match thoughts!?

[criticalelement]

pgy1 anesthesia 95% fill rate. 55 spots unfilled in pgy1 match

68percent went to us seniors the rest (other)


In advanced standing 40 spots went unfilled for a 91% match rate. 60% went to us seniors


32 spots went unfilled for Physician (R) spots

so roughly 125 or so spots unfilled

I think this is worse then last year.

Looks like mostly foreigners or NON US seniors if I am reading that correctly

ER did great in match. Only 1 spot unfilled.
Physiatry didnt do badly at all. I am surprised they have very few spots available.

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[criticalelement]

It is a tad bit worse then last year. Less US Seniors matched into anesthesia. More unfilled spots. The Match gods have not released which programs went unfilled. Or I cannot find it.

 

[deleted171991]

http://www.blog.greatzs.com/2016/03/is-anesthesiology-at-end-of-road.html

 

[criticalelement]

http://www.blog.greatzs.com/2016/03/is-anesthesiology-at-end-of-road.html

Thanks. Nice synopsis.

 

[criticalelement]

One thing the author at great zzzs did not mention is that even though the pgy1 spots are increasing the number of advanced standing spots are decreasing so it may be a wash. I still concur that we are graduating WAAAY too many anesthesia grads which is why everyone thinks a fellowship will make them more employable..

 

[amLOLdipine]

Everything comes and goes in waves. There is a huge surge in EM competitiveness and interest right now, but 5-10 years down the road that may lead to significant oversupply and EM grads may have the same issues finding jobs as radiology grads do today.

Radiology only had 61% filled by US seniors this year, but it's a definite improvement over last year when only 50% of spots were filled by US seniors.

One thing the author at great zzzs did not mention is that even though the pgy1 spots are increasing the number of advanced standing spots are decreasing so it may be a wash. I still concur that we are graduating WAAAY too many anesthesia grads which is why everyone thinks a fellowship will make them more employable..

The bolded part is true. Total # of anesthesiology spots has stayed constant since 2013, at roughly around 1600 per year between PGY-1 and PGY-2 spots. There is a shift towards more anesthesia programs becoming categorical.

 

[BLADEMDA]

"Why is the most talked about anesthesia tech in the past five years related to how to remove anesthesiologists from the procedure room? Why does the anesthesiology match every year feel more and more like a sinking ship and nobody wants to be stuck as the last one out.?"

ZMD

 

[BLADEMDA]

• Dermatology, Orthopaedic Surgery, Radiation-Oncology, and Vascular Surgery filled all available first-year positions.
• Emergency Medicine offered 1,895 first-year positions, an increase of 74, and filled all but one.
• Neurological Surgery, Otolaryngology, General Surgery, and integrated Plastic Surgery each had fewer than 5 unfilled first-year positions.

 

[BLADEMDA]

http://www.nrmp.org/wp-content/uploads/2016/03/Advance-Data-Tables-2016_Final.pdf

68% of the positions for Anesthesiology in 2016 were filled by U.S. seniors. Please notice the trend of positions filled by US seniors.

2012- 78.9%
2013- 74.8%
2014- 71.9%
2015- 73.0%
2016- 68.7%


My solution to the problem is reduce the number of available positions by 300-500 per year in order to boost employment opportunities for graduating residents.

 

[ERRES2288]

Anesthesiology is getting less competitive every year and the numbers support this.

 

[criticalelement]

Anesthesiology is getting less competitive every year and the numbers support this.

Partly the reason for this is that the residency is 6 months too long as is and they wanna make it 18 months too long when the value of the training is decreasing and decreasing every single year and the training is being watered down, becoming less efficient.

 

[deleted126335]

A bad job market caused the med students to stay away from anesthesia in the 90s. This was largely responsible for the good job market of the 2000s.

At that time there were a few thousand unfilled spots in the match across all specialties so the med students had lots of options. Currently there are about as many US Medical Graduates per year as there are total spots in the match. So they will keep coming. Anesthesiology will simply get a smaller share of the top of med school classes. Not to mention programs been able to fill the few unfilled spots with IMGs outside the match, etc.

 

[patriot6]

http://www.nrmp.org/wp-content/uploads/2016/03/Advance-Data-Tables-2016_Final.pdf

68% of the positions for Anesthesiology in 2016 were filled by U.S. seniors. Please notice the trend of positions filled by US seniors.

2012- 78.9%
2013- 74.8%
2014- 71.9%
2015- 73.0%
2016- 68.7%


My solution to the problem is reduce the number of available positions by 300-500 per year in order to boost employment opportunities for graduating residents.

