Facts about the Match

Introduction  Prior to the mid 70’s, getting into a residency was “crazy”  Then the NIMP became the NRMP  Programs were still quite variable so getting into the “right place” was important (but still pyramidal)  The ACGME has “leveled the field”  Today the “Match” really means finding the program that matches the applicant

Caveats  Students get information from many sources (Student Affairs, current residents, other students, parents, family doctor, etc)  Much of the information is WRONG

NRMP USF Data Characteristic 25th 50th 75th Match Characteristics: 1. Number of matched seniors Percentage of class matched Mean number of programs ranked Mean number of programs ranked in matched specialty Student Characteristics: 5. Mean number of work experiences Mean number of volunteer experiences Mean number of research experiences Mean number of publications Percent AOA members USMLE Step Scores: 10. Mean Step 1 score Mean Step 2 Scores Percentile Distribution for All Matched Seniors: All Specialties Combined

Characteristic 25th 50th 75th Match Characteristics: 1. Number of matched seniors Percentage of class Mean number of programs ranked Mean number of programs ranked in matched specialty --Does Not Apply for Unmatched Seniors -- Student Characteristics: 5. Mean number of work experiences Mean number of volunteer experiences Mean number of research experiences Mean number of publications Percent AOA members USMLE Step Scores: 10. Mean Step 1 score Mean Step 2 scores NRMP USF Data 25. Percentile Distribution for All Matched Seniors: Unmatched

Program P(match givenUS) Family Medicine 0.98 Internal Medicine 0.98 Pediatrics 0.98 Neurology 0.97 Psychiatry 0.95 Anesthesiology 0.94 Emergency Medicine 0.94 Obstetrics/Gynecology 0.94 Pathology 0.94 Physical Medicine 0.94 All Programs 0.93 Radiology 0.88 General Surgery 0.88 Neurosurgery 0.82 Orthopedic Surgery 0.82 Otolaryngology 0.82 Dermatology 0.73 Plastic Surgery 0.71 Vascular Surgery (integrated) 0.67

111 (of 126) schools responded 14,623 seniors represented (NRMP = 16,070) 871 unmatched on Monday 3/15/10 (6.0%) 194 without a PGY-1 position on 3/29/10 (1.3%) 179 “ready to start” according to their student affairs deans (1.2%) 2010 Match-Scramble Survey

Of those not competitive for chosen field 49- USMLE issues 28- Rank order issues 18- Difficulty with the process 16- Geography 13- Overly Aggressive 11- Poor interviewing skills 6- Professionalism issues 2- Poor Letters of Recommendation 1- Poor advice 2010 Match-Scramble Survey

Things to consider  How competitive is the student  How competitive is the discipline  How much help is the student going to need, how do you help get it  Alternate Plan, where indicated  “What Color is Your Parachute-2010” by Richard Bolles ($12.91 at Amazon) Interviewing skills Dress  Careers in Medicine (AAMC resource)

2010 NRMP Data for US Seniors Matched US Seniors 93.3% %matched first choice52.7% %matched second choice15.4%68.1% %matched third choice9.2%77.3% %matched 4th choice5.3%82.6% %matched >4th choice11.6%94.2% %unmatched 5.9% Couples match rate (N=808 couples)93.4% USF 2010 Class Data ApplicationsInterviewsAttended# ranked first quartile15755 median third quartile Minimum3110 Maximum

Things to Address  Need to list at least 7 institutions that the student is willing to go to (or more)  Interviewing do’s and don’ts  How to put together a match list.

Determining “risk”  Surgery example risk of surgery is estimated by risk of operation x risk of patient  Match example Risk of not matching is a combination of risk of “chosen field” x risk of student  Take home message Understand how competitive your field is Understand how competitive you are

Risk of Discipline 90+%80-89%70-79%60-69%50-59% Anesthesiology 93%Emergency Med 88%Med Peds 77%Dermatology 69%Plastic Surgery 56% Neurology 95%Family Med 87%Orthopedics 75% Pathology 90%Internal Med 85%Otolaryngology 77% Pediatrics 90%Neurosurgery 82%Radiation Onc 79% Psychiatry 90%Obstetrics 88%Surgery 71% Radiology Diagnostic 90%Physical Med 89%

Your Risk  Getting an interview USMLE Step 1 Score Rank in Class Getting help  Getting ranked highly AOA “Audition Rotation” +/- Rank in Class Interview Letter from someone KNOWN

Getting “GOOD” advice  Career Counselor/Master Trainers Michael Flannery (IM) Erika Abel (IM/Peds) Lara Katzin (Neuro) William Marshall (Surgery & Specialties) Kelly O’Keefe (Emergency Medicine) Eduardo Gonzalez (Family Medicine)  USF Faculty (sometimes wrong)  Residents (often wrong, N=1)  Other Students (often wrong, N=0)  Family/friends (usually wrong, old)

USMLE Step 2 Exam  Required to be ranked?  Delay in starting residency  Score “decays” with time

Summary  Get good advice  Understand the field and yourself  Meet with USF Chair and/or PD  Rank at least 7 programs  Have a developed “Plan B”  DON’T count on the scramble  Take Step 2 early