Medical How competitive will neurology be for the 2020 match?

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Raryn

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I will be applying to neurology this coming year. I have mid level stats and lots of interest and activity in the field (started a SIGN chapter through the AAN at my school, some research, conferences etc.) I am looking to match ideally in NY. I've heard neurology "hasn't been competitive" but I am wondering if this is changing. I plan to apply to over 100 programs.
I'll try to answer your question in general terms and then for you more specifically.

To answer the question about whether Neurology is becoming more competitive over time, the best longitudinal data we have is the NRMP Results and Data, which has been released in some form going back all the way to 1984. All of the archives are on the NRMP website.

The 2018 one has comprehensive data from 2018 and comparators for the prior 4 years. Lets use the % of slots filled by US graduates as a proxy for competitiveness over time - clearly the more US grads applying, the harder it is for any given individual to match. Looking at table 8, for PGY1 neurology slots (which is about 2/3 of them), this has ranged from 50.5% in 2014 to 55% in 2015. 2018? 50.7, near the bottom of the range. If you look at the 2013 data, that % had varied further from 47.6% (2013) to 62.8% (2009). Going back to the 2008 data, the same (lack of) trend holds - that 5 year period ranged from % of US applicants from 46.5% in 2005 to 59.3% in 2008. You can keep going further back, but it's fairly obvious at this point that at least by this measurement that Neurology has not been getting particularly more competitive over time.

Are there other measurements you can use to gauge competitiveness? Sure. You could use number of unfilled slots (no pattern that I could see glancing at the data). You could use board scores - but here we have significantly less data because the "Charting Outcomes" comprehensive reports do not come out as often. You have to take any analysis of those longitudinally with a grain of salt as well - board scores have gone up on average over time, so every field has rising board score averages.

Our best snapshot of how competitive it might be for you though is definitely the Charting Outcomes data set. Looking just at Charting Outcomes for IMGs (since you're an IMG), Neurology in 2018 (page 147) for US IMGs a match rate of 55% with a mean Step 1 score of those who matched of 227. Looking deeper in the data, all but one person who had 8 or more interviews (continguous ranks) matched. In fact, basically everyone with more than 3 interviews matched. Step 1 Score above 230 and Step 2 score above 240 also seemed to clearly improve chance of matching - though folks did match with lower scores. Number of research projects didn't seem to correlate with matching well (if at all), nor did publications/abstracts/presentations, volunteer experiences, work experiences, or advanced degrees. That doesn't mean these things are useless at the level of the individual program - quality of the experience probably matters - but just a boolean "having it or not having it" is fairly useless.

You can also look at Charting Outcomes in 2016 (page 147) and 2013 (page 88) but more or less the same outcomes hold. Eyeballing it, 2016 was a more competitive year than 2018 and 2013 was less competitive than both, but (other than board scores going up over time, which holds for every field) there's no clear trend of increased competitiveness.

Apply broadly enough to get three or four interviews and you'll probably match. I don't know enough about neurology specifically to tell you how broadly that has to be.

(Part of this is going to be luck as well - if you apply in a year like 2009 where there's a ton of US grads, you might be squeezed out just because they're taking up more spots. It's one of the hazards of applying to a relatively smaller field. You have zero way of predicting that)
 
Thank you so much for a thorough reply. I’m a little confused as to why around 50% match rate translates into high chances of matching if I get a few interviews. Is this because of all the applicants with lower step scores?

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It's page 150 of the Charting Outcomes for the Match IMGs 2018. Take a look at the next few pages as well to get a clearer idea of how the data is laid out.

50% match rate is primarily determined by the large number of people with only 1 rank that didn't match at all. You can see that at 8+ it's 100% except for the single person with >16 ranks who didn't match.

I'm not saying it's easy for a US-citizen IMG to match Neurology. It's not easy for an IMG to match anything. But it's easier than most specialties, and it doesn't seem to have gotten more competitive over time.
 
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