I like that solution.

Why the large increase in res spots over just a short four years?

 

[criticalelement]

I like that solution.

Why the large increase in res spots over just a short four years?

The long hours, un predictable daily schedule, CRNA encroachment which is getting more of a reality everyday, the national managmenet companies consolodating efforts to decrease the need for us and decrease our autonomy ,(and they are getting laws changed to help their cause) the huge liability burden that is palpable daily are resonating with US seniors. IN other words, it aint worth it.

 

[bashwell]

I think it's unlikely for most residencies to reduce spots.

 

[ERRES2288]

A bad job market caused the med students to stay away from anesthesia in the 90s. This was largely responsible for the good job market of the 2000s.

At that time there were a few thousand unfilled spots in the match across all specialties so the med students had lots of options. Currently there are about as many US Medical Graduates per year as there are total spots in the match. So they will keep coming. Anesthesiology will simply get a smaller share of the top of med school classes. Not to mention programs been able to fill the few unfilled spots with IMGs outside the match, etc.

This is not true. There are about 18,000 USMD graduates and about 27,000 spots.

 

[deleted126335]

This is not true. There are about 18,000 USMD graduates and about 27,000 spots.

Correct, I should have said more applicants than spots not necessarily US Seniors.

 

[Mman]

http://www.nrmp.org/wp-content/uploads/2016/03/Advance-Data-Tables-2016_Final.pdf

68% of the positions for Anesthesiology in 2016 were filled by U.S. seniors. Please notice the trend of positions filled by US seniors.

2012- 78.9%
2013- 74.8%
2014- 71.9%
2015- 73.0%
2016- 68.7%


My solution to the problem is reduce the number of available positions by 300-500 per year in order to boost employment opportunities for graduating residents.

I find the trend in % of US grads filling the spots interesting, but it is kinda funny that people don't mention there are more US grads matching into anesthesia now than in the past. 2012 saw 725 US grads match into anesthesia (78.9% of 919). 2016 saw 774 (68.7% of 1127) US grads match into anesthesia. So more US grads going into anesthesia than in the past, just that residency spots went up even more.

Has the number of graduating US med students changed in the last 4 years? If not, anesthesia got a slightly higher percentage of US grads going into it, albeit into a bigger increase in residency slots.

 

[Planktonmd]

http://www.blog.greatzs.com/2016/03/is-anesthesiology-at-end-of-road.html

Excellent article! Sums what we have been saying here for years!

 

[Planktonmd]

I like that solution.

Why the large increase in res spots over just a short four years?

Because the leadership thinks that the surgical home initiative will rescue anesthesiology and the future is bright so why not expand?
Kinda like when someone buys a mansion based on the hope of winning the lottery!

 

[Planktonmd]

I find the trend in % of US grads filling the spots interesting, but it is kinda funny that people don't mention there are more US grads matching into anesthesia now than in the past. 2012 saw 725 US grads match into anesthesia (78.9% of 919). 2016 saw 774 (68.7% of 1127) US grads match into anesthesia. So more US grads going into anesthesia than in the past, just that residency spots went up even more.

Has the number of graduating US med students changed in the last 4 years? If not, anesthesia got a slightly higher percentage of US grads going into it, albeit into a bigger increase in residency slots.

Yes, The number of U.S. graduates increased from 15927 in 2006 to 18708 in 2015, a 15% increase.
And if you want the last 4 years then also yes: 17362 in 2011 and 18708 in 2015, a 7% increase.
This means over these 4 years there was a 7% increase in US graduates while the percentage of them who matched into anesthesia declined 10%.

 

[NOsaintsfan]

The numbers for US grads doesn't include osteopathic students. DO students are lumped into the "other" category.

Just thought I would mention that so people don't incorrectly think that because their was a 68.7% match by US seniors that doesn't mean that 31.3% was fill by foreign grads.

Osteopathic students likely make up a large part of that 31.3%.

 

[pgg]

Lies, damn lies, and statistics?

 

[deleted162650]

Anyone think it's odd that EM is hot while Anes not so much? EM suffers from the same problems we do: no pt ownership, increasing mid level presence, large AMC presence and employee positions in general. What am I missing here?

 

[Mman]

And if you want the last 4 years then also yes: 17362 in 2011 and 18708 in 2015, a 7% increase.
This means over these 4 years there was a 7% increase in US graduates while the percentage of them who matched into anesthesia declined 10%.

