is it really becoming more competitive?...reproduction prohibited without the written permission of...
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Mona M. Signer President and CEO November 7, 2014
Main Residency Match Is It Really Becoming More Competitive?
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Today’s Topics Main Residency Match Changes to Match Week 2016 Something(s) old, something new
Reproduction prohibited without the written permission of the NRMP.
0
5,000
10,000
15,000
20,000
25,000
30,000
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
US Allopathic SeniorsWho ObtainedPositions throughSOAP
US Allopathic SeniorsMatched
US AllopathicGraduating Seniors
NRMP PGY 1 Positions
Data sources: NRMP, AAMC
First-Year GME Positions Allopathic Medicine
No Shortage of PGY-1 Slots for Graduating Seniors
~8,500 more PGY-1 positions than graduating US seniors
Reproduction prohibited without the written permission of the NRMP.
0
5,000
10,000
15,000
20,000
25,000
30,000
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
AOA Matches
US Osteopathic Seniors andGraduates Who ObtainedPositions through SOAPUS Osteopathic Seniors andGraduates Matched
Non US IMGs Who ObtainedPositions through SOAP
Non US IMGs Matched
US IMGs Who ObtainedPositions through SOAP
US IMGs Matched
US Allopathic Seniors WhoObtained Positions throughSOAPUS Allopathic SeniorsMatched
US Allopathic + OsteopathicGraduating Seniors*
US Allopathic GraduatingSeniors
Data sources: NRMP, AAMC, AACOM, AOA
First-Year GME Positions Allopathic and Osteopathic Medicine
+22,000 USMDs & DOs Obtained PGY-1 Positions in 2014 6,300 IMGs matched to
PGY-1 positions
Reproduction prohibited without the written permission of the NRMP.
PGY-1 Positions Offered and Filled 500 More Positions in 2014
0
5,000
10,000
15,000
20,000
25,000
30,000
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Offered Filled Filled US Seniors
+ 2,678 PGY-1 positions since
All In Policy
Source: Results and Data, Main Residency Match
Reproduction prohibited without the written permission of the NRMP.
Active Applicants 113 Fewer Seniors, 85 Fewer Applicants
05,000
10,00015,00020,00025,00030,00035,000
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Others Osteopathic Physicians IMGs US IMGs US Physicians US Seniors
Source: Results and Data, Main Residency Match
Reproduction prohibited without the written permission of the NRMP.
PGY-1 Matches by Applicant Type 500 Fewer Unmatched Applicants
0
5,000
10,000
15,000
20,000
25,000
30,000
35,000
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Unmatched Others Osteopathic Physicians IMGs US IMGs US Physicians US Seniors
Source: Results and Data, Main Residency Match
Reproduction prohibited without the written permission of the NRMP.
1,181 Unfilled Positions About Half Preliminary
466 486 481 455 473 461 444 484 459 449
184 194 136 127 89 105 129 123 74 80
994 862
663 696 487 459 425 460
367 427
97 71
101 92
59 82 103 146
112 127 63
0
200
400
600
800
1,000
1,200
1,400
1,600
1,800
2,000
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Surg-Prelim Med-Prelim T-Year & Peds-Prelim Categorical Advanced ReservedSource: Results and Data, Main Residency Match
Reproduction prohibited without the written permission of the NRMP.
Unmatched Seniors, Unfilled PGY-1 Positions in SOAP
More Unmatched Seniors than PGY-1 Positions
1,694
0
500
1,000
1,500
2,000
2,500
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
975
921 934
Unfilled PGY-1 Positions in SOAP
U.S. Seniors Unmatched to PGY-1 Positions
Source: NRMP
Reproduction prohibited without the written permission of the NRMP.
Unmatched Applicants, Unfilled PGY-1 Positions in SOAP
Nine Unmatched Applicants for Every Unfilled Position
1,694
Unfilled PGY-1 Positions in SOAP
934
5,588
8,583
01,0002,0003,0004,0005,0006,0007,0008,0009,000
10,000
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
All Applicants Unmatched to PGY-1 Positions
Source: NRMP
Reproduction prohibited without the written permission of the NRMP.
