Psych on fire last 3 years

[Blitz2006]

www.nrmp.org

Match stats are out, here is a statement directly from nrmp

"Psychiatry offered 1,495 first-year positions, 111 more than in 2016, and filled all but four. The overall fill rate was 99.7 percent, and 61.7 percent were filled by U.S. seniors. Since 2012, the number of Psychiatry positions has increased 378, or 34 percent, and the number of positions filled by U.S. allopathic seniors has increased by 307."

After reviewing table 7, over the past 3 years, US MD has increased by 12%, 10% and 8.5% most recently. Highest among all specialities.

Other notables, strong year for Obgyn, ER and surprisingly DR (since it is now separate from IR).

But no trend as impressive as psych.

Great for the field, congrats to all of you that matched.

Well deserved!



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[Seroquel]

My school (average US MD) had 14 people apply for psych, 11 match with several people not getting their top choice, and 3 did not match and soaped into IM.

 

[Merely]

My school (average US MD) had 14 people apply for psych, 11 match with several people not getting their top choice, and 3 did not match and soaped into IM.

3 USMDs didn't match psych...they must've had serious red flags...

 

[Blitz2006]

3 USMDs didn't match psych...they must've had serious red flags...

Historically people who didn't match into IM would soap into psych... Now it's flipped proving a change in trends

And only 4 unfilled spots is impressive. Sure, perhaps Psych PDs were less aggressive in their ranking this year, but nonetheless..

 

[OldPsychDoc]

As PDs we're just all shaking our heads. Subjectively, we all felt that we saw a stronger pool of applicants this year, and clearly more US MD & DO seniors than past years--but there was a sense that we were all interviewing the same people. (Of course, it's not 'legal' for us to ask where else they are applying...so we kind of have to guess, and share match rosters with our friends regionally.)

...perhaps Psych PDs were less aggressive in their ranking this year, but nonetheless..

Not sure what you mean by 'less aggressive'--personally we ranked all of our interviewees that we were willing to have in our program, but we did decline a LOT of interviews with applicants that might have had more of a chance 2-3 years ago--especially Caribbean grads with no explicit local ties.

3 USMDs didn't match psych...they must've had serious red flags...

More likely just kind of mediocre, not as compelling as the new, better applicants, and possibly not willing to apply or rank widely enough?

 

[Blitz2006]

As PDs we're just all shaking our heads. Subjectively, we all felt that we saw a stronger pool of applicants this year, and clearly more US MD & DO seniors than past years--but there was a sense that we were all interviewing the same people. (Of course, it's not 'legal' for us to ask where else they are applying...so we kind of have to guess, and share match rosters with our friends regionally.)


Not sure what you mean by 'less aggressive'--personally we ranked all of our interviewees that we were willing to have in our program, but we did decline a LOT of interviews with applicants that might have had more of a chance 2-3 years ago--especially Caribbean grads with no explicit local ties.


More likely just kind of mediocre, not as compelling as the new, better applicants, and possibly not willing to apply or rank widely enough?

I was actually referring to your comment in another thread, where you state that unfilled spots is not really a measure of competitiveness, but how 'risk averse' PDs are with their rank lists.. Or maybe Macdonald Triad made that comment? My bad if I'm mistaken.

Regardless, I still feel 4 unfilled spots is somewhat of a marker of a change of tide for our field..

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[Seroquel]

3 USMDs didn't match psych...they must've had serious red flags...

One of them had to repeat internal medicine, but the other two had no serious red flags. Probably a combination of not ranking enough and not applying broadly. Still, our psych coordinator was very surprised.

 

[OldPsychDoc]

I was actually referring to your comment in another thread, where you state that unfilled spots is not really a measure of competitiveness, but how 'risk averse' PDs are with their rank lists.. Or maybe Macdonald Triad made that comment? My bad if I'm mistaken.

Regardless, I still feel 4 unfilled spots is somewhat of a marker of a change of tide for our field..