Actually the number who matched into anesthesia increased by 6.8% (725 then up to 774 now). So basically a wash in terms of percent of grads going into anesthesia from 4 years ago. 725/17362 = 4.18%, 774/18708=4.14%

 

[Mman]

The numbers for US grads doesn't include osteopathic students. DO students are lumped into the "other" category.

Just thought I would mention that so people don't incorrectly think that because their was a 68.7% match by US seniors that doesn't mean that 31.3% was fill by foreign grads.

Osteopathic students likely make up a large part of that 31.3%.

good point

 

[deleted171991]

Anyone think it's odd that EM is hot while Anes not so much? EM suffers from the same problems we do: no pt ownership, increasing mid level presence, large AMC presence and employee positions in general. What am I missing here?

The midlevel presence is much smaller. And they are shielded from malpractice in many states. That by itself significantly decreases the risk of working with midlevels.

 

[Doctor4Life1769]

Anyone think it's odd that EM is hot while Anes not so much? EM suffers from the same problems we do: no pt ownership, increasing mid level presence, large AMC presence and employee positions in general. What am I missing here?

Shift work, no call. When you are done with your 8-12hr shift, you're done.
Sure, it's more intense and anything comes through the door you gotta treat, but you can also street folks too. Call the consult and you're done with that pt, as well. Just have to shore up the discharge paper work as that is one of the bigger reasons for a lawsuit.

Burnout rate is huge, but you work for 5-10 years max, can always shift into urgent care or something else.

 

[ERRES2288]

I can't quite understand it either but EM is HOT. A lot of our top students that could do anything picked it.

 

[psychbender]

I'm not so sure I agree with your statement that the presence is smaller and they are more shielded, FFP. On the interview trail for fellowship, I've encountered quite a few EM attendings going back to training who complain about PAs and NPs in the ED just like we do with CRNAs. Several of them mention that PAs/NPs see patients independently, the doc has zero input, but at the end of the shift, X percent of their charts must be signed with an attestation that the doc agrees with their assessment and plan. This is all done well after the patient has been discharged from the ED, and the attending is still responsible for patient outcomes, as they signed the chart.

 

[Planktonmd]

Actually the number who matched into anesthesia increased by 6.8% (725 then up to 774 now). So basically a wash in terms of percent of grads going into anesthesia from 4 years ago. 725/17362 = 4.18%, 774/18708=4.14%

I thought we were comparing percentages... The percentage of US grads to the total number of spots decreased although there were an increase in the total number of US graduates.
But I agree with you... they increased the number of residency spots for no good reason!

 

[ERRES2288]

I looked at some old match data I found interesting. In 1996, 17% of anesthesia matches were US seniors. Was up to about 50% by 2000.

 

[deleted126335]

I looked at some old match data I found interesting. In 1996, 17% of anesthesia matches were US seniors. Was up to about 50% by 2000.

Job market was the pits then. So those with the most choices, (i.e., US allopathic seniors) avoided anesthesia. Of course, almost nobody realized that few going into anesthesia in the mid 90s would lead to a bull market for anesthesiologists in the 2000s.

 

[criticalelement]

Anyone think it's odd that EM is hot while Anes not so much? EM suffers from the same problems we do: no pt ownership, increasing mid level presence, large AMC presence and employee positions in general. What am I missing here?

I dont think it is odd at all. In Emergency you can work 10 shifts a month and be considered full time. There are many jobs where you can work whatever amount of shifts you want. There is more of a need for ER docs. It is more difficult to widgetize EM. They have to diagnose and figure out what the **** is going on with the patient or else.Anesthesia does less diagnosing and cerebral thinking. Dont get me wrong Anesthesia is a difficult and stressful job but a different kind. There is no way a mid level can do the job of a well-trained ER doc. Especially in the diagnosing department and the differential and parallel processing. A mid level can get through an anesthetic and bring out a patient alive, give antibiotics on time, write down they gave Beta blocker etc etc which is the metric; all of a sudden they are equivalent.

 

[criticalelement]

Job market was the pits then. So those with the most choices, (i.e., US allopathic seniors) avoided anesthesia. Of course, almost nobody realized that few going into anesthesia in the mid 90s would lead to a bull market for anesthesiologists in the 2000s.

