Give me an explanation for this (residency competition)

[MacGyver]

Something is going on here that I dont understand.

Every year, every specialty, no matter what it is, claims that its getting "more" competitive. Dont matter if its family med, internal med, neuro, gas, peds, derm, neurosurg, rads, etc if you go to each of those boards the residents on those forums will say they are getting "more" competitive every year

My criteria for "competitiveness" is number of slots divided by number of applicants.

Residencly slots are supposed to be a zero sum game. Meaning that if one specialty gets more competitive, then other specialties get less competitive. The only explanations for all residencies getting more competitive simulatenously are:

1) Residency slots are staying flat or declining and number of applicants is rising

2) Could be the increased number of DO schools opened up the last 10 years.

3) Could be the 2 or 3 new MD schools that have opened up the last 5 years

4) Could be the IMG applicant pool has increased

So whats the deal here? Are all these specialties REALLY getting more competitive or are all the people on the various forums smoking crack? For every specialty that gets MORE competitive, zero sum law demands that another specialty must be getting LESS competitive, unless one of hte caveats I stated above applies

Fill me in people

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[Idiopathic]

more competitive may not necessarily mean that people are getting squeezed out, although i think a comparison of anesthesia over the past ten years (from 600 unfilled spots to 500+ unmatched applicants) is a great example. it could mean that the quality of individuals applying (especially to a certain range of programs) is getting better. and you say zero-sum game? i say how many FP spots go unfilled and then are filled mysteriously before June. that is where your 'loss' comes from, i believe, as several people fall back on FP or IM (although not this year apparently). Also, perhaps people are applying to more programs and some candidates are missing out on interviews or getting them late, etc.


Likely though, its just that every post-match group thinks their specialty is the most competitive.

 

[penguins]

I think the numbers are open to interpretation - the same stats can give different people different conclusions.
It is also a pride thing- "hey, isn't my speciality cool?"
Let them all say it. It doesn't hurt....
The only #s that mean anything to me is the % of US Med school seniors that matched. That is what I judge it by.

That isn't perfectly accurate either as there must be some level of weeding oneself out.
If I had applied to derm, I wouldn't have matched, therefore, I wouldn't have bothered. Maybe I would have tried for gas or ob/gyn because I had a shot... maybe I applied for 4 specialties. Even if the same # apply and are matched in derm and FP, derm is still more competitive because of self-selection.

 

[Atlantic]

Most med schools in my state are increasing in class size. For instance, our school went up from 100 to 120 per class last year and will continue to expand. Just another possibility.

 

[Plastikos]

Most med schools in my state are increasing in class size. For instance, our school went up from 100 to 120 per class last year and will continue to expand. Just another possibility.

The number of graduating physicians is increasing, spots are likely increasing but possibly to a smaller extent. I only consider US applicants when i think about these things. Sometimes IMGs can make up over 50% of apps to a field making it appear very competitive.
I also agree about self-selection, some average applicants in one field are stars in another.

 

[Beck928]

That isn't perfectly accurate either as there must be some level of weeding oneself out.
If I had applied to derm, I wouldn't have matched, therefore, I wouldn't have bothered. Maybe I would have tried for gas or ob/gyn because I had a shot... maybe I applied for 4 specialties. Even if the same # apply and are matched in derm and FP, derm is still more competitive because of self-selection.

That's what I think too. I mean, those with only the most competitive scores go for Derm or ENT, etc. It's the same way about matching at your #1, you usually apply to the places you think you'd get an interview (for example, I didn't dare apply to Mass General).

 

[Hitch]

1) Residency slots are staying flat or declining and number of applicants is rising

2) Could be the increased number of DO schools opened up the last 10 years.

3) Could be the 2 or 3 new MD schools that have opened up the last 5 years

4) Could be the IMG applicant pool has increased

Yes, the match is getting tougher, and yes, these are the reasons.

 

[8744]

An American medical student with a pulse and the desire can match into family medicine. It is not competative even though there are individual programs that are very competative.

Dermatology on paper looks easy to get into because most people applying match. However, not only do the top students self-select for derm but the interview process also weeds out or selects for the top predators. Students who could easily match into IM or FP wouldn't even get interviews for derm, radiology, or any of the other super-competative fields.

FP and IM have hundreds of open spots after the match. Even after the scramble there are many open spots. Plenty of supply, low price.

 

[WatchingWaiting]

Every year, every specialty, no matter what it is, claims that its getting "more" competitive. Dont matter if its family med, internal med, neuro, gas, peds, derm, neurosurg, rads, etc if you go to each of those boards the residents on those forums will say they are getting "more" competitive every year

My criteria for "competitiveness" is number of slots divided by number of applicants.

I think it is mostly a psychosocial issue. First off, most applying med students pre-match want to play up their field and argue that their field is on the way up and/or have an excuse if they don't get one of their top matches. Post-match, your accomplishment looks better if the field is becoming more competitve. Second off, most residency directors are also going to generally want to promote their own specialty, have self-esteem that their field is on the way up, have something nice to say to unmatched applicants ("it's not you, it was just a brutal match this year"), and the like.

