Official 2015 Match Statistics

[qwerty89]

http://www.nrmp.org/wp-content/uploads/2015/03/ADT2015_final.pdf

Looks like the number of residencies has held fairly constant since 2011 and even declined from last year (except for the (R) Physicians spots).

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[radster]

Would be interested to see/hear what current radiology residents have to say about this trend.

 

[Raryn]

Interesting data. Looks like the fill rate continues to go down, with rads being the only non-prelim specialty at <90% (not counting specialties with <30 spots total).

 

[deleted564680]

Posted this over on AM...worth a repeat over here I suppose.

I know this comes up a lot and I thought I'd give my two cents just based upon some observations. I certainly agree that the job market has been poor lately but checking the ACR job list it seems to be turning around. I also agree that the number of unfilled spots is increasing and the number of US MDs is decreasing. I think radiology leadership has to take some of the blame but honestly it's kind of a unique situation as well.

Radiology is a very self-selective field for those who can handle not being around patients, want to learn/read/etc., and for the most part enjoy an intellectual field. I have met tons of medical students that 1. Don't think they could ever do it and 2. Still think it is really competitive. I was a chemistry major in college and I would equate radiology with that. There's a reason why people choose psychology, nutrition, exercise science, etc. rather than chemistry, physics, or engineering. Radiology is very challenging, and not everyone is cut out for it. Most people feel comfortable transitioning into IM, EM, etc. from medical school but see radiology as something they will have to learn from almost scratch.

Looking as the USMLE statistics, radiology still attracts much higher scores/applicants across the board. Even though IM, EM, Ob/gyn, FM, etc. had less unfilled spots, I feel this is truly self-selection. Their USMLE scores are 10-15 points lower as well. The field suffers more from its inherent difficulty than most people realize. Yes, the job market being poor has made it worse and caused some "top" students to jump ship to ortho/urology/derm, but I don't think the mid-range applicant will choose radiology based on its complexity and length of training.
The wildcard in all of this is next year when IR splits off. I think you will see it become one of the most difficult to match into and it should bring up the field in general. Time will tell.

--------

Some then mentioned IR being the "hip" thing right now and I sort of agree with that as well. It seems that each subspecialty is doing more and more procedures as well. Lots of programs are now having their body section do biopsies, etc. instead of IR. Neuro does a lot of its own procedures. MSK does injections. I think IR will have to become a full clinic/rounding surgery-like subspecialty focused on high-end interventions. Just my opinion though.

 

[FranzLO]

Hm, sorry for my ignorance but will DR residency > IR fellowship still be an option in the next 5-10 years, or will IR residency need to be completed?

 

[Gadofosveset]

"Beginning in 2015, ACGME will accept applications for individual programs. The application/approval process takes time. It is likely that only a small number of IR Residency programs will participate in the 2016 match.

Full nationwide implementation of the IR Residency is likely to ramp up over a seven year period (2015 - 2022)."

http://www.sirweb.org/misc/IR_ResFAQs_FINALFINAL_102714.pdf

IR programs will still need fellows drawn from the older pathway until this pathway is fully operational, but that path is going to be phased out, probably on a variable schedule from institution to institution.

 

[Gadofosveset]

Rads competition going down and OB/GYN competition going through the roof... one thing to also consider is that the world is just crazy.

 

[oldmanimager]

As a radiology attending who graduated fellowship several years ago - let me give my 2 cents...

The job market probably peaked the year before I graduated fellowship, when you could get a job anywhere with a full partnership. That is no longer the case...You will find work, but will most likely be taken advantage of - ironically, at the hands of older radiologists who are happy to pave their retirement on your back. It is simple greed at work here.

My group is no longer offering partnerships, and they are making similar money they were making years ago - BUT the new guys aren't and currently, it looks like they won't for the foreseeable future. In fact, it seems more likely that the grey hairs will ride the new grads until it is time for them to retire - then they will sell practice to private equity, leaving everyone else in the lurch as permanent employees.

I spent my whole medical school career thinking that the biggest enemies were malpractice lawyers, insurers, hospitals trying to make you employees, even other specialties trying to impinge our turf...I've been surprised to learn that my biggest opponents have been older radiologists who are happy to sell you out for a few extra bucks. Beware.

