location alone. Sure you might only apply to residencies in an area, but you're not picking every possible type under the sun, unless some catastrophic event happens that forces you to go home and you just need a job.

This is what you will be doing for the rest of your life, and sure, you might choose a community hospital over a university one to stay in a certain location, but you're not going to choose say surgery over medicine just for based on location. They might all seem the same from a pre-med's perspective, but they are very different jobs and lifestyles.

Also, it's not unusual for people to like 2 or even 3 different specialties, but the idea of not caring at all is ridiculous (again unless you're in a desperate situation or a catastrophic event happened, but no one plans that going into med school). Also, applying to more than that becomes an expensive, tedious and difficult process on eras. Different fields have different requirements for LORs, what they look for, and even have different schedules for when and how they interview.

Also, as I alluded to above, if it doesn't matter what you do in life as long as you stay close to home, why not apply to local PA/NP programs? I mean if it's that important that you'd do anything, why would you do med school far away? Any differences you find in the residency fields are as variable as the difference between an MD/DO and a PA/NP.

 

[charger246]

I want to be a doctor, not a PA/NP and that's why I'm going to medical school. But at the same time, there are some things that are much more important to me than medicine, and family/being close to family is one of them. It's that simple and that's why I care about the location of my residency over the specialty. If you don't mind spending 8 years away from your family, that's fine. You can do whatever you want to, just like I can.

 

[SLC]

I want to be a doctor, not a PA/NP and that's why I'm going to medical school. But at the same time, there are some things that are much more important to me than medicine, and family/being close to family is one of them. It's that simple and that's why I care about the location of my residency over the specialty. If you don't mind spending 8 years away from your family, that's fine. You can do whatever you want to, just like I can.

Fair enough. The answer is no though, you can't just get whatever location you want for residency. You can try, and you can do a lot to increase the chance that you can be close to mom and dad; but in the end, the program has to want you and if they don't, you won't go there.

Best of luck, I personally think the idea you're floating is crazy, but as you said, you can do what you want.

 

[DocWinter]

I would have to imagine that if I were a residency director and had a prospective resident walk in to interview, to learn that he or her was not interested in orthopedic surgery, or family, or ER, or whatever I oversaw, but to learn instead he had decided on this life choice by location alone - I wouldn't touch it with a 39.5' pole. If you had narrowed down to two specialties, maybe, I could understand location being a prime reason. But your ideology comes across immature and flighty.

 

[jl lin]

It's insane to even go through the processes of attempting MS acceptance, MS, and the long beating of residency w/o really wanting to explore what kind areas of medicine interest you most and light your fire, so to speak. Seriously. It's just plain nutty. If you don't have interest or passion to seek out a residency that interests you and aren't willing to go to where you must to develop in that area--of course within reason if you have, say kids or whatever--I wouldn't want to keep you as my physician.

I'm sorry. I had one MD as my physician. He came from another country, seemed nice and relatively intelligent; but I think his biggest issue is that he has little passion and interest/curiosity for what he is doing. Plus, he was nicely on the condescending side--and my skin is tougher than a lot of folks' skin--but he just really doesn't listen to his patients. Other family members and friends went to him, and he missed some important stuff. and ignored them in a politely condescending way, as well. I think he has a bit of the lifestyle he wanted, but he is no ball of fire, compassion, and intellectually curiosity or even insight. I switched to his partner, who is an American educated/trained DO, b/c he posses all of those things the other fellow does not. My other family members have now switched to this other physician as well.

See, people actually want physicians that not only are bright, highly knowledgeable and insightful (And IMHO not holding too too hard and fast to EBM, although it's important--point: medicine is both an ART & Science). They want a physician who is able to listen, have compassion, and truly care and in the know about what they are doing. How can you get to any of this without passion and a sense of direction other than geography and that's it?

Regardless of where you end up, first year residency, if you are NOT interested in what you are doing enough to be all up in it, you will probably flounder or burn out and hate your life. You generally don't have a lot of time for anything other than residency when in residency, so other than immediate family priorities--such as spouse & kids--what difference does it make where you are? It's not like you will be able to have much of a personal life during those years--somewhat, but not much--even if you get matched into a more lifestyle-friendly field of medicine.

