NRMP UPDATE. Mona M. Signer President and CEO November 8, Reproduction prohibited without the written permission of the NRMP.

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1 NRMP UPDATE Mona M. Signer President and CEO November 8, 2015

2 TODAY S TOPICS Main Residency Match Trends US Seniors Strategies in the Match Match Week 2016 New at NRMP

3 FIRST-YEAR GME POSITIONS ALLOPATHIC MEDICINE 30,000 25,000 20,000 15,000 >9,200 more PGY-1 positions than US seniors in the Match US Allopathic Seniors Who Obtained Positions through SOAP US Allopathic Seniors Matched 10,000 US Allpathic Seniors in the Match NRMP PGY 1 Positions 5,000 Allopathic Projection** US Allopathic Graduating Seniors Data sources: NRMP, AAMC * 2015 US allopathic graduating seniors were projected using 2011matriculant data from AAMC minus attrition. Attrition rate was estimated to be 3% using both graduation for the past 5 years and corresponding matriculant data.

4 MAIN RESIDENCY MATCH PGY-1 Positions Offered and Filled +500 Positions in , ,287 PGY-1 positions with All In Policy 25,000 20,000 15,000 10,000 5, Offered Filled Filled US Seniors

5 POSITION INCREASES BY SPECIALTY 2,000 At least +50, ,800 1,600 1,400 1,200 1, IM FM AN PS EM PD NE SG SG Prelim PA CM IM Prim OB

6 ACTIVE APPLICANTS: More Seniors, 635 More Total Applicants All In Policy 35,000 30,000 25,000 20,000 15,000 10,000 5, Others DOs IMGs US IMGs Prior US Grads US Seniors

7 PGY-1 MATCH RATES BY APPLICANT TYPE 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Overall 2015 PGY-1 Match Rate: 75% All In Policy US Seniors Osteopathic Physicians US IMGs IMGs Prior US Grads

8 SENIORS MATCHED TO PGY-1 POSITIONS 2,000 More US Seniors Matched Over 10 Years 18,000 16,000 14,000 12,000 10,000 8,000 6,000 4,000 2,000 14, ,932 1,

9 SENIORS MATCH RATES BY PREFERRED SPECIALTY 100% 90% 80% 70% % 50% 40% 30% 44 20% 10% 0% Source: NRMP Data Warehouse

10 UNMATCHED US SENIORS BY SCHOOL FIVE-YEAR AVERAGE: Number Unmatched 10 5 Average = 6.7 graduates/school Average = 5.5% of class 0 0% 5% 10% 15% 20% 25% 30% Percent Unmatched

11 PERCENT UNMATCHED SENIORS 100% Who Ranked One Specialty 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% TS DM OS NS OT OB SG PH PS EM PL RO MP FM PD PA NE IM AN RD CN VS

12 UNMATCHED SENIORS AND PGY-1 POSITIONS IN SOAP 2,000 1,500 1, U.S. Seniors With ROLs Unmatched to PGY-1 Positions 1, PGY-1 Positions in SOAP

13 PREFERENCES OF UNMATCHED SENIORS AND AVAILABLE SOAP POSITIONS Orthopaedic Surgery General Surgery Obstetrics-Gynecology Internal Medicine Emergency Medicine Pediatrics Otolaryngology Family Medicine Psychiatry Neurological Surgery Dermatology Anesthesiology Physical Medicine & Rehab Plastic Surgery Internal Medicine (PGY-1 Only) Internal Medicine-Pediatrics Neurology Pathology Surgery-Preliminary (PGY-1 Only) Radiology-Diagnostic Thoracic Surgery Radiation Oncology Transitional Year Vascular Surgery Other Child Neurology Preferred Specialty Available Positions

14 SENIORS IN SOAP ,500 2,000 2,142 2,076 2,050 1,500 1,816 1, SOAP Eligible Offers Accepted Unique Applicants With Offers No Position Post-SOAP* SOAP 2012 SOAP 2013 SOAP 2014 SOAP 2015 *Previous presentations included only seniors with a certified ROL who did not have any position at the conclusion of SOAP, regardless of whether they participated in SOAP. This presentation includes all SOAP-participating seniors who did not have any position at the conclusion of SOAP.

