Charting Outcomes of the Match (2022)

[enchantments]

2022 Data is out

Summary (2020)

Summary (2022)

Most notable drops in match rate seem to be Ortho (~14%), DR (~12%), and Plastics (~9%). DR obviously being the most surprising, since anyone who scored at least average on Step 1 in 2020 was virtually guaranteed to match.

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[efle]

I wonder how much of the DR bump comes from surgical subspecialty applicants using it as a backup. I think most people going for ortho, plastics, derm etc would choose DR over IM.

And this chart, as always, is ridiculous.

 

[Cath Up]

I wonder how much of the DR bump comes from surgical subspecialty applicants using it as a backup. I think most people going for ortho, plastics, derm etc would choose DR over IM.

And this chart, as always, is ridiculous.

View attachment 357271

Wow. I see thousands and thousands of hours of wasted time if only PDs would care less about research output, which doesn't matter for most of those specialists.

 

[Dr. Anonymouss]

Wow. I see thousands and thousands of hours of wasted time if only PDs would care less about research output, which doesn't matter for most of those specialists.

It's honestly ridiculous that research is becoming essential for almost all specialties. Research is and should be mutually exclusive because we are going to be practitioners of clinical medicine, not research scientists. I have zero interest in research and am only doing the bare minimum to check the box. Not only just this, but we are also churning out papers that are essentially garbage. Research has become less about what you publish and more about how much you publish. Research should be left to those who have an interest in it and want to genuinely solve or identify a problem/trend. It should not be performed by people like me who are doing the bare minimum in order to be competitive for residency.

 

[Putkernerinthehall]

It's honestly ridiculous that research is becoming essential for almost all specialties. Research is and should be mutually exclusive because we are going to be practitioners of clinical medicine, not research scientists. I have zero interest in research and am only doing the bare minimum to check the box. Not only just this, but we are also churning out papers that are essentially garbage. Research has become less about what you publish and more about how much you publish. Research should be left to those who have an interest in it and want to genuinely solve or identify a problem/trend. It should not be performed by people like me who are doing the bare minimum in order to be competitive for residency.

Why are medical students (and residents ?) "churning out papers that are essentially garbage?"

 

[voxveritatisetlucis]

Why are medical students (and residents ?) "churning out papers that are essentially garbage?"

Because papers are a pseudo requirement for residency and fellowship and it’s difficult to get published in a high impact journal (especially for those who go to low tier schools without a focus on research)

 

[Dr. Anonymouss]

Why are medical students (and residents ?) "churning out papers that are essentially garbage?"

Let's be honest with each other. The quality of work has declined significantly. In regards to medical research: Research for the sake of research doesn't provide much if it doesn't actually further scientific knowledge. By this I mean, if it isn't either confirming current knowledge that we have or reinforcing that our current practices/procedures/treatments are better or worse than alternatives then what is the point? The issue is there is only so many quality papers that can be written without new information, technology, or procedures being developed, yet academia has pushed research on not only its faculty to publish frequently, but also its medical students. All this does is take away from quality papers and diminishes what medical research should really be about. As I said earlier, all this is becoming now is a numbers game. It's more about how much you publish than what you publish.

 

[voxveritatisetlucis]

Clearly anesthesiology and radiology being used as alternative to EM. Guessing these two will stay competitive for years to come. Looks like PM&R, is also getting more competitive.

Interestingly, neurology doesn’t seem to have become more popular despite many people saying that the treatments on the horizon have/will make it more enjoyable and lucrative.

Wonder why match rate increased for psych. Been hearing how competitive it has become

 

[Browns99]

Clearly anesthesiology and radiology being used as alternative to EM. Guessing these two will stay competitive for years to come. Looks like PM&R, is also getting more competitive.

Interestingly, neurology doesn’t seem to have become more popular despite many people saying that the treatments on the horizon have/will make it more enjoyable and lucrative.

Wonder why match rate increased for psych. Been hearing how competitive it has become

I don't think Psych was ever considered a "highly" competitive field. That's not to say it was at the bottom with respect to competitiveness, but certainly not at the top with your sub-surgical specialities, IR, derm, etc.

