Doximity Compensation Report 2018

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Can anyone comment on job security 10-20 years down the line? Feel like with all the schools opening, large classes, midlevels gaining practice rights, feel like in the near future we can't even count on medicine being the best in terms of job security.
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HueySmith said:
Can anyone comment on job security 10-20 years down the line? Feel like with all the schools opening, large classes, midlevels gaining practice rights, feel like in the near future we can't even count on medicine being the best in terms of job security.
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Depends on what fields you go into. I think in fields that can open practices, you'll always have a job. Your salary may go down, you may have more competition from midlevels, but as long as theres no law preventing you from opening your clinic and seeing patients that way, then you'll have a job. you'll be the boss. It's much harder to say about employee type jobs though like pathology, radiology, EM, Anesthesiology
 
anbuitachi said:
A 20% retirement saving rate on a 100k salary starting at 22 yrs old gets you 7M by 67 with the usual growth assumptions. A 20% retirement on 200k salary starting at age 32 gets you 6M by 67.
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Why is the doctor only saving 20% of their income? If you want this to be an apples to apples comparison, then the two careers need to be living off the same yearly amount. Otherwise, the MD might have less saved up at the end (although $6M is more than enough to retire on anyway), but they've lived on more than $5k extra per month than the SWE.
 
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anbuitachi said:
A 20% retirement saving rate on a 100k salary starting at 22 yrs old gets you 7M by 67 with the usual growth assumptions. A 20% retirement on 200k salary starting at age 32 gets you 6M by 67. And don't forget the higher tax brackets and 200k debt you have to pay off. It's not about the annual salary, it's about the net career income..
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People always do this when trying to prove a point. When comparing two things they are extremely generous with one variable and extremely stingy with another.. I can promise its wayyyyyyyyyyyy more common for a doctor to be making more than 200k than it is for a 22 year old to make 100k... So I dont know why you randomly chose those numbers.

And like stated above, if you want to compare better, have them live off the same amount per year.
 
shouldvestudied said:
Why is the doctor only saving 20% of their income? If you want this to be an apples to apples comparison, then the two careers need to be living off the same yearly amount. Otherwise, the MD might have less saved up at the end (although $6M is more than enough to retire on anyway), but they've lived on more than $5k extra per month than the SWE.
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smurfeyD said:
People always do this when trying to prove a point. When comparing two things they are extremely generous with one variable and extremely stingy with another.. I can promise its wayyyyyyyyyyyy more common for a doctor to be making more than 200k than it is for a 22 year old to make 100k... So I dont know why you randomly chose those numbers.

And like stated above, if you want to compare better, have them live off the same amount per year.
Click to expand...

The point is for people to do the math.. You can say a million things about the imperfections of those 2 comparisons and I agree. It's impossible to do a complete analysis. The issue is most people dont even bother and dont even realize the fact that more money per year for doctor starting at older age may not be more than less but started younger.

@smurfeyD Like I mentioned above, I'm comparing people in high paying fields. Medicine accepts teh top students from college. Vast numbers are top students from top colleges. This is the group that we should be comparing to. Sure you can say there are plenty of 22 yr olds working for Mcdonalds and that's fine but we are generalizing here because that's the best we can do. It's likely that top students graduating from good schools going to high paying fields (business/finance/tech/law/health).

If you want to get into more details which I was too lazy to do, other things to consider are many doctors end up doing longer residencies, and fellowships, and take years doing research to be more competitive for residency/fellowships. The general surgery residents at my institution on average take 6-7 years to graduate residency because of research. All these things i didn't account for. I choose an optimistic age (32) to start. The reason I chose a lower salary (200k) is because 1) I chose a lower starting age, 2) I didn't account for the years doctors will take to pay off their on average now 200k loans 3) I am not accounting for raises in salary that happens a lot more often in other fields than in medicine.

Perhaps my experiences are biased, but I can tell you that I graduated almost 10 years ago from college and among all my peers, I can tell you that business majors such as analysts had starting salaries of about 65-75k with yearly 5-10k bonus for total of about 70-85k per year. (None of these numbers include employer retirement contributions). The Ibankers made 150k+ starting but I usually dont compare MD to Ibankers since it's obvious IB make much more money. Computer programmers started at about 90-100k with ~50k signon bonus over 5 years, and yearly bonus of a few thousand. Now close to 10 years out of college, those very same business people are making 150-200k total after bonus, the programmers are making 150k+ with some already making 200/300k+. And that's the reason why I decided to go with those numbers when I did the math , because doctors usually dont get those types of raises since we dont get those types of promotions. We also dont get those types of bonuses.
 
intubesteak said:
Medicine has the lowest risk of any field...probably why it attracts neurotic people who constantly think the sky is falling.
Click to expand...