13,276 SOAP-Eligible Applicants
2,050 1,025
3,724
752
5,688
37 0
1,000
2,000
3,000
4,000
5,000
6,000
US Senior US Grad USIMG Osteo IMG Other
US Senior US Grad USIMG Osteo IMG OtherSource: NRMP
Reproduction prohibited without the written permission of the NRMP.
U.S. Seniors in SOAP 2012 - 2014
1,816
605 567
262
2,076
595 571 528
2,050
609 623
412
0
500
1,000
1,500
2,000
2,500
SOAP Eligible Offers Accepted Unique Applicants WithOffers
No Position Post-SOAP
SOAP 2012 SOAP 2013 SOAP 2014Source: NRMP
Reproduction prohibited without the written permission of the NRMP.
Percentage of Programs Citing Each Factor in Interview Selection
53%
54%
55%
60%
60%
61%
61%
61%
62%
62%
63%
63%
67%
67%
68%
69%
69%
70%
71%
77%
81%
82%
48%
57%
65%
63%
56%
56%
54%
61%
34%
69%
69%
65%
69%
70%
84%
75%
61%
80%
70%
78%
86%
94%
0% 25% 50% 75% 100%
Graduate of highly regarded U.S. medical schoolPerceived interest in program
Evidence of professionalism & ethicsAudition elective/rotation within your department
Consistency of gradesOther life experience
Volunteer/extracurricular experiencesHonors in clerkship in desired specialty
Applicant flagged with match violation by NRMPHonors in clinical clerkships
Perceived commitment to specialtyPersonal prior knowledge of the applicant
Class ranking/quartileGaps in medical education
Medical Student Performance EvaluationGraduate of US allopathic medical school
Grades in clerkship in desired specialtyUSMLE/COMLEX Step 2 scoreGrades in required clerkships
Personal StatementLetters of recommendation in the specialty
USMLE/COMLEX Step 1 score
2014 2012Source: NRMP Program Director Survey
Reproduction prohibited without the written permission of the NRMP.
More Programs Use the MSPE
39%
56%
57%
58%
58%
61%
62%
63%
66%
68%
69%
70%
72%
74%
75%
78%
81%
83%
85%
74%
83%
80%
74%
76%
88%
85%
79%
87%
87%
94%
91%
87%
91%
62%
90%
86%
79%
83%
0% 25% 50% 75% 100%
Internal Medicine/Pediatrics
Pathology-Anatomic and Clinical
Family Medicine
Otolaryngology
Obstetrics and Gynecology
Physical Medicine and Rehabilitation
Neurology
General Surgery
Pediatrics
Average for all specialties
Psychiatry
Emergency Medicine
Anesthesiology
Radiology-Diagnostic
Plastic Surgery
Internal Medicine Categorical
Radiation Oncology
Orthopaedic Surgery
Dermatology
2014 2012
Reproduction prohibited without the written permission of the NRMP.
More Programs Use Step 1 Target Scores
Scores Required?
36
63
1
31
68
1 0%
20%
40%
60%
80%
100%
Yes, pass only Yes, targetscore
No
Consider applicants who fail 1st attempt?
26
61
13
26
63
11 0%
20%
40%
60%
80%
100%
Never Seldom Often2012 2014
Source: NRMP Program Director Survey
Reproduction prohibited without the written permission of the NRMP.
200
210
220
230
240
250
260
270
2007 Median
Note: Step 1 scores are not available for the majority of osteopathic physicians included within the independent applicant category.
Source: NRMP Data Warehouse and AAMC Data Warehouse.
Step 1 Scores Are Rising By Preferred Specialty
200
210
220
230
240
250
260
270
2011 Median 2007 Median
200
210
220
230
240
250
260
270
2014 Median 2011 Median 2007 Median
200
210
220
230
240
250
260
270
2014 Median 2011 Median 2007 Median
Source: Charting Outcomes in the Match
2014 Median 2011 Median 2007 Median
Reproduction prohibited without the written permission of the NRMP.