If I sound bitter, it's because I am. I entered the field at the height of competitiveness, only to enter a job market in shambles, where your bosses could give 2 ****s how good you are - you are a commodity, a drone who does what they are told. I'm happy to answer any questions and give advice to the best of my ability; I went to a good residency and the best fellowship for my subspecialty.

 

[shark2000]

As a radiology attending who graduated fellowship several years ago - let me give my 2 cents...

The job market probably peaked the year before I graduated fellowship, when you could get a job anywhere with a full partnership. That is no longer the case...You will find work, but will most likely be taken advantage of - ironically, at the hands of older radiologists who are happy to pave their retirement on your back. It is simple greed at work here.

My group is no longer offering partnerships, and they are making similar money they were making years ago - BUT the new guys aren't and currently, it looks like they won't for the foreseeable future. In fact, it seems more likely that the grey hairs will ride the new grads until it is time for them to retire - then they will sell practice to private equity, leaving everyone else in the lurch as permanent employees.

I spent my whole medical school career thinking that the biggest enemies were malpractice lawyers, insurers, hospitals trying to make you employees, even other specialties trying to impinge our turf...I've been surprised to learn that my biggest opponents have been older radiologists who are happy to sell you out for a few extra bucks. Beware.

If I sound bitter, it's because I am. I entered the field at the height of competitiveness, only to enter a job market in shambles, where your bosses could give 2 ****s how good you are - you are a commodity, a drone who does what they are told. I'm happy to answer any questions and give advice to the best of my ability; I went to a good residency and the best fellowship for my subspecialty.

Things you mention may be true in some groups and especially in some parts of country like Manhattan or SF. But come on. This is not the Robin Hood story. The system that you are describing is not sustainable. I agree that for a period of 2-3 years a few business owners can take advantage of junior people. But let's be honest. This does not last long. Radiology contracts are not the private property of a group and specific individuals.

Your group may be different, but my group makes almost everybody a partner.

By your description you finished fellowship in 2008 or 2009. Are you one of the partners in your group that take advantage of new people?

 

[bashwell]

Are you one of the partners in your group that take [sic] advantage of new people?

Respectfully, I think this line of questioning may be a bit too antagonistic. Not sure if it's beneficial to go there. I nevertheless genuinely appreciate your other thoughts though.

 

[Gadofosveset]

As a radiology attending who graduated fellowship several years ago - let me give my 2 cents...

The job market probably peaked the year before I graduated fellowship, when you could get a job anywhere with a full partnership. That is no longer the case...You will find work, but will most likely be taken advantage of - ironically, at the hands of older radiologists who are happy to pave their retirement on your back. It is simple greed at work here.

My group is no longer offering partnerships, and they are making similar money they were making years ago - BUT the new guys aren't and currently, it looks like they won't for the foreseeable future. In fact, it seems more likely that the grey hairs will ride the new grads until it is time for them to retire - then they will sell practice to private equity, leaving everyone else in the lurch as permanent employees.

I spent my whole medical school career thinking that the biggest enemies were malpractice lawyers, insurers, hospitals trying to make you employees, even other specialties trying to impinge our turf...I've been surprised to learn that my biggest opponents have been older radiologists who are happy to sell you out for a few extra bucks. Beware.

If I sound bitter, it's because I am. I entered the field at the height of competitiveness, only to enter a job market in shambles, where your bosses could give 2 ****s how good you are - you are a commodity, a drone who does what they are told. I'm happy to answer any questions and give advice to the best of my ability; I went to a good residency and the best fellowship for my subspecialty.

This is kind of exaggerated.
The business dynamics you're describing are not completely off, but totally nonspecific... this dynamic is routine in many other scenarios (e.g. law). What is unusual is that there once was a bubble in rads where the normal dynamics were not applied.

Sounds like the best option is academics... no one using anyone else in that realm.

 

[oldmanimager]

I'm not one of the partners who condones taking advantage of others. I don't agree with my group's philosophy; I am usually at odds with my partners about what to do with future hires. There are probably about 1/3 that want to keep people as partners, 1/3 that want to make everyone new an employee, and 1/3 who don't care either way. However, the leadership of the group drives most decision making they would prefer everyone to be an employee.