Depends on how you define risk. Risk of what? Cause the risk of you getting sued is one of the highest of any career. "75 percent of physicians practicing in a low-risk specialty will have been sued by the time they are age of 65 years, 19 percent will have made an indemnity payment. For those in the high risk specialties, 99 percent will have been sued by age 65, and 71 percent will have lost."

I dont think the sky is falling and if it will fall, it will probably not fall quickly. However, one thing you cant deny is how much worse doctors have it today that in the past. Lack of respect, far higher malpractice, less patient time, far more paper/EMR work, more insurance BS, fewer drug rep meals, and lower pay. 40-45% of doctors are dissatisfied. It's a pretty large number considering how much work and money you had to put in to get there. However I can say with confidence that todays residency graduates also dont know much about how much they are worth and that only makes our future worse. It's funny because when i work with older attendings, i always hear them complain about how it's terrible to work in medicine compared to before, and how there is no money left in medicine anymore. But i guess sometimes it's better for your mental health to be more ignorant.

I think medicine , especially our pay, will be far lower in the future. Why? Because our country cant sustain our healthcare cost and not go bankrupt. And the people at the bottom of the food chain are the doctors. No unions are here to protect us. Administrators will blame (and have been blaming) the high cost on doctors 'ridiculous' salaries. Insurance obviously will try to decrease payments. Patients and the public will see doctors' 200k+ salaries and cry outrage. And honestly as long as the people of our country don't start taking care of their health and thus reduce the cost, I don't see how we will get out of this mess without some major change. The other way for our fields to not go down is if somehow the supply of doctors go down significantly.

That's why I keep telling pre meds to really know what you are getting into. Really do that research, do the math, talk to as many doctors as they can before pulling that trigger. Year after year, the supply of people wanting to go into medicine is far higher than the spots. As long as that's true, tuition can keep going up because people are willing to pay it, and salaries and work conditions can keep going down, b/c doctors need the money to pay off loans and start living a life.
 
anbuitachi said:
The point is for people to do the math.. You can say a million things about the imperfections of those 2 comparisons and I agree. It's impossible to do a complete analysis. The issue is most people dont even bother and dont even realize the fact that more money per year for doctor starting at older age may not be more than less but started younger.

Perhaps my experiences are biased, but I can tell you that I graduated almost 10 years ago from college and among all my peers, I can tell you that business majors such as analysts had starting salaries of about 65-75k with yearly 5-10k bonus for total of about 70-85k per year. (None of these numbers include employer retirement contributions). The Ibankers made 150k+ starting but I usually dont compare MD to Ibankers since it's obvious IB make much more money. Computer programmers started at about 90-100k with ~50k signon bonus over 5 years, and yearly bonus of a few thousand. Now close to 10 years out of college, those very same business people are making 150-200k total after bonus, the programmers are making 150k+ with some already making 200/300k+. And that's the reason why I decided to go with those numbers when I did the math , because doctors usually dont get those types of raises since we dont get those types of promotions. We also dont get those types of bonuses.
Click to expand...

Definitely...

<10% of the US population is making 6 figure and around 1/3 has bacc degree
 
Going into medicine is "worth it" for now....can't say the same 10-15 years down the line.
 
anbuitachi said:
Depends on how you define risk. Risk of what? Cause the risk of you getting sued is one of the highest of any career. "75 percent of physicians practicing in a low-risk specialty will have been sued by the time they are age of 65 years, 19 percent will have made an indemnity payment. For those in the high risk specialties, 99 percent will have been sued by age 65, and 71 percent will have lost."

I dont think the sky is falling and if it will fall, it will probably not fall quickly. However, one thing you cant deny is how much worse doctors have it today that in the past. Lack of respect, far higher malpractice, less patient time, far more paper/EMR work, more insurance BS, fewer drug rep meals, and lower pay. 40-45% of doctors are dissatisfied. It's a pretty large number considering how much work and money you had to put in to get there. However I can say with confidence that todays residency graduates also dont know much about how much they are worth and that only makes our future worse. It's funny because when i work with older attendings, i always hear them complain about how it's terrible to work in medicine compared to before, and how there is no money left in medicine anymore. But i guess sometimes it's better for your mental health to be more ignorant.