 

[voxveritatisetlucis]

I don't think Psych was ever considered a "highly" competitive field. That's not to say it was at the bottom with respect to competitiveness, but certainly not at the top with your sub-surgical specialities, IR, derm, etc.

That’s definitely true but I’ve read old threads on here encouraging IMGs to dial apply IM with psych as a backup because it was seen as even easier to get than IM I guess. Now, I’ve heard of a fair amount of USMDs not matching psych (not sure if this is because they applied too top heavy or had glaring red flags.

Maybe in 2020 the match rate was lower because people still figured it was not really competitive (so they applied to fewer programs, maybe top heavy). Now, maybe they’re just applying to more programs and adding in some community ones

 

[enchantments]

Wonder why match rate increased for psych. Been hearing how competitive it has become

I honestly don't see Psych ever becoming a highly competitive specialty, unless its median salary levels rise to Derm levels, if not more. It's certainly not bad in terms of hours/pay/lifestyle, but I imagine that working long-term with the psych patient population is not as welcoming as most other outpatient specialties.

 

[MDMechEngr]

the premium pay in psych is for hazard pay.

 

[voxveritatisetlucis]

How on earth does one even get 30+ Published papers without a PhD or research year. That’s right up there with some junior faculty at the undergrad school I attended:

 

[Shunsui]

How on earth does one even get 30+ Published papers without a PhD or research year. That’s right up there with some junior faculty at the undergrad school I attended:

Correct me if I’m wrong but that # includes abstracts and presentations which I would assume are much easier to pump out.

I suppose quantity>quality is the name of the game

 

[JoaoMoutinho]

How on earth does one even get 30+ Published papers without a PhD or research year. That’s right up there with some junior faculty at the undergrad school I attended:

These are overwhelmingly abstracts and presentations, and even then I doubt most of those are at major conferences.

I remember reading somewhere on here that average ACTUAL publications for applicants matched to neurosurgery was still less than 1 a couple years ago, though my memory may be a little foggy.

 

[operaman]

How on earth does one even get 30+ Published papers without a PhD or research year. That’s right up there with some junior faculty at the undergrad school I attended:

Yeah it’s unfortunate that they lump everything together like that. It ends up double counting a lot - like every paper likely has an abstract or oral presentation to go with it because that’s just how these things usually go. It’s also easy to count abstracts you submitted a few places - national meeting, regional meeting, school research day, etc. So a strong student with 5 first author papers would also likely have 5-8 abstracts or orals to go with those sake projects. Add in a couple mid author papers also with abstracts/orals and you can quickly cross 20.

I wish they would separate out actual publications, but my guess is that those number are fairly low across all fields and harder to compare.

 

[voxveritatisetlucis]

Yeah it’s unfortunate that they lump everything together like that. It ends up double counting a lot - like every paper likely has an abstract or oral presentation to go with it because that’s just how these things usually go. It’s also easy to count abstracts you submitted a few places - national meeting, regional meeting, school research day, etc. So a strong student with 5 first author papers would also likely have 5-8 abstracts or orals to go with those sake projects. Add in a couple mid author papers also with abstracts/orals and you can quickly cross 20.

I wish they would separate out actual publications, but my guess is that those number are fairly low across all fields and harder to compare.

What would you say is the average number of real publications for ENT? Would it be closer to 8.5 since the reported number is 17. Maybe assume that each paper has one additional thing attached to it so 8.5x2.

Would all of these usually be in ENT. I noticed that the three who matched from my school had high volume of overall publications but only a few in ENT. I would guess that this is because the school is somewhat low tier and doesn’t have enough ENT related research going on.

 

[operaman]

What would you say is the average number of real publications for ENT? Would it be closer to 8.5 since the reported number is 17. Maybe assume that each paper has one additional thing attached to it so 8.5x2.

Would all of these usually be in ENT. I noticed that the three who matched from my school had high volume of overall publications but only a few in ENT. I would guess that this is because the school is somewhat low tier and doesn’t have enough ENT related research going on.

That’s a tough question because even within pubs it’s hard to distinguish - first author? Case reports? Do we count both accepted/submitted/indexed?

It’s really a wide range, but less than 5 definitely stands out negatively on the low side unless they’re all first author and high quality papers in good journals. Most are probably in the 5-10 range with a few first authors and the rest middle author. So 8.5 isn’t a bad estimate actually.

