CNN.com Article On Match Day And Why More and More Students Are Going Unmatched

[tonyyounmd]

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Thank you to everyone for helping me on this article, especially the staff at StudentDoctor.net. Unfortunately, the subject of Match Day and being unmatched needs more than a 600 word article to do it justice. Your comments are appreciated!

http://thechart.blogs.cnn.com/2012/03/16/why-your-waiter-has-an-m-d/

 

[armybound]

thanks for sharing, Doc.

posted this on my FB.

 

[turkeyjerky]

Thank you for this--very well written for such a short article.

 

[Houmd]

This was an outstanding article. I wish more people understood the need for increasing the number of residency positions in the United States. It's unreal to me how the notion of increasing medical schools, and not to mention the call for increasing enrollment at current medical schools is not followed by an increase in the number of residency positions.

 

[JackShephard MD]

I enjoyed it. Nice job.

 

[Microshaft]

poor sam

 

[terrypk1]

Good luck on your new book idea Dr. Youn.

 

[SurfingDoctor]

I'm going to be the bad guy and say honestly, I don't feel sorry for him. If he came to this country to be a doctor, there are plenty of spots in the internal medicine, pediatric and family practice field for him to practice medicine as there are almost always open spot that go unfilled. And these open spots are the reason for practitioner shortages, not because all the surgical spots are filled. But he doesn't want that and can't find a job. He seems to feel that being a waiter is a better use of his time and skills then being a general practitioner, that's his problem then, not the system's.

 

[Houmd]

I'm going to be the bad guy and say honestly, I don't feel sorry for him. If he came to this country to be a doctor, there are plenty of spots in the internal medicine, pediatric and family practice field for him to practice medicine as there are almost always open spot that go unfilled. And these open spots are the reason for practitioner shortages, not because all the surgical spots are filled. But he doesn't want that and can't find a job. He seems to feel that being a waiter is a better use of his time and skills then being a general practitioner, that's his problem then, not the system's.

I'm gonna be a worse guy and say that you sound like you don't fully understand the ins and outs of IMGs.

The harsh reality of the matter is that it is entirely a political game. Many places in the US would much rather have unfilled positions than fill them with IMGs. Also, IMGs aren't all equal in the opportunity for residency & permanent licensure. For example, an IMG graduating from a school not approved by the state of California's very controversial "approval list" will never be eligible for residency or licensure in a handful of states. Any IMG conducting rotations outside of his/her country but not on the controversial New York list is not eligible for residency in the state of New York. Add those up and you are automatically at a great disadvantage on number of programs in which you can even apply.

Even with unfilled positions the numbers speak for themselves. So many people go unmatched each year that it is insane. The US could exponentially decrease the physician shortage if they increased residency positions, but that isn't the ultimate goal because it would likely decrease physician salaries. This is why the AMA is always recommending increasing enrollment and med schools while never pushing nearly as hard for increased residencies. It's all politics and it's not nearly as easy for an IMG as you seem to think it is.

 

[ineed2stpsmurfn]

I'm going to be the bad guy and say honestly, I don't feel sorry for him. If he came to this country to be a doctor, there are plenty of spots in the internal medicine, pediatric and family practice field for him to practice medicine as there are almost always open spot that go unfilled. And these open spots are the reason for practitioner shortages, not because all the surgical spots are filled. But he doesn't want that and can't find a job. He seems to feel that being a waiter is a better use of his time and skills then being a general practitioner, that's his problem then, not the system's.

Seconded. He probably got his education for free, and now wants to get paid the big bucks simply cause he came here or bust? come on...🙄

 

[Houmd]

Seconded. He probably got his education for free, and now wants to get paid the big bucks simply cause he came here or bust? come on...🙄

you know what they say about when you assume.....

 

[officedepot]

.

 

[SurfingDoctor]

Even with unfilled positions the numbers speak for themselves. So many people go unmatched each year that it is insane. The US could exponentially decrease the physician shortage if they increased residency positions, but that isn't the ultimate goal because it would likely decrease physician salaries. This is why the AMA is always recommending increasing enrollment and med schools while never pushing nearly as hard for increased residencies. It's all politics and it's not nearly as easy for an IMG as you seem to think it is.

