Combined Internal Medicine-Pediatrics Match 2016 and other Data Allen Friedland, MD, FACP, FAAP We hope you as excited about our combined specialty as we are. We provide this information to help you make informed decisions about Combined Internal Medicine-Pediatrics (Med-Peds) residency programs.

How many intern positions and med-peds programs are there in the country?

Programs and Number of Positions of Med-Peds Programs As you can see the explosion of med-peds residency programs occurred in the 1980’s and 1990’s and has plateaued since 2009 (354) and has increased again since (2015 at 380 intern positions). There are approximately 1300 residents in training over the four years currently in the 78 residency programs. Med-Peds residents comprise 1.9% of all residents in all specialties through the National Residency Matching Program (NRMP). National Resident Matching Program 2016 3

Does med-peds fill in the match (NRMP) well?

Med-Peds Match 2016 (79 programs with 386 positions) NE: 2 spots IN: 14 spots MI(6): 26 spots OH(4): 27 spots MN: 10 spots WI (2): 8 spots KY(2): 11 spots IL(5): 24 spots ME: 3 spots NY(4): 19 spots MA(4): 20 spots CT: 4 spots RI: 4 spots PA(4): 17 spots NJ(2): 7 spots DE: 4 spots DC: 4 spots MD: 8 spots WA ND MT ME FL RI CA DC MN VT WI NY NH OR ID SD WY MI MA PA IA CT NE NJ IL NV UT IN OH CO DE WV KS MO KY VA MD AR TN NC NM OK AZ SC MS AL GA CA (4): 18 spots CO: 4 spots UT: 3 spots AZ: 6 spots TX LA HI PR OK(2): 6 spots AR: 6 spots TX(2): 14 spots LA(3):16 spots MO (2): 9 spots KS: 3 spots VA:6 spots WV(3): 8 spots TN(2):18 spots NC(3):18 spots MS: 4 spots SC(2): 7 spots AL: 6 spots FL(2): 11 spots P. Rico: 2 spots

Med-Peds Overall Fill Rate thru the Match 99% Positions Med-Peds has a strong fill rate thru the match (NRMP) each year and in 2015 there was a 99% fill rate through the NRMP with 1 open positions (379/380 positions filled). National Resident Matching Program 2016 6

Overall Fill Rates By Residency In NRMP Match (US and IMG) Percent Fill The Med-Peds overall fill rate is comparable to the other specialties. About 55% of our residents are women. National Resident Matching Program 2016 7

The NRMP uses the term “US Seniors” to denote US allopathic seniors What percent of intern positions are matched with US allopathic graduates? The NRMP uses the term “US Seniors” to denote US allopathic seniors

Fill Rates By Residency In Match (US Allopathic Seniors only) 85% 329 interns Percent Fill 329/386 matched med-peds intern positions came from US graduates. A 84% US graduate fill rate is higher than comparable specialties. In general, an additional interns come from osteopathic schools. The NRMP does not include osteopathic graduates in the US seniors total. National Resident Matching Program 2016 9

What are the absolute numbers of matched interns from allopathic, osteopathic and international medical schools?

US Graduates (allopathic) Matched into Med-Peds Applicants Out of the 386 intern positions offered, 329 were filled through the match by allopathic US graduates. The other 60 intern positions were filled by osteopathic and international medical graduates. The data for the number of osteopathic and international medical graduates that matched into med-peds separated out by the NRMP is not yet available for 2015. National Resident Matching Program 1989-2016

US Graduates (Osteopathic) Matched into Med-Peds (N = 291 from 2004-2016) Applicants 1999: 10 2004: 13 of 1099 total DO matched (1.2% of all DO matched) 2005: 20 of 1045 total DO matched (1.9% of all DO matched) 2006: 21 of 1024 total DO matched (2.1% of all DO matched) 2007: 24 of 1136 total DO matched (2.1% of all DO matched) 2008: 24 of 1339 total DO matched (1.8% of all DO matched) 2009: 27 of 1408 total DO matched (1.9% of all DO matched) 2010: 21 of 1444 total DO matched (1.5% of all DO matched) 2011: 21 2012: 27 2013: 21 2014: 34 2015: 34 2016: 25 National Resident Matching Program 2004-2016

International Medical Graduates Matched into Med-Peds Applicants National Resident Matching Program 2009-2016

Total Allopathic Applicants to ERAS Compared to Those That Rank and Match into Med-Peds (NRMP) This illustrates that 452 allopathic students applied to at least 1 med-peds program. About 422 allopathic students ranked at least one med-peds program (which means that some students were not interested in med-peds or did not interview with med-peds programs). Out of the 422 that ranked med-peds program somewhere on their rank lists, 329 matched into a med-peds program. It is not unusual for there to be a drop off in numbers applying to any specialty. ERAS data (unpublished) with permission 2016 National Resident Matching Program 2000-2016

Are there regional differences in the number of applicants that apply to med-peds programs?

