How competitive has anesthesiology become in the residency match?
Started by YellowSalamander
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If your narrative is reasonably compelling, then no problem. /s
The most important things will be:
-Your step 2 score
-Your performance in med school (lack of remediations or failures or negative comments on deans letter)
-Lack of DUI or other criminal issues
-perception of your school
-you give them a gold signal
Since many schools are now pass fail and prohibit their faculty from putting negative comments in the dean’s letter, it can be difficult to distinguish their top students from the mediocre ones. Honestly, only if your personal statement is VERY compelling, it could make a difference. Otherwise, most are white noise. In my opinion, a good personal statement almost never gets you an interview if your step score is low. Same with letters of recommendation. They rarely are a difference maker.
You would be surprised at how many top ten medical schools exist in the US. The number may be as high as 50-60.
The most important things will be:
-Your step 2 score
-Your performance in med school (lack of remediations or failures or negative comments on deans letter)
-Lack of DUI or other criminal issues
-perception of your school
-you give them a gold signal
Since many schools are now pass fail and prohibit their faculty from putting negative comments in the dean’s letter, it can be difficult to distinguish their top students from the mediocre ones. Honestly, only if your personal statement is VERY compelling, it could make a difference. Otherwise, most are white noise. In my opinion, a good personal statement almost never gets you an interview if your step score is low. Same with letters of recommendation. They rarely are a difference maker.
You would be surprised at how many top ten medical schools exist in the US. The number may be as high as 50-60.
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Step 2 score? Any research or dedicated rotations with an Anesthesiologist? These will determine which tier you are likely to Match into.
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Nope. Everyone has that. It matters about as much as their letter of recommendation for them, which is not much...unless there is some special connection/friendship between the PD and the letter writer. Then there is frequently a phone call.
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Top 10 in…..
- Research Funding
- Graduates going into primary care
- Graduates getting into specialties
- Class Size
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- Being featured in Top 10 lists
I would give some extra consideration to applicants who had rotated on our service and shined. OP should consider spending time at their target program(s). How they interacted with OR staff and our dept would matter to me. The OR is a small community and the last thing I want ro do is to hire a problem. 2 former residents come to mind. One from JHS and the other from UCSF. Both with great metrics but poor social skills/work ethic. I was constantly being accosted by OR staff and surgeons demanding "Do you know what your resident just did/said?" This is why I would lean toward applicants who spent time our program, one of the 60 top 10's. However, YMMV.
I agree with this completely. A month in your department can allow the department to get a much better assessment of a candidate. This is why an away rotation can help a lot or hurt a candidate. It requires self reflection of the candidate which most people, including myself, are not very good at. Most truly annoying people have no idea that this is how they are perceived.
However, Blade simply said “dedicated rotations with an anesthesiologist.” I trust that anyone who is applying to anesthesiology will have this (although some upstart DO schools struggle with this tremendously because they just farm people out to random clinical sights with poor oversight as to the quality of the clinical sights).
Good away rotations are competitive and candidates are often only able to get 1-2, so they must apply early and choose wisely. Often, without good mentorship, they may acquire an away rotation at a program where they are not going to be competitive. Because you have to apply early, that is a real danger. Most students have no idea where they will be competitive unless they are top half of the class or have a fantastic step 2 score (which many don’t know yet when applications are sent out for away rotations).
If you can get an away at a program you fit well with and would be happy training at AND you can impress them and walk the fine line of hard work without getting on everyone’s nerves because you’re always underfoot, then you have a great chance at that singular program. If you do that twice at different programs, then you might just have two sure things to provide a safety net.
The process now is challenging because applicants are forced to show some of their cards (the gold signal system). Additionally, there are fewer ways to set yourself apart from others based on the data that the med schools provide (pass/fail grades, no class rank, meaningless Dean’s letters, P/F step I). So applicants are forced to take some gambles, such as a silver signal to programs that they know have given interviews to silvers in the past and hope that past behaviors predict future behaviors.
The only saving grace is that applicants apparently have access to how programs have made interview selections in the past so they can make an educated gamble.
It’s a tough road out there.
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"If you can get an away at a program you fit well with and would be happy training at AND you can impress them and walk the fine line of hard work without getting on everyone’s nerves because you’re always underfoot, then you have a great chance at that singular program. "
I think this is a tough balance to find. Looking back, when I was a visiting med student, I would have annoyed the crap out of my current self. I suspect I was annoying to the residents there. I got glowing reviews on my one visiting rotation and some strong letters of rec that carried weight at my interviews, but after all that, still didn't match at the place I rotated. That rotation and the letters likely helped me match where I did, got me the interview at the institution (sympathy interview?), but was likely neutral for my chance of actually matching there. I was VERY gung ho and proactive. I was just what you want out of a resident, but not necessarily what you want out of a 4th year visiting med student.
Its taken me my whole life to learn to shut up and allow silence to exist from time to time.
It's a lot more competitive than before
OP,
With the general information you've provided and without knowing where you are in school and how close you are to your application cycle, it is not possible to give you any meaningful advice on your situation. As has been mentioned earlier, the initial screening criteria are almost certainly going to be your Step 2 and your grades.
