Petition to Address Residency Shortages

[BrooklynBulls]

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I don't think spending more time studying for something translates to higher score. It's not easy to sit and study for months on end. You start forgetting the details you studied a month or two ago. IMO

I agree, which is why I've sent the President a petition to make medical school no longer than 6 weeks. I've yet to hear a response. Thanks Obama.

 

[W19]

Fair enough!

And yes, it doesn't surprise me one bit that he would score very well. Congrats to him for doing so well

With these FMG having all their time to study for step1, I guess one will need 240+ in step 1 to match into primary care or psych in the next few years...

 

[cs24]

By going through material slowly for an entire year and using resources like FC or Q banks to keep your knowledge fresh it is inevitably going to be easier for you to master the material than someone who has a small fraction of the time.

Sounds suspiciously like medical school, except you get two years...

With these FMG having all their time to study for step1, I guess one will need 240+ in step 1 to match into primary care or psych in the next few years...

 

[username456789]

@pathologyDO I am not following on that one, I guess... Anyway, my brother in-law whose med school education is completely different from ours, spend a whole year studying for step1 and score in the 99% percentile and he acknowledged that if he spent 6-8 weeks studying for it, he would have never passed it...

As is typical of most foreigners, you're confusing the old double-digit score with a percentile, which it absolutely is not. Unless he truly scored somewhere >270 or so.

They did away with the double digit score partially because people got confused. FMGs would tirelessly claim that they were all in the "99th percentile", when in reality you would receive a "99" when scoring just slightly above the national mean (based on the 3 digit score).

Anyway, just a slight digression, but you wouldn't believe how many foreign grads there are walking around out there who think they actually scored anywhere near the 99th percentile.

 

[the argus]

With these FMG having all their time to study for step1, I guess one will need 240+ in step 1 to match into primary care or psych in the next few years...

You don't know what you are talking about. Please go look at the data.

Independent applicants have lower board scores than US MDs in practically every specialty in the match (and the overwhelming number of actual positions). The only specialties that independent applicants score higher on Step 1 than US MDs are PM&R's 391 positions (222 vs 220, which I'm sure is statistically insignificant), and vascular surgery, which has a grand total of 51 positions (<10 of which went to independents). There are also a two, gen surg and anesthesia, where the scores are equal.

Here's some advice that will serve you well for the rest of medical school: look things up before you comment on them!

 

[W19]

As is typical of most foreigners, you're confusing the old double-digit score with a percentile, which it absolutely is not. Unless he truly scored somewhere >270 or so.

They did away with the double digit score partially because people got confused. FMGs would tirelessly claim that they were all in the "99th percentile", when in reality you would receive a "99" when scoring just slightly above the national mean (based on the 3 digit score).

Anyway, just a slight digression, but you wouldn't believe how many foreign grads there are walking around out there who think they actually scored anywhere near the 99th percentile.

He scored 262... I thought that was somewhat in the 99% percentile...

 

[W19]

You keep saying this. It's not true. At all.

I might be exaggerating, but that thread in the residency forum was very alarming.

 

[charmiedermie]

With these FMG having all their time to study for step1, I guess one will need 240+ in step 1 to match into primary care or psych in the next few years...

The average matched applicant for Psych and Family Med had Step 1 scores of 220 and 218, respectively, in 2014. It won't jump 20 points in 3 years. You're fine.

 

[jw3600]

With these FMG having all their time to study for step1, I guess one will need 240+ in step 1 to match into primary care or psych in the next few years...

Are we going to see a return of a W19 literary classic: Complete Paranoia- A Personal Diary of a Medical Student?

 

[W19]

Are we going to see a return of a W19 literary classic: Complete Paranoia- A Personal Diary of a Medical Student?

🙄It's easy for people who already matched to say... oh well, nothing has changed, but the reality is no one is safe since things are changing faster than we even realize... Good for you if you are enjoying your cushy residency appointment in derm etc..., but to sit behind your computer and attack me because I have concerns about how fast things are changing is unwarranted...

 

[Mass Effect]

They aren't changing any faster than they have been in the past.

That isn't exactly true. Med schools have increased their enrollment and new schools are popping up at a faster rate than in the past.

 

[Mass Effect]

Med school enrollment has been increasing pretty steadily since 2005 when the AAMC started calling for expansion, and new schools aren't a phenomenon exclusive to this year.

Histrionics that people who matched just a couple of years ago can't understand how hard it is now are just that...histrionics.