ERAS Applicants to Med-Peds U. S ERAS Applicants to Med-Peds U.S. Graduates (Allopathic and Osteopathic) by Region Applicants There were 510 applicants that applied through the Electronic Resident Application System (ERAS) to at least 1 med-peds program for the 2016 match. Here is the breakdown of applicants by region for the medical schools. Many applicants apply to more than 1 specialty in addition to med-peds. Most commonly people apply to family medicine, internal medicine and pediatrics in addition to med-peds. In addition, some students after applying to med-peds do not pursue it in the NRMP. ERAS data (unpublished) with permission 2016

Osteopathic Applicants To Med-Peds Through ERAS Osteopathic Applicants vary by geography and listed is the number of osteopathic applicants in that geography Overall osteopathic applicants are 7.6% (2000)  10% (2016) of all med-peds US applicants (52 DO/452 US MD and DO graduates) that applied to at least 1 med-peds program. ERAS data (unpublished) with permission 2016

International Applicants To Med-Peds Through ERAS Most Applicants to Med-Peds (10 + applicants in 2016) St. George's University School of Medicine (35) Ross University School of Medicine (33) American University of Antigua College of Medicine (19) Allama Iqbal Medical College (13) Dow Medical College (12) Applicants ERAS data (unpublished) with permission 2016

When there are unfilled positions how many are there and what part of the country are they in?

National Resident Matching Program Regional Stats 2006-2016 Med-Peds Unmatched Positions to Total Intern Positions by Region (2006-2016) 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 N. East 6 93 4 95 2 85 3 86 90 88 5 Central 7 135 103 11 130 127 125 1 124 128 South 19 123 22 126 23 119 8 115 118 122 132 131 137 West 25 27 28 26 30 31 Total 32 376 33 378 36 362 17 354 359 365 18 366 12 374 380 386 The total number of intern positions by region of the country has not changed much since 2006. Here is a table that lists the number of open positions and the total number of intern positions offered in the NRMP. There were 7 (unfilled) open programs in 2014 in the NRMP Total positions and open positions and open programs Northeast Central South West 2006: 6/93= 4 programs 7/135 19/123 0/25 2007: 4/95= 3 program 7/103 22/126 0/27 2008: 2/85= 1 program 11/130 23/119 0/28 2009: 3/86= 2 programs 4/127 8/115 2/26= 1 program 2010: 0/90 2/125=1 program 2/118=2 programs 0/26 2011: 0/88 0/127 3/123=2 programs 0/27 2012: 6/85= 3 programs 6/127= 3 programs 6/122= 4 programs 0/28 2013: 0/86 1/130= 1 program 2/124= 2 program 0/26 2014: 5/88= 3 programs 3/124= 1 program 4/132= 3 programs 0/30 2015: 0/90 0/128 1/131= 1 program 0/31 2016: 0/90 0/128 2/137= 1 program 0/31 Programs Unmatched 2006: 17/84 (20%) 2007: 16/82 (19.5%) 2008: 17/79 (21%) 2009: 12/79 (15%) 2010: 3/78 (3.8%) 2011: 2/77 (2.5%) 2012: 10/77 (13%) 2013: 3/77 (3.9%) 2014: 7/79 (8.9%) 2015: 1/78 (1.3%) 2016: 1/ ( ) The numbers in each cell= Open positions/Total positions National Resident Matching Program Regional Stats 2006-2016

What are average USMLE and COMLEX scores and other important data?

Independent Applicants (NRMP: combines DO and IMG applicants) Summary Statistics 2014 U.S. Seniors Matched Unmatched (n=280) (n=11) Independent Applicants (NRMP: combines DO and IMG applicants) Matched Unmatched (n=66) (n=52) Mean USMLE 1 233 223 225 216 Mean USMLE 2 245 234 224 Mean # contiguous ranks 9.6 2.8 6.9 1.7 Mean number of distinct specialties ranked 1.3 2.3 1.8 2.0 This is a summary of the 2014 data. This summary data is produced every few years The NRMP includes all non allopathic applicants in the Independent Applicant Category (e.g. Osteopathic and International Medical Graduates) The “mean number of contiguous ranks” relates to how long is the applicants’ match lists in the desired specialty ranked #1. Someone that ranks 20 med-peds programs in total but has other specialties interspersed on the rank list will have a number lower than 20. The key is to rank as many med-peds programs in a row to give yourself that best chance of matching into med-peds. 2014 Charting the Outcome: NRMP and AAMC

Osteopathic Boards Data (n=190) 2004-2016 Average COMLEX and USMLE 266 till 2015 went into med-peds. This is data compiled from program directors and reflects about 60% of all osteopathic graduates that entered med-peds programs since 2004. Data includes 188 (COMLEX 1 scores), 176 (COMLEX 2 scores) and 12 (COMLEX 3 scores). Data includes 78 (USMLE 1 scores), and 55 (USMLE 2 scores). The average COMLEX score of those matching into med-peds is slightly higher than osteopathic students matching in other specialties. Only about 40% take USMLE 1 and fewer take USMLE 2 (29%). The average USMLE scores seem to be lower than US allopathic graduates (230, 242) that match into med-peds. N=78 N=55 Med-Peds Directors Survey 2016 (unpublished) 23

Summary of Med-Peds Depth and breadth of two disciplines that allows flexible career goals without Surgery and OB training. The perfect “double major” Four years of training that is rigorous but humane; gives added maturity to your career Wide variety of practice styles and settings; effective with variety of patient problems Dual board certification in Internal Medicine and Pediatrics that is unique Niches of special populations; cross fertilization of knowledge Almost 50 years of rich history in Med-Peds

Combined Internal Medicine-Pediatrics A specialty worth consideration !!