How Competitive is "Competitive?

[biophysicianai]

How competitive is residency matching? That is to say, how often do people say "I want to be a (insert subfield)" but end up getting forced into practicing in a subfield that is less selective?

If I was aiming for one of those competitive subfields - radiology, dermatology, neurosurgery, etc. - and I didn't have the best step scores or LORs, would I probably end up in a less prestigious residency program within that field, or in a completely different field entirely that doesn't tend to be as competitive for matches?

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[NotAProgDirector]

If you are not competitive enough, you will not get a spot in these fields at all. Competitive = some combination of performance in medical school + USMLE + Research + whom you know.

 

[biophysicianai]

so what happens to you if you don't match?

 

[DrMom]

you scramble into a position that didn't fill in the match, likely in a non-competitive field

 

[Law2Doc]

you scramble into a position that didn't fill in the match, likely in a non-competitive field

Generally, school advising helps avoid this for most applicants. Many schools are heavy handed in bluntly telling students to "think again" if they scored 187 on Step 1 and in the bottom third of their class and decided they wanted to do derm. Schools also suggest folks apply to "backup" fields when going for something debatably out of their reach. And many of the advanced programs require preliminary years, so most people list those singly at the end of their ranking list so they end up with something for a year even if the advanced program doesn't come through.

Over 94% of US allo med students match, and those that didn't usually weren't applying to the most competitive fields, I don't think. Good advising prevents low scorers from going down a bad path, and high scorers for ending up without a soft landing.

 

[howelljolly]

.

 

[dragonfly99]

If you aren't in the top 1/3 of your medical school class and don't have above average board scores, your chances of matching into derm are super low. Also, having an MD/Ph D helps.

Radiology is slightly less competitive than derm but still if you weren't in the top 1/3 of your class with above average USMLE you more likely than not wouldn't match. The exception to this might be if you are at a top 10 or 15 school and had LOR's from someone famous and did very well in your radiology rotation.

Neurosurg you would definitely need to have honors in your neurosurgical rotation, good LOR's from neurosurgeons and a good USMLE score. There are few spots so "who you know" is probably important, as is the surgeons perception of how smart you are. I think it would be quite hard to get a spot without being in the top 1/3 of your class, but again if you were at a very well known school, might sneak in with a slightly lower class rank if you are well connected and had a high Step 1 score.

People who don't match have to either scramble or do a year of research, if they can find a lab that will take them. They could then apply again the next year, but mostly people just go into their backup field(s).

There was a resident in my internal medicine residency who did an entire medicine residency and then went back and did a radiology one. It's rare but it does happen. I don't know the back story (i.e. whether he originally applied to radiology and didn't get in).

Agree w/above post that usually the medical schools will advice/tell you whether you are competitive vs. not. If they tell you you are not, usually you are not. If you aren't competitive it makes sense to either change fields or at least apply to a backup specialty in addition to derm or radiology, etc.

 

[howelljolly]

OK... what I was going to say was...

Even though you listed a bunch of competitive residencies, I wonder if you are confusing residency with fellowship.

Since you have to apply for the field you Match into, you cant really get "stuck" with anything. You may not get your dream specialty, but you can't get stuck with something you dont want.

Unless...

The only way you can get stuck in a field is if you never get accepted into a fellowship. You might go through a medicine or pediatrics residency with every intention of going for a fellowship, such as cardiology. If you are not a competitive applicant, you may never get a cardiology fellowship, and will be "stuck" practicing general medicine or pediatrics.

 

[DocNickRiviera]

You can do just fine getting into radiology with an average board score. As long as you are willing to apply broadly and go somewhere less competitive. Don't let people discourage you

 

[asiq11]

If you are not competitive enough, you will not get a spot in these fields at all. Competitive = some combination of performance in medical school + USMLE + Research + whom you know.

Is this true for AMG's or IMG's?

 

[howelljolly]

If you are not competitive enough, you will not get a spot in these fields at all. Competitive = some combination of performance in medical school + USMLE + Research + whom you know.

Is this true for AMG's or IMG's?

Both, but in different ways.

Its fairly straightforward to understand what it means for an AMG.

For an IMG...

Med school performance means: the name, or lack thereof, of the school, and your individual performance.

USMLE: same thing, but some programs may look at your Step1 more closely as some foreign schools don't emphasize these subjects

Research: only counts if it has lead to a publication in an established peer reviewed journal. I seem to remember a HouseMD episode where this was addressed.

Whom you know: in the US.

 

[PeepshowJohnny]

You can do just fine getting into radiology with an average board score. As long as you are willing to apply broadly and go somewhere less competitive. Don't let people discourage you

I'd agree with you a few months ago, but apparently the interview trail is BRUTAL this year.