You are absolutely right in that I don't know a lot about IMGs, and knowing about people's opinion in the US, I'm sure there is a lot of discrimination and it's really unfortunate. But that was not my argument. Opening more surgical residency spots doesn't fix the fact that that there is a shortage of primary care practitioners. Opening more primary care residency spots and filling them does. But if it's one's dream to be a doctor and help people, but only people with only certain aliments, and there are no spots in that particular field and they don't want to do a different field that has availability, the issue falls on the person not willing to compromise. That is not a systems issue. And this does not apply to just IMGs, it applies to everyone who wants to be a doctor. And yes I know US graduates have a lot of debt, but so what. I have a lot of debt and I went into a primary care residency, it's not like it is some impossible hurdle. People just don't like making sacrifices.

 

[IDBasco]

Why didn't "Sam" do a residency in his own country?

I'm sorry, but if I went overseas after graduating and couldn't get a residency, I wouldn't really feel like people owed me any sympathy.

Unless I'm missing something.😕

 

[Houmd]

You are absolutely right in that I don't know a lot about IMGs, and knowing about people's opinion in the US, I'm sure there is a lot of discrimination and it's really unfortunate. But that was not my argument. Opening more surgical residency spots doesn't fix the fact that that there is a shortage of primary care practitioners. Opening more primary care residency spots and filling them does. But if it's one's dream to be a doctor and help people, but only people with only certain aliments, and there are no spots in that particular field and they don't want to do a different field that has availability, the issue falls on the person not willing to compromise. That is not a systems issue. And this does not apply to just IMGs, it applies to everyone who wants to be a doctor. And yes I know US graduates have a lot of debt, but so what. I have a lot of debt and I went into a primary care residency, it's not like it is some impossible hurdle. People just don't like making sacrifices.

I very much agree with your statements here. Although I can understand why he would attempt to obtain a surgery residency (since he was previously a surgeon and is familiar with is) as an IMG he really should take what he can get. Unfortunately even so things aren't so easy for him.

Increasing the number of primary care residencies is absolutely what we need. When I complain about the offset ratio of applicants to residency positions I firmly believe that the sector needing to be increased is primary care, which happens to be the area most IMGs choose. Unfortunately instead of increasing the number of primary care positions people are more interested in having mid-level providers instead.

However across the bar I think there is a need for increased residency positions with a few exceptions but that primary care needs it the most. The whole "too many patients too few physicians" gets old after awhile when we have the ability to drastically adjust the ratio within a 4-10 year period but choose not to do so.

Why didn't "Sam" do a residency in his own country?

I'm sorry, but if I went overseas after graduating and couldn't get a residency, I wouldn't really feel like people owed me any sympathy.

Unless I'm missing something.😕

Sam probably did do a residency in his own country, but in order to practice in the US you have to start over and repeat residency here in the US, no matter how many years of post-graduate training or experience you have. I don't believe Sam in this situation went overseas for residency but rather came to the USA attempting to obtain a residency and become a physician here for his family's sake. This isn't uncommon.

 

[SpecterGT260]

I'm gonna be a worse guy and say that you sound like you don't fully understand the ins and outs of IMGs.

The harsh reality of the matter is that it is entirely a political game. Many places in the US would much rather have unfilled positions than fill them with IMGs. Also, IMGs aren't all equal in the opportunity for residency & permanent licensure. For example, an IMG graduating from a school not approved by the state of California's very controversial "approval list" will never be eligible for residency or licensure in a handful of states. Any IMG conducting rotations outside of his/her country but not on the controversial New York list is not eligible for residency in the state of New York. Add those up and you are automatically at a great disadvantage on number of programs in which you can even apply.

Even with unfilled positions the numbers speak for themselves. So many people go unmatched each year that it is insane. The US could exponentially decrease the physician shortage if they increased residency positions, but that isn't the ultimate goal because it would likely decrease physician salaries. This is why the AMA is always recommending increasing enrollment and med schools while never pushing nearly as hard for increased residencies. It's all politics and it's not nearly as easy for an IMG as you seem to think it is.

As long as seats are currently going unfilled in the practices with shortages, we will not make this up by expanding residency programs

 

[SpecterGT260]

I very much agree with your statements here. Although I can understand why he would attempt to obtain a surgery residency (since he was previously a surgeon and is familiar with is) as an IMG he really should take what he can get. Unfortunately even so things aren't so easy for him.

Increasing the number of primary care residencies is absolutely what we need. When I complain about the offset ratio of applicants to residency positions I firmly believe that the sector needing to be increased is primary care, which happens to be the area most IMGs choose. Unfortunately instead of increasing the number of primary care positions people are more interested in having mid-level providers instead.

