Resident ITE scores have plummeted 25% in the last 5 years

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EM lost its competitiveness years ago. Remember 500+ unmatched spots?

EM went from 99.6% US MD match to mid 40s. Now second highest IMG match after FM if I recall correctly, somewhere around 15%.

EM lost all of the good test takers and most of those who could work hard to achieve a good score. I just noticed the current pgy-1 score of 50%. Whoa. Like, are they even studying these days? Apparently not. Wild.
 
Emapp20177 said:
EM lost its competitiveness years ago. Remember 500+ unmatched spots?

EM went from 99.6% US MD match to mid 40s. Now second highest IMG match after FM if I recall correctly, somewhere around 15%.

EM lost all of the good test takers and most of those who could work hard to achieve a good score. I just noticed the current pgy-1 score of 50%. Whoa. Like, are they even studying these days? Apparently not. Wild.
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Certain people will roast you for pointing out the most obvious and easy ways to see how competetive a specialty is. Now no step 1 score reporting.. why would anyone try hard. Plenty of med schools are pass / fail also.
 
This is fake news. As an EM program director, I receive the ITE ABEM data reports on national means/medians every year. The values quoted in this article for 2025 ITE national data is dead wrong. I have already reached out to the author and physician editors requesting they print a retraction.

As physician scientists, if we see a sudden unexplained drop in a data point like this, the first thing we should all be doing is going back to the source data to ensure it is correct. In this case, it is not.
 
em_PD_philly said:
This is fake news. As an EM program director, I receive the ITE ABEM data reports on national means/medians every year. The values quoted in this article for 2025 ITE national data is dead wrong. I have already reached out to the author and physician editors requesting they print a retraction.

As physician scientists, if we see a sudden unexplained drop in a data point like this, the first thing we should all be doing is going back to the source data to ensure it is correct. In this case, it is not.
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Maybe the author got it wrong because they're a recent graduate and got a subpar residency experience...
 
EctopicFetus said:
Isnt this always the answer when someone fails. It is never their fault is is always bias, too random etc. Listen the test when i took it was dumb, had some weird questions etc. Meanwhile I passed.. as did 90% of other EM trained people. The test isnt harder.. the docs are dumber.
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The national ITE data quoted in the article is wrong.
 
DocEspana said:
I skipped a bunch of responses (ADHD hitting *hard* tonight). Did we have any clear theories on why it suddenly went from a 1-2% score drop yearly to a 13% drop in average score suddenly? Also that it dropped across the board, so its not like the 2025 entering class is stupid - because its 2nd and 3rd years ****ing up too.

was the test suddenly unusually hard? Did AI just sap everyone of their ability to study? Did the downstream effects of covid during the first year of medical school finally present themselves in the current intern class?
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it didn't drop suddenly - the data quoted is wrong.
 
em_PD_philly said:
it didn't drop suddenly - the data quoted is wrong.
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IDK if its disappointing or reassuring to hear its wrong.

Im noticing youre saying it didnt drop suddenly... did it drop a similar amount just more evenly? Or a notably smaller amount overall (thus likely without that one year mega drop)
 
em_PD_philly said:
Please see my post below. The national median ITE scores quoted in this piece are incorrect. As a PD, I receive the national reports every year. Irresponsible reporting.
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Are you willing to post the data to prove your point?

I'm genuinely interested in seeing it. Would be very interesting if the report was fake news.
 
HemorrhagicShock said:
Are you willing to post the data to prove your point?

I'm genuinely interested in seeing it. Would be very interesting if the report was fake news.
Click to expand...
Ask your program director. They can give you the correct numbers. There was a modest decline orders of magnitude less than what was quoted in the article. The author and publication has been made aware.
 
I don't have PD access to an original copy of ABEM's ITE scores list but regardless of the specific numbers there has been a drastic reduction in the most recent ABEM QE scores over the past 5 years from 92% to 82% graduates passing the exam. The ABEM test results are openly published online so its undeniable that recent residency graduates have done much worse on exams. I'll add that if the article had wrongly reported the numbers there's literally nothing stopping anyone from posting the numbers since its not private information and its easy to post the exam scores.
 
alpinism said:
I'll add that if the article had wrongly reported the numbers there's literally nothing stopping anyone from posting the numbers since its not private information and its easy to post the exam scores.
Click to expand...