They definitely aren’t always all ENT though. Many of those include middle author stuff from undergrad as well as non ent work from Med school. As for actual ent pubs, less than 3 would be low end, average 3-6.

The range can be pretty startling. With more people taking research years you’ll often see some wildly impressive CVs. I remember one guy applying when I did who had 60+ solid ent pubs, and was a really cool awesome guy on top of it. I think he was over 100 on pub Med by the end of residency. He was and still is an outlier, though it’s not uncommon to see 10-20+pubs from students who had productive research years.

The competitiveness is getting insane across all the highly desired fields. I feel like all of us on the attending side feel like we would have a hard time matching today and many of these applicants have CVs that rival many junior faculty. I have a friend who’s an attending at a very prestigious program and he had 1 first author publication when he got his position. And he’s not that old!

Times have changed.

 

[voxveritatisetlucis]

The competitiveness is getting insane across all the highly desired fields. I feel like all of us on the attending side feel like we would have a hard time matching today and many of these applicants have CVs that rival many junior faculty. I have a friend who’s an attending at a very prestigious program and he had 1 first author publication when he got his position. And he’s not that old!

Times have changed.

This is so true and it isn’t even limited to med school or residency. College admissions are crazy tough now too. For example, I interviewed like 10ish students this year as an alumni interview and not a single one got in. Some of these kids were from top boarding schools (think Exeter, Deerfield, Andover etc.), legacies, multi sport athletes, had already published some sort of research. A couple got deferred or waitlisted but most got flat out rejected:

i doubt my kids will in despite legacy status and alumni engagement tbh

 

[TelemarketingEnigma]

I wish they would separate out actual publications, but my guess is that those number are fairly low across all fields and harder to compare.

This is a big issue I have with the way NRMP collects this data. On ERAS there’s actually more nuance to the publication types, but the way NRMP asks applicants it lumps everything together. I think NRMP needs to change the question they ask to help calm this research mania

 

[workaholic007]

for point of reference, the increase in radiology and anesthesiology scores is not due to dual applications. Only individuals who ranked the speciality as their top choice are used in the calculations.

for example, if you applied anesthia and IM, and ranked anesthia over IM, you do not go into the IM stats. This is to the best of my knowledge

 

[NegativeMargin]

Yeah the trends in "research" are definitely note worthy. I know half a dozen people that were Juniors as I was graduating from UG who had 2-3 posters and a presentation multiple years running, and they all had a publication before I left. They also already had their minds set on doing a gap year for research before applying to med school. They'll already be at 10+ in that category, and that's in a college ranked like 83rd in the nation.

It seems research years are definitely going to become more commonplace. Though to note, a lot of people see the number of projects and immediately say "Great, we're getting flooded with bad publications just so people can match into residency." While that surely could be true to a certain extent, the vast majority of this stuff will only be seen by the researchers themselves, and whoever attends the local gatherings where the abstracts, posters, and presentations are put out.. at least that's how it appears to my knowledge.

That said, as a non-trad I can't say I'm 100% stoked at the possible future prospect of falling in love with a specialty only to realize I'll have to do a research year because I won't be competitive.

 

[JoaoMoutinho]

That’s a tough question because even within pubs it’s hard to distinguish - first author? Case reports? Do we count both accepted/submitted/indexed?

It’s really a wide range, but less than 5 definitely stands out negatively on the low side unless they’re all first author and high quality papers in good journals. Most are probably in the 5-10 range with a few first authors and the rest middle author. So 8.5 isn’t a bad estimate actually.

They definitely aren’t always all ENT though. Many of those include middle author stuff from undergrad as well as non ent work from Med school. As for actual ent pubs, less than 3 would be low end, average 3-6.

The range can be pretty startling. With more people taking research years you’ll often see some wildly impressive CVs. I remember one guy applying when I did who had 60+ solid ent pubs, and was a really cool awesome guy on top of it. I think he was over 100 on pub Med by the end of residency. He was and still is an outlier, though it’s not uncommon to see 10-20+pubs from students who had productive research years.