However across the bar I think there is a need for increased residency positions with a few exceptions but that primary care needs it the most. The whole "too many patients too few physicians" gets old after awhile when we have the ability to drastically adjust the ratio within a 4-10 year period but choose not to do so.





Sam probably did do a residency in his own country, but in order to practice in the US you have to start over and repeat residency here in the US, no matter how many years of post-graduate training or experience you have. I don't believe Sam in this situation went overseas for residency but rather came to the USA attempting to obtain a residency and become a physician here for his family's sake. This isn't uncommon.

I dont think it's fair to assume Sam has tried and failed other specialties without being given that information. Also, FMGs are not a good standard when writing a paper when your thesis is that it is harder for med students to match. I had issues reading the article on my phone tho so I am going off the title and the first couple paragraphs before the site grenaded

 

[SpecterGT260]

Also, read the bottom. 5.9% unmatched was given for the time this was written. The update gives a 5% unmatched rate (95% matched) as the lowest (highest matched) in 30 years. This goes well beyond any financial issues relating to the doctor crunch. This is shaping up to be more of a boogie man than it needs to

 

[Houmd]

Specter your numbers are only considering AMGs. Every year most all AMGs match via the NRMP and the remaining positions are filled by IMGs who tend to get the remaining scraps. Even though all these positions get filled (with few exceptions that most IMGs would jump on if they had the chance) the shortage of physicians still exists.

This means that you are missing my point entirely.

If a shortage of physicians exists already as we enroll ~24k medical graduates per year into residency programs with anywhere from 8-10k unmatched fully eligible applicants then why would we saturate the pool even more without increasing residency positions. We could easily graduate 30k residents per year and affect the physician shortage if we wanted but that wouldn't make the powers at be very happy.

Most AMGs don't ever think of this because it doesn't affect them right now but in a only a few years the applicant pool will be filled and ungodly amount of more AMG applicants, thus saturating the pool even further and making everything that much more competitive for AMGs and virtually putting IMGs (and probably DOs) out of the picture altogether. If the applicant pool is going to become way more saturated with american medical graduates then there needs to be a proportionate increase in residency positions. We aren't helping the public in anyway by keeping the amount physicians in the market constant, we are only hurting them and helping our own pockets. That's the reality of it.

Also, if you're that quick to disregard any IMG (particularly those having practiced in another country) then I hope you are never allowed to go practice in any other country with that superiority complex. Who is to say that a surgeon in Western Europe isn't as capable as a US surgeon?

 

[IDBasco]

Sam probably did do a residency in his own country, but in order to practice in the US you have to start over and repeat residency here in the US, no matter how many years of post-graduate training or experience you have. I don't believe Sam in this situation went overseas for residency but rather came to the USA attempting to obtain a residency and become a physician here for his family's sake. This isn't uncommon.

The article doesn't make it sound like he did a residency. And assuming he was from the country he went to medical school in, he absolutely "went overseas" to get a residency. Frankly, I don't think FMGs should even be able to participate in the main match. They should wait until after the US MDs and DOs have had a go at it. Especially if Medicare funds are being used to train them.

 

[Houmd]

The article doesn't make it sound like he did a residency. And assuming he was from the country he went to medical school in, he absolutely "went overseas" to get a residency.

The article doesn't directly indicate whether or not he did a surgical residency so I will give you that. But it's not fair to assume one way or the other whether or not he did. However if he had done a residency in another country, under our system it wouldn't count for anything.

Frankly, I don't think FMGs should even be able to participate in the main match. They should wait until after the US MDs and DOs have had a go at it. Especially if Medicare funds are being used to train them.

Wow.......This is the exact type of narcissistic & entitled statement I would expect from a medical student desperately trying to claim his superiority over someone else........

[Hypothetical Scenario]: So you REALLY think that an IMG with board scores Step I: 265+ & Step II: 265+ should automatically be less qualified than ANY AMG even if he has multiple failed attempts? Get over yourself.....

In the perfect world the most qualified candidate would get the position, but unfortunately the world is very anti-IMGs mostly because people such as yourself refuse to educate yourself on the environment all around you (IMGs). There are a lot more of them than you think, and you will probably never realize that some of your attendings have probably been IMGs.