Percentage of Programs Using USMLE Step 2 CK Scores for Interview Selection
Scores Required?
33
48
20
31
50
19
0%
20%
40%
60%
80%
100%
Yes, pass only Yes, targetscore
No
Consider applicants who fail 1st attempt?
32
59
8
35
58
6 0%
20%
40%
60%
80%
100%
Never Seldom Often2012 2014
Source: NRMP Program Director Survey
Reproduction prohibited without the written permission of the NRMP.
Percentage of Programs Using USMLE Step 2 CS & Step 3 Scores for Interviews
Step 2 CS Scores Required?
77
23
78
22
0%
20%
40%
60%
80%
100%
Yes, pass only No
Step 3 Scores Required?
21
10
69
18 11
71
0%
20%
40%
60%
80%
100%
Yes, pass only Yes, targetscore
No2012 2014
Source: NRMP Program Director Survey
Reproduction prohibited without the written permission of the NRMP.
200
210
220
230
240
250
260
270
2007 Median
Step 2 CK Scores Are Rising By Preferred Specialty
Note: Step 1 scores are not available for the majority of osteopathic physicians included within the independent applicant category.
Source: NRMP Data Warehouse and AAMC Data Warehouse.
200
210
220
230
240
250
260
270
2011 Median 2007 Median
200
210
220
230
240
250
260
270
2014 Median 2011 Median 2007 Median
200
210
220
230
240
250
260
270
2014 Median 2011 Median 2007 Median
Source: Charting Outcomes in the Match
2014 Median 2011 Median 2007 Median
Reproduction prohibited without the written permission of the NRMP.
Average Percentage Applications Rejected
30%
30%
32%
37%
39%
40%
45%
47%
48%
53%
54%
54%
55%
55%
57%
57%
62%
62%
68%
29%
26%
31%
33%
41%
39%
45%
46%
47%
51%
56%
58%
52%
61%
48%
48%
62%
61%
68%
0% 25% 50% 75% 100%
Plastic Surgery
Radiation Oncology
Otolaryngology
Dermatology
Emergency Medicine
Radiology-Diagnostic
Physical Medicine and Rehabilitation
Orthopaedic Surgery
Anesthesiology
Average for all specialties
Pathology-Anatomic and Clinical
Pediatrics
Obstetrics and Gynecology
Psychiatry
Internal Medicine/Pediatrics
Neurology
General Surgery
Internal Medicine Categorical
Family Medicine
2014 2012
Source: NRMP Program Director Survey
Reproduction prohibited without the written permission of the NRMP.
50%
51%
55%
55%
57%
57%
58%
60%
62%
64%
67%
68%
71%
74%
80%
82%
88%
93%
93%
0% 25% 50% 75% 100%
Passing USMLE Step 2 CS/Comlex Level 2
Grades in required clerkships
Audition rotation within department
Personal statement
Graduate of U.S. allopathic medical school
Class rank
Personal prior knowledge of applicant
Leadership qualities
Perceived interest in program
Evidence of professionalism
Perceived commitment to specialty
MSPE
USMLE Step 2/Complex Level 2
Recommendation letters in specialty
USMLE Step 1/Comlex Level 1
Feedback from current residents
Interactions with housetaff during interview
Interpersonal skills
Interactions with faculty during interview
Factors in Ranking Applicants It’s All About the Interview
Source: NRMP Program Director Survey
Reproduction prohibited without the written permission of the NRMP.
PGY-1Match Rates by Applicant Type
No Change for U.S. Seniors
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
US Seniors
Osteopathic Physicians
US IMGs Prior US Grads IMGs
Source: Results and Data, Main Residency Match
Reproduction prohibited without the written permission of the NRMP.
44
77 79 80 85 86
90 90 94 95 96 96 96 96 96 96 97
71 77 76
85 89
75
89 93 91
97 99 96 98 97 96 96 96
79
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2011 2014
Match Rates By Preferred Specialty
No Change for U.S. Seniors
Source: NRMP Data Warehouse.
Reproduction prohibited without the written permission of the NRMP.
