exmike

NOR * CAL
10+ Year Member
15+ Year Member
May 19, 2003
4,206
10
251
40
Bay Area
Status
Fellow [Any Field]
Forgive me for being less than informed about this because I'm an upcoming MS1.

I've been looking at match lists for the last few years and have noticed an interesting trend.

It seems like the "top tier" schools are matching increasingly disproportionate numbers of students to specialties which from the ladder theory would mean that students at "lower tier" (esp. offshore) schools are being pushed progressively towards primary care residencies (IM + FP)

Is this just a wholesale move away from primary care (which i assume is part of it), or is it that as most students move towards specialties, inevitably the top schools will get the lions share of those slots.
 

punjabiMD

10+ Year Member
15+ Year Member
Aug 4, 2002
167
0
241
Scottsdale, AZ
Status
Attending Physician
I believe this is the ongoing cycle of specialy demand in work.
Some specialties are starting to become saturated, so there's a trend where applicants will need to be from a more competitive school to make the match.
On the other side, primary care/FP is undergoing a huge rise in demand (b/c of the huge popularity in specializing over the past years) so a lot of people are going into it.

This is one reason why, when recent undergrad pre-med applicants interview at schools, the "thing" to say when asked "what field do you plan to go into?" was "I plan to go into primary care."

I've been told however, that those of us who decide to (sub)specialize (which entails, in most cases, more years of post-grad training), by the time we are ready to practice, the FP/PC fields will be close to saturated and the specialties will again be in high demand.

It cycles like this over and over.
 

punjabiMD

10+ Year Member
15+ Year Member
Aug 4, 2002
167
0
241
Scottsdale, AZ
Status
Attending Physician
oh, and about the FMGs, it seems that there has always been (at least maybe for the last 10-15 years) a bias against them in the specialties, especially at larger, more competitive, academic residencies.

Many extremely intelligent FMGs I know have told me that w/o a U.S. M.D. degree, you can forget about getting into a top-tier program.
 

lkjh

Junior Member
15+ Year Member
Mar 21, 2004
7
0
0
Visit site
Status
Most of the top medical schools are part of large academic institutions that use tertiary care centers as teaching hospitals. There is often minimal exposure to primary care/outpatient. In a place when hypertension gets a renal consult, hematuria gets a urology consult, and any rash gets a derm consult, it often seems more obvious to go into a spcialty than it does to go into PC. There are obviously other reasons, but this is one of them.
 

Bevo

Radiology, R1
7+ Year Member
15+ Year Member
Jan 27, 2002
1,630
2
0
41
in hell
Status
Resident [Any Field]
regarding FMGs:

we're excluded from some top tier programs and really comptitive residencies but the walls aren't solid.

We had someone go into orthopedic surgery last year.

Someone matched into Medicine at Mayo last week and into Urology.

Its not common, but its certainly not impossible. And we get scatterings into radiology, anesthesiology, EM, etc.

Dont know about the quality of the programs though.

Residencies: I think that spots that are popular are those that provide the best money/per lifestyle.

thats why things like Derm are always popular.

I think PM&R might be a more popular residency in the future (at least from what I understand about the lifestyle).

Anesthesiology is very cyclical I believe. A few years ago it was very easy to get into. Now its a bit harder. Same with surgery.
 

Mr. Rosewater

Senior Member
7+ Year Member
15+ Year Member
Dec 18, 2003
796
0
0
erf
Visit site
Status
Originally posted by lkjh
Most of the top medical schools are part of large academic institutions that use tertiary care centers as teaching hospitals. There is often minimal exposure to primary care/outpatient. In a place when hypertension gets a renal consult, hematuria gets a urology consult, and any rash gets a derm consult, it often seems more obvious to go into a spcialty than it does to go into PC. There are obviously other reasons, but this is one of them.

I just wanted to say that i think this a very interesting point. thanks for sharing.