I think medicine , especially our pay, will be far lower in the future. Why? Because our country cant sustain our healthcare cost and not go bankrupt. And the people at the bottom of the food chain are the doctors. No unions are here to protect us. Administrators will blame (and have been blaming) the high cost on doctors 'ridiculous' salaries. Insurance obviously will try to decrease payments. Patients and the public will see doctors' 200k+ salaries and cry outrage. And honestly as long as the people of our country don't start taking care of their health and thus reduce the cost, I don't see how we will get out of this mess without some major change. The other way for our fields to not go down is if somehow the supply of doctors go down significantly.

That's why I keep telling pre meds to really know what you are getting into. Really do that research, do the math, talk to as many doctors as they can before pulling that trigger. Year after year, the supply of people wanting to go into medicine is far higher than the spots. As long as that's true, tuition can keep going up because people are willing to pay it, and salaries and work conditions can keep going down, b/c doctors need the money to pay off loans and start living a life.
Click to expand...

For the record, you are making some valid points here. Quite a lot actually.

Just avoid rehashing the fanfics where you are automatically making $150k at age 28 just because you had a 3.8 GPA in college. That's all we're trying to say.
 
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TrueConjecture said:
For the record, you are making some valid points here. Quite a lot actually.

Just avoid rehashing the fanfics where you are making $150k at age 28 just because you have a 3.8 GPA in college. That's all we're trying to say.
Click to expand...

Hey maybe it's because i graduated from a ivy school that i'm seeing that salary range at my age. maybe you dont see that in peers around your gpa range if you went to a state school ? And Im not talking about english/history majors. I'm talking about mainly business/finance/tech fields. I think one of my points is for those who want to make money, dont get blinded by medicines large numbers. There are many good ways to make money. Sure not everyone smart is making 150k at age 28, no doubt about that, but there are a lot of jobs out there in the US right now that pays a lot especially over time.

And I know this part is biased since i went to a top 30 college, but i just checked the updated placement for graduating class from my alma mater in the department of computer science. The average starting salary for new college grads from there is 107k . Factor in the annual bonus, and the sign on bonus (~10k / yr over 5 yrs), and it's about 120k right off the bat from college.
 
anbuitachi said:
Hey maybe it's because i graduated from a ivy school that i'm seeing that salary range at my age. maybe you dont see that in peers around your gpa range if you went to a state school ? And Im not talking about english/history majors. I'm talking about mainly business/finance/tech fields. I think one of my points is for those who want to make money, dont get blinded by medicines large numbers. There are many good ways to make money. Sure not everyone smart is making 150k at age 28, no doubt about that, but there are a lot of jobs out there in the US right now that pays a lot especially over time.

And I know this part is biased since i went to a top 30 college, but i just checked the updated placement for graduating class from my alma mater in the department of computer science. The average starting salary for new college grads from there is 107k . Factor in the annual bonus, and the sign on bonus (~10k / yr over 5 yrs), and it's about 120k right off the bat from college.
Click to expand...
If you went to an Ivy League and thats where youre getting your anecdotal data, then its deeeefinitely biased haha those aren't average numbers across the country.
 
smurfeyD said:
If you went to an Ivy League and thats where youre getting your anecdotal data, then its deeeefinitely biased haha those aren't average numbers across the country.
Click to expand...
Not only that, people can get into med school (DO school specifically) with 3.3 and 24-25 MCAT, which is not terribly difficult if English is your native language. These people can become EM/Gas docs and start making 350k+/yr at the age of 29-30...

I, myself, would not be able to get into an IV league school for undergrad had I applied... By the way, nothing against DO since my stats were more in line with DO, and was lucky to get into a low tier MD...
 
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anbuitachi said:
Hey maybe it's because i graduated from a ivy school that i'm seeing that salary range at my age. maybe you dont see that in peers around your gpa range if you went to a state school ? And Im not talking about english/history majors. I'm talking about mainly business/finance/tech fields. I think one of my points is for those who want to make money, dont get blinded by medicines large numbers. There are many good ways to make money. Sure not everyone smart is making 150k at age 28, no doubt about that, but there are a lot of jobs out there in the US right now that pays a lot especially over time.

And I know this part is biased since i went to a top 30 college, but i just checked the updated placement for graduating class from my alma mater in the department of computer science. The average starting salary for new college grads from there is 107k . Factor in the annual bonus, and the sign on bonus (~10k / yr over 5 yrs), and it's about 120k right off the bat from college.
Click to expand...
Your peers from undergrad are probably more exceptional than like half of US physicians.
 