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That was McTriad--but unfilled spots has been in single digits every year since I've been a PD--so I guess we're a pretty risk-averse group. (We are.)

 

[Blitz2006]

According to table 7, over the past few years there have been 11, 14, 31 and 15 unfilled spots...thats why I'm impressed with this 4 number this year.



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[OldPsychDoc]

According to table 7, over the past few years there have been 11, 14, 31 and 15 unfilled spots...thats why I'm impressed with this 4 number this year.
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Ah--I see where you got that.
I believe that the actual availability was much less that those numbers each year though.
And 4...that might as well be zero if you go unmatched.

 

[thepoopologist]

My podunk program in the middle of nowhere matched strong candidates split evenly between USMD and USDO schools. The top top candidates that I saw during the interview/audition season had Step 1/2 scores in the 240s to 260s. The majority had grades and scores at or above the mean. It really looked different this year

 

[Drrrrrr. Celty]

My podunk program in the middle of nowhere matched strong candidates split evenly between USMD and USDO schools. The top top candidates that I saw during the interview/audition season had Step 1/2 scores in the 240s to 260s. The majority had grades and scores at or above the mean. It really looked different this year

Kind of terrifying lol.

 

[sloop]

More people than I expected at my school did not get their top choice. I did, which I was very happy about. On the other hand, despite not all getting their top choice, exactly the people I expected to do so matched at great programs. My overall impression is that psych is not a "pulse to match" field like perhaps it was in the past, but U.S. applicants with decent apps won't have trouble.

 

[liquidshadow22]

Are there currently 4 unfilled positions or was this pre-SOAP?

 

[FlowRate]

Psychiatry: 1495 positions, 1067 seniors applying, 923 matched. That doesn't mention how many were applying to more than one specialty. I'd imagine the vast majority of US seniors without serious red flags will have no issue matching into the specialty.

Compare that to prelim and transitional positions, which have combined <3000 positions and >3000 unique applicants.

 

[TheaterOfTheme]

Psychiatry: 1495 positions, 1067 seniors applying, 923 matched. That doesn't mention how many were applying to more than one specialty. I'd imagine the vast majority of US seniors without serious red flags will have no issue matching into the specialty.

Compare that to prelim and transitional positions, which have combined <3000 positions and >3000 unique applicants.

Is that Allopathic seniors only?


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[OldPsychDoc]

Is that Allopathic seniors only?


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Correct--these reports don't include osteopathic seniors for some reason--and there's been huge growth in those applicants as well, further squeezing out IMGs.

 

[Mad Jack]

As a DO with stats around the mean, I'm really pondering how to process this... There's a swath of programs that are lower-tier in the Northeast that I'm fine applying to, but now I'm like, "do I take Step 2 if my Step 1 is already solid? Do I apply to 30 programs? 40? 50?" I just want to stay close to home, and the match is getting more and more intimidating each year.

 

[billybb]

I'm pretty sure some people will be saying that psych has not become competitive at all compared to the past again (I've seen the argument go on and on in this forum), but it is evident that it has indeed become competitive. The stats prove it, and NRMP explicitly mentioned it in one of their three bullet points.

 

[Blitz2006]

I'm pretty sure some people will be saying that psych has not become competitive at all compared to the past again (I've seen the argument go on and on in this forum), but it is evident that it has indeed become competitive. The stats prove it, and NRMP explicitly mentioned it in one of their three bullet points.

But it also important not to create "hysteria" either. The point of these discussions is to illustrate the relativeness of competition. U.S MDs no longer can walk into a Top 10 program, but they still shouldn't have a problem matching into a program if they apply widely/"smartly". US DOs should also not have a problem matching if they apply widely. The people who should be concerned are US MD/DO with red flags, IMG, FMGs, etc.

 

[splik]

I'm pretty sure some people will be saying that psych has not become competitive at all compared to the past again (I've seen the argument go on and on in this forum), but it is evident that it has indeed become competitive. The stats prove it, and NRMP explicitly mentioned it in one of their three bullet points.

