Is It Really Becoming More Competitive?...Reproduction prohibited without the written permission of...

Reproduction prohibited without the written permission of the NRMP.

Mona M. Signer President and CEO November 7, 2014

Main Residency Match Is It Really Becoming More Competitive?


Today’s Topics Main Residency Match Changes to Match Week 2016 Something(s) old, something new


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


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


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


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



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



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


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


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


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


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


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


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


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


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


Source: Charting Outcomes in the Match



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%


No

Consider applicants who fail 1st attempt?

32

59

8

35

58

6 0%

20%

40%

60%

80%

100%

Never Seldom Often2012 2014



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%


No2012 2014



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


200

210

220

230

240

250

260

270


Source: Charting Outcomes in the Match



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



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



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



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.


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?


Today’s Topics Main Residency Match Trends Changes to Match Week 2016 Something(s) old, something new


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?


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


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%





DIOsPDs



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%





DIOsPDs



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



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


Today’s Topics Main Residency Match Trends Changes to Match Week 2016 Something(s) old, something new


PRISM The Program Rating and Interview Scheduling

Manager


Match Events


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!


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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Is It Really Becoming More Competitive?...Reproduction prohibited without the written permission of...

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