Competitive residencies

[deleted4401]

I've just started medical school, and I know it is early, but a few of us were talking about residencies and how hard specific ones are to get...

Okay, on this site I looked up a few 'harder' residencies: Dermatology, Orthopedics, Emergency, Allergy/Immunology, Urology, Radiology ... They all say get AOA, and that's what my friends say, too.

The question I have: at my school, top 25% are eligible for AOA and only 15% of the class actually get it. That means about 25 kids get it. So, are those the only kids that can get these residencies?

I'm not even sure if I'm interested in those fields, but what I'm even more unsure of is that I would be capable of attaining top 15% of my class. Seriously, I feel like everyone around me is top notch, and that I'm not that much better or not that much worse than the next guy.

What do you guys think? Do you need to bust your tail and honor everything, or can you get some high passes and a few honors and some passes and get to where you want to go? Or is it board dependent? Because I have a few priorities that lie above all: 1) I want to learn everything (the science and the art) well enough so that I can be an amazing doctor (not just ace tests / boards) 2) I want to stay in good mental and physical health 3) I want to continue service activities. Everything else comes next.

What do the elders (Dr. Cox, etc.) suggest?

Thank you for your help...

Simul
Tulane Med '05
(first exam tomorrow - just a half block gross written, but still my first med school exam!)

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[MacGyver]

This is a topic that frankly confuses me. It seems as if the competition for residencies does not match up well with common med student perceptions.

For example, out of all the possible residency types, I've only seen maybe 3 or 4 that are labeled as noncompetitive. When I say noncompetitive, that means that the average med student with average letters of rec, average grades, and average USMLE would have a good probability of getting in SOMEWHERE.

Now, how can it be that only 3 or 4 are noncompetitive when every year 95 something percent match somewhere? If only 3 or 4 are really noncompetitive, then it seems to me like the unmatched rate would be MUCH greater than it is in reality.

For every single residency, people say you need AOA. But a max of only 20% get AOA, yet you need it for almost every residency? I dont buy this, since it defies common sense.

If only 20% of med students get AOA, then likewise you should only need AOA for a small portion of residencies, not all of them like everyone seems to be implying.

My impression is that there are around 5 residency types that are truly worthy of the 'competitive' label. I'd like to see a list of what you people think are the competitive and noncompetitive ones. I bet every single person who lists it out would write that 80% of the residencies are competitive. That makes no sense, and cant be true, if in fact so few people go unmatched every year.

 

[GreatPumpkin]

These are all relative questions. There are "competitive" programs for every field. But, there are certain residencies that are certainly tough. People other than AOA get spots, but usually they have some sort of other special accomplishment or lots of research or know someone etc. Derm, ortho, rad onc, urology, optho, and rad are all tough. Especially the ones that are small specialties. Things that are not real tough, path, anes., PM&R, FP, IM, general surgery. If you want to compare look to see if the specialty has a good percentage of IMGs. If so it likely is not as competitive. These type of stats are located on the Match website.

web page

 

[droliver]

Here's the way I see it:

Less or Noncompetative:
Family practice
neurology
anesthesia
Internal Medicine
pathology
pediatrics
Physical Medicine & rehab
Psychiatry
Med-Peds

Moderately competative:
Emergency medicine
Urology
Obgyn
General Surgery
Radiology
Neurosurgery

Very competative:
Dermatology
Orthopedics
ENT
integrated Plastic Surgery


Some of the less competative field can be very competative at specicific programs (ie. medicine @ UCSF or Johns Hopkin's, Peds @ Boston Childrens or CHOP in Phialdelphia) but you do not need to be a superstar in medical school to match somewhere in theses fields. The intermediate group will have "average" people who match with better rank, scores, & AOA status, but those qualities are not absolute at a number of the programs. Again some positions in this group are super-competative & require sterling credentials to even get an interview for. For the most competative group, the majority of those matching will be AOA or sometimes in-house candidates of lesser qualifications are able to earn a spot by forming relationships with the faculty at their school.

Just my observations...

 

[Mango]

According to Dr. Kenneth Iserson (he wrote the book), whom I heard speak at the AMA conference in Chicago this summer, the current top five most difficult residencies to gain a position in are:

Derm
Optho
Neurosurg
EM
Ortho

He grouped a middle and a lower bracket as well, but those all fell as one would expect.

 

[nyskindr]

Allergy and Immunology fellowships which follow IM or Peds residency have many IMGs in them and will not be very competitive.
Top programs in ER and Urology will choose from an elite applicant pool.... but many who match at community hospitals and mid- level programs are not AOA.

 

[Kirk]

Ok, clue me in... whats AOA?

 

[FunkaDesi]

Things that are not real tough, path, anes., PM&R, FP, IM, general surgery. If you want to compare look to see if the specialty has a good percentage of IMGs. If so it likely is not as competitive.

R U kidding me?

Difficulty determined by IMG concentration? It may be true, but it is not a good way to go about looking at it....Thats like saying, "IMGs are a marker of a poor program."

And Pumpkin, you are totally wrong about general surgery being "easy" and I think putting Gen Surg in the same boat as Pathology is very amusing...

 

[GreatPumpkin]

Originally posted by FunkaDesi:
•R U kidding me?

Difficulty determined by IMG concentration? It may be true, but it is not a good way to go about looking at it....Thats like saying, "IMGs are a marker of a poor program."

And Pumpkin, you are totally wrong about general surgery being "easy" and I think putting Gen Surg in the same boat as Pathology is very amusing...•

I was not trying to say that IMGs are markers for a poor program. Most IMGs are very highly qualified, and they must be to match. But, they do coorelate farily well with the competitiveness of the specialty. And, it is data we can see. Since there is no "competitiveness multiplier" that is put out by the AMA, we have to look at what we have.

As far as lumping general surgery with pathology. I was only lumping specialties in two catagories very competitive and not. Over the last few years general surgery has not been "very competitive". Granted path is much easier to match in than surgery, but that wasn't the question. We were talking about specialties that almost require AOA to match and general surgery does not. Unless, you are talking about specific programs. There are also specific path programs that are tough to get into as well.