The said nothing of the sort. They said:

• Psychiatry offered 1,495 first-year positions, 111 more than in 2016, and filled all but four. The overall fill rate was 99.7 percent, and 61.7 percent were filled by U.S. seniors. Since 2012, the number of Psychiatry positions has increased 378, or 34 percent, and the number of positions filled by U.S. allopathic seniors has increased by 307.

This indicates quite clearly that the expansion of psychiatry residency positions has kept ahead of the number of US allopathic seniors matching into psychiatry by a comfortable margin. 61.7% of positions filled by US seniors vs 61.4% in 2016.

There are of course more US allopathic and osteopathic students than in the past given the proliferation of new schools and expansion of class size. There has been a disproportionate number of these going into psychiatry. I do believe that psychiatry is somewhat more attractive than in the past, as the millenials are more interested in lifestyle, med schools are selecting more wooly/touchy feely students, and remuneration has increased significantly in recent years. More people are double applying, and psychiatry has become a popular backup among a small proportion of students applying to competitive lifestyle specialties. But most medical students would not consider a career in psychiatry. This is not going to change. Psychiatry is not a competitive specialty and never will be. But it is certainly more attractive than it was in the past, particular compared to the 1990s when many programs closed or reduced their numbers because they could not attract residents. It is definitely more difficult for IMGs than it was when I applied for residency.

 

[On Walden Pond]

... This is not going to change. Psychiatry is not a competitive specialty and never will be. But it is certainly more attractive than....

Never say never. The rise of the Millenials will find psychiatry to be an oasis in an otherwise stressful, bloody, and wearisome world.

 

[OldPsychDoc]

The said nothing of the sort. They said:

• Psychiatry offered 1,495 first-year positions, 111 more than in 2016, and filled all but four. The overall fill rate was 99.7 percent, and 61.7 percent were filled by U.S. seniors. Since 2012, the number of Psychiatry positions has increased 378, or 34 percent, and the number of positions filled by U.S. allopathic seniors has increased by 307.

This indicates quite clearly that the expansion of psychiatry residency positions has kept ahead of the number of US allopathic seniors matching into psychiatry by a comfortable margin. 61.7% of positions filled by US seniors vs 61.4% in 2016.

There are of course more US allopathic and osteopathic students than in the past given the proliferation of new schools and expansion of class size. There has been a disproportionate number of these going into psychiatry. I do believe that psychiatry is somewhat more attractive than in the past, as the millenials are more interested in lifestyle, med schools are selecting more wooly/touchy feely students, and remuneration has increased significantly in recent years. More people are double applying, and psychiatry has become a popular backup among a small proportion of students applying to competitive lifestyle specialties. But most medical students would not consider a career in psychiatry. This is not going to change. Psychiatry is not a competitive specialty and never will be. But it is certainly more attractive than it was in the past, particular compared to the 1990s when many programs closed or reduced their numbers because they could not attract residents. It is definitely more difficult for IMGs than it was when I applied for residency.

Again--I'd like to see how that 39.3% broke down by DO seniors vs. US Citizen IMGs vs. FMGs this year. I really suspect that DO percentage is significantly larger this year.

 

[Blitz2006]

Never say never. The rise of the Millenials will find psychiatry to be an oasis in an otherwise stressful, bloody, and wearisome world.

Psychiatry is just as stressful as other specialities, in a different way. Hours may be better, but that doesn't mean the stress is less.

Psychiatry will become more competitive in my opinion as it continues to evolve as more of an integrated speciality with other specialities.

Anecdotally, I've had many students decide on psych past few years because they were pleasantly surprised that it is possible to integrate medical knowledge in settings such as CL, geriatrics.

I keep saying it over and over again, but psych is not as competitive as it should be because it is poorly taught and exposed in medical school. 4 weeks in an inpatient unit is not representative of a career in psychiatry...

