Charting Outcomes in the Match 2018 Edition & Program Director Survey

[hallowmann]

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A bit surprised this was not posted yet, but breaking from tradition of releasing this report the day after NRMP apps go out, they have released all their reports. I'm still peeling through it to see about any changes/trends, but I'll post the links for now.

A few things:
-They separated seniors and graduates for Osteo!
-82.6% of Osteopathic Seniors matched to their preferred (i.e. the one they ranked first) specialties. Do not confuse this with the percentage that matched, as that number is higher (>85%).
-More specialties are represented, including more surgical subspecialties - the numbers aren't pretty for those.
-They included USMLE scores for Osteo (and they're actually on the higher side - Matched average is 227 and Unmatched average is 220 for Step 1)
-Based on skimming through, the average number of ranks that seems to start to show a pretty big distinction between matching and not is ~10. This varies by specialty, with some being as low as 7 and some being into the teens.
-The USMLE Step 1 score at which it appears that taking the exam is "worth it" seems to be somewhere in the 210-220 range, which is consistently with what many of us already believed. Depending on the specialty, this too varies.
-When it comes to surgery/surgical subspecialties:
----DOs consistently do worse compared to other specialties
----For many the USMLE cutoff for which the USMLE seems to truly make a difference is closer to >230, and for some fields, more research makes a big difference.
----For many of them, scores and research similar to US MD applicants in the same fields seems to be a big factor in matching or not.
----There is an almost shocking range of DO USMLE scores that apply to certain specialties. NeuroSurg has DOs with score ranges from 200-260, and its not surprising that those that match are in the group that have USMLE Step 1 scores >240.
-Overall, the big thing that shocks me is just how high DO USMLE scores are and they generally correlate more with US MD scores than I expected, being only 4-5 pts below their US MD counterparts for matched vs. unmatched applicants.

What does this mean?:
-Surgery and surgical subspecialties are still an uphill battle. To be competitive you really have to compare to the US MD applicants for those fields, and as a group, those DOs that apply to those fields, generally don't.
-DOs should be ranking >10 programs at least
-DOs who are debating whether or not to take the USMLE Step 1 should aim for a score >210-220, but this varies by specialty, so adjust accordingly
-Competition is steep in a lot of fields in the NRMP, keep this in mind when you start to build your app and apply. Have backups, apply to enough programs to get sufficient interviews, and be realistic.



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

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

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

2018 NRMP Program Director Survey
http://www.nrmp.org/wp-content/uploads/2018/07/NRMP-2018-Program-Director-Survey-for-WWW.pdf
Some Points:
-This looks pretty similar to previous years
-Generally speaking more programs consider and regularly rank DOs than US IMGs/non-US IMGs, however, there are exceptions and these are primarily in General Surgery and the surgical subspecialties. This is not a surprise, but still disappointing nonetheless.
-Interestingly, something like 40% of programs actually do have target cutoffs for COMLEX Level 1 scores. That actually means that the numbers mean something to those programs

 

[iceclimb12]

Great analysis, thanks!

 

[rg2o3]

Thanks for this!

 

[Ho0v-man]

Unless I’m misunderstanding, it looks like we have about the same likelihood of matching as our MD counterparts if we have the same step scores. Cool.

Edit: for most fields

 

[rg2o3]

Would you all attribute the lower match percentage of preferred specialty due to the students error? Example being, applying to ortho when you’re barely competitive for FM?

 

[cubswin]

Would you all attribute the lower match percentage of preferred specialty due to the students error? Example being, applying to ortho when you’re barely competitive for FM?

Could also be applying to the wrong ortho program. Best bet would be to apply to the ortho programs that used to be AOA. Maybe they will still show DO favoritism.

 

[hallowmann]

Would you all attribute the lower match percentage of preferred specialty due to the students error? Example being, applying to ortho when you’re barely competitive for FM?

Likely a combination of factors (e.g. not being competitive enough, not applying/interviewing at enough programs, inherent anti-DO bias, applying unwisely to only "wrong" programs as cubswin describes). You can actually see with the NeuroSurg score distribution of unmatched DO seniors, there were some people that applied to Neurosurgery with 200s on Step 1. Those people were reaching for the stars, but they likely had a backup (or at least I hope they all did).

 

[rg2o3]

Likely a combination of factors (e.g. not being competitive enough, not applying/interviewing at enough programs, inherent anti-DO bias, applying unwisely to only "wrong" programs as cubswin describes). You can actually see with the NeuroSurg score distribution of unmatched DO seniors, there were some people that applied to Neurosurgery with 220s on Step 1. Those people were reaching for the stars, but they likely had a backup (or at least I hope they all did).

