Charting Outcomes in the Match 2018 Edition & Program Director Survey

[TheBoneDoctah]

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

From what I have seen/heard, research is going to be more important if you are applying to a more academic program vs. less AND more important if you are applying to more competitive specialties. There is a spectrum, but pretty much, the two extremes would be neurosurg/derm/ortho/ENT/IM at MGH (need research) vs. other specialties in middle of nowhere Missouri (no research). Everything else (ex. ortho in middle of nowhere Missouri or FM at MGH) are in that spectrum and are going to be more program specific.

This is a long-winded answer meaning it's program/location/specialty specific and that research will not hurt you.

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[Drrrrrr. Celty]

Doing more is not going to usually hurt you.

 

[Dr.Bruh]

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

Surprised nearly 1/4 of EM applicants matched with just a COMLEX score and the overwhelming majority having no research.

 

[Dr.Bruh]

Doing more is not going to usually hurt you.

Well, it might. If you try to juggle too much at once and your performance in rotations or the quality of dedicated study time suffers is would.

 

[Drrrrrr. Celty]

Well, it might. If you try to juggle too much at once and your performance in rotations or the quality of dedicated study time suffers is would.

Then you're not doing too much, you're failing the basic requirements.

 

[AnatomyGrey12]

Surprised nearly 1/4 of EM applicants matched with just a COMLEX score and the overwhelming majority having no research.

EM isn’t a research focused field. Unless you’re trying to climb the academic ladder (basically the antithesis if most EM applicants lol) then you don’t need it.

 

[ohmanwaddup]

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.

What’s direct primary care?

 

[AnatomyGrey12]

What’s direct primary care?

The patient pays the doc directly without dealing with insurance.

 

[hallowmann]

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

They'll probably get better over time as the difference between DO and US MD lessens (as its happened over the last 15-20 yrs), but DOs will always match worse than US MDs.

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

Thanks. Fixed the OP. Its weird, it worked when I first posted, but maybe they updated it.

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.

Yeah, I think that's true for the most part, but I also think I've seen enough high tier matches (maybe not in IM) in some specialties to know that DOs shouldn't stop trying for them, just that they should temper their expectations. It will always be a reach though.

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.

EM has expanded a lot, and there's a big range of programs, so if you apply right, you're almost guaranteed to match. When you start getting limited geographically or apply only to more competitive programs, that's when things go south. Its kind of like Rads like that.

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.

While this may be true, to be fair the last program directors survey felt a bit inflated for IMGs from what I remember. Now I don't think there is significant different between 75% and 74% when you are dealing with surveys year-to-year, but maybe that 69% to 64% means something.

 

[QueenJames]

What’s direct primary care?

Membership based service that saves your patient money and allows you to get paid more, see less patient per day, spend more time with patients, and is a big middle finger to insurance companies that try to ***** since they are trying to find a way NOT to pay you.

It's the future, basically.

It's the ONLY way I'd do FM and wanna see if it can apply to IM as well.

 

[Scrubs101]

Membership based service that saves your patient money and allows you to get paid more, see less patient per day, spend more time with patients, and is a big middle finger to insurance companies that try to rape you for each dollar since they are trying to find a way NOT to pay you.

It's the future, basically.

It's the ONLY way I'd do FM and wanna see if it can apply to IM as well.

Similar to concierge medicine? If so i shadowed a dope IM doc that did that, so it’s totally possible

 

[QueenJames]

Similar to concierge medicine? If so i shadowed a dope IM doc that did that, so it’s totally possible

Kinda the same concept but this is more affordable than a "concierge" setting as far as I know.

Meds and labs and procedures are all included within the monthly fee so it's quite a bargain if you break it down.

It's seriously made me consider FM a lot more lately.

 

[rg2o3]

Kinda the same concept but this is more affordable than a "concierge" setting as far as I know.

Meds and labs and procedures are all included within the monthly fee so it's quite a bargain if you break it down.

It's seriously made me consider FM a lot more lately.

So, all patients just psy a monthly fee and all services are included?

 

[QueenJames]

So, all patients just psy a monthly fee and all services are included?

Yupp. Look up atlasMD. There's other members on here that do it successfully.

It really is the future.

 

[Robotfishbrain]

Interesting to see that the Psych match rate is on the lower end of the spectrum. I wonder why this is.

I wish we could see match rates with some more clean data. It'd be nice to get a data set we could manipulate (e.g. remove people who ranked less than 10 programs, had red flags, etc.)

 

[GrignardsReagent]

Quick question. In the NRMP program director survey, what does "consistency of grades" actually mean? Is that what I am supposed to read for pre-clinical grades and their relative importance?

 

[AnatomyGrey12]

Interesting to see that the Psych match rate is on the lower end of the spectrum. I wonder why this is.

I wish we could see match rates with some more clean data. It'd be nice to get a data set we could manipulate (e.g. remove people who ranked less than 10 programs, had red flags, etc.)

I mean you kind of can for some stuff. Like for general surgery the reported match rate is 50%, but if you subtract all the people that applied without a Step score it jumps up to 62%, and if you then take out the people that applied with below a 210 Step 1 then it goes up even further to 66%.