And as aforementioned, the number of medical students is growing. So the fact that specialties such as anesthesia and medicine are declining in US MD while others like PMR and Psych are growing is an indication of which way the tides are turning.

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[SixStringPsych]

Psychiatry is just as stressful as other specialities, in a different way. Hours may be better, but that doesn't mean the stress is less.

Psychiatry will become more competitive in my opinion as it continues to evolve as more of an integrated speciality with other specialities.

Anecdotally, I've had many students decide on psych past few years because they were pleasantly surprised that it is possible to integrate medical knowledge in settings such as CL, geriatrics.

I keep saying it over and over again, but psych is not as competitive as it should be because it is poorly taught and exposed in medical school. 4 weeks in an inpatient unit is not representative of a career in psychiatry...

And as aforementioned, the number of medical students is growing. So the fact that specialties such as anesthesia and medicine are declining in US MD while others like PMR and Psych are growing is an indication of which way the tides are turning.

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Off topic but are numbers of PM&R really growing? No one went into it from my school. And anesthesia and EM consistently have an avg of 20 students each matching every year


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[Merovinge]

Off topic but are numbers of PM&R really growing? No one went into it from my school. And anesthesia and EM consistently have an avg of 20 students each matching every year
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PM&R is shifting from "You went to med school to be a chiropractor" to "you get paid what to do what and go golfing when!?"

 

[Blitz2006]

Off topic but are numbers of PM&R really growing? No one went into it from my school. And anesthesia and EM consistently have an avg of 20 students each matching every year


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Sure, refer to Table 8.

http://www.nrmp.org/wp-content/uploads/2017/03/Advance-Data-Tables-2017.pdf


PM&R in the past 5 years of US MD % has gone up from 51% to 61% (exactly like Psych, 10% increase from 51).

Meanwhile Anesthesia has gone down from 75% to 67%, 8 point drop. I suspect people are worried about CRNAs? Perhaps job market is not so hot in gas either? I'm not sure.

ER is competitive as well, but has been for the past few years, no real increase in numbers, but steadily difficult to match into.

Psych is only 5 points behind Anesthesia (62% to 67% in US MD).

So yeah, PM&R and Psych are the hottest specialities right now. Lets see if the trend continues. Radiology dropped over 6 years, 2009 to 2015 (Rads has bounced back nicely past 2 years, but nowhere near the level of ROAD it was 10 years ago, this year it was 71% US MD, up from 58% 2 years ago), so I can't see why Psych can continue to increase for the next 2-3 years....and with the baby boomers entering geriatric era, I suspect PM&R will maintain its acceleration and overtake psych.

 

[MidwestMD2015]

This indicates quite clearly that the expansion of psychiatry residency positions has kept ahead of the number of US allopathic seniors matching into psychiatry by a comfortable margin. 61.7% of positions filled by US seniors vs 61.4% in 2016.

I noticed that too, but I was puzzled. Why are so many more positions becoming available in psychiatry (a percentage increase greater than any other specialty), and is that a trend that will continue?

Imagine these stats if the positions HADN'T increased by such big numbers! We'd have a very different situation.

 

[redbandit]

Why has psych become such a hot commodity? Or is this pseudo

 

[splik]

In the past there were a great number of psychiatry positions andmore psychiatry residencies in past but because they could not fill they got rid of them. many positions were eligible for residency funding from medicare because the position exisited before the 1997 cap on funding. The VA has been putting more money into GME too. some local counties have also been putting money into residents for cheap labor and in the hope they will stay in those communities.

one thing to note is the 34% increase mentioned is not all new spots, just positions inthe match. in2012 and before many programs did not participate inthe match or offered positions outside the match. i know that year even good programs like yale and mt sinai offered positions outside the match which would not be reflected in the NRMP figures. from 2013 programs in the match had to be "all in" which significantly increased the positions in the match.