As far as the dynamic I described of groups selling out to private equity - that is not an exaggeration. Look up Radpartners. If you've never heard of them, this is exactly what they do: they buy up groups for some shares in the company or some dollar amount (not sure how they figure out the amount). Partners get a payout, associates get nothing, everyone in the group then becomes an employee.

I apologize for sounding overly negative, and maybe my group is unique, but the trend I've been seeing is profits over people. Disappointing. Now if you're willing to live in the sticks, the story may be different.

 

[shark2000]

I'm not one of the partners who condones taking advantage of others. I don't agree with my group's philosophy; I am usually at odds with my partners about what to do with future hires. There are probably about 1/3 that want to keep people as partners, 1/3 that want to make everyone new an employee, and 1/3 who don't care either way. However, the leadership of the group drives most decision making they would prefer everyone to be an employee.

As far as the dynamic I described of groups selling out to private equity - that is not an exaggeration. Look up Radpartners. If you've never heard of them, this is exactly what they do: they buy up groups for some shares in the company or some dollar amount (not sure how they figure out the amount). Partners get a payout, associates get nothing, everyone in the group then becomes an employee.

I apologize for sounding overly negative, and maybe my group is unique, but the trend I've been seeing is profits over people. Disappointing. Now if you're willing to live in the sticks, the story may be different.

Even if you are who you claim, you are as guilty as the other partners in the group. If you are a partner, some of your salary comes from taking advantage of new employees (according to what you yourself said).

Honestly, I doubt you are a radiologist in private practice. It is very very doubtful that a partner of a group 6-7 years into practice wakes up one day, decides to sign up for a STUDENT FORUM and on his first post tries to tell the medical students that how he and other partners in his group, screw up the new graduates.

Anyway, if what you say is correct, your group is in minority. Most groups don't want to ruin their reputation by hiring people every 6 months.

 

[PL198]

Rads competition going down and OB/GYN competition going through the roof... one thing to also consider is that the world is just crazy.

seriously blows my mind. you couldn't pay me enough money to be obgyn. that subject matter with that work environment, yeah no thanks I have absolutely 0 idea why someone would want to go into it unless they'd like to contribute to that environment.

 

[tco]

"Beginning in 2015, ACGME will accept applications for individual programs. The application/approval process takes time. It is likely that only a small number of IR Residency programs will participate in the 2016 match.

Full nationwide implementation of the IR Residency is likely to ramp up over a seven year period (2015 - 2022)."

http://www.sirweb.org/misc/IR_ResFAQs_FINALFINAL_102714.pdf

IR programs will still need fellows drawn from the older pathway until this pathway is fully operational, but that path is going to be phased out, probably on a variable schedule from institution to institution.

Talked with a few of the creators of the IR residency at SIR. They said that, as is currently designed, they will not "phase out" fellowship. The current fellowship will no longer exist, and it will become a two year independent residency. If your program can fulfill the requirements of the first year of the fellowship through an accredited special track (I forget what they called it) and you can compile enough procedures during fourth year, it will count as one year of the independent residency.

However, as I stated, the current path will never be "phased out" as many have been saying.

 

[Gadofosveset]

Talked with a few of the creators of the IR residency at SIR. They said that, as is currently designed, they will not "phase out" fellowship. The current fellowship will no longer exist, and it will become a two year independent residency. If your program can fulfill the requirements of the first year of the fellowship through an accredited special track (I forget what they called it) and you can compile enough procedures during fourth year, it will count as one year of the independent residency.

However, as I stated, the current path will never be "phased out" as many have been saying.

It's all on the FAQ.
If the number of spots remains the same, then with more IR residents, the IR "independent" path (which looks more like the current fellowship to me) gets diminished. At the moment, they plan on going either way, but I assume they're just hedging their bets. The current fellowship path is indeed being "phased out" in favor of the integrated and independent paths. How this all ends up is anyone's guess.

"Within a single institution, it will be possible to transfer between the IR and DR residencies during the PGY2-PGY4 years."
That should prove interesting...

Basically the whole thing is going to be a mess until the smoke clears.

