Main Residency Match. Is It Really Becoming More Competitive? Mona M. Signer President and CEO November 7, 2014

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1 Main Residency Match Is It Really Becoming More Competitive? Mona M. Signer President and CEO November 7, 2014

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

3 First-Year GME Positions Allopathic Medicine No Shortage of PGY-1 Slots for Graduating Seniors 30,000 25,000 20,000 15,000 10,000 ~8,500 more PGY-1 positions than graduating US seniors US Allopathic Seniors Who Obtained Positions through SOAP US Allopathic Seniors Matched 5,000 US Allopathic Graduating Seniors NRMP PGY 1 Positions Data sources: NRMP, AAMC

4 First-Year GME Positions Allopathic and Osteopathic Medicine +22,000 USMDs & DOs Obtained PGY-1 Positions in ,000 25,000 20,000 6,300 IMGs matched to PGY-1 positions AOA Matches US Osteopathic Seniors and Graduates Who Obtained Positions through SOAP US Osteopathic Seniors and Graduates Matched Non US IMGs Who Obtained Positions through SOAP Non US IMGs Matched 15,000 US IMGs Who Obtained Positions through SOAP US IMGs Matched 10,000 5,000 US Allopathic Seniors Who Obtained Positions through SOAP US Allopathic Seniors Matched US Allopathic + Osteopathic Graduating Seniors* US Allopathic Graduating Seniors Data sources: NRMP, AAMC, AACOM, AOA

5 PGY-1 Positions Offered and Filled 500 More Positions in ,000 25,000 20,000 15, ,678 PGY-1 positions since All In Policy 10,000 5, Offered Filled Filled US Seniors Source: Results and Data, Main Residency Match

6 Active Applicants 113 Fewer Seniors, 85 Fewer Applicants 35,000 30,000 25,000 20,000 15,000 10,000 5, Others Osteopathic Physicians IMGs US IMGs US Physicians US Seniors Source: Results and Data, Main Residency Match

7 PGY-1 Matches by Applicant Type 500 Fewer Unmatched Applicants 35,000 30,000 25,000 20,000 15,000 10,000 5, Unmatched Others Osteopathic Physicians IMGs US IMGs US Physicians US Seniors Source: Results and Data, Main Residency Match

8 1,181 Unfilled Positions About Half Preliminary 2,000 1,800 1,600 1,400 1,200 1, Surg-Prelim Med-Prelim T-Year & Peds-Prelim Categorical Advanced Reserved Source: Results and Data, Main Residency Match

9 Unmatched Seniors, Unfilled PGY-1 Positions in SOAP More Unmatched Seniors than PGY-1 Positions 2,500 2,000 1,694 1,500 Unfilled PGY-1 Positions in SOAP 975 1, U.S. Seniors Unmatched to PGY-1 Positions Source: NRMP

10 Unmatched Applicants, Unfilled PGY-1 Positions in SOAP Nine Unmatched Applicants for Every Unfilled Position 10,000 9,000 8,000 7,000 6,000 5,000 4,000 3,000 2,000 1, ,588 1,694 All Applicants Unmatched to PGY-1 Positions Unfilled PGY-1 Positions in SOAP 8, Source: NRMP

11 13,276 SOAP-Eligible Applicants 6,000 5,000 4,000 5,688 3,000 3,724 2,000 1, ,050 1, US Senior US Grad USIMG Osteo IMG Other Source: NRMP US Senior US Grad USIMG Osteo IMG Other

12 U.S. Seniors in SOAP ,500 2,000 2,076 2,050 1,500 1,816 1, Source: NRMP SOAP Eligible Offers Accepted Unique Applicants With Offers 262 SOAP 2012 SOAP 2013 SOAP No Position Post-SOAP

13 Percentage of Programs Citing Each Factor in Interview Selection USMLE/COMLEX Step 1 score Letters of recommendation in the specialty Personal Statement Grades in required clerkships USMLE/COMLEX Step 2 score Grades in clerkship in desired specialty Graduate of US allopathic medical school Medical Student Performance Evaluation Gaps in medical education Class ranking/quartile Personal prior knowledge of the applicant Perceived commitment to specialty Honors in clinical clerkships Applicant flagged with match violation by NRMP Honors in clerkship in desired specialty Volunteer/extracurricular experiences Other life experience Consistency of grades Audition elective/rotation within your department Evidence of professionalism & ethics Perceived interest in program Graduate of highly regarded U.S. medical school Source: NRMP Program Director Survey 34% 61% 68% 70% 67% 69% 67% 65% 63% 69% 63% 69% 62% 62% 61% 61% 54% 61% 56% 61% 56% 60% 63% 60% 65% 55% 57% 54% 48% 53% 82% 86% 81% 78% 77% 70% 71% 80% 70% 69% 75% 69% 84% 94% 0% 25% 50% 75% 100%

14 More Programs Use the MSPE Dermatology 83% 85% Orthopaedic Surgery 79% 83% Radiation Oncology 86% 81% Internal Medicine Categorical 78% 90% Plastic Surgery 62% 75% Radiology-Diagnostic 74% 91% Anesthesiology 72% 87% Emergency Medicine 70% 91% Psychiatry 69% 94% Average for all specialties 68% 87% Pediatrics 66% 87% General Surgery 63% 79% Neurology 62% 85% Physical Medicine and Rehabilitation 61% 88% Obstetrics and Gynecology 58% 76% Otolaryngology 58% 74% Family Medicine 57% 80% Pathology-Anatomic and Clinical 56% 83% Internal Medicine/Pediatrics 39% 74% 0% 25% 50% 75% 100%