If you want decent money and lifestyle for a much lesser investment in time, money, and prolonged aggravation, you might want to consider the route to CRNA. $160,000+ ^ is nothing to sneeze at for a ~2.5 yrs or so investment in a CRNA program after you complete a program of professional nursing, get licensed, and get a least a year of solid ICU experience. It would be relatively easy for me to pursue this b/c of my experience as a Critical Care RN, summa cum from a nice university, references, etc. I could be done in less than half the time as compared with becoming a physician. Then I could make a pretty nice income. I love critical care nursing and even CM, but now I want to spend time learning and growing with patients as a physician. There are a lot of things that have brought me to this. But yes. I could jump through all the hoops for CRNA, but the passion is lacking comparatively speaking. I could definitely be all bottom line/dollar at this point in my life. It's stupid for me though. It doesn't fit--and frankly, I don't think it's the best use of me--my life and time and my experence.

Also, as suggested, consider PA school. Especially if you work in an area that does procedures, you can make some good money.
Good luck whatever. But seriously. How many docs have you shadowed? Shadow some PAs, NPs and CRNAs too. How much clinical exposure have you gotten thus far?

 

[MLT2MT2DO]

You'd be surprised how many people have a huge desire to stay close to home, loved ones, family, etc. Its not really an absurd thing.

And if it is THAT important he should reconsider attending medical school out of state. Even if that is the only place he gets accepted.

 

[MLT2MT2DO]

I want to be a doctor, not a PA/NP and that's why I'm going to medical school. But at the same time, there are some things that are much more important to me than medicine, and family/being close to family is one of them. It's that simple and that's why I care about the location of my residency over the specialty. If you don't mind spending 8 years away from your family, that's fine. You can do whatever you want to, just like I can.

To me it sounds like you have no idea what you want. You're willing to spend 4 years to become an MD/DO but not another 3ish to go into your desired specialty? As mentioned you're either completely naive or this is a troll post.

 

[Apoplexy__]

To me it sounds like you have no idea what you want. You're willing to spend 4 years to become an MD/DO but not another 3ish to go into your desired specialty? As mentioned you're either completely naive or this is a troll post.

Dude chill out or OP will call you naive too...

 

[babdoc]

It will be interesting to see how the OP feels in three or four years. I imagine his/her opinion will change.

I wonder if s/he would have an easier time applying to each specialty located in the chosen states or picking a single specialty and applying in the state and in every contiguous/close state. For instance, if there are 15 different residency programs in a variety of specialties in that state and 4-6 programs in a single specialty in the state and those surrounding it, with which would s/he be more likely to be successful? My gut tells me it would be the latter in most cases.

 

[charger246]

To me it sounds like you have no idea what you want. You're willing to spend 4 years to become an MD/DO but not another 3ish to go into your desired specialty? As mentioned you're either completely naive or this is a troll post.

You're the naive one. You people are cracking me up, so I gotta thank you for that at least even if you've given utterly useless advice.

I'm willing to spend 3 years of medical school out of state. From what I understand, 4th year I can choose where I go mostly for elective rotations (which I will do back home in Missouri and which goes a long way in determining your residency as well from what I hear) and residency I will do back home as well.

I am not asking for my cake and to eat it as well (desiring a mega competitive or even moderately competitive specialty only at one location). I'm willing to do anything as long as I choose the location.

Sorry, but that's very feasible whether you like it or not.

*waits for the 50th "why not go the PA/NP route?" question*

 

[charger246]

It will be interesting to see how the OP feels in three or four years. I imagine his/her opinion will change.

I wonder if s/he would have an easier time applying to each specialty located in the chosen states or picking a single specialty and applying in the state and in every contiguous/close state. For instance, if there are 15 different residency programs in a variety of specialties in that state and 4-6 programs in a single specialty in the state and those surrounding it, with which would s/he be more likely to be successful? My gut tells me it would be the latter in most cases.

Historically this school averages around 13-15 matches out of around 230 students at my home state. Maybe only 1 of these matches is in what one could consider a competitive specialty.

I highly doubt there are many people from my home state at this school, and I doubt there are that many who want to go there for residency too. Shouldn't be that difficult. Sorry it bothers you people so much that I have different priorities in life outside of medicine, but that's the way it is. Too bad.

 

[DocWinter]

You're right, us actual medical students, residents, doctors and admissions councils have lost touch with reality and gained none but naivety through the process or completion of what you have yet to do...
Friend, 4+ years from now you will have matured and discovered what you want to do and this won't be an issue. No use trying to work through this problem at this time.

 

[SLC]

You're the naive one. You people are cracking me up, so I gotta thank you for that at least even if you've given utterly useless advice.

When 100% of the advice you're given is not what you want to hear you can get upset, but you can't really call it useless can you?

It doesn't matter though, you'll realize we are right soon enough.

 

[babdoc]

Historically this school averages around 13-15 matches out of around 230 students at my home state. Maybe only 1 of these matches is in what one could consider a competitive specialty.