The competitiveness is getting insane across all the highly desired fields. I feel like all of us on the attending side feel like we would have a hard time matching today and many of these applicants have CVs that rival many junior faculty. I have a friend who’s an attending at a very prestigious program and he had 1 first author publication when he got his position. And he’s not that old!

Times have changed.

What's the breakdown you see on types of papers? I'm used to basic science work, and it blows my mind that anyone could have that many papers so young–I'm assuming they have to be more on the case report/chart review end than what I personally am used to thinking of as a publication.

I don't think my thesis advisor–a (relatively young) full professor with multiple R01s–is on 60 papers. Even though I know it was an outlier, seeing that many from a med student is crazy.

 

[operaman]

What's the breakdown you see on types of papers? I'm used to basic science work, and it blows my mind that anyone could have that many papers so young–I'm assuming they have to be more on the case report/chart review end than what I personally am used to thinking of as a publication.

I don't think my thesis advisor–a (relatively young) full professor with multiple R01s–is on 60 papers. Even though I know it was an outlier, seeing that many from a med student is crazy.

Yeah most papers are clinical as you suspect. There are often some basic science papers in there too but those tend to be fewer simply because of the time involved.

The guy I knew with a crapload of papers started doing ent research in undergrad, then an MD/PhD at the same institution. It was also a research powerhouse with multiple labs and he was a badass who had projects running with all of them, so lots of basic science stuff too. So he had quite a head start and was just a gifted researcher as well. Kind of a perfect storm for racking up that many pubs.

 

[Rapsidy]

I honestly don't see Psych ever becoming a highly competitive specialty, unless its median salary levels rise to Derm levels, if not more. It's certainly not bad in terms of hours/pay/lifestyle, but I imagine that working long-term with the psych patient population is not as welcoming as most other outpatient specialties.

Psych patients are my peeps. Throw me inpatient psych any day and I’ll be a happy camper. Good to see the positive outcomes for psych considering I went into medical school wanting to be a psychiatrist and nothing in the first year has changed that yet.

 

[Med Ed]

What would you say is the average number of real publications for ENT? Would it be closer to 8.5 since the reported number is 17. Maybe assume that each paper has one additional thing attached to it so 8.5x2.

Would all of these usually be in ENT. I noticed that the three who matched from my school had high volume of overall publications but only a few in ENT. I would guess that this is because the school is somewhat low tier and doesn’t have enough ENT related research going on.

Some while back I was listening to a plastic surgeon pontificate on the utility of medical student research in applying to his field. They had crunched numbers and determined that, in terms of outcomes, when you got one "real" first author publication in a peer reviewed journal you reached the point of diminishing returns. Having zero hurt, but continuing to pile on more entries after the first one had little effect on the odds of matching.

I was surprised by this, but he generally knows what he's talking about.

 

[NicMouse64]

Look at the IM stats. It's actually become somewhat competitive. Crazy.

 

[Putkernerinthehall]

Look at the IM stats. It's actually become somewhat competitive. Crazy.

What are you seeing ? IM and Med/Peds both show slightly improved match %.

 

[NicMouse64]

What are you seeing ? IM and Med/Peds both show slightly improved match %.

Step scores mainly.

 

[operaman]

Some while back I was listening to a plastic surgeon pontificate on the utility of medical student research in applying to his field. They had crunched numbers and determined that, in terms of outcomes, when you got one "real" first author publication in a peer reviewed journal you reached the point of diminishing returns. Having zero hurt, but continuing to pile on more entries after the first one had little effect on the odds of matching.

I was surprised by this, but he generally knows what he's talking about.

I think there’s still a good bit of truth in that. Most of these pubs are not quality first author papers, though numbers on that front are growing too even compared to when I applied.

The first author ones really show you can get a project from A to Z, and once you have one you’ve kind of checked that box. I think the additional ones are fast becoming more about keeping up with the other applicants so at least you don’t stand out for being on the low end of the ever shifting bell curve.

 

[Angus Avagadro]

This is where I believe the med school applicant curve begins to trend down. More schools graduating students with no university hospitals being built. Some university affiliates are quite good and represents one bright spot. The ROI with respect to time and money is becoming onerous. Research years almost becoming necessary, cost for schooling rising, and physician compensation dropping as more docs enter the workforce. Our best and brightest may begin to look elsewhere for a career. If one is interested in primary care, I believe opportunities will exist for some time, but specialist slots will steadily become harder to match. The strategy for matching will become more and more important as time goes on.

