Residency Competitiveness: Whammy!
By txmed • Jan 5th, 2007 • Category: Uncategorized
“I’m All About Having Fun…”
Ah, the section stuffed with surgical sub specialties and docs who play with radiation.
3. Otolaryngology
T-4. Orthopedic Surgery
T-4. Urology
6. Neurosurgery
7. Radiation Oncology
8. Radiology
ENT, in my opinion, right now, is the second most competitive surgical subspecialty. ENT has recently gone to the regular match but in 2004 it enjoyed the second or third highest Step 1 average of any specialty at 237. It is true that U.S. Seniors that year matched at a 76% rate, compared to say even General Surgery from last year which was 74%.
That should just go to show you how much self selection goes on in this process.
Orthopedic (or if we go a little high brow with a British accent then orthopaedics), comes in tied at #4 with Urology.
Ortho Surgery has a reputation for being a ‘jock’ specialty. That is probably true; I wouldn’t want to go to into the interview without being able to talk about your sports playing experience (and not your equestrian riding). But these “guys” (and gals) are wicked smart.
You get to play with cool toys, and it turns out the spine work is probably the best paying work in all of health care. I worked in a big spine practice for a while. On top of that, the hand is one of the coolest things I’ve ever seen.
I’ve trailed off a bit, mostly cause I have some experience here having worked through my summers in a large orthopedic practice. Back to the true topic we find the median Step 1 for those who matched at around the same level as ENT, perhaps just slightly lower 235 - 237.
Urology is weird. They’ve decided they want to run their own match. That is right, there is a match ONLY for urology. It is the one specialty we do not have AOA % and Step 1 medians and means for.
So how can I justify putting it way up here?
Well I cannot imagine (looking at the other surgical sub specialties, the earning potential, etc.) that its Step 1 mean is lower than 230 and probably closer to 235. As well, the past two years it has filled completely. That is right, not a single unfilled residency spot.
Along the same lines with many surgical sub specialties it finds a U.S. Senior matching rate of ~75%.
Neurosurgery is a little odder. Its Step 1 slides down a little from say ENT to an average Step 1 of 234 for those who matched in 2005.
Yet it has a U.S. Senior matching rate approaching 90% in many years. That needs at least a little exploration. Personally, I think just from conjecture and hearsay there is a reasonable argument this might be the “toughest”/most work of any residency. It is certainly long. And while the earning potential is great, it has also faced major liability issues in recent years.
There may be self selection (to say ENT or other surgical sub specialties) amongst the “strongest” medical school graduates away from neurosurgery. Certainly we’ve seen an upticking in the % of U.S. Seniors matching (as recently as 1998 it was down at 71%), which would seem to support this theory.
In any case, the % U.S. Seniors matching should not be seen as neurosurgery being easier.
Radiation Oncology is a well paying specialty (not to make medical students seem shallow with all this discussion of earning potential). The matching rate for Seniors is up above 80% (although 2005 was a popular year for the specialty) and the Step 1 median for matched U.S. Seniors is right around 234.
The AOA % is right around 20, which is closer to neurosurgery than ENT or the 25+% of orthopedic surgery.
Finally, I was surprised at #8. You hear radiology is tough, but this isn’t a specialty that is on the brink of falling down into the category below (Made With Bits Of Real Panther). You could easily justify actually switching radiology with radiation oncology.
In part this is fairly amazing considering the number of radiology spots (more than a 1000, pretty comparable with general surgery). True there were actually less U.S. Senior applicants than positions. But that didn’t stop only 82% of those Seniors from matching.
The median Step 1 score for radiology is identical to that of radiation oncology at 234.
It is good to note that from the two specialties in the category to be revealed tomorrow you stay above 230 for the median Step 1 for Seniors who matched through Radiology and then drop SHARPLY, about 10 points, to the median Step 1 for pathology.
When you see it on a chart, it is a pretty impressive graphic demonstrating the strength of those who match into the specialties in this category (and the two to be revealed tomorrow). These are competitive specialties - open up that book, get to work on that QBank, work your ass off on the wards.