No one said it's a phenomenon exclusive to this year and I highly doubt that the people posting above are saying "OMG, things have changed so drastically since last year!" They're talking about the fact (and it is a fact) that every single year, new schools pop up and existing schools increase enrollment. No one is saying that's causing a one year to be a hell of a lot more competitive than the year before. We're talking about GRADUAL change, which is happening.

 

[Roxas]

You might be. W19 is incapable of understanding nuance and is posting stupid posts all over the site about needing a 240 to match into psych in Montana.

Dang, there goes my dream

 

[sazerac]

Dang, there goes my dream

Montana has three residencies (2xFM, 1xIM) and they each get over 1,000 applications for roughly 8 slots. You never had a chance.

 

[W19]

You might be. W19 is incapable of understanding nuance and is posting stupid posts all over the site about needing a 240 to match into psych in Montana.

Seriously!

 

[Freddie Mercury]

No one said it's a phenomenon exclusive to this year and I highly doubt that the people posting above are saying "OMG, things have changed so drastically since last year!" They're talking about the fact (and it is a fact) that every single year, new schools pop up and existing schools increase enrollment. No one is saying that's causing a one year to be a hell of a lot more competitive than the year before. We're talking about GRADUAL change, which is happening.

If anything, this "gradual change" actually seems to be in favor of applicants.

Minus the small dip this past year, over the past 5 years there have been more residency spots created than medical student spots (new schools, increasing enrollment at current schools etc). Although I agree with you - it will be interesting to see where this goes in the coming years. Maybe there were a lot of new schools opened in 2011 which explains the 2015 dip, and we might see continuing decreases in the future.

But either way - the alarmism from people like W19 is simply not supported by the actual numbers, and doesn't look to be an issue for the near future (and certainly not an issue for any current US MD student).

 

[Mass Effect]

The above chart is not accounting for previous MD grads, osteo grads, IMGs, and FMGs. If the match was exclusive to US MDs, then those numbers would be realistic. And yes, the bump in the number of USMD seniors is due to expansion and is starting to show.

 

[WingedOx]

It wasn't though. It was a few people posting over and over and over, and a ton of IMGs/FMGs/DOs. Same thing as the SOAP/scramble threads every single year.

97% of first time US MD test-takers pass USMLE step 1

95% of US MD grads match. Of those who don't, over 40% were shooting for competitive specialties like ortho, derm, etc.

You really need to stop being so alarmist.

AND those who don't match of course get something (sometimes quite good) in the SOAP.

 

[charmiedermie]

If anything, this "gradual change" actually seems to be in favor of applicants.

Minus the small dip this past year, over the past 5 years there have been more residency spots created than medical student spots (new schools, increasing enrollment at current schools etc). Although I agree with you - it will be interesting to see where this goes in the coming years. Maybe there were a lot of new schools opened in 2011 which explains the 2015 dip, and we might see continuing decreases in the future.

But either way - the alarmism from people like W19 is simply not supported by the actual numbers, and doesn't look to be an issue for the near future (and certainly not an issue for any current US MD student).

Do you have the chart with number of spots in board certified residencies (PGY-2 and higher)? Number of PGY-1 spots are useless.

 

[Freddie Mercury]

That's a little bit of a false increase, as a result of the all in policy (see the jump from 2012 to 2013). Those ~2000 positions have always existed, they just used to fill with pre-matches

Interesting... I'm trying to find the exact numbers for this change. Quickly plugging in the numbers, assuming it was exactly 2000 spots "added" with the policy change, there would be
1873 "truly new" PGY 1 positions
1554 additional US MD senior applicants

So not as much of an increase as previously thought, but still a relative increase nonetheless.

The above chart is not accounting for previous MD grads, osteo grads, IMGs, and FMGs. If the match was exclusive to US MDs, then those numbers would be realistic. And yes, the bump in the number of USMD seniors is due to expansion and is starting to show.

I understand your point. I think we're dealing with different arguments here - I'm really only concerned with US MD seniors applying, in regards to all the arguments about people paying hundreds of thousands of dollars to attend US allopathic medical school, and the fear of not getting a residency position. Of course, with the whole ACGME/AOA merger coming up, I'd be curious to see how the numbers come out.

 

[Mass Effect]

I understand your point. I think we're dealing with different arguments here - I'm really only concerned with US MD seniors applying, in regards to all the arguments about people paying hundreds of thousands of dollars to attend US allopathic medical school, and the fear of not getting a residency position. Of course, with the whole ACGME/AOA merger coming up, I'd be curious to see how the numbers come out.