 

[efle]

Some data in these papers. Incredibly few actual authorships in the giant pile of ERAS research entries. Most people are putting dozens of posters/abstracts and re-listing things

Medical Student Research Productivity: Which Variables are Associated with Matching to a Highly Ranked Orthopaedic Residency Program? - PubMed

Our results suggest that higher-tier orthopaedic residency programs match residents with greater research productivity than do lower-tier programs. Having 1 publication was associated with matching into a higher-ranked program but no significant associations were observed beyond the first...

pubmed.ncbi.nlm.nih.gov

The Otolaryngology Match: A Bibliometric Analysis of 222 First-Year Residents - PubMed

NA Laryngoscope, 129:1561-1566, 2019.

pubmed.ncbi.nlm.nih.gov

The Neurosurgery Match: A Bibliometric Analysis of 206 First-Year Residents - PubMed

H-index is a powerful research predictor of matching into neurosurgical research institutions and can be improved by starting research early, targeting high impact journals, and participating in original clinical and laboratory investigations.

pubmed.ncbi.nlm.nih.gov

 

[srirachamayonnaise]

Why are medical students (and residents ?) "churning out papers that are essentially garbage?"

Chart reviews and literature review are basically all crap. Worse, now med students are churning out crap about economic impact of whatever new practice is, be it telemedicine or whatnot. Complete garbage.

 

[TelemarketingEnigma]

What are you seeing ? IM and Med/Peds both show slightly improved match %.

I think med peds % only went up because total applicant numbers went down a little (at least across the board, not sure for MD specifically). Still filled 100% with no spots in soap.

Edit: actually looked a little closer - Compared to last year, more MD seniors applied/matched med peds. But I think it’s offset a bit by a handful more positions offered and a slight drop in DO applicants/matches. Overall med peds is so self selecting and enough people dual apply though that analyzing the data is always tricky

 

[jstwannagraduaaate!!!]

Dont get how a sane person looks at the trend of residency matching and says "yeah I still want to go to med school", increasing debt and lower matches yet med school is getting more competitive

 

[GadRads]

Surprised at the decreased match rate in radiology. Looks like the fear of AI has dissipated, and applicants see radiology as pretty midlevel-proof.

Also, students may be moving from EM and rad onc to radiology.

 

[Dr. Anonymouss]

Dont get how a sane person looks at the trend of residency matching and says "yeah I still want to go to med school", increasing debt and lower matches yet med school is getting more competitive

The problem is I think you only see these trends once you are on the inside. The majority of people saying "All I want to be is a doctor" don't bother to look at stuff like this when they are in high school or college. We all know how competitive it is to get accepted to medical school, but they don't see just how competitive it is to get a residency as well. This isn't necessarily an issue for those who want primary care and know they want primary care, but lots of people don't want primary care and lots of people change their mind once they get to clinicals. I can tell you that if I was dead set on only orthopedics that I would not have chosen to go to medical school. All the top tier specialties are just so far out of normal right now it's insane. Not only do you have to ACE all your tests in medical school, but you likely have to take a research year as well. It's just madness and it's only going to get worse I fear.

 

[Putkernerinthehall]

Chart reviews and literature review are basically all crap. Worse, now med students are churning out crap about economic impact of whatever new practice is, be it telemedicine or whatnot. Complete garbage.

My question was "why." Why are they putting out garbage? Who is accepting such garbage ? I'M trying to understand the root of the problem and why it doesn't get fixed.

 

[Putkernerinthehall]

This is extending into residency as well. My GI/Cards friends are submitting case report abstracts everywhere to conferences (most will take anything). Easy poster = a line in your resume

I definitely understand that you gotta play the game. Just wish this kinda stuff wasn’t necessary. 99% of research you do as a resident is fluff

Why does the medical establishment accept fluff ? Why do conferences take anything ? Don't they care about the quality of their conference event ?

 

[Rapsidy]

I’m not saying it’s this bad in medicine…but I think this article maybe explains some of the research fluff?