That is not what caused the bull market. That is part of the reason. The main reason in my opinion is the explosion of surgery centers, endoscopy centers, free standing dental offices etc etc etc in the early 2000s . This pulled many, many anesthesiologists from the hospitals because of the promise of no call no weekends. When the consolidation started to happen 10 years later (anesthesia managment companies, hospital buy outs) less opportunities exist. I think this will continue for the next 5-10 years. Also the financial downturn on 2008 kept many many old Fu cks in the job market. They are still in it but in the next few years things will change.

 

[Carbocation1]

There just really aren't that many specialties from which to select. You guys need to keep in mind the perspective of the med stud:

Surgery specialties comprise too much manual labor and studying anatomy all day is very boring. I also refuse to sacrifice 5-8 yrs of my prime years in residency to appease the fatcat, grey-hair surgeons. Can't stand in 1 spot for 8 hours.

FM/IM specialties involve dealing with fat, non-compliant smokers in clinic. Keep in mind the good patients who care about their health are in fact healthy and don't come to see you. You are left with nothing but Gomers. Endless rounds. IM subs make LESS than Hospitalist for MORE work, with the exception of GI, which is a disgusting field and will tank once scopes are cut.

Rads is being outsourced to India and IBM Watson. Path is boring and literally 0 jobs.

EM is gloried triage, don't need physicians for shotgun ordering/calling consults. Also have to deal with the very worst of society.

PMR - what do they actually do? People think you're a physical therapist.

Derm - did not go into med school for this. Also, very low barrier of entry for nurses, as the work is not difficult.

Neurology and OBGYN - don't think I need to explain these.

Peds - crazy parents, very low pay.

Psych - Crazy pts.

Rad onc - must have family connection and/or PhD to match. Must be willing to move cross country for residency or job. Will be replaced by med onc eventually.

Please tell me if I am missing anything. With GAS, I can expect to pull in 400K, interesting phys/pharm/pathophys, ACLS skills, fun to be facile with procedures, privacy, no pt follow up. Americans will always demand high quality anesthesia care.

 

[Consigliere]

Anyone think it's odd that EM is hot while Anes not so much? EM suffers from the same problems we do: no pt ownership, increasing mid level presence, large AMC presence and employee positions in general. What am I missing here?

Not surprised at all. What you are missing is that anesthesiology is just terrible and at this point in time, one of those specialities you do if you HAVE TO, not because you want to,

 

[Consigliere]

Please tell me if I am missing anything. With GAS, I can expect to pull in 400K, interesting phys/pharm/pathophys, ACLS skills, fun to be facile with procedures, privacy, no pt follow up. Americans will always demand high quality anesthesia care.

I wouldn't expect that at all. Don't set yourself up for more disappointment then you'll already be experiencing.

 

[criticalelement]

Americans will always demand high quality anesthesia care.

LOL. you are so cute.

Please tell me you are early in your training.

Americans don't demand anything.

Do you have any idea how many states have opted out of the physician supervision requirement of anesthesia?
Your post is mis guided.

very few bureacrats give a rats arse about you and your MD... especially an anesthesiologist.. thats for s huw

 

[patriot6]

There just really aren't that many specialties from which to select. You guys need to keep in mind the perspective of the med stud:

Surgery specialties comprise too much manual labor and studying anatomy all day is very boring. I also refuse to sacrifice 5-8 yrs of my prime years in residency to appease the fatcat, grey-hair surgeons. Can't stand in 1 spot for 8 hours.

FM/IM specialties involve dealing with fat, non-compliant smokers in clinic. Keep in mind the good patients who care about their health are in fact healthy and don't come to see you. You are left with nothing but Gomers. Endless rounds. IM subs make LESS than Hospitalist for MORE work, with the exception of GI, which is a disgusting field and will tank once scopes are cut.

Rads is being outsourced to India and IBM Watson. Path is boring and literally 0 jobs.

EM is gloried triage, don't need physicians for shotgun ordering/calling consults. Also have to deal with the very worst of society.

PMR - what do they actually do? People think you're a physical therapist.

Derm - did not go into med school for this. Also, very low barrier of entry for nurses, as the work is not difficult.

Neurology and OBGYN - don't think I need to explain these.

Peds - crazy parents, very low pay.

Psych - Crazy pts.

Rad onc - must have family connection and/or PhD to match. Must be willing to move cross country for residency or job. Will be replaced by med onc eventually.

Please tell me if I am missing anything. With GAS, I can expect to pull in 400K, interesting phys/pharm/pathophys, ACLS skills, fun to be facile with procedures, privacy, no pt follow up. Americans will always demand high quality anesthesia care.

This really sums up my perspective nicely.