I do expect the number of positions to continue to increase for now. We do need ro churn out mire psychiatrists are we are still below the number of residency positions in the early 1990s and pur workforce is dementing and going senile.

 

[MidwestMD2015]

I do expect the number of positions to continue to increase for now.

The big question, though, is whether or not the increase in positions can keep pace with the increase in graduates and applicants. It wouldn't take much to shift those benchmarks of 'competitiveness'.

Thanks for the historical insight!

I didn't realize that positions that existed before the cap were still eligible for Medicare funding to be 'reconstituted', so to speak. Additionally, though psychiatry does appear to have had a notable increase from the all-in policy, all other specialties had that too...which must mean that psychiatry was 'holding on' to more slots outside of the match than others. I can think of plenty of reasons why that would be good from a program perspective. Lastly, I'm curious how shifting priorities in the federal budget would change anything at the VA for trainees/programs--not sure where the proposed funding increase (4+ billion) for the Dept of Veteran's Affairs would exactly end up.

 

[splik]

tbh I think many of the new positions will struggle to fill and will provide questionable traininh. we are looking at new programs in the middle of nowhere. university of utah is planning on a residency program in pocatello idaho for instance lol. the mountain west states have been wanting to start psych programs for years. Alaska has wanted to create a program too. napa state hospitalwants to resurrect their residency program. I am actually quite concerned about plans to create sh***y programs like this. not a good thing imho

 

[billybb]

The said nothing of the sort. They said:

• Psychiatry offered 1,495 first-year positions, 111 more than in 2016, and filled all but four. The overall fill rate was 99.7 percent, and 61.7 percent were filled by U.S. seniors. Since 2012, the number of Psychiatry positions has increased 378, or 34 percent, and the number of positions filled by U.S. allopathic seniors has increased by 307.

This indicates quite clearly that the expansion of psychiatry residency positions has kept ahead of the number of US allopathic seniors matching into psychiatry by a comfortable margin. 61.7% of positions filled by US seniors vs 61.4% in 2016.

There are of course more US allopathic and osteopathic students than in the past given the proliferation of new schools and expansion of class size. There has been a disproportionate number of these going into psychiatry. I do believe that psychiatry is somewhat more attractive than in the past, as the millenials are more interested in lifestyle, med schools are selecting more wooly/touchy feely students, and remuneration has increased significantly in recent years. More people are double applying, and psychiatry has become a popular backup among a small proportion of students applying to competitive lifestyle specialties. But most medical students would not consider a career in psychiatry. This is not going to change. Psychiatry is not a competitive specialty and never will be. But it is certainly more attractive than it was in the past, particular compared to the 1990s when many programs closed or reduced their numbers because they could not attract residents. It is definitely more difficult for IMGs than it was when I applied for residency.

I don't understand why you are all of a sudden referring to 2016 stats. The trend is definitely shown in the report. 52 -> 62 in both Psych and PMR over the past 5 years. Has any specialty had a higher increase in proportion of US allopathic students? I greatly respect you and the PDs input in this forum, but don't get why you are in such denial that Psych is getting more competitive (not only for IMGs but for all). We're not arguing that Psych is one of the more competitive specialties in Medicine. All we are saying is that it is becoming relatively more competitive than before, and the rate is the fastest among all specialties. I'm happy to see this trend as a psych resident.

 

[MacDonaldTriad]

PMR is a very small fish in the sea. Two more or two less people going into it could change it's % a lot. I still say 61.7% isn't great, but I agree we are headed in a very good direction with a long way to go. Some very good students going into psych didn't match. I would Imagine that some serious reviews of what advice medical students are being given will be coming soon. They will conclude that it isn't just numbers, but variety in geographic flexibility and variety in type of programs.

 

[deleted736562]

Playing the devil's advocate here: the new positions in US medical schools are mostly going to less competitive individuals who would have otherwise gone to Carribean schools so it makes sense that these same individuals would preferentially target less competitive specialties such as psychiatry, FM or PMR.