While our specialty has gotten more competitive, you need to remember that it is one of the largest specialties by number of residents. There are A LOT of spots compared to the other competitive specialties. So while you will be best served by doing well on your exams and getting top grades (if your school actually grades you), you are still likely to match if you are a top half of your class type of student who checks the box in the other subjective metrics we have and is able to represent themselves well during away rotations and on your interview day.
What hasn't been mentioned is that the question shouldn't be "what do I need to do to get it?" Instead, what you should be doing is putting your best effort towards everything, because what you really want is choice. You want the ability to chose to signal any program and have them take your application seriously. And then you want the ability to chose where you want to go rather than crossing your fingers and hoping someone takes you.
With the general information you've provided and without knowing where you are in school and how close you are to your application cycle, it is not possible to give you any meaningful advice on your situation. As has been mentioned earlier, the initial screening criteria are almost certainly going to be your Step 2 and your grades.
While our specialty has gotten more competitive, you need to remember that it is one of the largest specialties by number of residents. There are A LOT of spots compared to the other competitive specialties. So while you will be best served by doing well on your exams and getting top grades (if your school actually grades you), you are still likely to match if you are a top half of your class type of student who checks the box in the other subjective metrics we have and is able to represent themselves well during away rotations and on your interview day.
What hasn't been mentioned is that the question shouldn't be "what do I need to do to get it?" Instead, what you should be doing is putting your best effort towards everything, because what you really want is choice. You want the ability to chose to signal any program and have them take your application seriously. And then you want the ability to chose where you want to go rather than crossing your fingers and hoping someone takes you.
I feel so bad for applicants now.
Research in anesthesia? Cmon now be real. We all went into this field because we hate research.
Sub internships? Letters? So BS. I didn’t learn anything meaningful about anesthesia until I was actually a CA1 doing it every day. What the heck is a med student supposed to do to shine?
The match is going to favor the rich kids that were able to get into better name brand colleges/med schools and able to work with mommy and daddy’s doctor friends for experience.
Research in anesthesia? Cmon now be real. We all went into this field because we hate research.
Sub internships? Letters? So BS. I didn’t learn anything meaningful about anesthesia until I was actually a CA1 doing it every day. What the heck is a med student supposed to do to shine?
The match is going to favor the rich kids that were able to get into better name brand colleges/med schools and able to work with mommy and daddy’s doctor friends for experience.
I 100% agree with your last point. I work with a bunch of people literally pushing their kids across the finish line to medical school admission. Not sure I’ve ever heard any of the kids say they were that interested.
On your first point though I’m going to protest. Other than grades/test scores, at the level of both medical school and residency admissions there is literally nothing better you can do than good research to broadly improve your chances. You’ll get a good letter out of it too. And yet I meet so many people who either do a meaningless 2 month project or ignore it completely. Anyone seriously asking how to improve their chances who is at a reputable school should at least explore the research options available to them.
To your last point, I think that having the right connections and access to resources gives people the leg up in virtually every part of society. Fair or not, that's the reality of the society we live in. So while there are things programs can do to try and level the playing field, it is what it is.
However, it is also the reality is that there are plenty of things that a medical student can do to "shine" and show that they are going to be a resident people want to work with. We are right in the middle of the current recruitment cycle and the difference between the students that are going to be ranked at the top of the list vs the ones at the bottom of the list is vast. While there is certainly a lot of subjectivity to process...we are not throwing darts at wall of pictures either.
If you dont mind me asking, what makes applicants stand out?
Who cares. When I graduated med school EM of all things was highly competitive. For anesthesia (if you were an AMG) all you needed was a pulse. Things have now reversed, purely due to job market and compensation. Plenty of EM people from 10 years ago who used all those connections probably regret it now. The same may happen in anesthesia…
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With respect, you should say the differences are vast in the things that you choose to care about. Not certain about residency admissions, but med school admission committees have changed a great deal in what they choose to care about as opposed to 40 years ago.
it’s insanely competitive now. Our residents most recent interns all had 260 on their step 2 with research and we aren’t even a name program. Location is good though.
Generational change.
Wised up to income potential during the early years and flexibility as you wind down your career or coming in as a part time FTE from the get go.
Late nights still have consequence, but way better than clinic 3 days a week.
Post call days, etc.
The old predatory practices have a target on their back and have been dying quickly in this environment.
Wised up to income potential during the early years and flexibility as you wind down your career or coming in as a part time FTE from the get go.
Late nights still have consequence, but way better than clinic 3 days a week.
Post call days, etc.
The old predatory practices have a target on their back and have been dying quickly in this environment.
Too complicated.
The famous "Sutton's Law" quote, attributed to bank robber Willie Sutton when asked "why do you rob banks?" , is "Because that's where the money is,"
The most recent step two average for 2024 was 250 with a standard deviation of 15.
I’d imagine the competitive specialties are probably averaging greater than a standard deviation above average. A 260 isn’t what it used to be.
There's a huge difference in getting a 260 on Step 2 vs Step 1 but people have forgotten since Step 1 is P/F now. Step 2 is much easier and clinically relevant. Step 1 is all about knowing nitty gritty details and it was soul crushing to study for.
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