Yeah, I noticed that and that’s one of the things that made me think that maybe students are not aware, or have poor advisors and it’s lowering the match rate. Regardless, I don’t believe that this supports the SDN picture that the sky. Who knows

 

[AnatomyGrey12]

Bottom line, try and look like your MD counterparts on paper. For surgical subs, be a baller and hope you have a little luck.

Edit: it’s nice to see validation of my general surgery suspicions. Break 230 and apply broadly and you’ve got a pretty good chance.

 

[hallowmann]

Yeah, I noticed that and that’s one of the things that made me think that maybe students are not aware, or have poor advisors and it’s lowering the match rate. Regardless, I don’t believe that this supports the SDN picture that the sky. Who knows

I think a major problem with DO schools in general is a lack of good advising for residency applications at the majority of DO schools. I remember having a handful of talks given at my school, mostly by 4th years with general advice, and it was usually 50/50 at best. There were also 1-2 from faculty/admin talks, but their advice was either just wrong or way outdated.

Bottom line, try and look like your MD counterparts on paper. For surgical subs, be a baller and hope you have a little luck.

Truth.

 

[rg2o3]

I think a major problem with DO schools in general is a lack of good advising for residency applications at the majority of DO schools. I remember having a handful of talks given at my school, mostly by 4th years with general advice, and it was usually 50/50 at best. There were also 1-2 from faculty/admin talks, but their advice was either just wrong or way outdated.



Truth.

Thankfully I’ve found the coveted members of SDN to guide me. Hah.

 

[W19]

Geat job @hallowmann!

 

[2021Doctor]

It looks like only four graduating DO seniors matched ACGME orthopedic surgery.
That seems like a low number to me.
It also looks like 11 IMGs matched ACGME orthopedic surgery.
Am I reading this correctly or am I mistaken?

 

[AnatomyGrey12]

It looks like only four graduating DO seniors matched ACGME orthopedic surgery.
That seems like a low number to me.
It also looks like 11 IMGs matched ACGME orthopedic surgery.
Am I reading this correctly or am I mistaken?

Yeah but go look at the average for matched and unmatched. Looking at the step score breakdown: There were 4 people that applied with below a 230. There were only 8 people that applied with a 230+, and 4 of them matched. I have very good sources that tell me that the UW GS match from KCU dual applied ortho and GS, and ended up ranking UW higher than at least one ortho program. He would be listed as an unmatched ortho candidate, even when he would have likely matched. Hard to know what would have happened. If you take him out then you are left with only 7 230+ realistic applicants to ortho from DO schools.

4/7 really is pretty good considering. Most great ortho applicants still matched through the AOA.

I’m curious to see what happens when every program is in one match and what the numbers look like. Overall this report is far more encouraging to me than I would have thought.

 

[QueenJames]

LEGIT.

 

[Dwan]

Unless I’m misunderstanding, it looks like we have about the same likelihood of matching as our MD counterparts if we have the same step scores. Cool.

Edit: for most fields

Matched applicants have a similar step, but the likelihood of matching at each cutoff is quite different (many with the appropriate step don't get in). For example, for Gsurg match rates: 220s=50% DO/ 80% MD, 230s = 72% DO/ 94% MD, and 240+ = 74% DO/ 97% MD. For specialty fields like ortho, MDs with <220 match at better rates than DOs with >240. This doesn't account for other factors such as research, however (generally lower among DOs).

 

[rg2o3]

Matched applicants have a similar step, but the likelihood of matching at each cutoff is quite different (many with the appropriate step don't get in). For example, for Gsurg match rates: 220s=50% DO/ 80% MD, 230s = 72% DO/ 94% MD, and 240+ = 74% DO/ 97% MD. For specialty fields like ortho, MDs with <220 match at better rates than DOs with >240. This doesn't account for other factors such as research, however (generally lower among DOs).

Obviously just speculation, but do you all ever see these numbers evening, even just slightly, in 10-15 years?

 

[Rekt]

Obviously just speculation, but do you all ever see these numbers evening, even just slightly, in 10-15 years?

No. There will be an increase of matches from established schools and from converted programs, but the sheer amount of bottom feeder diploma Mills that are opening will either keep it the same or bring it down.

 

[DrMcLovin]

It's going to be interesting to see the report once there's a single match for MD's & DO's. I'm glad they are adding USMLE scores as it makes the data more informative for future grads.

The only specialty I'm familiar with is ortho and most of us DO's are still matching through the AOA match. I know of at least 1-2 factors causing the numbers we see in the DO NRMP charting outcomes this year.

