Friday, March 17, 2017

Brief summary of 2017 residency match data

Here are some snippets from the NRMP Advance Data Tables for the 2017 Main Residency Match.

The number of PGY-1 positions offered was the highest total ever. US allopathic medical school seniors in the match numbered 18,539, which is also a new high. Only 5.7% of US seniors failed to match. That was a slightly lower percentage compared to 2016 and 2015.

The numbers were not as good for previous graduates of US allopathic medical schools with only 46% of 1472 applicants matching. Osteopathic graduates fared better with 81.7% of 3590 applicants matching.

I have blogged about the prospects for international medical school graduates. Of the 5069 US citizen graduates of international medical schools, 54.8% matched—a rate consistent with the totals for the last four years.

Non-US citizen international med school graduates in the match numbered 7284 with 52.4% obtaining PGY-1 positions—about 2% higher than last year and statistically significant with a p value of 0.026.

For categorical general surgery, 267 programs offered 1281 positions, and only three programs with a total of five positions were unfilled. Senior students from US allopathic schools comprised 78.4% of the 1276 who matched. Percentages of US senior students matching in categorical surgery for the previous four years were as follows: 2016--76%, 2015--80%, 2014--77%, 2013--81%.

For categorical internal medicine, 3245 US med school seniors filled 44.9% of the 7233 positions offered. Family medicine had a similar percentage of US med school seniors matching.

The figures of US seniors matching to internal medicine and family medicine were fairly consistent with previous years.

Overall, 28,849 PGY-1 positions were offered in this year's match with 27,688 filled. This left 1161 unfilled positions with 508 preliminary surgery openings making up nearly half of the vacant slots.

The number of active applicants in this year's match was 35,969 which was the most ever; 8281 (23%) failed to match.

This means that more than 7100 unmatched applicants will not be able to start residency training in July. I have blogged about this problem too and have no solution. What these people will do to make a living and for some, how they will pay back their tuition loans is unclear.

10 comments:

Anonymous said...

I am one of those IMGs that did not match this year. A British graduate with 4 years of training in the U.K. and currently conducting and publishing research at one of the countries top medical instituions. It's so shocking to know that someone with my expertise and experiences is viewed as less than desirable. Any other workforce and I'd be a commodity. Any tips on what to do next would be most welcome.

Skeptical Scalpel said...

I am sorry to hear about your problem.

You did not say how long you have been doing research. Maybe the issue is that you have been away from clinical medicine too long. Program directors prefer recent medical school graduates and candidates with recent hands-on patient care experience. The difficulty in matching one or more years after medical school graduation is not limited to international graduates. You will note that only 46% of US citizens who graduated from medical school before 2017 matched.

Your USMLE Step 1 score is also very important. Here are links to two posts I have written on the subject of international medical graduates and matching in surgery. They are not exactly relevant to your situation but the information may be of some use. http://skepticalscalpel.blogspot.com/2016/07/what-are-residency-prospects-for.html and http://skepticalscalpel.blogspot.com/2016/04/faqs-from-imgs-about-applying-for.html

You also did not mention whether you were granted any interviews.

One option would be to participate in the supplemental match and try to obtain a preliminary surgery position. As you can see from the post above, there are many such positions available.I am not sure what the deadline is for applying to the supplemental match, but you can find out on the NRMP website.

I think your only other option would be to get back into clinical medicine and try to go through the application/interview/match process next year.

artiger said...

I'd be curious what field the Anon poster above was interested in, i.e., surgical, medical, peds, etc. If unsure, a prelim surgery position is arguably an excellent choice.

Skeptical Scalpel said...

Yes, a little more info would help.

Sara Bubenik said...

The solution is actually quite clear. We have to let graduate MDs practice at a PA level. Opponents say there is a safty concern but I disagree. There is the same safety concerns for new PAs starting out as well. I just lobbied to try and pass legislation in Oregon for this very cause. The Oregon Medical Board was opposed ad the bill will not have further consideration. There opposition was vague and lacked supporting information. I am going to continue to petition for such legislation nationally. Graduates only have a 46% chance of matching one year after graduation. After that point they are essentially exiled from the medical community. Exiling graduates due to the bureaucracy of the NRMP is a billion dollar problem. Graduates have no means to pay back these loans putting several thousand people in default.

Skeptical Scalpel said...

Sara, thanks for commenting. Missouri has passed a law enabling medical school graduates who were unable to obtain a residency position to practice with some rather loose supervision. Whether anyone has actually done this is unclear.

