Residency Interviews - The Numbers

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PathDoctor

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The typical residency program received 904 applications for the 2018 Match. Programs immediately rejected 48% of those applications based on a “standardized screening process.” Of the applications reviewed in-depth, programs only sent out 121 interview requests. Of those who interviewed, only 82 were actually ranked. A fraction of those ranked actually matched at a given program.

What do the numbers tell us? The first thing you’ll notice is how important Step 1 is. Virtually every single program requires that you take it. Even more, when you drill down into the data, about 2/3 of all programs said they have a target score for their Step 1 exam.
Why would Step 1 be so important? An obvious reason is that programs need a way to compare vast numbers of students on an equivalent basis. As stated before, programs only offer ~13% of all applicants an interview. Of the 1,208 programs who responded, 736 (61%) stated that there was a score under which they generally don’t grant interviews. The mean cutoff score? A Step 1 score in the 210s.
Conversely, 623 (52%) stated that there was a score above which they would generally invite applicants to an interview. In other words, many programs will give you an invite based off a high Step 1 score alone. The magic score? The mean was in the 230s. (Note that the spread was broad, ranging from about 220 for the 25%ile to 240 for the 75%ile).
If you’re below a program’s Step 1 cutoff, your extracurriculars won’t matter. It won’t matter how many committees you served on, doctors you shadowed, or times you volunteered at the free clinic.
Have you ever told yourself, to stand out, you need to do more than “just study for Step 1.” If you’re mastering the material and learning how to apply it, then by all means start doing research. However, be careful that you’re not doing these things INSTEAD of studying for Step 1. Many people hope to do well on Step 1 AND excel at other things. Yet, by spreading themselves too thin, they end up struggling at everything.
This squared with my experiences. When I applied, I had only taken Step 1, and had scored 270. Despite not having taken Step 2 CK or CS, all but one program I applied to granted an interview.
Getting an interview is important. Being among the first to receive an invitation – to secure your preferred dates – is equally important. On the strength of my Step 1 score, I received my first-choice date at all my interviews. I grouped all my interviews together by location. This saved time, money, and hassle. I completed all my California interviews within two weeks. I bought a one-way ticket to New York, and had all 4 of my New York interviews within the same week. Then I took the bus to Boston and had all 4 of my Boston interviews the week after that. My last interview was December 13, before most programs had seen half their interviewees.
The take-away? Don’t sacrifice your Step 1 preparations in trying to stand out with extracurriculars.
 
This may be field dependent, but for Derm, the New York city programs for the most part all clustered their interviews during the same week on purpose for the reason you said. I interviewed at NYU, Cornell, and Einstein all during the same week.

Another reason that Step scores are important is that it is thought to be an indication on future board performance. If a resident from a program fails Boards, the program is watched. If a program has a certain % of failures over a 5 year period, then the program starts to have issues from above.

If the program is small, they want to be sure they pick the people with great step scores (and hopefully great personalities and work ethic) so that those board failures don't occur since it doesn't take as many failures to get to that % fail rate.

I find that people often seem to overlook this concept when they put out the "Steps scores shouldn't matter" argument, instead just attaching the screening principle to narrow down the field to argue how it's 'not fair'. :'(

It's used to narrow down the field, but it's also used to hopefully maintain the pass rate on boards for a program.

I'm sure someone will post something about how it has never been proven that there is a correlation between steps and passing boards. Whatever, I don't make the rules.
 
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The "fraction of those who were ranked actually matched into a program" part is idiotic. Yes, of course only SOME fraction of those people who were ranked matched into a specific program. That's the way the match works...it's not like college applications. Programs can't take all of the people they rank. So if a specific program fills before they get to you in a rank list, then yeah you won't match there. However, as the algorithm works it's way down and more and more applicants get matched to programs, you become more likely to match SOMEWHERE as other people get taken out of the pool for all other programs.

A better metric to look at would be "how many interviews do I need for myself individually to match anywhere in this speciality"? Charting the Outcomes measures this metric in "number of consecutive ranks vs probability of matching", which gives a good idea of how many interviews you have to go to (thus how many places you need to rank) to get to a 50%, 70%, 90%, etc chance of matching overall. As you can see from charting the outcomes, once you get over a handful of interviews in most specialities, your chances of matching overall shoot up pretty drastically.
 
This post doesn't strike me as revealing any particularly new information.

What's more, it's very location and specialty dependent.
 
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