8,500 more PGY-1 positions than graduating seniors 9,300 more PGY-1 positions than active seniors in
the Match 2,100 DOs and 6,300 IMGs matched to PGY-1
positions 500 fewer unmatched applicants in 2014 200 fewer seniors with no position post-SOAP No change in percentage of applications rejected USMLE Step scores are rising No change in seniors’ PGY-1 match rate No change in seniors’ match rates by preferred
specialty
Is the Match More Competitive?
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Today’s Topics Main Residency Match Trends Changes to Match Week 2016 Something(s) old, something new
Reproduction prohibited without the written permission of the NRMP.
Match Week 2016 Goal: Allow unmatched applicants more time to process their options before submitting SOAP applications
NRMP survey of program directors & institution officials When are applications downloaded? When are applications reviewed? When are preference lists created? Do you review “second phase” applications? Do you support or oppose schedule change?
Reproduction prohibited without the written permission of the NRMP.
When do you begin downloading applications?
85
9 5
0 1
81
10 8
0 1 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Monday before5:00p.m.
Monday after 5:00p.m.
Tuesday morning Tuesday afternoonbefore 5:00 p.m.
Tuesday after 5:00p.m.
DIOsPDs
Source: NRMP All In & SOAP Survey
Reproduction prohibited without the written permission of the NRMP.
When do you begin reviewing applications?
54
28
17
0 1
65
16 15
2 1 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Monday before5:00p.m.
Monday after 5:00p.m.
Tuesday morning Tuesday afternoonbefore 5:00 p.m.
Tuesday after 5:00p.m.
DIOsPDs
Source: NRMP All In & SOAP Survey
Reproduction prohibited without the written permission of the NRMP.
When do you finalize a first-round preference list?
13 9
36
24 18
12 7
24 26 31
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Monday before5:00p.m.
Monday after 5:00p.m.
Tuesday morning Tuesday afternoonbefore 5:00 p.m.
Tuesday after 5:00p.m.
DIOsPDs
Source: NRMP All In & SOAP Survey
Reproduction prohibited without the written permission of the NRMP.
Do you support the SOAP schedule change?
12
36 41
7 6
14
28
50
6 3
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Strongly support Support No preference Oppose Strongly oppose
DIOsPDs
Source: NRMP All In & SOAP Survey
Reproduction prohibited without the written permission of the NRMP.
Match Week 2016 Monday 10:30 a.m. School Unmatched Seniors Report
11:00 a.m. Applicant “Did I Match?” Program “Did I Fill?” Unfilled positions on Web 2:00 p.m. ERAS opens for applicants 3:00 p.m. Programs begin receiving applications Tuesday Applicant/program communication Wednesday 11:30 a.m. Programs finalize preference lists 12:00 p.m. Program offers begin: valid for 2 hours Thursday 8:00 a.m. School match notification letters School match results Applicant choices by specialty 2:00 p.m. Program Roster of Matched Applicants Friday 12:00 p.m. Match Day Ceremonies 1:00 p.m. Applicant “Where Did I Match?” 5:00 p.m. Last offers expire 12:00 p.m. Match Results by Ranked Applicant Match Outcome for All Programs
Reproduction prohibited without the written permission of the NRMP.
Today’s Topics Main Residency Match Trends Changes to Match Week 2016 Something(s) old, something new
Reproduction prohibited without the written permission of the NRMP.
PRISM The Program Rating and Interview Scheduling
Manager
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Match Events
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1. Charting Outcomes in the Match, 2014 2. NRMP Program Director Survey, 2014 3. NRMP – OPDA Match Tips for Applicants and
Program Code of Conduct 4. Professional Profile, Match Registration 5. NRMP 2015 Applicant Survey
Reminders!
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How well are students prepared for residency? Do we need more GME slots? Can we obtain residency program-specific data? What are the alternatives to clinical medicine? Is the MSPE relevant for program directors? Tracking unmatched applicants Competency-based curricula The human side of medicine
A National Conversation on the Transition from Medical School to Residency
October 1-3, 2015
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