NRMP Match Data 2015

[the argus]

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Yeah, combination of curious, nervous, and a bit excited, pretty much exactly what I'm feeling.



Between 2011 DO matriculation and 2015 DO matriculation there was an increase of ~1300 students. [1][2] Between 2011 and 2015 on the US MD side there was an increase of ~1400 students. [3] My numbers of ~3000 extra students in the pipeline is a bit of an overestimation, as the real number is around 2700 given matriculant stats from AACOM and AAMC, but I wouldn't call it "way overshooting... AMG expansion" estimates.

Expansion of schools and class sizes has persisted, if not increased, and assuming the same trend, we can expect a student increase of ~3000 every 4 years. Previous studies done now do not take into account new schools that have not even yet been proposed, therefore they can only look at a projection several (4-6) yrs out, as opposed to 10+ yrs out. Now obviously my numbers are not prophetic, but given the assumptions I stated (expansion continues, residencies stay at the rate they've been), we will see that surplus number shrink into the low thousands (1000-3000 maybe) over the next 10-14 yrs.

As far as your study goes, I actually think it underestimates the effect (combination of increasing estimation of GME expansion than I had seen, but I'll take their word for it - not sure this will persist though through the merger period, but we'll have to wait and see - and decreasing AMG expansion estimates, which may happen, but we'll see), and in the end their outlook is slightly better than mine with a reduction of only 35% of the extra spots, compared to my 71%. Now if we extend that out to 15-16 years from now as opposed to 7-8 yrs, it will be pretty close to my (guess)timate.

[1] 2011 DO Matriculant profile http://www.aacom.org/docs/default-source/data-and-trends/2011-aacomasmprofsummrpt.pdf?sfvrsn=8

[2] 2015 DO Matriculants by State http://www.aacom.org/docs/default-source/data-and-trends/2015_MatCOMState.pdf?sfvrsn=14

[3] 2006-2015 MD Matriculant profile https://www.aamc.org/download/321462/data/factstablea4.pdf

I guess we just disagree on how to characterize the scale of changes. You think a reduction of 35% vs 71% is only "slightly better," where as I did and would still characterize that as "way overshooting." You initially said in ~10 years the number of residency positions would be marginally greater, now you are saying its 15-16 years. Thats a big difference.

Your explanation proves what I was saying, you are just making your numbers up. And there's nothing wrong with that, just present it that way. Your original post gave the sense that your numbers were actually based in something, instead of having the qualifier that they were your own predictions predicated on a bunch of assumptions that may or may not be true.

 

[hallowmann]

I guess we just disagree on how to characterize the scale of changes. You think a reduction of 35% vs 71% is only "slightly better," where as I did and would still characterize that as "way overshooting." You initially said in ~10 years the number of residency positions would be marginally greater, now you are saying its 15-16 years. Thats a big difference.

Your explanation proves what I was saying, you are just making your numbers up. And there's nothing wrong with that, just present it that way. Your original post gave the sense that your numbers were actually based in something, instead of having the qualifier that they were your own predictions predicated on a bunch of assumptions that may or may not be true.

Haha, where was I making numbers up? 3000 instead of 2700? If you look back that's pretty much the only number I mentioned. In 7-8 years it'll be down to 4400 even by your article's estimation, which I would argue is actually an underestimation, because if anything the rate of expansion has increased as demonstrated by the 2700 new students over the past 4 yrs. Add on a few more years and it'll be down to 3000 or less, which is what I described in my subsequent post, considering right now more than double that number are filling with IMGs and quadruple that number of IMGs are applying every year. Wait another 5-6 and they'll be even less.

In any case your post reminds me why I stear clear of arguments with you. First you arbitrarily claim I'm making up numbers and greatly overstating AMG expansion, then when I show you proof that the numbers are pretty close to what I said, you come back with, yeah, but it'll be a few more years before what you said would fit the argus's semantics.

I've said my peace and backed up with data. Argue with it what you will.

 

[TheaterOfTheme]

Haha, where was I making numbers up? 3000 instead of 2700? If you look back that's pretty much the only number I mentioned. In 7-8 years it'll be down to 4400 even by your article's estimation, which I would argue is actually an underestimation, because if anything the rate of expansion has increased as demonstrated by the 2700 new students over the past 4 yrs. Add on a few more years and it'll be down to 3000 or less, which is what I described in my subsequent post, considering right now more than double that number are filling with IMGs and quadruple that number of IMGs are applying every year. Wait another 5-6 and they'll be even less.