Head Back To Residency Competitiveness Front Page
txmed is a fourth year medical student with a strong interest in health care policy and politics. In addition to From Medskool, he writes for Medscape and helps run the popular medical blog carnival Grand Rounds.
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I would bump radiation oncology higher, just because of the degree of self-selection involved. Tons of MD-PhDs, heavily published candidates. I would also say urology is just as competitive or maybe little more competitive than ENT.
It is such a subjective little endeavour to “rank” the competitiveness. I think it would’ve been better just to group them in these broad categories without further quantifying them.
You’re right though, there’s a fine argument with keeping Rad Onc where it is or switching it with Neurosurgery. Not that neurosurgery is a slouch in weighing research, but I’m certainly under the impression as you mentioned that Rad Onc heavily favors those with the publications.
As for Urology…I’ve just never seen any numbers.
Good points. Wanted to add that I think this is a great site, enjoyable daily read. And anyone who categorizes residency competitiveness with Anchorman is ok in my book.
Urology match statistics are available on the AUA website: http://www.auanet.org.
Urology Match Statistics
Jan 2007
Jan 2006
Jan 2005
Jan 2004
Jan 2003
Jan 2002
Jan 2001
Jan 2000
Programs
Positions Offered
241
235
232
222
236
233
221
230
Positions Filled
239
235
232
218
235
233
218
228
Positions Open
2
0
0
4
1
0
3
2
Applicants
Registrations
476
469
451
415
468
422
418
422
Lists Submitted
348
350
347
310
365
336
326
342
Ranked by Programs
331
319
313
301
350
321
311
320
Matched
239
235
232
218
235
233
218
228
Not Matched
109
115
115
92
130
103
108
114
Averages and Match Results
Average Applications
43.3
39.5
41.2
40.7
37.6
33.8
32.4
32.0
Average Interviews
10.4
9.9
10.2
10.6
10.0
10.3
9.9
9.9
Average Offers
8.5
8.9
4.0
4.1
3.2
3.8
4.0
3.8
US Seniors Matched
79%
77%
78%
80%
71%
80%
76%
76%
US Graduates Matched
41%
45%
42%
43%
46%
38%
27%
36%
Int’l Graduates Matched
14%
25%
16%
25%
33%
23%
31%
26%
Women Matched
69%
62%
69%
68%
63%
73%
62%
63%
There are 112 non-military accredited urology residency programs in the United States. (Military programs cannot participate due to government regulations regarding eligibility.) For 2007, 110 non-military accredited urology residency programs in the United States listed 241 positions with 239 vacancies being matched. 348 applicants submitted preference lists netting 109 unmatched applicants. Of U.S. senior medical students applying, 79 percent were matched.
I appreciate the catch and link. If you read through the post, I have the data you linked to for Urology from WUStL’s excellent website. What the AUA does not appear to release, and what I mean by ’statistics,’ is % AOA of those who match and average Step 1 score.
It appears to be the only specialty for which those two statistics are not available (SF Match was the only match which supplied that info to the general medical community for a long time but now the NRMP has come around).
However, if you find that data for Urology I would love to have it.
Wow, things do change. An eternity ago (12 years?!) Physical Medicine and Rehab was hot. Radiology kinda sucked (it will all be read overseas within 10 years) and as a classmate put it, anesthesia was about as popular as a chancre on his… well you know.
But, derm was still popular, there was no Integrated Plastics, and the surgical subspecialties were high.
Of course, in the 60’s and 70’s Ortho was just for those students who couldn’t get in to anything else.
Things really do change which is why even from year to year this list is a joke.
I just matched into Urology (2008) and was wanting to see some statistics. All they told us is:
404 rank lists submitted
246/247 spots filled
That’s only a 61% match rate, which seems kind of low. I’m sure that rate includes foreign medical students too. Only 4/7 students matched from my US School.