I blogged about this at the time [http://www.physiciansweekly.com/practicing-without-residency-training/] and didn't think it was a good idea. My main objection was and still is that most medical school graduates are not capable of independent practice. Medical schools simply do not train their students with that end in mind.

I suggested a better solution which was to fund more primary care residency positions in the state so that medical students could be properly trained.

That post has generated quite a few comments, most of which disagreed with me. It is said to read some of the predicaments that people have found themselves in because they were unable to find a residency.

A problem which I did not mention in the post is that the Missouri program would help only a few of the thousands of unmatched medical school graduates who are unmatched every year.

I have been writing about the oversupply of medical school graduates for several years. Prospective medical students, particularly those who will be attending offshore schools, should be aware that the prospects of matching will continue to decrease in the next few years. Several new US medical schools are opening. Their graduates will undoubtedly receive preference in the matching process.

This is explained in another post I wrote [http://skepticalscalpel.blogspot.com/2016/08/shortage-of-doctors-in-future-maybe.html].

Disasterbot said...

When the average cost of U.S. Private Medical Schools is $278,455 and $207,868 for Public Schools (Bloomberg, 2013) we have created a mountain of useless debt. At 3,630 US Medical Students not matching THIS YEAR (not to mention those that have applied previously or have just given up hope and moved on) what we have is a major policy disaster. We have thrown away 14,520 years of people's lives that could have been better spent gardening, working fast food, becoming a policy lobbyist or just sitting at home in their underwear blogging about how bad this sucks. We have also created a waste of 5+% of the capacity of U.S. Medical Schools. Taxpayers support these institutions and if the product is thrown away, why not just shut down US medical schools and substitute foreign trained doctors? It would be far cheaper and from what we are told, the quality is the same or better than our own graduates. I personally think that there is room for everyone but that we need to rapidly expand our capacity for residency training (especially in primary care) and come up with flexible licensing for people that don't match. You can't tell me that an MD will kill people doing supervised practice when a PA and an NP and in some states a Naturopath can act as primary care givers with little to no supervision. In addition - why aren't the schools being called to task? Alums should stop donating until this problem is solved. I imagine that they will move a little money from their administrative slush funds and make sure that their graduates get the training they deserve. When you are eligible to participate in the match that means that you have the capacity to be a doctor, period. People in the medical community have to start owning this problem now.

Skeptical Scalpel said...

I'm not sure how you arrived at the figure of 3,630 US med students not matching. I get a somewhat lower number which is still a problem.

I agree med school is too costly. I blogged about that in November 2016 {http://skepticalscalpel.blogspot.com/2016/11/why-is-medical-school-tuition-so-high.html}.

The type of supervision proposed in Missouri is essentially no supervision at all. Proponents of the Missouri scheme say even a poorly trained and poorly supervised doctor is better than none at all which is the situation in some rural areas. I'm not sure.

If Trump has his way, we will see fewer foreign doctors, not more.

It is quite a mess, isn't it?

Anonymous said...

Been following your blog for a while now and was waiting to post after my match which was last week. I'm a USIMG from a caribbean medical school with high 240s/low 250s on step exams, a couple of published abstracts, good LORs, etc. I applied to GS this year received 9 GS interviews, 1/3 university programs and 2/3 community. Received multiple post-interview emails from PDs saying I'm ranked high and would love to have me there. Did not end up matching and took a spot in the SOAP in IM. Not really sure what happened here but I do know that it seems to be getting harder and harder to match as an IMG with more DOs entering the match. In hindsight, I should have gone after a pre-lim spot but after having 9 programs pass up on me, perhaps it just wasn't meant to be.

Skeptical Scalpel said...

Stories like yours make me feel bad for you and the others who are caught in this dilemma.

You are correct about more D.O. graduates entering the match this year. According to the NRMP Advance Data Tables, the number of D.O. grads in the match rose from 2982 in 2016 to 3590 this year and about 600 more D.O.'s matched as PGY-1s this year compared to last year.

The post interview emails saying you would be ranked highly is a common and deplorable issue. I blogged about this in 2014 [http://skepticalscalpel.blogspot.com/2014/04/a-match-day-lament-we-will-rank-you.html].

If you've been following me, you know that I have made an effort to educate people considering matriculating at offshore schools because the odds of matching in surgery are low, and depending on what school you attend, the odds of matching at all are probably worse than 50-50.

Internal medicine is not so bad, and if you are procedurally oriented, you can do a fellowship in gastroenterology or maybe pulmonary/critical care. I wish you well.

Post a Comment