 

[PL198]

sounds like they're going to oversaturate the market with IRs due to the lowered turn-around time and you know people are going to be jumping for it when the new pathways come out, it'll be cool kid on block for sure.

I say this is beneficial for DR.

 

[Gadofosveset]

We can call it "discontinued and reborn in a strange new form" if there are objections to "phased out".

 

[Gadofosveset]

I like it that "continuing the current fellowship" is to add another year of fellowship... so... to PGY-7. I'm sure they're only thinking of the trainees' benefit by adding an extra year of low paid labor.
If they construct it like other two-year fellowships and a trainee could practice as a half-salary attending in PGY-7, that might be worthwhile. It might be tough to do that while you're acting as an ICU junior resident, though.

We'll see how the ESIR goes (that alternative pathway)... Who in the world would choose the independent track if they could choose the ESIR? Probably residents from small programs.

It's going to be an interesting trade-off. Residents from smaller programs won't be able to ESIR (probably... otherwise, why does the track exist?) so they'd have to "independent" in, but take the hit of an extra year of training. I imagine this will discourage some... but training programs may want them more because it's an extra year of labor. So it may be a wash.

I guess the ABR doesn't have a monopoly on goofing up the works. It's gonna get weird.

 

[tco]

It's all on the FAQ.
If the number of spots remains the same, then with more IR residents, the IR "independent" path (which looks more like the current fellowship to me) gets diminished. At the moment, they plan on going either way, but I assume they're just hedging their bets. The current fellowship path is indeed being "phased out" in favor of the integrated and independent paths. How this all ends up is anyone's guess.

"Within a single institution, it will be possible to transfer between the IR and DR residencies during the PGY2-PGY4 years."
That should prove interesting...

Basically the whole thing is going to be a mess until the smoke clears.

I was specifically told by the head of the committee that you will always be able to become an IR even if you go into a DR residency.

You can only lateral transfer if there's an open spot or if someone wants to switch.

 

[Gadofosveset]

I was specifically told by the head of the committee that you will always be able to become an IR even if you go into a DR residency.

Yup. It's also in the FAQ I posted at the very beginning of this whole thing.
It was my fault I wasn't completely clear in my first post, but I corrected my vagueness afterward. I didn't mean to say that one couldn't go from DR residency to IR, but the older pathway of DR residency --> one year IR fellowship is being "phased out"... except for this ESIR thing which is a one year deal that allows them to intially correct labor supply/demand imbalances, I assume.

With the current plans, one can go into IR fellowship from DR residency, but
- unless there are an increase in overall spots, you may be competing for fewer spots (if this will make a difference is unclear since many IR-bound-folk will likely divert initially to the residency and it may end up being a wash)
- the proposed DR --> IR pathway is now two years of fellowship ("independent")
- there's some ESIR wildcard/hedge, which no-one knows (or is telling) quite how that will work out. It sounds like a one-year fellowship track which residents from larger institutions can tap... but who knows what it means

When the IR residency starts, fellows will be needed that same year. These will be drawn from NRMP, I assume... for the two-year track, I guess, since that's the new normal? Maybe they will stay one year of "fellowship" until the first class of IR residents begins their PGY 5 year? Then things will switch to the two year cycle?

So... if "fellowship" is one year long, will those ESIR fellows before the first IR resident class hits PGY-5 be promoted past PGY-6 to PGY-7 (as the FAQ says they will be PGY-7?) What does that even mean? Will they not tap the ESIR and continue the traditional fellowship and "phase out" traditional PGY-6 fellows to PGY-7 ESIRs, independent PGY-6 and PGY-7, and integrated PGY-6 and PGY-7?

Add to the mix that different residencies are "coming online" at different rates.... if one residency is not online and offers a one year trad PGY-6 fellow spot... who would choose a two year integrated spot?
and the curriculum is now different (a trad PGY-6 fellow doesn't rotate in the ICU, etc... will a PGY-7 ESIR "fellow"?)

It will be interesting to see what IR residencies become in 8-10 years. Will they mandate a certain portion of spots as open spots for integrated/ESIR (if ESIR is still around). I'm not sure why they would do that if they can match and fill in the intial match. The wild card is the ability to switch back and forth in PGY-2 PGY-4 years... that makes it hard for program directors to plan their workforce.... which I doubt they would like very much.