Was wondering about that

Trying my hardest not to make Epstein files-esque "I have the files, it's right here but you can't see them" jokes when this supposed PD is like "the data is wrong, but I can't show you"
 
AlmostAnMD said:
Was wondering about that

Trying my hardest not to make Epstein files-esque "I have the files, it's right here but you can't see them" jokes when this supposed PD is like "the data is wrong, but I can't show you"
Click to expand...
Samw. Is this actually 'Big ABEM' trying to sway the conversation?
 
When we receive the scores from ABEM, they stipulate that we cannot share data externally. Anyone at a residency program can ask their PD who can verify that I am in fact correct.

I expect EMNews will be printing a retraction shortly.
 
em_PD_philly said:
When we receive the scores from ABEM, they stipulate that we cannot share data externally. Anyone at a residency program can ask their PD who can verify that I am in fact correct.

I expect EMNews will be printing a retraction shortly.
Click to expand...

You’re not allowed to post the individual scores but it’s fine to post the median scores.

There’s a whole thread with all the ITE scores from previous years.

ABEM ITE scores
 
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WhatJobDoIPick said:
I mean who cares if it's factual or not.

Doesn't change the fact that this field has become bottom barrel IMG at best. Hell, even good IMGs can get into Ortho.
Click to expand...

Exactly.

It's painful to hear that it's becoming popular again too. However, at this point, any medical student who is choosing EM knows what the sentiment is among attending physicians who have been doing it for a while.

There are stories and warnings across all social media that span decades, and I even recall EM attendings trying to warn me against it while I was on rotation.

Thus any medical student choosing EM now deserves their outcome. I genuinely wish them the best; they'll need it.
 
The only possible silver lining of EM tanking over the last couple of years, is that the supply/demand mismatch for competent docs should still keep the locums market hot. Not sure the newer grads like to grind hard shifts, drive far, or deal with s****y EMRs, etc. It feels like where pre-covid the job market was saturated in my area, it is slightly turning over again.

Factoring in all the new FSEDs in the mix over the last several years, there are more jobs than before. I also think the attrition rate is higher and people exit the field earlier. Maybe, MAYBE EM can go through a resurgence like anesthesia is going through compared to 6-10 years ago, but for us like 3-5 years from now? I just don't see how these small rural hospitals staff their EDs without subsidizing it massively just like they pay their surgeons, and other proceduralists. The only real losers will be docs stuck in desirable locations but that has always been the case.
 
This is just the story of late-stage capitalism, right? Brand/company slowly builds credibility and clout through intense focus on quality control and efforts to gain a monopoly on the market. Once monopoly is obtained, thoughts turn to maximizing profit through rapid expansion and a de-emphasis on quality. Loss of initial mission and (often) leadership combined with need for funding the rapid expansion leads to private equity involvement. PE involvment then creates an entire class of people in the brand/company whose goals no longer align with the original mission of the company. Brand/company slowly devolves into creating the least expensive/worst version of the product that still brings profit.
 
Arcan57 said:
This is just the story of late-stage capitalism, right? Brand/company slowly builds credibility and clout through intense focus on quality control and efforts to gain a monopoly on the market. Once monopoly is obtained, thoughts turn to maximizing profit through rapid expansion and a de-emphasis on quality. Loss of initial mission and (often) leadership combined with need for funding the rapid expansion leads to private equity involvement. PE involvment then creates an entire class of people in the brand/company whose goals no longer align with the original mission of the company. Brand/company slowly devolves into creating the least expensive/worst version of the product that still brings profit.
Click to expand...