At the end of the day, the holy grail of competitiveness remains Step 1 scores and third year clerkship grades. Is psychiatry really outpacing other specialties when it comes to these parameters? Not sure.

And as an aside, the obsession with % US seniors is not always healthy. I see it everywhere: non-US IMGs tend to be some of the most driven individuals in all of US medicine in general and have contributed a great share to the diversity and flourishing of psychiatry.

 

[Merovinge]

And as an aside, the obsession with % US seniors is not always healthy. I see it everywhere: non-US IMGs tend to be some of the most driven individuals in all of US medicine in general and have contributed a great share to the diversity and flourishing of psychiatry.

Yes and no. Presently I think more yes than no, historically probably more no than yes (I say this as a minority member who grew up in the states and has had a tremendous amount of interaction with non-US MDs in my time in medicine). When folks come who barely speak English much less interact with american culture and choose psychiatry it's not to raise diversity or flourish the field; it's because it was all they could get into except IM/FM and felt it was easier work. I think the field getting more competitive will only help to ensure the IMGs are the kind you are referring too. Further, ours is certainly a field that heavily benefits from having providers who know the culture they are working in so I think many will always be pleased to see the rate rising.

 

[MacDonaldTriad]

I agree that scores and clerkship grades are better than %US grads. I also agree that there are well motivated smart IMGs who will outperform a majority of US grads. I also agree that some PDs have an unfounded bias against IMGs. I also point out that open minded PDs are also painfully aware that the greatest bias against IMGs exists among the competitive US applicants who pay close attention to how many IMGs are in programs.

 

[SmallBird]

I also point out that open minded PDs are also painfully aware that the greatest bias against IMGs exists among the competitive US applicants who pay close attention to how many IMGs are in programs.

People who use that metric are idiots.

MGH matched an IMG in psych this year.

Johns Hopkins General Surgery program has several IMGs.

There are some truly malignant psych programs that try and recruit a lot of IMGs and treat them poorly. Avoid those. But if you are going to choose between two strong programs based on who has fewer IMGs you are making a mistake.

 

[OldPsychDoc]

People who use that metric are idiots.
...
There are some truly malignant psych programs that try and recruit a lot of IMGs and treat them poorly. Avoid those. But if you are going to choose between two strong programs based on who has fewer IMGs you are making a mistake.

You're right, of course. But all of those MS3s browsing program websites right now don't care. Just a sad fact.

 

[Blitz2006]

You're right, of course. But all of those MS3s browsing program websites right now don't care. Just a sad fact.

I agree that scores and clerkship grades are better than %US grads. I also agree that there are well motivated smart IMGs who will outperform a majority of US grads. I also agree that some PDs have an unfounded bias against IMGs. I also point out that open minded PDs are also painfully aware that the greatest bias against IMGs exists among the competitive US applicants who pay close attention to how many IMGs are in programs.

Exactly.

This is why US MD% is a good indicator of a competitiveness of a specialty, whether or not you agree is subjective.

 

[zyxab]

You're right, of course. But all of those MS3s browsing program websites right now don't care. Just a sad fact.

Maybe that's true of the less enlightened MS3's, but I'm not sure why you'd want to work with such people in the first place. (I'm not picking on you in particular, I understand this is how the vast majority of PD's think.)

 

[Blitz2006]

Playing the devil's advocate here: the new positions in US medical schools are mostly going to less competitive individuals who would have otherwise gone to Carribean schools so it makes sense that these same individuals would preferentially target less competitive specialties such as psychiatry, FM or PMR.

At the end of the day, the holy grail of competitiveness remains Step 1 scores and third year clerkship grades. Is psychiatry really outpacing other specialties when it comes to these parameters? Not sure.

And as an aside, the obsession with % US seniors is not always healthy. I see it everywhere: non-US IMGs tend to be some of the most driven individuals in all of US medicine in general and have contributed a great share to the diversity and flourishing of psychiatry.