If you truly believe that any overly-qualified IMG should not even be able to compete for a position with you then you aren't really caring about the patients and are simply caring about yourself. When worst comes to worst I want the best damn physician available and I don't care where he/she graduated from.


And as for your medicare statement, that argument ONLY applies to any IMG that comes here for training and immediately leaves. Most all IMGs coming to the US to train are here to stay, and do just that....so that argument is void.

 

[phltz]

The article doesn't make it sound like he did a residency. And assuming he was from the country he went to medical school in, he absolutely "went overseas" to get a residency. Frankly, I don't think FMGs should even be able to participate in the main match. They should wait until after the US MDs and DOs have had a go at it. Especially if Medicare funds are being used to train them.

One of the things that's really helped America over the years is that we've been able to scoop up many of the brightest and most ambitious people from around the world. Pretty much since WWII, our laboratories, universities, research centers, companies, and, yes, hospitals have been able to poach the top talent from pretty much everywhere else. If you were a residency director, would you want to be told that you couldn't pick a doctor who graduated at the top of their class from All India Institute of Medical Sciences until after all the American doctors who graduated near the bottom of their class from the University of West Bumble**** had gotten matched?

 

[SpecterGT260]

Specter your numbers are only considering AMGs. Every year most all AMGs match via the NRMP and the remaining positions are filled by IMGs who tend to get the remaining scraps. Even though all these positions get filled (with few exceptions that most IMGs would jump on if they had the chance) the shortage of physicians still exists.

This means that you are missing my point entirely.

If a shortage of physicians exists already as we enroll ~24k medical graduates per year into residency programs with anywhere from 8-10k unmatched fully eligible applicants then why would we saturate the pool even more without increasing residency positions. We could easily graduate 30k residents per year and affect the physician shortage if we wanted but that wouldn't make the powers at be very happy.

Most AMGs don't ever think of this because it doesn't affect them right now but in a only a few years the applicant pool will be filled and ungodly amount of more AMG applicants, thus saturating the pool even further and making everything that much more competitive for AMGs and virtually putting IMGs (and probably DOs) out of the picture altogether. If the applicant pool is going to become way more saturated with american medical graduates then there needs to be a proportionate increase in residency positions. We aren't helping the public in anyway by keeping the amount physicians in the market constant, we are only hurting them and helping our own pockets. That's the reality of it.

Also, if you're that quick to disregard any IMG (particularly those having practiced in another country) then I hope you are never allowed to go practice in any other country with that superiority complex. Who is to say that a surgeon in Western Europe isn't as capable as a US surgeon?

Yes. I specifically said that FMGs skew the numbers inappropriately

 

[SpecterGT260]

u didn't really read what I said....

 

[sineapse]

He probably got his education for free

Hyperbole much?

 

[CaptainSSO]

Good article--I like your writing style.

 

[boggvir]

Highest match rate in 30 years for AMGs this year.

 

[officedepot]

.

 

[boggvir]

Em averages have been increasing as far as I know.

 

[gasblaster]

Em averages have been increasing as far as I know.

Considering there were no spots in EM after the match. It's definitely getting more competitive.

 

[ronaldo23]

yeah the article pretty much sucked for the most part. Some fields are getting harder to match (gen surgery) but that also comes with other fields being easier and easier (EM, peds, etc). The problem with people not matching is that they don't assess their competitiveness for a field enough and therefore pick one that is too difficult and they go unmatched.

However that article focused on IMG... it's always been hard for them. It's going to get harder for them since more medical schools are opening up. That's just the way it is. My advice if you're IMG: just stay in your country if you want to practice medicine and if you don't care about your job then come here legally at least.

EM is not getting easier, didn't they have like zero unfilled spots this year?

 

[turkeyjerky]

EM is not getting easier, didn't they have like zero unfilled spots this year?

Hush now. Mustn't let evidence get in the way of EM bashing.

 

[MT Headed]

Hush now. Mustn't let evidence get in the way of EM bashing.

Yeah, it would be terrible if somebody mentioned the EM applicants who didn't match and had to SOAP into multiple offers from Anes and Rads programs that couldn't fill. Gotta keep that on the down-low for sure.

 

[Druggernaut]

If a shortage of physicians exists already as we enroll ~24k medical graduates per year into residency programs with anywhere from 8-10k unmatched fully eligible applicants then why would we saturate the pool even more without increasing residency positions. We could easily graduate 30k residents per year and affect the physician shortage if we wanted but that wouldn't make the powers at be very happy.