Goddam

what a great summary

sad but great
 
Arcan57 said:
This is just the story of late-stage capitalism, right? Brand/company slowly builds credibility and clout through intense focus on quality control and efforts to gain a monopoly on the market. Once monopoly is obtained, thoughts turn to maximizing profit through rapid expansion and a de-emphasis on quality. Loss of initial mission and (often) leadership combined with need for funding the rapid expansion leads to private equity involvement. PE involvment then creates an entire class of people in the brand/company whose goals no longer align with the original mission of the company. Brand/company slowly devolves into creating the least expensive/worst version of the product that still brings profit.
Click to expand...

Residency training has become a business with the primary goal of rapidly manufacturing low cost doctors.

Fun Fact about the recent 2025 match:

Number of Ivy League non profit university medical students that matched - 30

Number of Caribbean for profit university medical students that matched - 300
 
Arcan57 said:
This is just the story of late-stage capitalism, right? Brand/company slowly builds credibility and clout through intense focus on quality control and efforts to gain a monopoly on the market. Once monopoly is obtained, thoughts turn to maximizing profit through rapid expansion and a de-emphasis on quality. Loss of initial mission and (often) leadership combined with need for funding the rapid expansion leads to private equity involvement. PE involvment then creates an entire class of people in the brand/company whose goals no longer align with the original mission of the company. Brand/company slowly devolves into creating the least expensive/worst version of the product that still brings profit.
Click to expand...

Other examples: Panera and chipotle.
 
AlmostAnMD said:
omg

I used to get such massive gut-busting burritos from Chipotle
Click to expand...

Interesting tidbit on Chipotle:

“Maybe if Chipotle’s quality was even half of what it was back in 2005, I wouldn’t be writing this. But anyone with taste buds and a memory knows: the prep, the cook methods—hell, the soul of the food itself—has been sharply, systematically ****ified.

I still remember the steak. Back when it was rich, tender, smoky perfection. Back when they used top sirloin. And if they ever had to downgrade to top round (a rare occurrence), they posted signs and apologized. That’s how much they respected you.

Fast forward to now? They’re shoveling in beef shoulder clod, and hoping you’re too busy doomscrolling to notice. Well, I noticed.

Let’s break it down like a butcher would, Kobe beef is 10, shank is a 1:

Top Sirloin (2005–2015): 7.5 to 8 out of 10. Lean, flavorful, tender. Real steak.

Top Round (2015–2018): 6 to 6.5. Slight downgrade, but still legit.

Beef Shoulder Clod (Post-2019): 4 if you're feeling generous. Gristly, fatty, riddled with sinew. Stew beef passed off as premium protein.

And here’s the kicker: the universally despicable shoulder clod has 2–3x the fat, but it’s not the good kind. It’s chewy, connective tissue fat. It’s stringy. It’s textural betrayal in every bite.

Some corporate simps—the “cHiPoTlE wAy” cultists—will call this too harsh, it's just food, blah blah blah. Let me be clear: I speak from a decade in the food industry, wholesale experience, and as a ** former** Chipotle GM that bailed before COVID. I’m not some guy mad about a soggy burrito—I’m someone who watched this brand sell its soul one degraded cut of meat at a time.

This isn’t about store employees AT ALL. Those folks bust their asses daily and don’t get enough credit. This outrage is aimed directly at executive leadership, the ones who made this shameful switch and bet you’d never notice.

And guess what?

You did notice. You just didn’t know why it sucked now.

So here it is: You will NEVER again receive a pre-2018 tier Chipotle entrée—especially not if you're ordering steak. It’s not steak anymore. By butcher’s standards, it’s stew beef. And last time I checked, Chipotle doesn’t serve soup.

Stop lying to yourself. Stop thinking: “Maybe it’s just this store. Maybe this time it’ll be like it used to be.” No—it won’t. It’s dry. It’s rubbery. And if it’s not, then congratulations, you just dodged a mouthful of gristle and regret. No matter how much you trim the steak-like substitute, it can't change the bad base cut!

Chipotle will not change until we make them.”
 
sloh said:
Interesting tidbit on Chipotle:

“Maybe if Chipotle’s quality was even half of what it was back in 2005, I wouldn’t be writing this. But anyone with taste buds and a memory knows: the prep, the cook methods—hell, the soul of the food itself—has been sharply, systematically ****ified.