Building off that I'm a little surprised the match rate of individuals with between a 210-230 had a 44% match rate. That's actually a lot better than what you would initially think lol.

One conclusion we can for sure make is that for GS having a Step score is paramount. Only 5/23 (22%) matched without one, which is even a lot lower than the rate of people who had a 210-220 score lol (40%)

 

[Drrrrrr. Celty]

Interesting to see that the Psych match rate is on the lower end of the spectrum. I wonder why this is.

I wish we could see match rates with some more clean data. It'd be nice to get a data set we could manipulate (e.g. remove people who ranked less than 10 programs, had red flags, etc.)

I think the biggest reason behind it is still the people who are applying to psych. Lots of unimpressive applicants with little to no clear reason for why they want to go into psychiatry other than it's a residency they think they have a good shot at and or like the lifestyle exclusively.

 

[Drrrrrr. Celty]

They'll probably get better over time as the difference between DO and US MD lessens (as its happened over the last 15-20 yrs), but DOs will always match worse than US MDs.



Thanks. Fixed the OP. Its weird, it worked when I first posted, but maybe they updated it.



Yeah, I think that's true for the most part, but I also think I've seen enough high tier matches (maybe not in IM) in some specialties to know that DOs shouldn't stop trying for them, just that they should temper their expectations. It will always be a reach though.



EM has expanded a lot, and there's a big range of programs, so if you apply right, you're almost guaranteed to match. When you start getting limited geographically or apply only to more competitive programs, that's when things go south. Its kind of like Rads like that.



While this may be true, to be fair the last program directors survey felt a bit inflated for IMGs from what I remember. Now I don't think there is significant different between 75% and 74% when you are dealing with surveys year-to-year, but maybe that 69% to 64% means something.

Sounds like EM is going to end up turning into radiology, that or start funneling into urgent care type style practice.

 

[UnoMas]

I mean you kind of can for some stuff. Like for general surgery the reported match rate is 50%, but if you subtract all the people that applied without a Step score it jumps up to 62%, and if you then take out the people that applied with below a 210 Step 1 then it goes up even further to 66%.

Building off that I'm a little surprised the match rate of individuals with between a 210-230 had a 44% match rate. That's actually a lot better than what you would initially think lol.

One conclusion we can for sure make is that for GS having a Step score is paramount. Only 5/23 (22%) matched without one, which is even a lot lower than the rate of people who had a 210-220 score lol (40%)

I think it's either being super ill-informed or having massive balls applying to MD Gen Surg without a Step 1 score sans a good back-up plan

I know an upperclassmen who applied without a Step 1 score, did 4 audition rotations at MD community GS programs with current DO residents, who ended up scrambling for an FM spot despite having a 600+ level 1 score. I mean the sheer effort and work that it takes to do well on FOUR surgery audition rotations is probably 1000-fold of sitting down and do Uworld for 3-4 weeks. I blame both the lack of appropriate advising from the school and the lack of foresight from the student

 

[AnatomyGrey12]

I think it's either being super ill-informed or having massive balls applying to MD Gen Surg without a Step 1 score sans a good back-up plan

I know an upperclassmen who applied without a Step 1 score, did 4 audition rotations at MD community GS programs with current DO residents, who ended up scrambling for an FM spot despite having a 600+ level 1 score. I mean the sheer effort and work that it takes to do well on FOUR surgery audition rotations is probably 1000-fold of sitting down and do Uworld for 3-4 weeks. I blame both the lack of appropriate advising from the school and the lack of foresight from the student

Yeah the general advising for DO students is horrible, however students need to not trust their schools and they need to do research on their own. It's not like the data isn't out there. If I hear one more admin say that Step isn't important anymore and that COMLEX is just as accepted I think I might lose it.

 

[UnoMas]

Yeah the general advising for DO students is horrible, however students need to not trust their schools and they need to do research on their own. It's not like the data isn't out there. If I hear one more admin say that Step isn't important anymore and that COMLEX is just as accepted I think I might lose it.

The 2 main advisors that we have are both PhDs. I don't blame them for the ill advice because I don't think they know any better, SDN trolls are more informed about the process than they are. However, they do make it incredibly difficult for students who need extra time to prepare for the Steps. "We don't give extra time off to study for Step 1." "You don't get to use your 4th year elective to study for Step 1 or Step 2 now that you discovered that your specialty of interest requires a Step 1 score but hey there are 3-4 required Family Med rotations, 1 rural medicine rotation that we need you to complete during 4th year"

Students who did not do so hot on the diagnostic level 1 exams are immediately advised not to take Step 1. A better approach would be to create a 4-week optional "Clinical Enrichment Rotation" where interested 3rd year students can enroll and use it to study for Step 1 exam. At least that way the students are provided extra opportunity to try and if they still fail, it's on them.