15 More Programs Use Step 1 Target Scores Scores Required? Consider applicants who fail 1 st attempt? 100% 100% 80% 80% 60% % % 40% 20% % % Yes, pass only Yes, target score 1 No 1 0% Never Seldom Often Source: NRMP Program Director Survey

16 Step 1 Scores Are Rising By Preferred Specialty Median 2014 Median 2011 Median Median Median Median 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. Source: Charting Outcomes in the Match

17 Percentage of Programs Using USMLE Step 2 CK Scores for Interview Selection Scores Required? Consider applicants who fail 1 st attempt? 100% 100% 80% 80% 60% 40% % 40% % % % Yes, pass only Yes, target score No 0% Never Seldom Often Source: NRMP Program Director Survey

18 Percentage of Programs Using USMLE Step 2 CS & Step 3 Scores for Interviews Step 2 CS Scores Required? Step 3 Scores Required? 100% 100% 80% 60% % 60% % 40% 20% 0% Yes, pass only 23 No 22 20% 0% Yes, pass only Yes, target No score Source: NRMP Program Director Survey

19 Step 2 CK Scores Are Rising By Preferred Specialty Median 2014 Median 2011 Median Median Median Median 2007 Median 2007 Median 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. Source: Charting Outcomes in the Match

20 Average Percentage Applications Rejected Family Medicine 68% 68% Internal Medicine Categorical 61% 62% General Surgery 62% 62% Neurology 48% 57% Internal Medicine/Pediatrics 48% 57% Psychiatry 61% 55% Obstetrics and Gynecology 52% 55% Pediatrics 58% 54% Pathology-Anatomic and Clinical 56% 54% Average for all specialties 51% 53% Anesthesiology 47% 48% Orthopaedic Surgery 46% 47% Physical Medicine and Rehabilitation 45% 45% Radiology-Diagnostic 39% 40% Emergency Medicine 41% 39% Dermatology 33% 37% Otolaryngology 31% 32% Radiation Oncology 26% 30% Plastic Surgery 29% 30% Source: NRMP Program Director Survey 0% 25% 50% 75% 100%

21 Factors in Ranking Applicants It s All About the Interview Interactions with faculty during interview Interpersonal skills Interactions with housetaff during interview Feedback from current residents USMLE Step 1/Comlex Level 1 Recommendation letters in specialty USMLE Step 2/Complex Level 2 MSPE Perceived commitment to specialty Evidence of professionalism Perceived interest in program Leadership qualities Personal prior knowledge of applicant Class rank Graduate of U.S. allopathic medical school Personal statement Audition rotation within department Grades in required clerkships 93% 93% 88% 82% 80% 74% 71% 68% 67% 64% 62% 60% 58% 57% 57% 55% 55% 51% Passing USMLE Step 2 CS/Comlex Level 2 50% Source: NRMP Program Director Survey 0% 25% 50% 75% 100%

22 PGY-1Match Rates by Applicant Type No Change for U.S. Seniors 100% 90% 80% 70% 60% 50% 40% US Seniors Osteopathic Physicians US IMGs Prior US Grads IMGs 30% 20% 10% 0% Source: Results and Data, Main Residency Match

23 Match Rates By Preferred Specialty No Change for U.S. Seniors 100% 90% 80% 70% % 50% 40% 44 30% 20% 10% 0% Source: NRMP Data Warehouse

24 Is the Match More Competitive? 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 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

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

26 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?

27 When do you begin downloading applications? 100% 90% 80% 70% 60% % 40% DIOs PDs 30% 20% 10% 0% Monday before 5:00p.m Monday after 5:00 p.m. 5 8 Tuesday morning Tuesday afternoon before 5:00 p.m. Tuesday after 5:00 p.m. Source: NRMP All In & SOAP Survey

28 When do you begin reviewing applications? 100% 90% 80% 70% 65 60% 54 50% 40% DIOs PDs 30% 28 20% % 0% Monday before 5:00p.m. Monday after 5:00 p.m. Tuesday morning Tuesday afternoon before 5:00 p.m. Tuesday after 5:00 p.m. Source: NRMP All In & SOAP Survey

29 When do you finalize a first-round preference list? 100% 90% 80% 70% 60% 50% DIOs 40% 30% 20% 10% PDs 0% Monday before 5:00p.m. Monday after 5:00 p.m. Tuesday morning Tuesday afternoon before 5:00 p.m. Tuesday after 5:00 p.m. Source: NRMP All In & SOAP Survey

30 Do you support the SOAP schedule change? 100% 90% 80% 70% 60% 50% 40% DIOs PDs 30% 20% 10% 0% Strongly support Support No preference Oppose Strongly oppose Source: NRMP All In & SOAP Survey

31 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

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

33 PRISM The Program Rating and Interview Scheduling Manager

34 Match Events

35 Reminders! 1. Charting Outcomes in the Match, NRMP Program Director Survey, NRMP OPDA Match Tips for Applicants and Program Code of Conduct 4. Professional Profile, Match Registration 5. NRMP 2015 Applicant Survey

36 A National Conversation on the Transition from Medical School to Residency October 1-3, 2015 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

37 NRMP Like us on Facebook Follow us on Follow us on LinkedIn

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