One of the more entertaining exercises is to go read some of the editorials put out by program directors in moribund/unpopular/poorly reimbursed areas (the CT-Surgery program directors, for example, are a real crack-up for complete delusionality/B.S.; family practice program directors arguing they are the way of the future also have a propensity for rampant B.S.) and see how they attempt to put a positive swing on their residency and their resident's future prospects.

I would also add that percentage applicants matched is not a very good criteria for determining competitiveness. As mentioned, self-selection plays a rather important role. There was an article on cnnfn today that compared getting a job in Indian call-centers to getting into Harvard titled "Harder than Harvard." The douch who came up with that one used the 1% versus 9% acceptance rates for the two positions as his criteria for making this rather stupid argument: http://money.cnn.com/2006/03/15/magazines/fortune/infosys_fortune_032006/index.htm

 

[Finally M3]

Students who could easily match into IM or FP wouldn't even get interviews for derm, radiology, or any of the other super-competative fields.

The caveat being, IM/FP at a top-tier university setting is as or more difficult than a community based rads program.

 

[Sebastian.]

An American medical student with a pulse and the desire can match into family medicine. It is not competative even though there are individual programs that are very competative.

Dermatology on paper looks easy to get into because most people applying match. However, not only do the top students self-select for derm but the interview process also weeds out or selects for the top predators. Students who could easily match into IM or FP wouldn't even get interviews for derm, radiology, or any of the other super-competative fields.

FP and IM have hundreds of open spots after the match. Even after the scramble there are many open spots. Plenty of supply, low price.

Summary: Only IM and FP are easy to match into. Therefore the match is getting tougher.



BTW: IM at a good program is actually quite competitive. FP doesn't really count. Not even DO's or FMG's are applying for those spots.

 

[docmd2010]

i agree with the above, especially with the fact that getting into a us med school (allo or osteo) is getting very difficult. More and more applicants with stellar credentials are getting rejected and this is a sign of an increase in quality of our med school classes across the nation. i think as a whole, it's becoming more and more competitive due to the fact that people, on average, are smarter than they were before, so hence step 1 averages for residencies will, overall, be higher. of course the increase in applicants, from foreign institutions as well as do's can certainly cause an increase in competition.

 

[WatchingWaiting]

The caveat being, IM/FP at a top-tier university setting is as or more difficult than a community based rads program.

Yeah, that's not really true. It's harder to match IM at a top academic program than rads at a community hospital. But, FP will take anyone with a pulse. If you look at the unfilled list in family practice over the last two to three years, it has been possible to scramble into UCSF, UCLA, Duke, and pretty much every other top-tier academic institution that actually has a family practice residency at least one of the years.

 

[zippy81]

Yeah, that's not really true. It's harder to match IM at a top academic program than rads at a community hospital. But, FP will take anyone with a pulse. If you look at the unfilled list in family practice over the last two to three years, it has been possible to scramble into UCSF, UCLA, Duke, and pretty much every other top-tier academic institution that actually has a family practice residency at least one of the years.

Duke is not an ideal place for FP (my advisor told me to not waste my time even researching it). The best programs are community programs and the top ones never have to scramble and take only well qualified US applicants. Sure, overall FP is the easiest specialty to get, but don't use the big academic centers or weak community programs as a comparison. Top-tier academic centers are NOT the place to do FP and the strongest candidates stay away for the most part.

 

[8744]

The caveat being, IM/FP at a top-tier university setting is as or more difficult than a community based rads program.

Of course. I meant as a specialty.

 

[DRDARIA]

Of course. I meant as a specialty.

Agreed that IM is easier to match into as a specialty based on sheer number of slots in lower tier/community based programs. So there is a place for non-competitive applicants to go. But there are lots of pretty darn non-competitive applicants in some of the "so-called" competitive specialties that any (successful) IM applicant to middle tier or above programs could easily match into. Heck I know a SUCCESSFUL radiology applicant that had to repeat courses in med school, and I know ortho residents with average board scores and slightly above average grades. Any US grad in the top half of their class can match into any major specialty (excluding derm and optho-- those are in a different category), if they pick their spots and apply smartly, and do a good job on putting together their app. Everybody makes a big deal about fill percentages. The stat that matters is how many US grads who applied exclusively to a specialty matched in it-- and thoses numbers are very high in ALL specialties. (And yes, there is of course some self-selection first).

Maybe this post should be "what are the most competitive programs (regardless of specialty) to get into".

Overall, guess it's a good thing we all like different areas.

 

[skypilot]

Doesn't the prevalence of electronic applications mean that all these programs are getting hundreds of applications? Because of this the whole game becomes more of a crapshoot and your odds of getting into a specific program may be reduced even though your odds of matching into your specialty are the same.

It changes the Program Director's perception if suddenly they are getting 600 applications for 20 slots