"Get Me Off Your Fucking Mailing List" is an actual science paper accepted by a journal

Vox is a general interest news site for the 21st century. Its mission: to help everyone understand our complicated world, so that we can all help shape it. In text, video and audio, our reporters explain politics, policy, world affairs, technology, culture, science, the climate crisis, money...

www.vox.com

I’d hope that most everyone isn’t sending their “research” to pay to publish journals, and at least will attempt something important/relevant to them, but with standards set so low, is it really that silly to imagine students would use every single advantage they possibly could considering the hundreds of thousands of dollars in debt on the line if you don’t match?

 

[srirachamayonnaise]

Why does the medical establishment accept fluff ? Why do conferences take anything ? Don't they care about the quality of their conference event ?

umm.. good question. My understanding is this. It really costs almost nothing to start a journal. And the founders and editors of those journals pad their resume with those titles and they basically accept all garbage. As long as PubMed indexes those journals, people will submit garbage in order to claim they are pubmed indexed. The whole process really benefits both parties and therefore you see all the crap being published every second. It's the proliferation of the internet. Before that, the journals had to be physically printed and mailed to subscribers... nowadays it's just like a blog. Well the economics of the journal is that usually the school pays for the publication out of their research budget. I am fine with this arrangement but unfortunately this has spilled out into medical education and residency and fellowship application processes. Some specialties are notoriously EASY to publish... and their journals accept almost anything without major revision.

 

[voxveritatisetlucis]

Some specialties are notoriously EASY to publish... and their journals accept almost anything without major revision.

Which ones? Asking for a friend

 

[Med Ed]

I think there’s still a good bit of truth in that. Most of these pubs are not quality first author papers, though numbers on that front are growing too even compared to when I applied.

The first author ones really show you can get a project from A to Z, and once you have one you’ve kind of checked that box. I think the additional ones are fast becoming more about keeping up with the other applicants so at least you don’t stand out for being on the low end of the ever shifting bell curve.

I've seen every permutation of this play out, from the student who spends 3+ years on a single high quality publication to the one who churns out 20+ pieces of repetitive trash (Letters to the editor? Really?). Ultimately quality usually seems to win out over quantity.

 

[Mad Jack]

Clearly anesthesiology and radiology being used as alternative to EM. Guessing these two will stay competitive for years to come. Looks like PM&R, is also getting more competitive.

Interestingly, neurology doesn’t seem to have become more popular despite many people saying that the treatments on the horizon have/will make it more enjoyable and lucrative.

Wonder why match rate increased for psych. Been hearing how competitive it has become

Positions have vastly expanded in psychiatry, up around 150 from the year prior. There were over 600 more positions than US MD applicants.

 

[voxveritatisetlucis]

Positions have vastly expanded in psychiatry, up around 150 from the year prior. There were over 600 more positions than US MD applicants.

Wow didn’t know that. Have these fields not learned the hazards of rapid residency expansion from radonc and EM?

 

[Mad Jack]

Wow didn’t know that. Have these fields not learned the hazards of rapid residency expansion from radonc and EM?

Every field is expanding like crazy. Psych didn't expand much more than IM or medicine in general over the last 17 years. There were 983 spots filled in 2005, compared with 2,047 this year, a 108% increase. There were 4,768 IM positions in 2005, compared with 9,380 today, a 96.7% increase. Overall positions climbed from 22,221 to 39,205 in 2022, an increase of 76.5%. Psych had far more demand than most other fields, and unlike EM or radonc, doesn't require you to set up in a facility, which keeps you from having other people dictate your terms and driving your wages down artificially.

 

[RickyScott]

 

[cptsam]

Wow didn’t know that. Have these fields not learned the hazards of rapid residency expansion from radonc and EM?

there is a scarcity of psychiatrists, unlike that in rad onc or EM

 

[Banco]

Anything surgical basically.


Mean Step 1/2 for ENT: 250/257
Mean Step 1/2 for Plastics: 251/257


Good luck...

 

[Mad Jack]

there is a scarcity of psychiatrists, unlike that in rad onc or EM

There was once a scarcity of EM and radonc, hence the increase in positions. I think psych has a higher ceiling overall though for total positions