I highly doubt there are many people from my home state at this school, and I doubt there are that many who want to go there for residency too. Shouldn't be that difficult. Sorry it bothers you people so much that I have different priorities in life outside of medicine, but that's the way it is. Too bad.

Okay, since we are both from MO, and I went to school there, I feel more comfortable commenting on your prospects. There are a lot of programs in MO. If you do reasonably well in med school, you will have a good chance of matching into something. That being said, you still might do better if you end up liking a specialty like family medicine or internal medicine. There are 13 FM programs and 10 IM programs in the state (WashU is essentially unattainable for a DO, so make that 9 for IM). You'd have a good chance of getting a spot in one of those programs if you're interested in those specialties. All we are trying to say is that if you have the interest and focus on one specialty, you'll have a better chance than if you shotgun a bunch of specialties, not to mention you'll be doing the specialty for 30+ years...

 

[IlDestriero]

No it's not. That may be your goal for residency, but it's not mine. I don't like pediatrics or family practice, but if it's the only specialties that will get me back to my home state, then I'll do it.

This line of thinking doesn't make any sense.
Once you are done with your training, you can try to move anywhere you want, however there is no guarantee there will be a job for you there.
One of my friends had to leave his employer of 15 years because they moved his group to another state and he didn't want to relocate with them. He was a senior person, lots of experience, making a good income and with a good career trajectory (regular promotions and increasing responsibility). It is a large global corporation. The sky was the limit. He's now unemployed and nothing has panned out. He lives in a smaller city and now it looks like he will have to end up moving anyway.
Be careful being too geographically limited.

 

[petyr_baelish]

Since you are from Missouri and not Southern California, I don't think you'll have any problems matching back home, OP. Missouri (particularly rural Missouri) has a dire need for more physicians.

 

[babdoc]

And if all else fails, you could be an "assistant physician." 🙄

http://www.sciencebasedmedicine.org...mary-care-shortage-with-assistant-physicians/

 

[shibby1111]

Can I get whatever location I want for residency if I am not selective/do not care about which specialty I match into?

Long story short, I didn't get into any of my local schools but got into out of state schools. It's pretty far away, but looking at the match list the school historically matches around 10-14 students out of ~230 per year back at my home state.

My main priority is getting back to my home state for residency, so are the chances of this good assuming my only factor when picking residency/specialty is location? (It's an East coast school and I'm from the Midwest, also thinking that there won't be too many people from my Midwest home state attending this school who want to go back there for residency, not sure if that will help me too...)

^says the pre-med. you're not going to know what state your in during medical school as temperature is constant inside the building. you're not going to know what state your in during residency as temperature is constant inside the building.

 

[IslandStyle808]

I want to be a doctor, not a PA/NP and that's why I'm going to medical school. But at the same time, there are some things that are much more important to me than medicine, and family/being close to family is one of them. It's that simple and that's why I care about the location of my residency over the specialty. If you don't mind spending 8 years away from your family, that's fine. You can do whatever you want to, just like I can.

So your not okay with being a PA/NP, but you are okay with a speciality that you may not like as long as you get back to the state of residence you want. You pretty much proven with your comment that what you want to do is greater than where you want to work. If you were to read this thread in four years, do you really believe your specialty choice won't matter as much as being a doctor? It will definitely matter just as much.

 

[charger246]

So your not okay with being a PA/NP, but you are okay with a speciality that you may not like as long as you get back to the state of residence you want. You pretty much proven with your comment that what you want to do is greater than where you want to work. If you were to read this thread in four years, do you really believe your specialty choice won't matter as much as being a doctor? It will definitely matter just as much.

Not at all. I'll do medicine, and I'll go away for 3-4 years to study it since I didn't get in anywhere local, but after that I'm coming back where I want to be. And by not being selective about which specific area of medicine I want to match into, I give myself a better chance of matching at my preferred location. Since I made this thread I've talked to a few people about this very issue and they say it's very realistic to match where you want to, especially if you don't care about specialties.

 

[SLC]

The main problem (besides the obvious risk of you being very, very unhappy) is that residencies want to see dedication to their particular specialty from applicants. It's one of the main things they cite as being influential in ranking interviewees.

This plan is not only asinine; but it's going to require you to write believable personal statements about each and every program you apply to. They will not be impressed by "I really don't care too much about psychiatry, but being here in MO is absolutely critical to me" It will not end well, I can't stress that enough.

But if you want to believe only the folks who are telling you what they know you want to hear, then knock yourself out.