1. Nassau University program took applications through the DO side of ERAS but ended up matching 1 in AOA and the other in NRMP match after interviewing ~50 people. Since they can only see COMLEX scores and don't require an audition rotation they ended up interviewing a lot of people with good COMLEX scores but mediocre USMLE scores. I know of a few people who interviewed there and went unmatched in the AOA match and went into the NRMP match with 1 rank for 1 spot. This is one of the factors contributing to why we see the 10 unmatched orthopedic applicants with 1 contiguous rank (page 150)

2. Broward ended up only offering 1 spot in the DO match this year and 2 in NRMP. People who used a precious audition month on this program could have went unmatched in the AOA if they only had 1-3 other months to audition at other DO programs. Most DO programs require an audition so this could have really hurt some applicants. Unfortunately the people who went unmatched in the AOA match were unlikely to snag one of the other 2 spots.

Overall, it looks like the folks with 3+ ranks are the stellar applicants who decided to only rank a few in the AOA match or skip the AOA match entirely. It is unlikely someone with 1-2 ranks in the NRMP match would end up in that situation willingly without first going unmatched. Judging from the PD survey it is still an uphill battle getting interviews at ACGME programs that werent AOA at some point.

 

[rg2o3]

No.

Have we not already seen an increase in DOs marching ACGME since DO became a thing? Why would this trend not increase? Even slightly. (Not sure if this is even the case, just intrigued)

 

[AnatomyGrey12]

Obviously just speculation, but do you all ever see these numbers evening, even just slightly, in 10-15 years?

Have we not already seen an increase in DOs marching ACGME since DO became a thing? Why would this trend not increase? Even slightly. (Not sure if this is even the case, just intrigued)

What is your specific question? DOs will never match as well as MDs, although the numbers aren’t as bleak as previously thought.

 

[rg2o3]

What is your specific question? DOs will never match as well as MDs, although the numbers aren’t as bleak as previously thought.

Yeah, definitely. In his post he compared match rates of DOs to MDs that had similar step scores. For example,

Matched applicants have a similar step, but the likelihood of matching at each cutoff is quite different (many with the appropriate step don't get in). For example, for Gsurg match rates: 220s=50% DO/ 80% MD, 230s = 72% DO/ 94% MD, and 240+ = 74% DO/ 97% MD. For specialty fields like ortho, MDs with <220 match at better rates than DOs with >240. This doesn't account for other factors such as research, however (generally lower among DOs).

So, I. Just wondering if anyone believes that rates with similar steps as MDs ever evening out. Even a little, say 60% DO/80% MD for the given example.

 

[AnatomyGrey12]

So, I. Just wondering what the consensus on math rates with similar steps as MDs ever evening out. Even a little, say 60% DO/80% MD for the given example.

Likely no.

 

[Jinxapotato]

Yeah, definitely. In his post he compared match rates of DOs to MDs that had similar step scores. For example,


So, I. Just wondering if anyone believes that rates with similar steps as MDs ever evening out. Even a little, say 60% DO/80% MD for the given example.

Depending on specialty really, for surgical stuff, likely no. For non surgical stuff, I think the odds of matching (not considering quality of match) is pretty even as it is now

 

[Goro]

A bit surprised this was not posted yet, but breaking from tradition of releasing this report the day after NRMP apps go out, they have released all their reports. I'm still peeling through it to see about any changes/trends, but I'll post the links for now.



2018 NRMP Program Director Survey
http://www.nrmp.org/wp-content/uploads/2018/06/NRMP-2018-Program-Director-Survey-for-WWW.pdf
Some Points:
-This looks pretty similar to previous years
-Generally speaking more programs consider and regularly rank DOs than US IMGs/non-US IMGs, however, there are exceptions and these are primarily in General Surgery and the surgical subspecialties. This is not a surprise, but still disappointing nonetheless.
-Interestingly, something like 40% of programs actually do have target cutoffs for COMLEX Level 1 scores. That actually means that the numbers mean something to those programs

I ran into a dead link for the PD's survey. The live one can be found here:
http://www.nrmp.org/wp-content/uploads/2018/07/NRMP-2018-Program-Director-Survey-for-WWW.pdf

 

[jw3600]

While I think overall this is good results for DOs, the one thing this kind of analysis cannot show is competitiveness of programs matched into within a specialty. Now for a lot of us that were just happy to be physicians this isn't a huge deal but people should be made aware. DOs do and will always continue to struggle with matching at top tier institutions. That said an OB is an OB. A general surgeon a general surgeon and so on.

 

[cubswin]

Yeah, definitely. In his post he compared match rates of DOs to MDs that had similar step scores. For example,


So, I. Just wondering if anyone believes that rates with similar steps as MDs ever evening out. Even a little, say 60% DO/80% MD for the given example.