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W19 said:
Not only that, people can get into med school (DO school specifically) with 3.3 and 24-25 MCAT, which is not terribly difficult if English is your native language. These people can become EM/Gas docs and start making 350k+/yr at the age of 29-30...


I, myself, would not be able to get into an IV league school for undergrad had I applied... By the way, nothing against DO since my stats were more in line with DO, and was lucky to get into a low tier MD...
Click to expand...

I think everyone on sdn can agree that with those stats your odds are not great. That's similar to comparing to becoming rich in other fields w a poor education. Yes you can. But it's pretty hard

Plenty of smart people don't get into ivy. Many smarter than myself. Coming from ivy I can tell you plenty of ivy applicants get rejected to med school. Because we go thru the same weed out classes. And those C's in organic do weed people out.

VA Hopeful Dr said:
"Ivy league graduates make great money immediately out of college therefore medicine isn't a great career".

Makes sense.
Click to expand...

Who said medicine isn't a great career?


Ho0v-man said:
Your peers from undergrad are probably more exceptional than like half of US physicians.
Click to expand...

Maybe but I attended an avg med school per Forbes . Our class avg that year almost 10 yrs ago was was 3.7, and MCAT of 32. It's higher now but even back then a significant portion of my class graduated from top schools. Those who didn't weren't any less smart I felt. I thought my fellow med students were definitely smarter academically than Ivy peers on average. Those who couldn't handle it dropped or failed out over the 4 years.
 
anbuitachi said:
I think everyone on sdn can agree that with those stats your odds are not great. That's similar to comparing to becoming rich in other fields w a poor education. Yes you can. But it's pretty hard

Plenty of smart people don't get into ivy. Many smarter than myself. Coming from ivy I can tell you plenty of ivy applicants get rejected to med school. Because we go thru the same weed out classes. And those C's in organic do weed people out.
Click to expand...
Your odds are not great, but good if you apply to the 'right' schools...
 
anbuitachi said:
I think everyone on sdn can agree that with those stats your odds are not great. That's similar to comparing to becoming rich in other fields w a poor education. Yes you can. But it's pretty hard

Plenty of smart people don't get into ivy. Many smarter than myself. Coming from ivy I can tell you plenty of ivy applicants get rejected to med school. Because we go thru the same weed out classes. And those C's in organic do weed people out.



Who said medicine isn't a great career?




Maybe but I attended an avg med school per Forbes . Our class avg that year almost 10 yrs ago was was 3.7, and MCAT of 32. It's higher now but even back then a significant portion of my class graduated from top schools. Those who didn't weren't any less smart I felt. I thought my fellow med students were definitely smarter academically than Ivy peers on average. Those who couldn't handle it dropped or failed out over the 4 years.
Click to expand...
Good points. I guess all physicians are significantly smarter than all the people in these other fields that don’t work as hard. We’re also all simultaneously dumber because we can’t see how much better it is to be a banker/software engineer than a doc.

I get what you’re saying and it’s not like I totally disagree with you, but you neglect personal interest. I’m doing pretty well in med school but would struggle to pass software engineering/coding/IB. I could never feel motivated to study that. A buddy of mine is making bank as a software engineer who would straight up crumble in med school. If an Michael Phelps put the same effort into law school that he put into swimming would he be the greatest lawyer of all time? Not everyone can do literally anything.
 
anbuitachi said:
Depends on how you define risk. Risk of what? Cause the risk of you getting sued is one of the highest of any career. "75 percent of physicians practicing in a low-risk specialty will have been sued by the time they are age of 65 years, 19 percent will have made an indemnity payment. For those in the high risk specialties, 99 percent will have been sued by age 65, and 71 percent will have lost."

I dont think the sky is falling and if it will fall, it will probably not fall quickly. However, one thing you cant deny is how much worse doctors have it today that in the past. Lack of respect, far higher malpractice, less patient time, far more paper/EMR work, more insurance BS, fewer drug rep meals, and lower pay. 40-45% of doctors are dissatisfied. It's a pretty large number considering how much work and money you had to put in to get there. However I can say with confidence that todays residency graduates also dont know much about how much they are worth and that only makes our future worse. It's funny because when i work with older attendings, i always hear them complain about how it's terrible to work in medicine compared to before, and how there is no money left in medicine anymore. But i guess sometimes it's better for your mental health to be more ignorant.