 

[ShyRem]

Bottom line: probably. But you won't like it and it probably isn't going to be your first choice. See, residency programs tend to want people who WANT that specialty. They want to see a spark there for that field. Frankly, if I were a PD and you can across my desk applying to every residency program in a particular area of the country but not a particular area of medicine, I wouldn't even rank you. Anywhere. Because you don't want to learn medicine, you just want to live somewhere and to do that, you don't need to take up valuable space in my program. I want people who WANT to be there and WANT to learn. Makes the hard work and long hours much easier. If you don't care about what kind of medicine you practice, then that's how you're likely to treat patients too. No thanks.

I would encourage you to find your niche and figure out what kind of medicine you want. THEN apply to every program around your desired location. You are far better off matching that way than applying to every single program regardless of field in your hometown. You may end up a couple of hours from home, but at least you will be intellectually satisfied and close enough to drive home on your golden weekends. It's all about balance.

You're also quite young in your journey. Relax. Take your time and learn medicine. Figure out what ignites your passions. If, however, all you truly care about is living at home then don't take space in med school and don't get into hundreds of thousands of dollars of debt to be unhappy for 3 years. It's not worth it. Really.

You may look at the above and disagree. This only shows your naivete. If you want to succeed you may want to listen to those who have gone through the process. You asked for advice, you're getting it. No need to be mean just because you don't like the answers of those older and wiser than yourself. It is your life and how you choose to be miserable or happy is completely up to you.

 

[ChrisGriffen]

This is like the prequel to a massive trainwreck.

***** doesnt even know what medicine IS yet. Already thinks he loves all of it equally.

Cant wait for when 5 local hospitals get applications to every different program they offer. Laughable to think they wont just get thrown away. Do you think PDs dont talk to each other? Nobody will rank you if you dont commit to a specialty.

But since you are ignoring all logical advice, please don't mail me 2000 dollars.

 

[hallowmann]

I've heard that attrition rates in residencies is up to 20% in some fields (edited) and most of it isn't from being kicked out. Just think about that, 1 in 5. Programs know this, and go very far out of their way to find people that actually want to be in their field and in their program specifically. They want people who will make it through in one go and successfully take boards and pass on their first try. Just throwing that out there.

 

[MLT2MT2DO]

I've heard that attrition in residencies is on the order of 20% and most of it isn't from being kicked out. Just think about that, 1 in 5. Programs know this, and go very far out of their way to find people that actually want to be in their field and in their program specifically. They want people who will make it through in one go and successfully take boards and pass on their first try. Just throwing that out there.

20% residency attrition? This must be an AOA issue, any ACGME attrition near that would be malignant as hell...but I digress.

 

[IlDestriero]

That statistic is not accurate. Few residents get the axe during training. Some leave on their own for any number of reasons, but 20%? Not even close.

 

[costales]

Here's some data - from AAMC:

 

[babdoc]

That statistic is not accurate. Few residents get the axe during training. Some leave on their own for any number of reasons, but 20%? Not even close.

It seems like programs are more apt to hold a resident back a year or part of a year rather than kick them out all together. Usually, that's reserved for something really egregious.

 

[hallowmann]

20% residency attrition? This must be an AOA issue, any ACGME attrition near that would be malignant as hell...but I digress.

I actually read this in a book targeted to MDs about specialties. I'll double check their source when I find the book.

Also, to be clear, by attrition, I included delaying or transferring to different programs, so attrition might not be the best word, but you see my point. And I said, most is not from being kicked out of residency, but rather from transferring to a another program (either within the same field or a different one).

Here's some data - from AAMC:

I'm a little confused by these graphs, do you have links to them so we can know what population the data represents? In the top one, FM attrition is like 5%, but in the bottom one its more like 10-15%. Am I missing something?

In any case, again, I was describing the total percent of residents that either don't finish on time, get kicked out, switch to another program within the same field, or switch to another program in another field (so maybe attrition isn't the right word, but again my point was that the proportion that leave their program - in most cases for another - is said to be shockingly high).

This is not an AOA vs. ACGME issue, it's a residency issue. From the family members and friends that are APDs and PDs (at ACGME programs), when I mentioned hearing this number it seemed believable to them, but take that for what its, especially given that they are from programs primarily in a specific region.

EDIT: ACGME FM guidelines require that attrition, meaning the number of residents to not complete the program may not exceed 15% averaged over 5 yrs. That doesn't really tell me about turnover rates (which is probably what I should have called it) with residents leaving programs and new residents entering, but should at least gives an ipper limit on hard attrition.

