NRMP Update · NRMP Update. Reproduction ... 1 Anesthesiology 1 Neurology 3 Dermatology 1...

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Mona M. SignerPresident and CEOGroup on Student AffairsApril 2017

NRMP Update


Today’s Topics

Main Residency Match Trends

SOAP

Seniors’ Application & Ranking Strategies

NRMP Conference


Main Residency Match

PGY-1 Positions Offered and Filled6,609 More Positions Since 2008

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Offered Filled Filled US Seniors

+ 989 PGY-1

positions

over 2016

All In Policy


0

500

1,000

1,500

2,000

2,500

IM FM EM PD AN PS NE SG OB DR DM OS PA


At Least + 50 PositionsChange Since 2008


2016 Main Residency Match

• 2 AOA programs

1 Family Medicine 1 Pediatrics

• 146 dually-accredited programs = 1,149 positions

2017 Main Residency Match

• 37 AOA programs, 166 positions

1 Anesthesiology 1 Neurology

3 Dermatology 1 Obstetrics/Gynecology

8 Emergency Medicine 2 Orthopaedic Surgery

5 Family Medicine 2 Pediatrics

13 Internal Medicine 1 Diagnostic Radiology

• 187 dually-accredited programs = 1,292 positions


New AOA Programs


15,242 15,638 16,070 16,559 16,52717,487 17,374 18,025 18,187 18,539

1,8702,013

2,0452,178 2,360

2,677 2,7382,949 2,982

3,590

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Others IMGs US IMGs DOs Prior US Grads US Seniors

All In Policy


Active Applicants7,232 More Applicants Since 2008


94.3

46

81.7

54.8

52.4

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

US Seniors

Osteopathic

Physicians

US IMGs

Prior US Grads

IMGs

All In Policy


PGY-1 Match Rate by Applicant TypeOverall Match Rate = 77.0%


7,7978,548

8,794 8,2038,421

9,091 8,5838,653

8,6408,281

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

US Seniors US Physicians DOs US IMGs IMGs Others Unmatched

All In Policy


PGY-1 Positions Filled by Applicant Type8,281 Unmatched Applicants With ROLs


3,121

156

1,236

1,594

706

-65

-1,000

0

1,000

2,000

3,000

4,000

US Senior US Grad USIMG DO IMG Other


PGY-1 Matches by Applicant TypeChange Since 2008


71

75 76 77 79

85

89 89 8991 91

9396 96 96 96 96 97 97 98 99

76

93

80 80

8783

91

84

75

90

96

90

98

91

97 96 9597 98

9593

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

2014 2017

Match Rates By Preferred Specialty

Most Seniors Match to Preferred Specialty


Today’s Topics


SOAP


NRMP Conference


455 473 461 444 484 459 449 475 465 508

127 89 105 129123

74 80123 100

72

663 663

453 423452

352408

378400

530

9259

82 103

146

112

127

210

108

7163

55

46

47

0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Surg-Prelim Med-Prelim T-Year & Other Prelim Categorical Advanced Reserved

SOAP


Unfilled Positions1,279 Unfilled Positions, Half PGY-1 Only


486

141

67

77

128

17

31

54

17

44

9

26

16

3

1

4

25

5

0

11

5

2

0

1

3

1

3

0 50 100 150 200 250 300 350 400 450 500

Surgery-Preliminary

Family Medicine

Internal Medicine-Preliminary

Anesthesiology

Internal Medicine

Radiology-Diagnostic

Transitional Year

Pathology

Child Neurology

Pediatrics

Obstetrics-Gynecology

Neurology

Other

Psychiatry

Physical Medicine & Rehab

Dermatology

Internal Medicine - Pediatrics

General Surgery

Neurological Surgery

Otolaryngology

Radiation Oncology

Plastic Surgery

Emergency Medicine

Orthopaedic Surgery

Thoracic Surgery

Vascular Surgery

Interventional Radiology

2016

SOAP2017

SOAP

486


1,177 Unfilled Positions in SOAP


22

20

8

6

5

5

5

4

4

3

3

3

3

2

2

2

1

1

1

11

0 10 20 30 40 50

Surgery-Preliminary

Anesthesiology

Child Neurology

Emergency Medicine

Radiology - Diagnostic

Dermatology

Internal Medicine-Preliminary

Internal Medicine

Transitional Year


Neurodevelopmental Disabilities

Otolaryngology

Radiation Oncology

Pathology

Neurology

Pediatrics-Preliminary

Psychiatry

Pediatrics

Medicine-Anesthesiology

Medicine-Medical Genetics

Pediatrics-Medical Genetics

484

444


102 Unfilled Positions Not in SOAP


Unmatched Seniors

PGY-1 Positions in SOAP

More Unfilled Positions Than Seniors Unmatched!