But it's not a different argument. What you're not taking into account is that the 27,000 PGY 1 positions you listed are not just for US MD seniors. It's not like they're earmarked for them and only them. They're the total number of positions in the match and while US MD seniors certainly have an advantage, those spots are not theirs for the taking. Therefore, in order to truly analyze the situation, you have to include DO, IMG, and FMG. When you do that, you realize the chart isn't showing the whole story.

 

[the argus]

But it's not a different argument. What you're not taking into account is that the 27,000 PGY 1 positions you listed are not just for US MD seniors. It's not like they're earmarked for them and only them. They're the total number of positions in the match and while US MD seniors certainly have an advantage, those spots are not theirs for the taking. Therefore, in order to truly analyze the situation, you have to include DO, IMG, and FMG. When you do that, you realize the chart isn't showing the whole story.

I think they certainly are theirs for the taking.

Take IM for example. For applicants with step 1 191-200, 90% of US MDs matched, as opposed to 26% of independent applicants. Hell, for independent applicants with step 1 251-260, only 86% matched.

A higher percentage of US MDs with step 1 191-200 matched than independents with step 1 251-260. I don't know what your definition of "theirs for the taking" is, but for me this goes well beyond an "advantage.

All US MDs might not get their absolute first choice for specialty, but they are pretty much guaranteed a categorical residency position unless they have completely **** the bed.

 

[Mass Effect]

I think they certainly are theirs for the taking.

Take IM for example. For applicants with step 1 191-200, 90% of US MDs matched, as opposed to 26% of independent applicants. Hell, for independent applicants with step 1 251-260, only 86% matched.

A higher percentage of US MDs with step 1 191-200 matched than independents with step 1 251-260. I don't know what your definition of "theirs for the taking" is, but for me this goes well beyond an "advantage.

All US MDs might not get their absolute first choice for specialty, but they are pretty much guaranteed a categorical residency position unless they really have **** the bed.

As I said, they have an advantage. That doesn't mean they're entitled to the spot or that it's automatically theirs because they're USMDs.

 

[the argus]

As I said, they have an advantage. That doesn't mean they're entitled to the spot or that it's automatically theirs because they're USMDs.

The stats show that a categorical spot is automatically theirs unless they have really ****ed up

 

[PL198]

I think they certainly are theirs for the taking.

Take IM for example. For applicants with step 1 191-200, 90% of US MDs matched, as opposed to 26% of independent applicants. Hell, for independent applicants with step 1 251-260, only 86% matched.

A higher percentage of US MDs with step 1 191-200 matched than independents with step 1 251-260. I don't know what your definition of "theirs for the taking" is, but for me this goes well beyond an "advantage.

All US MDs might not get their absolute first choice for specialty, but they are pretty much guaranteed a categorical residency position unless they have completely **** the bed.

you're trying to compare scores between US MD and IMG and it makes no sense. You guys study for that stuff for like a year. There's a reason a PD would rather have a US MD with a 200 than an IMG with a 260.

 

[the argus]

you're trying to compare scores between US MD and IMG and it makes no sense. You guys study for that stuff for like a year. There's a reason a PD would rather have a US MD with a 200 than an IMG with a 260.

First off, I wasn't saying this was good or bad. I think US MDs should get priority, and I understand why they do. (and I don't know anyone who studied for a year, 2-3 months was average for people I knew).

But you are otherwise proving my point, US MDs are highly coveted. To call this an "advantage" is completely understating it. If you are willing to apply to any specialty, US MDs are pretty much guaranteed a categorical residency position upon graduation. This isn't up for debate, the numbers are what they are.

 

[Mass Effect]

The stats show that a categorical spot is automatically theirs unless they have really ****ed up

I'm pretty sure you're talking about PRELIM spots, not categorical. Otherwise, there wouldn't be that many USMDs without a spot after Match Day. Either way, I'd still argue that a categorical spot isn't "automatically" anyone's. They have to work for it, like everyone else. And god forbid they want something other than primary care. They're called entitled, whiny flakes if they fail to match.

 

[PL198]

First off, I wasn't saying this was good or bad. I think US MDs should get priority, and I understand why they do. (and I don't know anyone who studied for a year, 2-3 months was average for people I knew).