 

[BLADEMDA]

There just really aren't that many specialties from which to select. You guys need to keep in mind the perspective of the med stud:

Surgery specialties comprise too much manual labor and studying anatomy all day is very boring. I also refuse to sacrifice 5-8 yrs of my prime years in residency to appease the fatcat, grey-hair surgeons. Can't stand in 1 spot for 8 hours.

FM/IM specialties involve dealing with fat, non-compliant smokers in clinic. Keep in mind the good patients who care about their health are in fact healthy and don't come to see you. You are left with nothing but Gomers. Endless rounds. IM subs make LESS than Hospitalist for MORE work, with the exception of GI, which is a disgusting field and will tank once scopes are cut.

Rads is being outsourced to India and IBM Watson. Path is boring and literally 0 jobs.

EM is gloried triage, don't need physicians for shotgun ordering/calling consults. Also have to deal with the very worst of society.

PMR - what do they actually do? People think you're a physical therapist.

Derm - did not go into med school for this. Also, very low barrier of entry for nurses, as the work is not difficult.

Neurology and OBGYN - don't think I need to explain these.

Peds - crazy parents, very low pay.

Psych - Crazy pts.

Rad onc - must have family connection and/or PhD to match. Must be willing to move cross country for residency or job. Will be replaced by med onc eventually.

Please tell me if I am missing anything. With GAS, I can expect to pull in 400K, interesting phys/pharm/pathophys, ACLS skills, fun to be facile with procedures, privacy, no pt follow up. Americans will always demand high quality anesthesia care.

Here is what you are Missing:

1. Ortho
2. Neurosurgery
3. ENT
4. Urology
5. Heme/Onc
6. Hand Surgery
7. Optho
8. Invasive Cards


Med Students need to look at all their options before choosing GAS.

 

[2018Duke]

Here is what you are Missing:

1. Ortho
2. Neurosurgery
3. ENT
4. Urology
5. Heme/Onc
6. Hand Surgery
7. Optho
8. Invasive Cards


Med Students need to look at all their options before choosing GAS.

#1-4, 6, 7 are VERY difficult to match into, not impossible but not realistic for some of us
#5 have to do IM
#8 bad job market and decreasing compensation

 

[BLADEMDA]

To some extent, MD anesthesiologists have become a victim of their own excellence. Deaths during the administration of anesthesia occur at a paltry rate of 1/250,00 cases nowadays. This remarkable improvement can be attributed solely to technical improvements in the monitoring of patients during a procedure. Things like continuous pulse oximetry, end tidal CO2 monitoring, and fiberoptic-based intubation equipment have almost completely eliminated major morbidity from the profession. This is a good thing. But maybe not so good for anesthesiologists. They practice in a very algorithmic, checklist-based manner.

Thus, it was relatively easy to teach their methods to CRNA’s during a period when the exponential rise in operative case loads made it necessary to incorporate “anesthesiology assistants” into a practice, thereby allowing one attending physician to cover multiple rooms. That recent studies have confirmed what everyone else in the OR already knew—that it didn’t really matter who was behind the drape while a cholecystectomy was ongoing—- is hardly a surprise. The less variability in clinical excellence one sees from certain specialists, there seems to be a commensurate decrease in perceived prestige. In other words, one’s individual reputation as a doctor can be paradoxically harmed when the overall complication rate of your chosen specialty is so low. You are seen as a mere “cog in the machine”, a cog that could easily be interchangeable with another doctor or, in this case, a CRNA.

http://www.kevinmd.com/blog/2011/01/md-anesthesiologists-victims-excellence.html

 

[BLADEMDA]

#1-4, 6, 7 are VERY difficult to match into, not impossible but not realistic for some of us
#5 have to do IM
#8 bad job market and decreasing compensation

Why is Number 8 worse than Anesthesiology? And Having to do IM for 3 years isn't a big deal.

 

[BLADEMDA]

 

[BLADEMDA]

 

[Planktonmd]

LOL. you are so cute.

Please tell me you are early in your training.

Americans don't demand anything.

Do you have any idea how many states have opted out of the physician supervision requirement of anesthesia?
Your post is mis guided.

very few bureacrats give a rats arse about you and your MD... especially an anesthesiologist.. thats for s huw

Americans demand only one thing: Cheap or free care!
And that's why many people don't mind having plastic surgery done in someone's garage or in Mexico if it costs less money.

 

[BLADEMDA]

 

[BLADEMDA]

 

[BLADEMDA]