1,059

0

500

1,000

1,500

2,000

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

1,100


U.S. Seniors With ROLs

Unmatched to PGY-1

Positions

1,300

883

SOAP


Unmatched Applicants


7+ Unmatched Applicants for Every Unfilled Position

Unfilled PGY-1 Positions in SOAP

1,177

8,281

0

2,000

4,000

6,000

8,000

10,000

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

All Applicants With ROLs

Unmatched to PGY-1

Positions

1,298

7,797

SOAP


13,796 SOAP-Eligible Applicants

124 Fewer Than 2016

2,140

1,001

3,934

901

5,803

17

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

US Senior US Grad USIMG DO IMG Other


Preferences of Unmatched Seniors

Available SOAP Positions

0

0

1

3

4

4

5

6

7

7

8

10

10

11

11

14

15

24

24

26

29

43

54

73

79

92

117

122

135

0 50 100 150 200 250 300 350 400 450 500 550 600

Pediatrics Preliminary

Obstetrics-Gynecology Preliminary

Internal Medicine-Pediatrics

Child Neurology

Radiation Oncology

Neurology

Transitional Year


Thoracic Surgery

Internal Medicine Preliminary

Surgery Preliminary

Other

Vascular Surgery

Pathology

Anesthesiology

Dermatology

Otolaryngology



Plastic Surgery


Pediatrics

Family Medicine

Internal Medicine (C & M)

Psychiatry


Orthopaedic Surgery

General Surgery

Emergency Medicine

Available Positions

Preferred Specialty


Preferences of Unmatched Applicants

Available SOAP Positions

33

1

5

5

6

7

9

9

9

9

9

54

70

83

118

124

141

161

178

93

185

188

258

362

433

460

0 50 100 150 200 250 300 350 400 450 500 550 600

Other

Pediatrics Preliminary

Obstetrics-Gynecology Preliminary


Radiation Oncology

Vascular Surgery

Thoracic Surgery

Internal Medicine-Pediatrics

Otolaryngology

Child Neurology

Plastic Surgery

Transitional Year


Dermatology

Surgery Preliminary

Internal Medicine Preliminary



Pathology

Orthopaedic Surgery

Neurology

Anesthesiology


Emergency Medicine

General Surgery

Pediatrics

Psychiatry

Family Medicine

Internal Medicine (C & M)

Available Positions

Preferred Specialty

2,499

1,196

717


SOAP Offers

2012 - 2017

1,033

878998

1,1291,022 1,076

613

399

470

481

477

533

92

50

63

56

53

46

0

500

1,000

1,500

2,000

2,500

2012 2013 2014 2015 2016 2017

Accepted Rejected Expired


2017 SOAP Positions

Offered & Accepted by Round

709

252

115

396

107

30

20

18

8

0

200

400

600

800

1,000

1,200

1 2 3

Accepted Rejected Expired

1,279 Unfilled Positions

1,177 Positions in Soap

End of Day 1:

216 positions

remained

End of SOAP:

101 positions

remained

SOAP Round


SOAP Positions

Accepted by Applicant & Position Type

32 6 1 8 4

355

1651 53 57

214

36

76

108

51

9

0

0

0

1

0

100

200

300

400

500

600

700

US Seniors US Grads USIMGs DOs IMGs

None Accepted PGY-1 Only PGY-2 Only Categorical PGY-1 & PGY-2

2,140

3,934 901 5,8031,001

1,066 applicants accepted 1,076 positions


U.S. Allopathic Seniors in SOAP

2013 - 2017

1,816

595 602 591

2,076

609 623

506

2,050

653 645

606

2,142

665 666615

2,140

610633

570

0

500

1,000

1,500

2,000

2,500

SOAP Eligible Offers Accepted Unique Applicants With AnyOffers

No Position Post-SOAP*

SOAP 2013 SOAP 2014 SOAP 2015 SOAP 2016 SOAP 2017

*Presentations before 2015 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.