I still remember the steak. Back when it was rich, tender, smoky perfection. Back when they used top sirloin. And if they ever had to downgrade to top round (a rare occurrence), they posted signs and apologized. That’s how much they respected you.

Fast forward to now? They’re shoveling in beef shoulder clod, and hoping you’re too busy doomscrolling to notice. Well, I noticed.

Let’s break it down like a butcher would, Kobe beef is 10, shank is a 1:

Top Sirloin (2005–2015): 7.5 to 8 out of 10. Lean, flavorful, tender. Real steak.

Top Round (2015–2018): 6 to 6.5. Slight downgrade, but still legit.

Beef Shoulder Clod (Post-2019): 4 if you're feeling generous. Gristly, fatty, riddled with sinew. Stew beef passed off as premium protein.

And here’s the kicker: the universally despicable shoulder clod has 2–3x the fat, but it’s not the good kind. It’s chewy, connective tissue fat. It’s stringy. It’s textural betrayal in every bite.

Some corporate simps—the “cHiPoTlE wAy” cultists—will call this too harsh, it's just food, blah blah blah. Let me be clear: I speak from a decade in the food industry, wholesale experience, and as a ** former** Chipotle GM that bailed before COVID. I’m not some guy mad about a soggy burrito—I’m someone who watched this brand sell its soul one degraded cut of meat at a time.

This isn’t about store employees AT ALL. Those folks bust their asses daily and don’t get enough credit. This outrage is aimed directly at executive leadership, the ones who made this shameful switch and bet you’d never notice.

And guess what?

You did notice. You just didn’t know why it sucked now.

So here it is: You will NEVER again receive a pre-2018 tier Chipotle entrée—especially not if you're ordering steak. It’s not steak anymore. By butcher’s standards, it’s stew beef. And last time I checked, Chipotle doesn’t serve soup.

Stop lying to yourself. Stop thinking: “Maybe it’s just this store. Maybe this time it’ll be like it used to be.” No—it won’t. It’s dry. It’s rubbery. And if it’s not, then congratulations, you just dodged a mouthful of gristle and regret. No matter how much you trim the steak-like substitute, it can't change the bad base cut!

Chipotle will not change until we make them.”
Click to expand...

While the stock has 10x'd in that time. Classic story. This is late-stage capitalism at its finest.
 
sloh said:
Interesting tidbit on Chipotle:

“Maybe if Chipotle’s quality was even half of what it was back in 2005, I wouldn’t be writing this. But anyone with taste buds and a memory knows: the prep, the cook methods—hell, the soul of the food itself—has been sharply, systematically ****ified.

I still remember the steak. Back when it was rich, tender, smoky perfection. Back when they used top sirloin. And if they ever had to downgrade to top round (a rare occurrence), they posted signs and apologized. That’s how much they respected you.

Fast forward to now? They’re shoveling in beef shoulder clod, and hoping you’re too busy doomscrolling to notice. Well, I noticed.

Let’s break it down like a butcher would, Kobe beef is 10, shank is a 1:

Top Sirloin (2005–2015): 7.5 to 8 out of 10. Lean, flavorful, tender. Real steak.

Top Round (2015–2018): 6 to 6.5. Slight downgrade, but still legit.

Beef Shoulder Clod (Post-2019): 4 if you're feeling generous. Gristly, fatty, riddled with sinew. Stew beef passed off as premium protein.

And here’s the kicker: the universally despicable shoulder clod has 2–3x the fat, but it’s not the good kind. It’s chewy, connective tissue fat. It’s stringy. It’s textural betrayal in every bite.

Some corporate simps—the “cHiPoTlE wAy” cultists—will call this too harsh, it's just food, blah blah blah. Let me be clear: I speak from a decade in the food industry, wholesale experience, and as a ** former** Chipotle GM that bailed before COVID. I’m not some guy mad about a soggy burrito—I’m someone who watched this brand sell its soul one degraded cut of meat at a time.

This isn’t about store employees AT ALL. Those folks bust their asses daily and don’t get enough credit. This outrage is aimed directly at executive leadership, the ones who made this shameful switch and bet you’d never notice.