15 TODAY S TOPICS Main Residency Match Trends US Seniors Strategies in the Match Match Week 2016 New at NRMP

16 PERCENT US SENIORS CITING EACH FACTOR: APPLICATIONS Geographic location Reputation of program Perceived goodness of fit Quality of residents in program Quality of curriculum & training Academic medical center program Quality of faculty Work/life balance Program size Quality of program director Social & recreational opportunities in area Housetaff morale Future fellowship opportunities in the institution Career paths of recent program graduates Preparation for fellowship training Balance between supervision & patient care Cost of living Quality of hospital facility Diversity of patient problems Program flexibility to pursue electives 70% 68% 68% 64% 64% 58% 57% 57% 56% 56% 55% 53% 52% 52% 52% 50% 48% 83% 80% 87% 0% 25% 50% 75% 100% Source: 2015 Applicant Survey

17 PERCENT US SENIORS CITING EACH FACTOR: APPLICATIONS (CONT D) Research opportunities Availability of electronic medical record Size of patient caseload Cultural/ethnic diversity of geographic location Opportunities to perform specific procedures Quality of ancillary staff Call schedule ABMS board pass rates Cultural/ethnic diversity at institution Salary Opportunity for international experience Vacation/parental/sick leave Having friends at the program Community-based program Supplemental income (moonlighting) opportunities Quality of ambulatory facilities Opportunity for systems-based practice Alternative duty hours Other benefits Previous Match violation 34% 33% 33% 29% 29% 28% 26% 25% 24% 24% 22% 21% 18% 15% 15% 13% 7% 5% 5% 43% 0% 25% 50% 75% 100% Source: 2015 Applicant Survey

18 PERCENT US SENIORS CITING EACH FACTOR: RANKING Geographic location Reputation of program Perceived goodness of fit Quality of residents in program Quality of curriculum & training Academic medical center program Quality of faculty Work/life balance Program size Quality of program director Social & recreational opportunities in area Housetaff morale Future fellowship opportunities in the institution Career paths of recent program graduates Preparation for fellowship training Balance between supervision & patient care Cost of living Quality of hospital facility Diversity of patient problems Program flexibility to pursue electives 80% 71% 87% 74% 62% 56% 66% 61% 47% 62% 45% 63% 44% 48% 49% 47% 43% 46% 42% 42% 0% 25% 50% 75% 100% Source: 2015 Applicant Survey

19 PERCENT US SENIORS CITING EACH FACTOR: RANKING (CONT D) Research opportunities Availability of electronic medical record Size of patient caseload Cultural/ethnic diversity of geographic location Opportunities to perform specific procedures Quality of ancillary staff Call schedule ABMS board pass rates Cultural/ethnic diversity at institution Salary Opportunity for international experience Vacation/parental/sick leave Having friends at the program Community-based program Supplemental income (moonlighting) opportunities Quality of ambulatory facilities Opportunity for systems-based practice Alternative duty hours Other benefits Previous Match violation 26% 29% 26% 22% 25% 26% 22% 23% 21% 20% 17% 13% 13% 11% 14% 8% 4% 4% 4% 39% 0% 25% 50% 75% 100% Source: 2015 Applicant Survey

20 MATCHED APPLICANTS*: APPLICATIONS, INTERVIEWS, PROGRAMS RANKED IN PREFERRED SPECIALTY US Senior Highest ratio of ranked programs to applications Applications Programs Ranked US Graduate Interviews Attended 9.2 Osteopathic US Foreign Foreign Source: NRMP 2015 Applicant Survey *Applicants matched to preferred or alternate specialty