I think medicine , especially our pay, will be far lower in the future. Why? Because our country cant sustain our healthcare cost and not go bankrupt. And the people at the bottom of the food chain are the doctors. No unions are here to protect us. Administrators will blame (and have been blaming) the high cost on doctors 'ridiculous' salaries. Insurance obviously will try to decrease payments. Patients and the public will see doctors' 200k+ salaries and cry outrage. And honestly as long as the people of our country don't start taking care of their health and thus reduce the cost, I don't see how we will get out of this mess without some major change. The other way for our fields to not go down is if somehow the supply of doctors go down significantly.

That's why I keep telling pre meds to really know what you are getting into. Really do that research, do the math, talk to as many doctors as they can before pulling that trigger. Year after year, the supply of people wanting to go into medicine is far higher than the spots. As long as that's true, tuition can keep going up because people are willing to pay it, and salaries and work conditions can keep going down, b/c doctors need the money to pay off loans and start living a life.
Click to expand...

1. Getting sued is not financially risky. Stressor, yes. But relatively low risk for something bad happening to you. Very few docs have financial repercussions for this.
2. Doctors have been saying all this for years, yet salaries continue to rise faster than inflation across the board (with a few exceptions). Everyone talks about the good ole days and we probably will too.
3. We are growing up with EMR and I don't think it will be as bad for our generation.
4. America is aging, fat, unhealthy, demanding, terrified of death, and has great expensive technology to keep people alive longer. Job security anyone?

Bottom line: once you get into medical school, all you need to do is delay gratification awhile and you are essentially guaranteed a comfortable life. From a financial standpoint it is a great option unless you want to be filthy rich.
 
W19 said:
Your odds are not great, but good if you apply to the 'right' schools...
Click to expand...

Thats being insanely optimistic. Sure those scores can get you into some DO schools if you apply everywhere, and then you need to get into EM and GI which are both competitive even for MD grads. Coming from DO will be a even bigger hurdle. I was originally interested in GI but i didn't want to take time off for research vs risk being stuck in IM if i dont get into GI and I already had decent step score as well. So yea if all the stars line up you may get into EM/GI with those stats but I think it's pretty irresponsible to just tell someone w/ those stats he/she can just do GI/EM and make 350k a yr at age 30.
 
@anbuitachi

EM and anesthesiology aka Gas (not GI) are not competitive for average med students...


You don't have to apply everywhere. You just have to apply to schools with low average stats (e.g.., the newer DO schools)
 
intubesteak said:
1. Getting sued is not financially risky. Stressor, yes. But relatively low risk for something bad happening to you. Very few docs have financial repercussions for this.
2. Doctors have been saying all this for years, yet salaries continue to rise faster than inflation across the board (with a few exceptions). Everyone talks about the good ole days and we probably will too.
3. We are growing up with EMR and I don't think it will be as bad for our generation.
4. America is aging, fat, unhealthy, demanding, terrified of death, and has great expensive technology to keep people alive longer. Job security anyone?

Bottom line: once you get into medical school, all you need to do is delay gratification awhile and you are essentially guaranteed a comfortable life. From a financial standpoint it is a great option unless you want to be filthy rich.
Click to expand...

I agree with you. In medicine after you finish the training, financially you will be comfortable.

1) It is a financial "stressor" since you will need to hire lawyers. They are not cheap. You are also missing work and missing work = lost wages. Sure it may not be the 5m lawsuit bomb that will destroy you but it will cost you thousands.

2) Not sure where you get that data from but physician salaries have been fairly FLAT when adjusted for inflation. According to the datawatch report published in 1992 (this is like the best data I can find on physician salaries in the old days), the average income of physicians in 1989 was 155800$ which when adjusted for inflation is $322,337.46 in 2018 money. The average surgeon made 220500$ in 1989$, which is equivalent to $456,196.47 today. The avg GP was making $198,409.26 in 2018 dollars. Tuition on the other hand has risen far faster than inflation rates so we are at a net lower salary.

3) Honestly I dont mind EMR, actually I prefer it. I'm tired of reading illegible garbage. At the same time, I dont understand why have to be so many inefficiencies with the EMRs. I recently worked in two affiliated hospitals and BOTH use Epic. Yet the layout was almost COMPLETELY different and can't be changed. It was like using a completely different EMR. Like they say, EMR is designed to optimize billing, not clinical duties, which i guess is the theme of american healthcare today.