But you are otherwise proving my point, US MDs are highly coveted. To call this an "advantage" is completely understating it. If you are willing to apply to any specialty, US MDs are pretty much guaranteed a categorical residency position upon graduation. This isn't up for debate, the numbers are what they are.

yeah then I agree with you there. If you're realistic about your stats and the locations you have available then from what I've seen you really have to screw up to not match. I think a lot of the problems are like a US MD with a 200 step 1 wants to work in FM in socal and thinks they can do it because it's FM

 

[the argus]

I'm pretty sure you're talking about PRELIM spots, not categorical. Otherwise, there wouldn't be that many USMDs without a spot after Match Day. Either way, I'd still argue that a categorical spot isn't "automatically" anyone's. They have to work for it, like everyone else. And god forbid they want something other than primary care. They're called entitled, whiny flakes if they fail to match.

No, categorical. And the USMDs that don't match either 1. tried for a competitive specialty, 2. didn't apply broadly enough, or 3. have a major red flag. Otherwise they match, plain and simple.

Let's not move the goalposts. I was in no way implying that USMDs don't have to work hard, so lets just shut that down right here.

And I'm sorry, but purely getting into a US allopathic program does not, and should not, guarantee you a position in a more competitive specialty. It does sound pretty entitled and whiny to assume otherwise.

 

[the argus]

yeah then I agree with you there. If you're realistic about your stats and the locations you have available then from what I've seen you really have to screw up to not match. I think a lot of the problems are like a US MD with a 200 step 1 wants to work in FM in socal and thinks they can do it because it's FM

exactly

 

[Mass Effect]

No, categorical. And the USMDs that don't match either 1. tried for a competitive specialty, 2. didn't apply broadly enough, or 3. have a major red flag. Otherwise they match, plain and simple

Every single person who fails to match falls into one of the above categories. You can't attribute that solely to US MDs.

Let's not move the goalposts. I was in no way implying that USMDs don't have to work hard, so lets just shut that down right here

Good to hear that wasn't your implication. Tough to tell from your posts when you include words such as "guarantee" in your posts over and over again.

And I'm sorry, but purely getting into a US allopathic program does not, and should not, guarantee you a position in a more competitive specialty. It does sound pretty entitled and whiny to assume otherwise.

Speaking of goal posts, when did I ever mention the word guarantee in relation to this? Never. What I said was that when someone complains that they didn't get that coveted neurosurgery spot, they're called entitled. No one said they were guaranteed the spot, but a person is allowed to vent about not getting their dream job without 10 other people pointing fingers and judging them.

 

[IlDestriero]

The only people that have to worry about matching somewhere (assuming they are smart about career choice, interviews, etc.), that don't have worrisome red flags, are those that are about 2 standard deviations below the mean. Anyone scoring 2 standard deviations below the mean should be worried about their future, jobs, etc.
It shouldn't come as a surprise that someone in the bottom of the class, barely passing, etc. might have a lot of problems ahead of them.
Perhaps the schools should remediate them and then dismiss them, but then we would have to endure all of the "Evil Heartless Medical School Kicked Me Out" posts.

 

[the argus]

Every single person who fails to match falls into one of the above categories. You can't attribute that solely to US MDs.

Wrong.

An FMG can apply to 100 FM programs and not match simply because his step scores are not high enough. This is not the case with US MDs. If any US MD that has passed all the steps (with any score), with no major red flags, applied to 100 FM programs, they are pretty much guaranteed (oops I used it again) to match.

 

[Mass Effect]

Wrong.

An FMG can apply to 100 FM programs and not match simply because his step scores are not high enough. This is not the case with US MDs. If any US MD that has passed all the steps (with any score), with no major red flags, applied to 100 FM programs, they are pretty much guaranteed (oops I used it again) to match.

Actually, the fact that he's an FMG is a major red flag, as is the fact that his step score isn't high enough. Oh, and given that he's an FMG with a low step score, perhaps he didn't apply broadly enough. Maybe he needed 150 programs to make it work. See how arbitrary your "three rules" really are? Nope, you don't.

 

[the argus]

Actually, the fact that he's an FMG is a major red flag, as is the fact that his step score isn't high enough. Oh, and given that he's an FMG with a low step score, perhaps he didn't apply broadly enough. Maybe he needed 150 programs to make it work. See how arbitrary your "three rules" really are? Nope, you don't.

You're being silly. Being an FMG and low step scores aren't what would generally be considered red flags. These are (negative) characteristics, not red flags. Red flags would be step failure, semester/clerkship failure, extended breaks in training, etc.