Today’s Topics


SOAP


NRMP Conference


40%

44%

46%

50%

51%

53%

54%

54%

54%

55%

56%

56%

56%

62%

63%

63%

67%

67%

82%

83%

88%

0% 25% 50% 75% 100%

Research opportunities

Program flexibility to pursue electives

Quality of hospital facilities

Diversity of patient problems

Preparation for fellowship training

Social & recreational opportunities in area

Career paths of recent program graduates

Future fellowship opportunities at the institution

Housestaff morale

Balance between supervision & patient care

Cost of living

Quality of program director

Program size

Quality of faculty

Work/life balance

Quality of curriculum & training

Academic medical center program

Quality of residents in program

Reputation of program

Perceived goodness of fit

Desired geographic location

Percent US Seniors Citing Each Factor:

Applications

Source: 2017 Applicant Survey


4%

4%

6%

7%

12%

14%

15%

16%

21%

22%

22%

23%

24%

26%

27%

29%

29%

31%

31%

33%

35%

36%

37%

0% 25% 50% 75% 100%

Previous Match violation

Other benefits

Schools for my children in the area

Alternative duty hours

Opportunity for systems-based practice

Having friends at the program

Supplemental income (moonlighting) opportunities

Quality of ambulatory facilities

Community-based setting

Opportunity for international experience

Salary

ABMS board pass rates

Vacation/parental/sick leave

Availability of electronic health records

Quality of ancillary staff

Call schedule

Size of patient caseload

Cultural/ethnic/gender diversity at institution

Opportunity to perform specific procedures

Other support network in the area

Future job opportunities for myself

Cultural/ethnic diversity of geographic location

Job opportunities for spouse/significant other


Applications (cont’d)



40%

41%

41%

42%

42%

44%

45%

45%

47%

47%

52%

59%

61%

61%

63%

63%

70%

74%

75%

80%

88%

0% 25% 50% 75% 100%

Program flexibility to pursue electives

Quality of hospital facilities

Social & recreational opportunities in area

Future fellowship opportunities at the institution

Diversity of patient problems

Cost of living

Preparation for fellowship training

Program size

Balance between supervision & patient care

Career paths of recent program graduates

Academic medical center program

Work/life balance

Housestaff morale

Quality of curriculum & training

Quality of program director

Quality of faculty

Reputation of program

Quality of residents in program

Desired geographic location

Interview day experience

Overall goodness of fit


Ranking



3%

3%

4%

5%

7%

11%

12%

12%

13%

18%

18%

19%

19%

19%

22%

23%

27%

28%

28%

28%

29%

30%

32%

36%

0% 25% 50% 75% 100%

Other benefits

Alternative duty hours

Previous Match violation

Schools for my children in the area

Opportunity for systems-based practice

Having friends at the program

Supplemental income (moonlighting) opportunities

Community-based setting

Quality of ambulatory facilities

Vacation/parental/sick leave

Opportunity for international experience

Salary

ABMS board pass rates

Availability of electronic health records

Opportunity to perform specific procedures

Quality of ancillary staff

Call schedule

Cultural/ethnic/gender diversity at institution

Cultural/ethnic diversity of geographic location

Size of patient caseload

Other support network in the area

Future job opportunities for myself

Job opportunities for my spouse/significant other

Research opportunities


Ranking (cont’d)



8%

13%

14%

21%

69%

80%

86%

2%

3%

24%

50%

77%

70%

94%

0% 20% 40% 60% 80% 100%

Ranked one or more program(s) where I applied but did notinterview

Ranked the programs based on the likelihood of matching

Ranked a mix of competitive and less competitive specialties tohave a "fallback"• plan

Ranked one or more less competitive program(s) in my preferredspecialty as a "safety net"

Ranked all programs that I was willing to attend

Ranked all programs at which I interviewed

Ranked programs in the order of my preferences

Matched Unmatched

Seniors’ Ranking Behavior: Matched & Unmatched

Source: NRMP 2017 Applicant Survey

More likely to rank all

programs where they

interviewed

Less likely to rank

“safety net” programs

More likely to rank based on

likelihood of matching

Less likely to rank

alternate specialty

Less likely to rank all

programs willing to attend

More likely to rank programs

where they did not interview

Less likely to rank

programs in order of

preference


Matched Applicants*: Applications, Interviews,

Programs Ranked in Preferred Specialty

110.5

114.8

46.6

56.7

41.4

7.8

9

10.6

7.2

12.5

7.1

9

9.8

7.2

12.1

0 10 20 30 40 50 60 70 80 90 100 110 120

Foreign

US Foreign

Osteopathic

US Graduate

US Senior

Applications

Programs Ranked

Interviews Attended

*Applicants matched to preferred or alternate specialtySource: NRMP 2017 Applicant Survey