Most AMGs don't ever think of this because it doesn't affect them right now but in a only a few years the applicant pool will be filled and ungodly amount of more AMG applicants, thus saturating the pool even further and making everything that much more competitive for AMGs and virtually putting IMGs (and probably DOs) out of the picture altogether. If the applicant pool is going to become way more saturated with american medical graduates then there needs to be a proportionate increase in residency positions. We aren't helping the public in anyway by keeping the amount physicians in the market constant, we are only hurting them and helping our own pockets. That's the reality of it.

There are more residency positions than US graduates, at least for the next few years. In the short term, increasing the number of graduates while holding the number of residencies constant will theoretically lead to undesirable primary care residencies filling, which then leads to more family practice physicians. They might not want to do FM, but if that's what they realistically have a shot for, plenty will take it, and the shortage will be less of an issue.

But that's a very short term outlook. I'm definately concerned about the outlook when I graduate (2015) and afterwards, when there isn't enough GME to go around. New programs can't be started overnight, so even if they get the ball rolling in the next year or two (unlikely, considering the budget cuts that were proposed in the last year), the next few years may get very ugly.

Maybe I shouldn't have taken that year off after college... At least I'm not in the class of 2016+.

 

[phltz]

yeah the article pretty much sucked for the most part. Some fields are getting harder to match (gen surgery) but that also comes with other fields being easier and easier (EM, peds, etc). The problem with people not matching is that they don't assess their competitiveness for a field enough and therefore pick one that is too difficult and they go unmatched.

Unrealistic optimism is part of the problem, but I'd argue that another big part of the problem is the skewed incentives that make some fields so much less desirable than others. I'd rather have a primary care physician who chose family or internal medicine because he/she wanted to, not because there were no other choices.

 

[ineed2stpsmurfn]

Hyperbole much?

did you see where he went to med school at?

"Sam obtained his medical degree from a school in Eastern Europe prior to immigrating to the United..."

 

[Socrates25]

Yeah, it would be terrible if somebody mentioned the EM applicants who didn't match and had to SOAP into multiple offers from Anes and Rads programs that couldn't fill. Gotta keep that on the down-low for sure.

EM is certainly more competitive this year than it has been, but lets not get carried away -- there are LOTS of fields more competitive, including plastics, neurosurg, gen surg, ENT, derm, rad onc, rads, optho, etc

 

[sineapse]

did you see where he went to med school at?

"Sam obtained his medical degree from a school in Eastern Europe prior to immigrating to the United..."

So? Being in Eastern Europe =/= free education 🙄

 

[SpecterGT260]

So? Being in Eastern Europe =/= free education 🙄

I don't know one way or the other but do some googling. Not every country treats med ed like we do. China is a good example. Med school is a consolation prize if u couldn't get into grad school

 

[sineapse]

I don't know one way or the other but do some googling. Not every country treats med ed like we do. China is a good example. Med school is a consolation prize if u couldn't get into grad school

I think you'll find the majority of countries don't treat med school as a 'consolation prize' 😕

 

[SpecterGT260]

I think you'll find the majority of countries don't treat med school as a 'consolation prize' 😕

Which is why I only gave 1 country..... seriously how did you extract THAT from what I said?

 

[gravitywave]

There are more residency positions than US graduates, at least for the next few years. In the short term, increasing the number of graduates while holding the number of residencies constant will theoretically lead to undesirable primary care residencies filling, which then leads to more family practice physicians. They might not want to do FM, but if that's what they realistically have a shot for, plenty will take it, and the shortage will be less of an issue.

But that's a very short term outlook. I'm definately concerned about the outlook when I graduate (2015) and afterwards, when there isn't enough GME to go around. New programs can't be started overnight, so even if they get the ball rolling in the next year or two (unlikely, considering the budget cuts that were proposed in the last year), the next few years may get very ugly.