I agree, Step 1 scores are an excellent marker. But unfortunately we won't have those stats until 2018 charting outcomes. So for now US MD% is best marker. I disagre with your statement on obsession with US MDs. While subjectively you may be right about non-US IMGs being driven, etc., the reality is exactly what Macdonald triad and OldPsychDoc stated above, which in turns makes US MDs more "valuable" to a program, even if he/she has inferior stats to an IMG...

 

[Blitz2006]

People who use that metric are idiots.

MGH matched an IMG in psych this year.

Johns Hopkins General Surgery program has several IMGs.

There are some truly malignant psych programs that try and recruit a lot of IMGs and treat them poorly. Avoid those. But if you are going to choose between two strong programs based on who has fewer IMGs you are making a mistake.

Sure, but from my research, most of the time the IMGs that match into these programs are "super stars" (Have a PhD, 20 publications, spent 3 years in a lab etc.), and only further confirming the stigma towards IMGs. Whereas the co-resident of the IMG that is US MD did the bare minimum and still got the same spot.

I'm not saying this is true of your 2 examples, but I'm generalizing on what I've observed.

 

[zyxab]

I agree, Step 1 scores are an excellent marker. But unfortunately we won't have those stats until 2018 charting outcomes. So for now US MD% is best marker. I disagre with your statement on obsession with US MDs. While subjectively you may be right about non-US IMGs being driven, etc., the reality is exactly what Macdonald triad and OldPsychDoc stated above, which in turns makes US MDs more "valuable" to a program, even if he/she has inferior stats to an IMG...

Charting outcomes 2016 came out just last year and there's no indication that Psych was significantly more competitive this year than last. In case you missed it, Psych has the second lowest Step 1 average. I'm sorry for being antagonistic but it kind of seems like you get off on the prospect of IMG's/DO's/etc. being locked out of their dream specialty.

 

[Blitz2006]

Charting outcomes 2016 came out last year and there's no indication that psychiatry was significantly more competitive this year than last. In case you missed it, Psych has the second lowest Step 1 average. I'm sorry for being antagonistic but it kind of seems like you get off on the prospect of IMG's/DO's/etc. being locked out of their dream specialty.

?

In the past 5 years US MD has gone up from 52 to 62%. Therefore, DO + IMG has gone down from 48 to 38%, right? I never said IMGs/DOs will be "locked out", its just relatively getting more difficult (Unlike other specialties where US MD% is stable or dropping).

USMLE scores are a good marker to compare between specialities within a group, such as US MD Psych vs. US MD Anesthesia, or IMG Psych vs. IMG Anesthesia.

 

[zyxab]

?

In the past 5 years US MD has gone up from 52 to 62%. Therefore, DO + IMG has gone down from 48 to 38%, right? I never said IMGs/DOs will be "locked out", its just relatively getting more difficult (Unlike other specialties where US MD% is stable or dropping).

USMLE scores are a good marker to compare between specialities within a group, such as US MD Psych vs. US MD Anesthesia, or IMG Psych vs. IMG Anesthesia.

Two sides of the same coin. By saying the higher the USMD% the better, you're also saying the lower the IMG/DO% the better. It shouldn't surprise you that this ruffles the feathers of some IMGs/DOs and those who sympathize with them.

In regards to your latter statement about Step 1 scores, I agree that they're a good marker of competitiveness, which puts Psych in the category of not all that competitive. (My point in the last post was that the Step 1 average reported in Charting Outcomes 2016 IS a good indicator of the current Step 1 average as there is no evidence that the competitiveness of Psych has significantly increased since last year.)

 

[FlowRate]

I don't understand why you are all of a sudden referring to 2016 stats. The trend is definitely shown in the report. 52 -> 62 in both Psych and PMR over the past 5 years. Has any specialty had a higher increase in proportion of US allopathic students? I greatly respect you and the PDs input in this forum, but don't get why you are in such denial that Psych is getting more competitive (not only for IMGs but for all). We're not arguing that Psych is one of the more competitive specialties in Medicine. All we are saying is that it is becoming relatively more competitive than before, and the rate is the fastest among all specialties. I'm happy to see this trend as a psych resident.