Sad to say but most of the time, the DO administration is the biggest hurdle DO students have to face when it comes to their own professional advancement, not the DO discrimination

 

[Goro]

The 2 main advisors that we have are both PhDs. I don't blame them for the ill advice because I don't think they know any better, SDN trolls are more informed about the process than they are. However, they do make it incredibly difficult for students who need extra time to prepare for the Steps. "We don't give extra time off to study for Step 1." "You don't get to use your 4th year elective to study for Step 1 or Step 2 now that you discovered that your specialty of interest requires a Step 1 score but hey there are 3-4 required Family Med rotations, 1 rural medicine rotation that we need you to complete during 4th year"

Students who did not do so hot on the diagnostic level 1 exams are immediately advised not to take Step 1. A better approach would be to create a 4-week optional "Clinical Enrichment Rotation" where interested 3rd year students can enroll and use it to study for Step 1 exam. At least that way the students are provided extra opportunity to try and if they still fail, it's on them.

Sad to say but most of the time, the DO administration is the biggest hurdle DO students have to face when it comes to their own professional advancement, not the DO discrimination

There are no clinical deans? I mean, no deans who are MD or DO who advise on GME???? If not, please PM me!

When my advisees seek advice on me about residency, I know my limitations and punt them immediately to our clinical deans, who DO know about such things?

 

[UnoMas]

There are no clinical deans? I mean, no deans who are MD or DO who advise on GME???? If not, please PM me!

When my advisees seek advice on me about residency, I know my limitations and punt them immediately to our clinical deans, who DO know about such things?

nvm not worth getting my ass reprimanded during 4th year hahah, I'll be more vocal after graduation

 

[Goro]

nvm not worth getting my ass reprimanded during 4th year hahah, I'll be more vocal after graduation

Do let me know at the time what penal colony you're at.

 

[UnoMas]

Do let me know at the time what penal colony you're at.

will do, I am incredibly happy with the education that I'm getting but definitely there's room for improvement

 

[navigator]

This was very humbling to read as an upcoming third year interested in IR

 

[AnatomyGrey12]

This was very humbling to read as an upcoming third year interested in IR

Yeah IR was an absolute blood bath this year for both MDs and DOs.

 

[Peach Newport]

Yeah IR was an absolute blood bath this year for both MDs and DOs.

This was one of the biggest surprises to me when reading charting outcomes, both MD and DO.

When people ask “what’s the most competitive specialty?” It’s easy to think derm, plastics, ortho... but according to data, the answer is Interventional Radiology...and it isn’t even close. No other specialty, even the historically brutal ones even came close to IR’s cutthroat match rates.

An MD with a 240 and 5+ research papers had just about a 50% chance of matching IR (meanwhile, those numbers give you about a 70% chance of matching plastics). To hit 70% chance in IR, you needed a 270+ Step 1 and 5+ publications.

Interestingly, the only 2 DOs that matches IR had a 230s-range step 1, but both had 9+ publications. Although the data pool is incredibly small, it seems like the major factor in matching IR is your research output. This makes sense for a new, up and coming field that is poised to take over so many procedures.

 

[Dwan]

This was one of the biggest surprises to me when reading charting outcomes, both MD and DO.

When people ask “what’s the most competitive specialty?” It’s easy to think derm, plastics, ortho... but according to data, the answer is Interventional Radiology...and it isn’t even close. No other specialty, even the historically brutal ones even came close to IR’s cutthroat match rates.

An MD with a 240 and 5+ research papers had just about a 50% chance of matching IR (meanwhile, those numbers give you about a 70% chance of matching plastics). To hit 70% chance in IR, you needed a 270+ Step 1 and 5+ publications.

Interestingly, the only 2 DOs that matches IR had a 230s-range step 1, but both had 9+ publications. Although the data pool is incredibly small, it seems like the major factor in matching IR is your research output. This makes sense for a new, up and coming field that is poised to take over so many procedures.

Do the charting outcomes account for dual applications? A lot of people dual apply DR and IR and may prefer more prestigious DR programs. I noticed the match rates for radiology dropped a lot as well from the past charting outcomes, and wonder if this overlap is partly the reason.

 

[Peach Newport]

Do the charting outcomes account for dual applications? A lot of people dual apply DR and IR and may prefer more prestigious DR programs. I noticed the match rates for radiology dropped a lot as well from the past charting outcomes, and wonder if this overlap is partly the reason.

You’ve gotta explain that one to me because that doesn’t make any sense. If someone wanted to go DR, why would they also apply to IR? The only reason to apply to both would be (as I see it) to have DR as a backup. If I’m applying IR, I can’t see myself ranking a DR program over IR for any reason, much less prestige.

 

[Dwan]

You’ve gotta explain that one to me because that doesn’t make any sense. If someone wanted to go DR, why would they also apply to IR? The only reason to apply to both would be (as I see it) to have DR as a backup. If I’m applying IR, I can’t see myself ranking a DR program over IR for any reason, much less prestige.

You can go IR from DR. There's a lot of debate in the IR forums, and there are also many who don't know for sure if they want to commit to IR (but have an interest and apply). I do know one very strong applicant in real life who ranked top tier DR over IR. You'll also find many discussions like this in the IR forums:
2nd year medical student with an interest in IR and/or DR/IR... What to expect?

This isn't my field of expertise so I can't comment on what's right/obvious, just that this happens.