 

[hse]

the 20% figure is mentioned several places on the web for surgical
https://www.facs.org/education/reso...n-the-dos-and-donts-of-winning-the-match-game
Despite the extensive application and residency screening processes, attrition from surgery programs remains high at approximately 20 percent, with many residents leaving for nonsurgical programs... A recent national study6 looking at attrition for all categorical general surgery residents on the 2007–2008 resident rosters found a cumulative attrition rate of 19.5 percent, with the highest attrition in the PGY-1 year (5.9%), PGY-2 year (4.3%), and research years (3.9%).
i found the original for those graphs posted above... its at
https://www.aamc.org/download/185478/data/2011_pwc_pugno.pdf

 

[costales]

Also, to be clear, by attrition, I included delaying or transferring to different programs, so attrition might not be the best word, but you see my point. And I said, most is not from being kicked out of residency, but rather from transferring to a another program (either within the same field or a different one).
I'm a little confused by these graphs, do you have links to them so we can know what population the data represents? In the top one, FM attrition is like 5%, but in the bottom one its more like 10-15%. Am I missing something?

The numbers in the top graph are annualized data i.e. annual rates. BTW In an ACGME journal article showing similar data (http://dx.doi.org/10.4300/JGME-D-12-00141.1) attrition is defined as "transferring to another program, transitioning to another specialty, withdrawal, dismissal, leave of absence, or other." The annual rate is a slope: "Data sets between 2000 and 2009 were complete for the total number of residents. The complete data were reported at a population level for the specialty, so inferences using confidence intervals were unnecessary. Rates of annual attrition were undertaken by fitting a line to the data and reporting a slope. Variability for the year-to-year attrition numbers and rates during the 10-year period were reported as a mean +/- SD."

i found the original for those graphs posted above... its at
https://www.aamc.org/download/185478/data/2011_pwc_pugno.pdf

Thanks. I forgot.

 

[hallowmann]

the 20% figure is mentioned several places on the web for surgical
https://www.facs.org/education/reso...n-the-dos-and-donts-of-winning-the-match-game
Despite the extensive application and residency screening processes, attrition from surgery programs remains high at approximately 20 percent, with many residents leaving for nonsurgical programs... A recent national study6 looking at attrition for all categorical general surgery residents on the 2007–2008 resident rosters found a cumulative attrition rate of 19.5 percent, with the highest attrition in the PGY-1 year (5.9%), PGY-2 year (4.3%), and research years (3.9%).
i found the original for those graphs posted above... its at
https://www.aamc.org/download/185478/data/2011_pwc_pugno.pdf

Thanks for the legwork and at least proving I wasn't completely pulling that number out of the air. I guess it makes sense for surgery to be high because of both the length of residency and the time commitment required.

That helps a bit since I couldn't find the book I read it out of, and I was starting to feel like I was crazy 😛

The numbers in the top graph are annualized data i.e. annual rates. BTW In an ACGME journal showing similar data (http://dx.doi.org/10.4300/JGME-D-12-00141.1) attrition is defined as "transferring to another program, transitioning to another specialty, withdrawal, dismissal, leave of absence, or other."

Thanks costales! So basically the complete attrition of residencies is anywhere from 3-7 times the number in the first graph. Is that right? In other words, FM is closer to 12%, IM is closer to 4%, Peds is ~9%, and Psych is in the range of 34+% (crazy).

Considering most residencies are in IM or FM, the average attrition is probably in between the two, with the 20%+ being more the upper outliers.

Thanks for correcting me everyone, I'll edit my post to reflect it.

 

[costales]

Yes, the cumulative attrition rate depends on the length of the program, and 20% is a widely quoted number for surgery (http://www.ncbi.nlm.nih.gov/pubmed/20739854) - a 20-year audit at Yale even found 30% (http://www.nesurgical.org/abstracts/2007/16.cgi).

 

[MLT2MT2DO]

Thanks costales! So basically the complete attrition of residencies is anywhere from 3-7 times the number in the first graph. Is that right? In other words, FM is closer to 12%, IM is closer to 4%, Peds is ~9%, and Psych is in the range of 24+% (crazy).

Considering most residencies are in IM or FM, the average attrition is probably in between the two, with the 20%+ being more the upper outliers.

Thanks for correcting me everyone, I'll edit my post to reflect it.

The annual report does not equal a cohort group so you don't get to multiply it by years of residency and state that's the number. Every year looks at all 3 or 4 or 5 etc years of residency.

So 9% is 9% in psych, not 9%*4 years of residency= 36% attrition.

 

[hallowmann]

The annual report does not equal a cohort group so you don't get to multiply it by years of residency and state that's the number. Every year looks at all 3 or 4 or 5 etc years of residency.

So 9% is 9% in psych, not 9%*4 years of residency= 36% attrition.

You sure about that? I get that it wouldn't be an exact estimate, because there is cohort variation, butyou can see from the FM graph that costales posted that FM attrition is in fact close to the 12% (roughly equal to adding each year).