A lot would have to happen. Pure speculation here:

AOA would need to stop school expansion. Focusing on quality over quantity. Newer schools often have a 500 mcat as a competitive score for applicants. Bringing in students who can’t compete with MD counterparts.
This will bring down the USMLE scores and match rate comparisons.

After years of focusing on education over expansion and increasing mcat requirements for admissions to all schools, the student body would be more competitive and achieve higher scores.

MD expansion would have to stay stagnant and residency spots would have to increase.

Then we could see match rates equal out. But even then, the matches would probably be to non academic institutions. It would take even longer for that to occur and probably will never occur as long as DO’s are the minority.

 

[Black Coffee 24/7]

I'm prepared to check urine dipsticks and med refills all day in primary care.

Honestly, if I'm forced into primary care, there's no way that I'm going to practice in a urban area. You can still feel like a physician if you're practicing primary care in rural communities.

 

[Drrrrrr. Celty]

It's pretty nice that they included step scores.

It's still an overall difficult to analyze document though. For sure the major take away is that if you can break a 210 it's advantageous.

 

[AnatomyGrey12]

It's pretty nice that they included step scores.

It's still an overall difficult to analyze document though. For sure the major take away is that if you can break a 210 it's advantageous.

Yeah and there are a few fields like that too. 230 seems to be a difference maker for GS.

Anesthesia and EM appear non-competitive lol

 

[Drrrrrr. Celty]

Yeah and there are a few fields like that too. 230 seems to be a difference maker for GS.

Anesthesia and EM appear non-competitive lol

Which isn't too surprising. If you want something mid range competitive you need to be above the average MD.

Gas has always been somewhat uncompetitive. EM is a surprise tbh.

 

[SLC]

It looks like only four graduating DO seniors matched ACGME orthopedic surgery.
That seems like a low number to me.
It also looks like 11 IMGs matched ACGME orthopedic surgery.
Am I reading this correctly or am I mistaken?

The number of IMG applicants compared to the number of DO applicants will show you that DO’s still match at a far higher rate.

 

[Goro]

The number of IMG applicants compared to the number of DO applicants will show you that DO’s still match at a far higher rate.

I'm seeing that, and compared to last year's survey, it's getting slighter better for DO and worse for IMG.

 

[DarkHorizon]

Can only comment on ortho as I am ortho. I am shocked that there were students applying MD ortho with scores lower than 230. Worse, there were students that applied with no USMLE at all, you can see that as unknown USMLE. I think the bias is there, but it may not be as bad as we think it is, as long as ou can hang with the big boys. There’s at least one individual that matched with scores between 230-240, another with 240-250. These are below average scores for ortho. Also, research experience and publications for match DO applicants for ortho were lacking compared to MD counterparts.

This leads me to conclude that if you did well on your step 1 and cranked out some research, along with solid away rotations, you should get a serious look from MD ortho programs. Sure there’s bias, but look at MD candidates matching with 220s and 230s. I’m sure being a solid DO student, you’d probably snatch a spot over those guys. My $0.02.

 

[Drrrrrr. Celty]

Can only comment on ortho as I am ortho. I am shocked that there were students applying MD ortho with scores lower than 230. Worse, there were students that applied with no USMLE at all, you can see that as unknown USMLE. I think the bias is there, but it may not be as bad as we think it is, as long as ou can hang with the big boys. There’s at least one individual that matched with scores between 230-240, another with 240-250. These are below average scores for ortho. Also, research experience and publications for match DO applicants for ortho were lacking compared to MD counterparts.

This leads me to conclude that if you did well on your step 1 and cranked out some research, along with solid away rotations, you should get a serious look from MD ortho programs. Sure there’s bias, but look at MD candidates matching with 220s and 230s. I’m sure being a solid DO student, you’d probably snatch a spot over those guys. My $0.02.

Some of these programs may have been old AOA ortho though.

 

[DarkHorizon]

Some of these programs may have been old AOA ortho though.

They weren’t, Uwashington, UTMB Galveston, Texas Tech, and LSU were the programs I believe. I could be wrong.

 

[AnatomyGrey12]

Some of these programs may have been old AOA ortho though.

They weren’t. Someone already detailed the AOA programs that were in the match and those spots (only like 3 or something) went to MDs.

And I can name the ortho marches off the top of my head just from the match list thread: UW, LSU, UTMB, and Texas Tech

Edit: one program was wrong.

 

[UnoMas]

I have been thinking this for years now, call me Positive Paul, but with the merger, the DO bone-fanatics will be forced to go MD or bust. I think we'll see more and more DO in more competitive places

 

[QueenJames]

I'm prepared to check urine dipsticks and med refills all day in primary care.