And guess what?

You did notice. You just didn’t know why it sucked now.

So here it is: You will NEVER again receive a pre-2018 tier Chipotle entrée—especially not if you're ordering steak. It’s not steak anymore. By butcher’s standards, it’s stew beef. And last time I checked, Chipotle doesn’t serve soup.

Stop lying to yourself. Stop thinking: “Maybe it’s just this store. Maybe this time it’ll be like it used to be.” No—it won’t. It’s dry. It’s rubbery. And if it’s not, then congratulations, you just dodged a mouthful of gristle and regret. No matter how much you trim the steak-like substitute, it can't change the bad base cut!

Chipotle will not change until we make them.”
Click to expand...

Tell me that you wrote this.
 
sloh said:
Other examples: Panera and chipotle.
Click to expand...
Any mass market candy. For a long time I thought I had just gotten older and maybe had less of a sweet tooth, but the everything is worse now. Butterfingers being the most obvious with Cadbury cream eggs a close 2nd. Even non-chocolate candy is worse, Twizzlers are now 90% wax. And I’m sure everyone on this board can name another brand that is hollowed out shell coasting on the fumes of brand recognition earned >2 decades ago.

The idea that growth supersedes everything, even profit, is decimating our quality of life.
 
Arcan57 said:
Any mass market candy. For a long time I thought I had just gotten older and maybe had less of a sweet tooth, but the everything is worse now. Butterfingers being the most obvious with Cadbury cream eggs a close 2nd. Even non-chocolate candy is worse, Twizzlers are now 90% wax. And I’m sure everyone on this board can name another brand that is hollowed out shell coasting on the fumes of brand recognition earned >2 decades ago.

The idea that growth supersedes everything, even profit, is decimating our quality of life.
Click to expand...

Yuuup even savory snacks like pringles and Smartfood White Cheddar:

A beloved popcorn brand that is no longer the same. This once-craved snack apparently lost its signature cheddar punch.

“The zing wasn’t zinging; the sharpness was dull.” 
The change seems tied to a 2021 ingredient tweak—less real cheese, more generic “natural flavors” and maltodextrin—making the flavor more bland and powdery.

“SmartFood used to be soooo good… now it’s meh — almost forgettable.”

www.eater.com

Why Doesn’t Smartfood Popcorn Hit Like It Used To?

One woman’s quest to figure out why her beloved white cheddar popcorn started to disappoint.
www.eater.com www.eater.com
 
sloh said:
Yuuup even savory snacks like pringles and Smartfood White Cheddar:

A beloved popcorn brand that is no longer the same. This once-craved snack apparently lost its signature cheddar punch.

“The zing wasn’t zinging; the sharpness was dull.” 
The change seems tied to a 2021 ingredient tweak—less real cheese, more generic “natural flavors” and maltodextrin—making the flavor more bland and powdery.

“SmartFood used to be soooo good… now it’s meh — almost forgettable.”

www.eater.com

Why Doesn’t Smartfood Popcorn Hit Like It Used To?

One woman’s quest to figure out why her beloved white cheddar popcorn started to disappoint.
www.eater.com www.eater.com
Click to expand...

HOLY ****.

These are in my EMS break room.
I eat them occasionally.
I used to eat one a day as a teen because they were great.
Now I eat a bag and say "Meh" to myself.
 
RustedFox said:
HOLY ****.

These are in my EMS break room.
I eat them occasionally.
I used to eat one a day as a teen because they were great.
Now I eat a bag and say "Meh" to myself.
Click to expand...

Wait is this actually true? Do you have evidence?

I legit thought I was just being a cynical adult like Stan in that South Park episode after he turned 10.

I notice this the most w peanut butter cups. Used to love them and now they're crap.
 
WhatJobDoIPick said:
Wait is this actually true? Do you have evidence?

I legit thought I was just being a cynical adult like Stan in that South Park episode after he turned 10.

I notice this the most w peanut butter cups. Used to love them and now they're crap.
Click to expand...

Look at the post by @sloh.
 
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