4) we'll see where our field goes in the next 10-20 years. at a certain point i expect a major change because the current expenditure is UNSUSTAINABLE. All the business guys want a piece of the pie because they know how juicy it is. They are milking healthcare as much as they can for as long as they can until it dries up and collapses our government.
 
W19 said:
@anbuitachi

EM and anesthesiology aka Gas (not GI) are not competitive for average med students...


You don't have to apply everywhere. You just have to apply to schools with low average stats (e.g.., the newer DO schools)
Click to expand...

I dont think that student mentioned above is your average med student. For one thing, being in DO is already a step behind in terms of residency application. And my fault i thought you meant GI when you said GAS. Oops. Agree GAS not competitive. However EM is. I dont know what year you became an resident but EM today is relatively competitive.
 
anbuitachi said:
I dont think that student mentioned above is your average med student. For one thing, being in DO is already a step behind in terms of residency application. And my fault i thought you meant GI when you said GAS. Oops. Agree GAS not competitive. However EM is. I dont know what year you became an resident but EM today is relatively competitive.
Click to expand...
I am about to start residency in 2 weeks... Classmates with below average step scores (210-221) matched EM easily to the point they had to cancel a few interviews... In fact, my closest friend in med school with 221 step1 applied to ~60 programs and got 30+ invites...

Here is the last 'charting the outcomes': Page 54 for EM

http://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-US-Allopathic-Seniors-2016.pdf
 
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W19 said:
I am about to start residency in 2 weeks... Classmates with below average step scores (210-221) matched EM easily to the point they had to cancel a few interviews... In fact, my closest friend in med school with 221 step1 applied to ~60 programs and got 30+ invites...

Here is the last 'charting the outcomes': Page 54 for EM

http://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-US-Allopathic-Seniors-2016.pdf
Click to expand...
Agree with you about anesthesiology
From my mid tier school, bottom 1/3 ranked students applied and got interviews at top programs. Also they matched very strong. Students at the class median matched at top programs (bwh, mgh, etc.). Its remarkably easy to match well into gas.
 
anbuitachi said:
Yea i checked too. Mean step 1 233, step 2 245. Both are above average.
Click to expand...
The competitiveness of a specialty is not ONLY about scores; there are other factors that are in play such as the number of applicants per spot. For instance, the average step1/2 IM/EM/Gen surg is pretty close but in term of competitiveness: Gen surg >> EM >> IM.

Another clear example: It's a heck a lot easier to match into IM than Obgyn while the average step 1/2 for IM is a little higher than Obgyn
 
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W19 said:
I am about to start residency in 2 weeks... Classmates with below average step scores (210-221) matched EM easily to the point they had to cancel a few interviews... In fact, my closest friend in med school with 221 step1 applied to ~60 programs and got 30+ invites...

Here is the last 'charting the outcomes': Page 54 for EM

http://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-US-Allopathic-Seniors-2016.pdf
Click to expand...

W19, I'm just curious, what is your beef with EM? I have seen you on several threads now saying negative things about EM.

As stated by prior poster, based on any measure such as Step 1 score, US senior percentage, match rate, etc, EM is at least moderately competitive, especially with programs that have been older than 2-3 years. There has been a great influx of positions with DO programs switching over to ACGME and some new CMG related programs. Having said that, even in 2018, it is still moderately competitive. I wrote a book on this and have all the graphs/stats if you need further proof.

Also, anecdotal stories are really not helpful in evaluating whether a specialty is competitive. 4/8 applicants matched derm with 201-210 step score. As a matter of fact, someone with a 221 had a 65% chance of matching derm, 61% chance matching ortho, and 89% chance matching general surgery. As you stated step 1 score may not even tell the whole story. Someone with a 221 with good step 2, good clinical grades, no red flags, hard-worker, well-liked, may match with even higher percentages.

Just because someone matches "easily" in a specialty with below average numbers doesn't mean that a specialty isn't competitive. As of last year (when I wrote the book), EM is moderately competitive, similar to general surgery and OB/GYN.
 
@Got Em

I have no beef with EM. I admire EM docs because their job is no cake walk. I was just pointing out to the other posters that step scores alone do not give the whole picture about competitiveness of specialty. I am an IM resident and if you read the post above you, you will notice that I also provide an example re: IM vs Obgyn. That is not to bash IM; it is just to further illustrate my point. I apologize if my posts come across this way.
 
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