Honestly, if I'm forced into primary care, there's no way that I'm going to practice in a urban area. You can still feel like a physician if you're practicing primary care in rural communities.

Yeah but Direct Primary Care is on the come up.

I'm slightly leaning towards FM at this point solely because of the DPC movement.

 

[heychloe]

I have spoken w/ the director of research at NRMP who makes these reports and she was extremely reciprocative and very interested in creating a report that would be most helpful to the students.

It's awesome that they included the Step scores this year.
But let's help them improve it even more.
Please give feedback and provide ideas to the nrmp.

I'm personally very curious about the confounding factors of Comlex and USMLE. Can a high Comlex scorers match well with Comlex alone, or did they match because they also usually have an accompanying good USMLE score. I know we have our assumptions, but it would be great to see it backed by numbers. It would also help argue against some DO schools' standing about the comlex.

 

[rddn_jk]

Something else that I don't think has been mentioned yet is that when you compare the 2016 PD survey to the 2018 PD survey you can see that there is a drop in programs that will rank Non-US IMG (69% to 64%) or US-IMG (75% to 74%). Its even more telling if you look at the percentage that say they will rank often, each drops about 4%. So the idea that with the merger the accommodation of an influx of DOs would push out IMGs seems to be correct.

 

[2021Doctor]

I ran into a dead link for the PD's survey. The live one can be found here:
http://www.nrmp.org/wp-content/uploads/2018/07/NRMP-2018-Program-Director-Survey-for-WWW.pdf

Thank you for posting that link.
It looks like the top overall factor in getting an interview is the level 1 board score (Figure 1).
It looks like the top overall factor in getting ranked in the match is interactions with faculty during the interview and visit (Figure 2).
Am I interpreting these figures correctly?

 

[Ho0v-man]

Matched applicants have a similar step, but the likelihood of matching at each cutoff is quite different (many with the appropriate step don't get in). For example, for Gsurg match rates: 220s=50% DO/ 80% MD, 230s = 72% DO/ 94% MD, and 240+ = 74% DO/ 97% MD. For specialty fields like ortho, MDs with <220 match at better rates than DOs with >240. This doesn't account for other factors such as research, however (generally lower among DOs).

Excellent point. Also, I’m sure the “tier” of programs is a notch lower. Seems more fair than I thought it would considering we attend inferior schools.

 

[DrMcLovin]

They weren’t. Someone already detailed the AOA programs that were in the match and those spots (only like 3 or something) went to MDs.

And I can name the ortho marches off the top of my head just from the match list thread: UW, LSU, UTMB, and Texas Tech

Edit: one program was wrong.

So it looks like the 6 spots that the 3 former DO ACGME accredited programs put in the NRMP match went to MD’s this yr

 

[2021Doctor]

So it looks like the 6 spots that the 3 former DO ACGME accredited programs put in the NRMP match went to MD’s this yr

How were you able to figure that out?

 

[DrMcLovin]

How were you able to figure that out?

This year there were 6 positions in the NRMP match from former DO/AOA programs and 43 ACGME/AOA dual accredited positions still offered in the AOA match.

If 4 DO’s matched in the NRMP match into the programs AnatomyGrey12 posted than nobody matched into the former AOA programs. Those programs were Broward (2 positions), Plainview (3 positions), Nassau (1 position).

 

[Dr.Bruh]

When it says “unknown USMLE” does that mean those people likely just applied with a COMLEX score??

 

[AnatomyGrey12]

When it says “unknown USMLE” does that mean those people likely just applied with a COMLEX score??

That’s how I’m reading it. I’m sure there are a few that just didn’t report but most likely most of those didn’t have a Step score

 

[Prehealth1011]

Looking at the Osteo outcomes, For EM..
No research projects? 104/119 matched (87%)
1 research project? 123/147 matched (83%)

Is research really that inconsequential for matching? For most fields it seems like there isn't really a difference between zero research vs some research. Unless i'm interpreting it totally wrong.

 

[Scrubs101]

Looking at the Osteo outcomes, For EM..
No research projects? 104/119 matched (87%)
1 research project? 123/147 matched (83%)

Is research really that inconsequential for matching? For most fields it seems like there isn't really a difference between zero research vs some research. Unless i'm interpreting it totally wrong.

I dont think EM values research all the much, from what i hear its all about SLOEs and Step 1.

But with other specialties I think the issue is we dont have the full picture for each applicant.

250 w no research vs 230 w research kinda thing. Having research can never hurt you (that im aware of) and should only expand options. Though may not be necesary if you rock everything else