No, but that's a very silly argument. You wouldn't expect derm to go from 85% -> 95% or whatever. Psych's score averages have only kept pace with score inflation.

Yes and no. Presently I think more yes than no, historically probably more no than yes (I say this as a minority member who grew up in the states and has had a tremendous amount of interaction with non-US MDs in my time in medicine). When folks come who barely speak English much less interact with american culture and choose psychiatry it's not to raise diversity or flourish the field; it's because it was all they could get into except IM/FM and felt it was easier work. I think the field getting more competitive will only help to ensure the IMGs are the kind you are referring too. Further, ours is certainly a field that heavily benefits from having providers who know the culture they are working in so I think many will always be pleased to see the rate rising.

People who use that metric are idiots.

MGH matched an IMG in psych this year.

Johns Hopkins General Surgery program has several IMGs.

There are some truly malignant psych programs that try and recruit a lot of IMGs and treat them poorly. Avoid those. But if you are going to choose between two strong programs based on who has fewer IMGs you are making a mistake.

Exactly, there is a very wide range of IMG's. I know an IMG who matched ortho surgery at MGH. He was a complete baller. We want that sort of IMG.

 

[deleted736562]

It shouldn't surprise you that this ruffles the feathers of some IMGs/DOs and those who sympathize with them.

As an IMG, I personally don't feel offended by this discussion at all. But I really think IMG doctors contribute a lot to the field, maybe sometimes because of coming from a different cultural background and they tend to be really motivated given the tough odds of landing a match. Many leaders in psychiatry and other fields of medicine have an IMG background, and they didn't really have 10 pubs prior to landing a spot or matched into MGH. That was supposed to be an aside, as it is true that %US Seniors is one measure of competitiveness, but given the increase of spots in US medical spots, I'm really not convinced that the increase in % in psychiatry implies increase of competitiveness.

 

[SmallBird]

You're right, of course. But all of those MS3s browsing program websites right now don't care. Just a sad fact.

I don't believe that. I think that most MS3's are wary of a program that has a predominance of IMG's, which is reasonable. There may be a subset of MS3's who would prefer a program with zero IMG's to a program with 3 or 4 across the years but my point is that that would be stupid, and would imply that Colorado has been the best residency for a long time because they haven't taken IMG's when other prestigious places have. Likewise, it is reasonable for a program director to aim to have several US-MD's as they make up the bulk of the applicant pool, but not reasonable to avoid having any IMG's because of perceived impacts on prestige.

Exactly, there is a very wide range of IMG's. I know an IMG who matched ortho surgery at MGH. He was a complete baller. We want that sort of IMG.

And the presence of that IMG should not make anybody less interested in that residency.

 

[Blitz2006]

No, but that's a very silly argument. You wouldn't expect derm to go from 85% -> 95% or whatever. Psych's score averages have only kept pace with score inflation.

Right, and people keep forgetting that there are specialties that are not keeping pace with growth of residency spots/medical student applicants. Of course, no one is expecting Ortho/Derm to go from 88% to 98%, but what about Peds/Path/IM/FM from 2013 to 2017 for US MD%?

Path: 45% to 36%
Peds: 70% to 68%
IM: 50% to 45%
Anesthesia: 75% to 68%
FM: 45% to 45%
ER: 82% to 78%
OBGYN: 76% to 81%

So comparatively, what PMR and Psych has achieved is decent.

And this isn't meant to "offend" any group of applicants. The point of SDN is to provide informative, objective data to help future applicants apply wisely and appropriately and avoid crisis of going unmatched. I never said that IMGs are better than DOs or US MD is better than IMGs as physicians.

If you believe you can match into Derm with 2 failed USMLE steps then go for it.