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Match rates this year looked surprisingly similar to last year, with only 0.9% less MDs and 1.6% less DOs landing a spot. I've been saying for a while I think those numbers aren't the full picture, because falling further down your ranklist or into a backup specialty are also "worse" outcomes. With the full data report for 2021 out, I tried to look closer.
1) Among US Seniors who applied to ONLY ONE specialty, 27% more failed to match (Table 14A). That's actually the same information as above - only a 1% worse rate for MDs, 7.0% versus 6.0%, but it looks much worse when you frame it relative to the prior year.
The numbers of unmatched students are:
US MD 2020: 955
US MD 2021: 1173
Change: 23% more unmatched
US DO 2020: 433
US DO 2021: 589
Change: 36% more unmatched
Total Seniors 2020: 1388
Total Seniors 2021: 1762
Change: 27% more unmatched
Keep in mind this is only capturing people who didn't dual apply. There were likely many more folks who fell off their ranks for their choice specialty into something else.
2) Match rate changes varied greatly by specialty.
Interestingly, this larger unmatched group was not all people falling off their list in competitive fields - some fields with high match rates were hit hard too. Anesthesia, for example, was 100% worse (up to 160 unmatched from 80). Emergency medicine was 50% worse (up to 260 unmatched from 170). Here's a summary of what got harder and what got easier for our year:
3) People also fell further down their ranks, a trend for decades.
Several hundred less people hit their top rank this cycle than last; similarly, several hundred more fell to rank 5 or lower.
Number of MDs falling to rank 5+ this year (2021): 3,778
Number of MDs falling to rank 5+ last year (2020): 3,190
Change: 18.4%
Number of DOs falling to rank 5+ this year (2021): 1,252
Number of DOs falling to rank 5+ last year (2020): 958
Change: 30.7%
This has been a trend for the last two decades. Adjusting for cohort sizes over the years, the rate of falling to 5 or lower has more than doubled. We're also at record low rates of matching to 1st choices.
TL;DR This year's match was rougher than the announced match rate made me realize, with hundreds more MDs and DOs unmatched. Certain fields like rads, gas and EM had, relatively, a much larger unmatched fraction than last year. We've continued to match our top choice less often and our 5th+ ranks more often. This was all in context of programs interviewing 15% more candidates this year.
We need to cap applications.
1) Among US Seniors who applied to ONLY ONE specialty, 27% more failed to match (Table 14A). That's actually the same information as above - only a 1% worse rate for MDs, 7.0% versus 6.0%, but it looks much worse when you frame it relative to the prior year.
The numbers of unmatched students are:
US MD 2020: 955
US MD 2021: 1173
Change: 23% more unmatched
US DO 2020: 433
US DO 2021: 589
Change: 36% more unmatched
Total Seniors 2020: 1388
Total Seniors 2021: 1762
Change: 27% more unmatched
Keep in mind this is only capturing people who didn't dual apply. There were likely many more folks who fell off their ranks for their choice specialty into something else.
2) Match rate changes varied greatly by specialty.
Interestingly, this larger unmatched group was not all people falling off their list in competitive fields - some fields with high match rates were hit hard too. Anesthesia, for example, was 100% worse (up to 160 unmatched from 80). Emergency medicine was 50% worse (up to 260 unmatched from 170). Here's a summary of what got harder and what got easier for our year:
Specialty | Percent Unmatched - 2021 | 2020 | Relative Change |
GenSurg-Prelim | 15.9 | 3.7 | 329.70% (Harder) |
IM/Peds | 6.3 | 2.1 | 200.00% |
Diagnostic Rads | 6.1 | 2.2 | 177.30% |
Anesthesia | 9.4 | 4.8 | 95.80% |
EM | 9.1 | 5.9 | 54.20% |
ENT | 28 | 22.3 | 25.60% |
Peds | 1 | 0.8 | 25.00% |
Derm | 13.5 | 11 | 22.70% |
Ortho | 21.7 | 18 | 20.60% |
Vascular | 14.6 | 13.6 | 7.40% |
Neuro | 2 | 1.9 | 5.30% |
Psych | 9.4 | 9 | 4.40% |
PM&R | 5.9 | 5.7 | 3.50% |
OBGYN | 10.7 | 10.5 | 1.90% |
GenSurg | 10.6 | 10.5 | 1.00% |
Plastics | 20.1 | 20.3 | -1.00% |
IM | 1.6 | 1.8 | -11.10% |
Neurosurg | 19.8 | 23 | -13.90% |
IM-Prelim | 1.5 | 2 | -25.00% |
FM | 1.6 | 3 | -46.70% |
Child Neuro | 1.3 | 3.4 | -61.80% |
Path | 1 | 4.5 | -77.80% (Easier) |
3) People also fell further down their ranks, a trend for decades.
Several hundred less people hit their top rank this cycle than last; similarly, several hundred more fell to rank 5 or lower.
Number of MDs falling to rank 5+ this year (2021): 3,778
Number of MDs falling to rank 5+ last year (2020): 3,190
Change: 18.4%
Number of DOs falling to rank 5+ this year (2021): 1,252
Number of DOs falling to rank 5+ last year (2020): 958
Change: 30.7%
This has been a trend for the last two decades. Adjusting for cohort sizes over the years, the rate of falling to 5 or lower has more than doubled. We're also at record low rates of matching to 1st choices.
TL;DR This year's match was rougher than the announced match rate made me realize, with hundreds more MDs and DOs unmatched. Certain fields like rads, gas and EM had, relatively, a much larger unmatched fraction than last year. We've continued to match our top choice less often and our 5th+ ranks more often. This was all in context of programs interviewing 15% more candidates this year.
We need to cap applications.