Look, you can either accept the data or not. The facts are that USMDs match at exceptionally high rates, to the point where you can pretty much call it a guarantee if they are willing to apply broadly in less competitive specialties.

This really isn't debatable. Arguing against it just makes it seem like you are unable to read simple charts and graphs.

 

[Mass Effect]

When did I argue against the fact that USMDs match at exceptionally high rates? I never once debated that. Not for a single moment. Don't change the debate in order to argue. What I said was that no one, even US MDs, were guaranteed a spot in any specialty and the fact that not every single US MD has a spot backs me up on that.

 

[the argus]

97% of US MDs that applied to FM last year matched. 97% is also the pass rate on step 1 for first time US MD testers. Coincidence?

 

[username456789]

97% of US MDs that applied to FM last year matched. 97% is also the pass rate on step 1 for first time US MD testers. Coincidence?

Absolutely it is.

 

[PL198]

97% of US MDs that applied to FM last year matched. 97% is also the pass rate on step 1 for first time US MD testers. Coincidence?

yeah that's a coincidence seeing as I have no idea how you're going to relate those two numbers.

 

[W19]

What would make a US grad not match into FM? Multiple step1 failures, 'unprofessionalism', multiple remediation in med school, apply only to CA etc...

 

[PL198]

What would make a US grad not match into FM? Multiple step1 failures, 'unprofessionalism', multiple remediation in med school, apply only to CA etc...

interviewing at 5 programs, being a tool

 

[NotAProgDirector]

He scored 262... I thought that was somewhat in the 99% percentile...

Assuming a mean of 228 and a SD of 21, a 262 is the 97th percentile. The 99th is a 265.

Both scores are fantastic.

 

[IlDestriero]

interviewing at 5 programs, being a tool

Personality disorder, aspergers, etc.

 

[DermatoFIGHT]

What would make a US grad not match into FM? Multiple step1 failures, 'unprofessionalism', multiple remediation in med school, apply only to CA etc...

How about not wanting to match into it lol. I can think of 100s who would rather take a year off than do FM.

 

[DermatoFIGHT]

Personality disorder, aspergers, etc.

Face tattoo, breath that smells like boiled bologna, etc

 

[the argus]

yeah that's a coincidence seeing as I have no idea how you're going to relate those two numbers.

Yea, reading it again I admit that was a stupid way of wording it.

I was trying to show that a higher percentage of USMDs have a major red flag on their application than don't match in FM. If 3% fail step 1, then at least 4-5% will have some red flag (if 3% get it from step 1 failure alone). But still only 3% of USMDs don't match in FM, which is less than the amount that have a major red flag on their application.

Barring a major screw-up, which even then isn't a deal breaker, USMDs are basically guaranteed a categorical residency position upon graduation. It might not be in their preferred specialty, but they will still be able to become licensed and practice medicine (and pay back loans, live a comfortable life, etc)

 

[PL198]

How about not wanting to match into it lol. I can think of 100s who would rather take a year off than do FM.

take a year off? hell no. good luck with that. I'd rather match into FM for sure. compound interest and living expenses aren't friendly things for someone without a job

 

[DermatoFIGHT]

take a year off? hell no. good luck with that. I'd rather match into FM for sure. compound interest and living expenses aren't friendly things for someone without a job

Depends how dedicated you are to your specialty. Sometimes going into a residency/specialty you are not passionate about will lead to bigger issues later down the line and dissatisfaction.

 

[DubVille]

What would make a US grad not match into FM? Multiple step1 failures, 'unprofessionalism', multiple remediation in med school, apply only to CA etc...

Wearing a Christmas sweater to interviews. Bringing parents to interviews. I saw both on prelim med interviews a few years back (I think they were for categorical).

 

[anbuitachi]

the government already can't afford to spend on healthcare even with tthis doctor 'shortage'. what do you think will happen when they add even more doctors? salaries will tank, autonomy will tank even more b/c they can always find someone to replace you. the whole field will become puppets of the administrators and government even more than it is today. then people will realize how awful it is, and the only people who will go into medicine will be FMGs b/c they have barely any loans and many of them are young since their medical education is shorter in their country.

from my experience, there is no shortage in big cities esp on the 2 coasts. the shortages are in the middle of no where states b/c no one wants to live there. Many doctors in certain specialties have difficulty even finding jobs. what they should do is drastically increase salaries in the middle of no wheres to attract people to go there, so big cities become less overcrowded and smaller areas get a MD