Maybe I shouldn't have taken that year off after college... At least I'm not in the class of 2016+.

let's not get ahead of ourselves here. the number of additional training slots being filled as a result of the AOA/AAMC expansions is negligible as nearly all those slots were being filled eventually anyway, by IMGs/the Scramble. I'm not sure exactly what the med school expansion is expected to accomplish when residencies are growing at a slower pace, but i'm pretty confident that LCME isn't going to keep expanding to the point that we see any substantial increase in the number of unmatched US seniors. sure it's going to be harder to get the most competitive specialities and more US allo will be headed to primary care, but it's very premature to be talking about a shortage of GME. remember that we were used to filling 1/3 of ACGME slots with non-US seniors up until very recently.

unless of course you are trying to come in from offshore. those people have a very dismal outlook. and whether ACGME is going to be willing to accomodate the rapidly increasing numbers of DO grads forever is another story as well. you'd have to think that they will act to protect their own younglings first if it came to that. but it probably won't. LCME will slow down the pace of expansion once we get to that point, it's not like they can't fine tune the process when it takes several years to get a new program off the ground.

 

[Law2Doc]

let's not get ahead of ourselves here. the number of additional training slots being filled as a result of the AOA/AAMC expansions is negligible as nearly all those slots were being filled eventually anyway, by IMGs/the Scramble. I'm not sure exactly what the med school expansion is expected to accomplish when residencies are growing at a slower pace, but i'm pretty confident that LCME isn't going to keep expanding to the point that we see any substantial increase in the number of unmatched US seniors. sure it's going to be harder to get the most competitive specialities and more US allo will be headed to primary care, but it's very premature to be talking about a shortage of GME. remember that we were used to filling 1/3 of ACGME slots with non-US seniors up until very recently.

unless of course you are trying to come in from offshore. those people have a very dismal outlook. and whether ACGME is going to be willing to accomodate the rapidly increasing numbers of DO grads forever is another story as well. you'd have to think that they will act to protect their own younglings first if it came to that. but it probably won't. LCME will slow down the pace of expansion once we get to that point, it's not like they can't fine tune the process when it takes several years to get a new program off the ground.

Yeah, if you read the ACGME press releases, circa 2005, it's pretty clear that having US grads fill all US residency slots is the end target, thereby having the LCME stamp of approval on all future doctors. Till we get to that point, expect med school enrollment to exceed residency slot increases. Caribbean schools are on borrowed time.

 

[surftheiop]

I feel bad for IMGs who are actually internationals and not just Americans who couldn't cut it to get into a US school. One of my friend's dad's was a well respected surgeon in pakistan and then came to the US and couldn't find any residencies for like 3 years. He then started going to random grand rounds lectures and happened to impress a pathology residency director. He finished his residency at the small program and then within 10 years he was a professor at an Ivy pathology program and now is very respected in the field. I see no reason why this guy shouldn't have been able to do surgery just because he wasn't born in the states.

 

[Braves123]

honestly what is wrong with staying in one's own country and servicing the system that trained you?

I personally don't know why an country that actually is facing a doc shortage would let their folks go overseas unless its stipulated that they return home to serve or pay some sort of fee. It doesn't make sense to train people then send them over seas where they're make money and pay taxes to another government.

 

[secants]

So when exactly in the future is this projected surge of American Grads going into Primary care gonna happen? Are the Caribbean schools panicking since they're going to see less and less people match from their school regardless if they have US clinical training sites for their 3/4th years?

 

[auburnO5]

Solid troll, OP. 9/10

 

[phltz]

honestly what is wrong with staying in one's own country and servicing the system that trained you?

I personally don't know why an country that actually is facing a doc shortage would let their folks go overseas unless its stipulated that they return home to serve or pay some sort of fee. It doesn't make sense to train people then send them over seas where they're make money and pay taxes to another government.

Different people have different reasons. I've worked with an IMG who is in the US because they married an American spouse, and one who left Eastern Europe when it was still under Communist control.

Trying to trap your citizens and preventing them from leaving is usually one of the big warning signs of a totalitarian, oppressive government. Honestly, think of all of the times you've heard the words "exit visa". Did you hear them in the context of a democratic state with respect for human rights? Or was it a tool to control the population and restrict dissent?

 

[drizzt3117]

People need to stop trying to equate % unfilled with competitiveness. It doesn't work that way.

Self selection is an enormous factor in residency choice. This year in radiology the recurring theme from PDs I've spoken to is that apps were down 15-20% but step scores were and AOA members were up 5-10% from last year. Considering even last year > 25% of US senior applicants had step 1 > 251, and less than 25% of applicants has < 230, obviously a lot of people with lower scores self-selected themselves out of the field when theyd've at least have had a chance to match had they not done so.

 

[Slade]

Is this "Considering even last year > 25% of US senior applicants had step 1 > 251, and less than 25% of applicants has < 230" specifically for Rads or all fields?