In any case your post reminds me why I stear clear of arguments with you. First you arbitrarily claim I'm making up numbers and greatly overstating AMG expansion, then when I show you proof that the numbers are pretty close to what I said, you come back with, yeah, but it'll be a few more years before what you said would fit the argus's semantics.

I've said my peace and backed up with data. Argue with it what you will.

Regardless of the rate, it is decreasing. A lot of unknown variables can happen in 8 years in addition to known ones like expansion, the merger, changes due to the affordable care act, *possible single-payer healthcare system* (unlikely), and increasing amount of mid-levels. Maybe some variables will turn in favor. This sure seems like a crazy time...

 

[hallowmann]

Regardless of the rate, it is decreasing. A lot of unknown variables can happen in 8 years in addition to known ones like expansion, the merger, changes due to the affordable care act, *possible single-payer healthcare system* (unlikely), and increasing amount of mid-levels. Maybe some variables will turn in favor. This sure seems like a crazy time...

Thats very true. Anything can really happen. If suddenly schools stop opening up, then this problem disappears. If a new law gets passed and suddenly a bunch of new residencies open up, then this problem disappears (and possibly another one appears). The current rate is just staggering though.

 

[GaiusOctavius]

The major purpose of the AOA/ACGME merger was to squeeze out the IMGs, particularly the Carib diploma mill grads who went there to skirt the rigor of the med schools screening process.

So yes, in time the IMGs will be squeezed out. That bus is coming.

What we will probably also see is that DOs will match predominantly into Primary Care, and MD grads into specialties. It's an evolutionary process. remember, at one time, surgeons were to be considered physicians. Don't believe me? Look at the official name of Columbia's med school.

That's not the "major purpose" of the single GME system. I'd guess program directors and their committee will take whoever has the best mastery of relevant material (as evidenced by board scores and a few other metrics) and whoever they think will be easiest or most pleasant to work with.

 

[TheaterOfTheme]

Thats very true. Anything can really happen. If suddenly schools stop opening up, then this problem disappears. If a new law gets passed and suddenly a bunch of new residencies open up, then this problem disappears (and possibly another one appears). The current rate is just staggering though.

Is there any factor besides greed that has led to this increase in schools, you think?

 

[Rekt]

Is there any factor besides greed that has led to this increase in schools, you think?

Nope. 100% money. If you hear otherwise, it's PR bull****.

 

[TheaterOfTheme]

Nope. 100% money. If you hear otherwise, it's PR bull****.

I mean--we have a huge and growing population. The question is, does this justify the expansion (even though expansion is mostly based in monetary gain).

 

[Goro]

So you have colleagues who are, or who know ACGME and AOA board members???

That's not the "major purpose" of the single GME system. I'd guess program directors and their committee will take whoever has the best mastery of relevant material (as evidenced by board scores and a few other metrics) and whoever they think will be easiest or most pleasant to work with.

 

[IslandStyle808]

I mean--we have a huge and growing population. The question is, does this justify the expansion (even though expansion is mostly based in monetary gain).

It is not growing as quickly as the so called "baby boomers." It is just that our population in general is larger that it was before. We don't need these school expansions at all because residency spots not increasing that much to begin with. All these schools are really are nothing more than monetary gain using the whole "our baby boomer population is retiring and we need more primary care physicians in rural areas" as an excuse to further the expansion. What would happen when the population finally decreases after decades of expansions (it's happening already in Europe and Japan)? Having too many schools and even residencies could tank physician salaries.

 

[GUH]

It is not growing as quickly as the so called "baby boomers." It is just that our population in general is larger that it was before. We don't need these school expansions at all because residency spots not increasing that much to begin with. All these schools are really are nothing more than monetary gain using the whole "our baby boomer population is retiring and we need more primary care physicians in rural areas" as an excuse to further the expansion. What would happen when the population finally decreases after decades of expansions (it's happening already in Europe and Japan)? Having too many schools and even residencies could tank physician salaries.

My perspective may be biased coming from California, but due to major demographic changes coming down the pipeline I doubt that the population will tank significantly in the next few decades unless the border is secured.

 

[IslandStyle808]

My perspective may be biased coming from California, but due to major demographic changes coming down the pipeline I doubt that the population will tank significantly in the next few decades unless the border is secured.

It definitely won't in the next several decades. However, if the expansion happens too much and populations do decrease, then schools will need to decrease the amount of seats offered or close their doors. This is more long term thinking and I mean 50-100 years down the line.