21 MATCHED APPLICANTS*: APPLICATIONS, INTERVIEWS, PROGRAMS RANKED IN ALTERNATE SPECIALTY US Senior Highest ratio of ranked programs to applications Fewest applications in alternate specialty Applications Programs Ranked Interviews Attended 3.7 US Graduate Osteopathic US Foreign Foreign Source: NRMP 2015 Applicant Survey *Applicants matched to preferred or alternate specialty

22 UNMATCHED APPLICANTS: APPLICATIONS, INTERVIEWS, PROGRAMS RANKED IN PREFERRED SPECIALTY US Senior Ranked programs where they did not interview Applications Programs Ranked US Graduate Interviews Attended 5 Osteopathic US Foreign Foreign Source: NRMP 2015 Applicant Survey

23 UNMATCHED APPLICANTS: APPLICATIONS, INTERVIEWS, PROGRAMS RANKED IN ALTERNATE SPECIALTY US Senior Fewest applications in alternate specialty Applications Programs Ranked US Graduate Interviews Attended 1.7 Osteopathic US Foreign Foreign Source: NRMP 2015 Applicant Survey

24 US SENIORS MATCHED AND UNMATCHED: APPLICATIONS, INTERVIEWS, PROGRAMS RANKED Matched to Preferred Specialty (applications, interviews, programs ranked in first-choice specialty) Matched to Alternate Specialty (applications, interviews, programs ranked in alternate specialty) Applications Programs Ranked Interviews Attended Unmatched (applications, interviews, programs ranked in preferred specialty) More applications in preferred specialty; lower yield Unmatched (applications, interviews, programs ranked in alternate specialty) Fewer applications in alternate specialty; lower yield Source: NRMP 2015 Applicant Survey

25 UNMATCHED SENIORS: LOWER YIELD PER APPLICATION, FEWER INTERVIEWS, FEWER PROGRAMS RANKED Average Number of Applications Submitted Preferred + Alternate Specialty Interviews Granted fewer interview offers 13.4 more applications Interviews Attended fewer interviews Programs Ranked fewer ranked programs Source: NRMP 2015 Applicant Survey Matched Unmatched

26 UNMATCHED SENIORS RANKING BEHAVIOR Ranked the programs in order of my preferences 81% 92% Less likely to rank programs in order of preference Ranked all programs at which I interviewed Ranked all programs I was willing to attend Ranked a mix of competitive and less competitive programs in preferred specialty Ranked one or more less competitive programs in first-choice specialty as a "safety net" Ranked one or more programs in an alternative specialty as a "fallback" plan Ranked programs based on the likelihood of matching Ranked one or more programs where I applied but did not interview 2% 8% More likely to rank programs where they did not interview 0% 20% 40% 60% 80% 100% 7% 9% 5% 17% 24% 43% 48% 64% 65% 68% More likely to rank alternate specialty 77% 77% More likely to rank based on likelihood of matching More likely to rank all programs where they interviewed Less likely to rank all programs willing to attend Less likely to rank a mix of programs Less likely to rank safetynet programs Matched Unmatched Source: NRMP 2015 Applicant Survey

27 TODAY S TOPICS Main Residency Match Trends US Seniors Strategies in the Match Match Week 2016 New at NRMP

28 MATCH WEEK 2016 Goal: Allow unmatched applicants more time to process their options before submitting SOAP applications All programs using web-based ERAS PDWS 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?

29 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 11:55 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 5:00 p.m. Last offers expire Friday 12:00 p.m. Match Day Ceremonies 1:00 p.m. Applicant Where Did I Match? 12:00 p.m. Match Results by Ranked Applicant Match Outcome for All Programs

30 TODAY S TOPICS Main Residency Match Trends US Seniors Strategies in the Match Match Week 2016 New at NRMP

31 UPDATED PUBLIC WEBSITE

32 UPDATED PUBLIC WEBSITE

33 NRMP PROGRESS REPORT

34 THE MATCH PRISM

35 QUESTIONS? NRMP