Highest ratio of ranked

programs to applications


57.9

67.2

15.5

32.7

14.6

3

4.4

2.9

3.8

4.2

2.9

4

2.6

3.8

3.9

0 10 20 30 40 50 60 70 80 90 100 110

Foreign

US Foreign

Osteopathic

US Graduate

US Senior

Applications

Programs Ranked

Interviews Attended

*Applicants matched to preferred or alternate specialtySource: NRMP 2017 Applicant Survey

Fewest applications in

alternate specialty

Highest ratio of ranked

programs to applications

Matched Applicants*: Applications, Interviews,

Programs Ranked in Alternate Specialty


91.6

96

47.9

56.3

61.2

2.8

2.7

4.6

3.1

7.2

3.2

3.2

5.8

4.4

7.4

0 10 20 30 40 50 60 70 80 90 100 110

Foreign

US Foreign

Osteopathic

US Graduate

US Senior

Applications

Programs Ranked

Interviews Attended


Ranked programs where

they did not interview

Unmatched Applicants*: Applications, Interviews,

Programs Ranked in Preferred Specialty


58

74

19.1

25.7

18.7

1.5

2.5

1.6

1.1

2.2

1.3

1.6

1.5

1.5

2

0 10 20 30 40 50 60 70 80 90 100 110

Foreign

US Foreign

Osteopathic

US Graduate

US Senior

Applications

Programs Ranked

Interviews Attended


Fewest applications in

alternate specialty

Unmatched Applicants*: Applications, Interviews,

Programs Ranked in Alternate Specialty


US Seniors Matched and Unmatched:

Applications, Interviews, Programs Ranked

18.7

61.2

33.1

41.3

2.2

7.2

8.4

12.6

2

7.4

7.9

12.3

0 10 20 30 40 50 60 70 80 90 100 110

Unmatched toAlternate Specialty

(applications,interviews, programs

ranked in alternatespecialty)

Unmatched toPreferred Specialty

(applications,interviews, programsranked in preferred

specialty)

Matched to AlternateSpecialty

(applications,interviews, programs

ranked in alternatespecialty)

Matched to PreferredSpecialty

(applications,interviews, programsranked in first-choice

specialty)

Applications

Programs Ranked

Interviews Attended


More applications in

preferred specialty;

lower yield

Fewer applications in

alternate specialty; lower

yield


8.4

8.2

9.3

82.0

14.7

15.2

20.9

57.7

0 10 20 30 40 50 60 70 80 90

Programs Ranked

Interviews Attended

Interviews Granted

Applications SubmittedPreferred + Alternate

Specialty

Average Number of

Matched Unmatched

Unmatched Seniors: Lower Yield Per Application,

Fewer Interviews, Fewer Programs Ranked

24.3 more

applications

11.6 fewer interview offers

7 fewer interviews

attended

6.3 fewer ranked programs



1.2

1.8

1.6

1.9

1.9

3.1

3.0

3.9

4.5

1.1

1.8

1.7

2.1

2.0

2.6

3.1

3.3

4.4

0 1 2 3 4 5

Pursue GME outside the U.S.

Pursue non-clinical training

Pursue another graduate degree

Delay graduation; reenter theMatch

Not participate in SOAP; reenterthe Match

Participate in SOAP for a positionin a less competitive specialty

Pursue research; reenter theMatch

Participate in SOAP for a Pposition; reenter the Match

Participate in SOAP for a positionin preferred specialty

Matched

Unmatched

Seniors Strategies if Unmatched


Extremely

likelyNot at all likely


Today’s Topics


SOAP


NRMP Conference


Anna Quindlen: Health Care in an Information Age

Dr. Daniel Goleman: Emotionally Intelligent Healthcare in Medical Education

Dr. Kenneth Shine: Sustaining the Medical Education Enterprise

NRMP Town Hall

Transition to Residency: Conversations

Across the Medical Education Continuum

May 4-6, 2017

www.nrmpconference.org


Broad Themes:

Goodness of Fit: exploring the role of medical schools and residency programs in addressing application overload

Matching Process: using Match data to understand and inform workforce planning

Unmatched Applicants: examining outcomes and considering alternatives to clinical medicine

Innovations in Medical Education: evaluating the flexibility of the Match in supporting competency-based curricula

Single Accreditation System: AOA programs in the NRMP

Transition to Residency: Conversations

Across the Medical Education Continuum

May 4-6, 2017


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Follow us on LinkedIn

www.nrmp.org

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866-653-NRMP

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