I stand by my statement that this will probably be a bit of a mess.

 

[radapplicant920]

Alright this is getting confusing... Can someone just explain what this means for someone starting as an R1 in July? Is it likely that the 1 year fellowship option will still exist if I apply to the IR match in 2017?

 

[preDoGuy24]

Alright this is getting confusing... Can someone just explain what this means for someone starting as an R1 in July? Is it likely that the 1 year fellowship option will still exist if I apply to the IR match in 2017?

I believe the class starting R1 on 2016 will be the last group to apply to the traditional 1 year fellowship...if they are available.

 

[dr seuss]

Alright this is getting confusing... Can someone just explain what this means for someone starting as an R1 in July? Is it likely that the 1 year fellowship option will still exist if I apply to the IR match in 2017?

I have an ABR powerpoint from a conference, it says:

1 year fellowships will eventually be phased out
Timeline for conversion to the new training program is long - 7 years for conversion from fellowship to residency
2015 First residency applications
2022 End of 1-year fellowships

 

[USMLE12DOC]

Good evening, I am a 2015 Graduate who matched into TY this year and will begin Radiology residency in 2016 at a community hospital in PA that has an IR fellowship in the hospital system.

With regards to the question about IR integration, DIRECT pathway and ESIR:
- Has anyone else currently in a DR program which also supports an IR fellowship discussed the "Early Integration" option
with the IR Fellowship PD? - I anticipate graduating DR in July 2020, right when the 1 year fellowship is said to become phased out.
For others entering residency and desiring to eventually enter IR this begs the same question.
It would make sense if the pathways become separate that a fellowship PD would be amenable to developing an IR focused curriculum
at the same hospital (as long as procedure volume is high enough), and thus allow say a PGY-3 to start the IR curriculum vs. waiting until after passing the ABR boards...

- That brings up the additional question of "Will DR/IR have to pass the ABR?" or will SIR force the ABR to develop a new exam?

Please respond with thoughts or comments!

 

[Gadofosveset]

- That brings up the additional question of "Will DR/IR have to pass the ABR?" or will SIR force the ABR to develop a new exam?

Answering the second question...

It seems unlikely that IR/DR will be boarded separately:
- Core exam covers what the IR/DRs learn PGY2-PGY4
- The cert exam can be tailored to interventional, so it can be an NIR module + "essentials of radiology" module + three interventional modules.
Currently, you would want to be boarded in DR so you have flexibility in job options.

 

[preDoGuy24]

Good evening, I am a 2015 Graduate who matched into TY this year and will begin Radiology residency in 2016 at a community hospital in PA that has an IR fellowship in the hospital system.

With regards to the question about IR integration, DIRECT pathway and ESIR:
- Has anyone else currently in a DR program which also supports an IR fellowship discussed the "Early Integration" option
with the IR Fellowship PD? - I anticipate graduating DR in July 2020, right when the 1 year fellowship is said to become phased out.
For others entering residency and desiring to eventually enter IR this begs the same question.
It would make sense if the pathways become separate that a fellowship PD would be amenable to developing an IR focused curriculum
at the same hospital (as long as procedure volume is high enough), and thus allow say a PGY-3 to start the IR curriculum vs. waiting until after passing the ABR boards...

- That brings up the additional question of "Will DR/IR have to pass the ABR?" or will SIR force the ABR to develop a new exam?

Please respond with thoughts or comments!

I think you can find most of your answers on the SIR website, SIR isn't going to be forcing anything...currently the plan is to have IR residents boarded in both interventional and diagnostic radiology...the testing differences between diagnostic and interventional come after the core during the certifying exam when IR people will take an Oral board exam NOT another written test to become certified...there is no plan right now to not have IR docs certified in DR, that would blow in my opinion and seriously hurt the IR residency pathway. I think you may be confusing some of the board exam steps in radiology. You take the core exam after 3rd year then a certifying exam 15 months after graduation. There is no "abr exam" unless you are referring to the Core?

I've never heard anyone else even mention this as a possibility.


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