2015 Group on Student Affairs Regional Meetings Mona M. Signer - - PowerPoint PPT Presentation

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2015 Group on Student Affairs Regional Meetings Mona M. Signer - - PowerPoint PPT Presentation

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2015 Group on Student Affairs Regional Meetings Mona M. Signer President and CEO April 2015 Reproduction prohibited without the written permission of the NRMP. Todays Topics Main Residency Match Trends Is the Match Becoming More

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Mona M. Signer President and CEO April 2015

2015 Group on Student Affairs Regional Meetings

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Today’s Topics

  • Main Residency Match Trends
  • Is the Match Becoming More

Competitive?

  • Changes to Match Week 2016
  • NRMP National Conference
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5,000 10,000 15,000 20,000 25,000 30,000 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

US Allopathic Seniors Who Obtained Positions through SOAP US Allopathic Seniors Matched US Allpathic Seniors in the Match US Allopathic Graduating Seniors NRMP PGY 1 Positions Data sources: NRMP, AAMC

First-Year GME Positions

Allopathic Medicine

>9,200 more PGY-1 positions than US seniors in the Match

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Main Residency Match

PGY-1 Positions Offered and Filled 500 More Positions Offered

5,000 10,000 15,000 20,000 25,000 30,000 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Offered Filled Filled US Seniors

+ 3,287 PGY-1 positions since All In Policy

All In Policy

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Position Increases by Specialty

At least +50, 2011 - 2015

200 400 600 800 1,000 1,200 1,400 1,600 1,800 2,000

IM FM AN PS EM PD NE SG SG Prelim PA CM IM Prim OB

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Active Applicants

651 More Seniors, 635 More Active Applicants

5,000 10,000 15,000 20,000 25,000 30,000 35,000 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Others DOs IMGs US IMGs Prior US Grads US Seniors

All In Policy

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PGY-1 Matches by Applicant Type

533 More Matched Seniors in 2015

5,000 10,000 15,000 20,000 25,000 30,000 35,000 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Unmatched Others DOs IMGs US IMGs Prior US Grads US Seniors

All In Policy

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Seniors Matched to PGY-1 Positions

2,000 More Seniors

2,000 4,000 6,000 8,000 10,000 12,000 14,000 16,000 18,000 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

14,992 16,932 1,093 949

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Seniors Matched to Primary Care

2006 - 2015

1,000 2,000 3,000 4,000 5,000 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Internal Medicine Pediatrics Family Medicine

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Percent Unmatched Seniors

Who Ranked One Specialty

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

TS DM OS NS OT OB SG PH PS EM PL RO MP FM PD PA NE IM AN RD CN VS

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1,306 Unfilled Positions

Half PGY-1 Only

486 481 455 473 461 444 484 459 449 475 194 136 127 89 105 129 123 74 80 123 862 663 696 487 459 425 460 367 427 391 71 101 92 59 82 103 146 112 127 210 63

200 400 600 800 1,000 1,200 1,400 1,600 1,800 2,000 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

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

55

All In Policy

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1,193 Unfilled Positions in SOAP

149 145 118 70 69 46 31 20 19 15 14 12 8 7 7 5 4 3 2 1 1 1

50 100 150 200 250 300

Surgery-Preliminary Family Medicine Radiology-Diagnostic Internal Medicine-Preliminary Anesthesiology Internal Medicine Transitional Year Pathology Child Neurology Neurology Psychiatry Pediatrics Other General Surgery Obstetrics-Gynecology Emergency Medicine Radiation Oncology Plastic Surgery Physical Medicine & Rehab Neurological Surgery Internal Medicine - Pediatrics Dermatology Otolaryngology Orthopaedic Surgery 2014 SOAP 2015 SOAP

446

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113 Unfilled Positions Not in SOAP

29 16 8 7 7 6 6 6 5 5 5 4 4 2 2 1

10 20 30 40 50

Surgery-Preliminary Anesthesiology Child Neurology Family Medicine Radiation Oncology Transitional Year Radiology - Diagnostic Pathology Internal Medicine Internal Medicine-Preliminary Dermatology Neurology Other Pediatrics - Preliminary Psychiatry Emergency Medicine

484 444

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Unmatched Seniors, PGY-1 Positions in SOAP

More Unmatched Seniors than PGY-1 Positions

500 1,000 1,500 2,000 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

1,093 973 PGY-1 Positions in SOAP U.S. Seniors With ROLs Unmatched to PGY-1 Positions

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Unmatched Applicants, PGY-1 Positions in SOAP

Nine Unmatched Applicants for Every Unfilled Position

Unfilled PGY-1 Positions in SOAP 973 8,653

2,000 4,000 6,000 8,000 10,000 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

All Applicants With ROLs Unmatched to PGY-1 Positions

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13,657 SOAP-Eligible Applicants

2,142 1,058 3,773 815 5,838 31

1,000 2,000 3,000 4,000 5,000 6,000 7,000 US Senior US Grad USIMG Osteo IMG Other

US Senior US Grad USIMG Osteo IMG Other

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Preferences of Unmatched Seniors and Available SOAP Positions

1 3 5 5 6 7 9 9 9 9 9 13 17 17 25 28 51 52 53 93 69 79 95 105 106 161

50 100 150 200 250 300

Child Neurology Other Vascular Surgery Transitional Year Radiation Oncology Thoracic Surgery Radiology-Diagnostic Surgery-Preliminary (PGY-1 Only) Pathology Neurology Internal Medicine-Pediatrics Internal Medicine (PGY-1 Only) Plastic Surgery Physical Medicine & Rehab Anesthesiology Dermatology Neurological Surgery Psychiatry Family Medicine Otolaryngology Pediatrics Emergency Medicine Internal Medicine Obstetrics-Gynecology General Surgery Orthopaedic Surgery

Preferred Specialty Available Positions

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Preferences of All Unmatched Applicants and Available SOAP Positions

23 23 24 29 35 39 53 63 76 92 92 106 107 119 128 191 194 201 250 253 322 480 536 659 1,377 2,551

1000 2000 3000

Child Neurology Thoracic Surgery Radiation Oncology Vascular Surgery Plastic Surgery Other Internal Medicine-Pediatrics Transitional Year Otolaryngology Radiology-Diagnostic Internal Medicine (PGY-1 Only) Dermatology Neurological Surgery Physical Medicine & Rehab Surgery-Preliminary (PGY-1 Only) Neurology Pathology Anesthesiology Orthopaedic Surgery Emergency Medicine Obstetrics-Gynecology General Surgery Pediatrics Psychiatry Family Medicine Internal Medicine

Preferred Specialty Available Positions

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SOAP Offers

2012 - 2015

1,033 878 998 1,129 613 388 470 481 92 50 63 56

500 1,000 1,500 2,000 2,500

2012 2013 2014 2015

Accepted Rejected Expired

939 Positions 1,075 Positions 1,193 Positions 1,132 Positions

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SOAP Positions

Offered & Accepted by Round

709 299 90 26 366 95 16 4 37 15 200 400 600 800 1,000 1,200 1 2 3 4 5

Accepted Rejected Expired

1,112 409 110 30 5

1,306 Unfilled Positions 1,193 Positions in Soap 4

End of Day 1: 185 positions remained End of SOAP: 64 positions remained

SOAP Round

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SOAP Positions

Accepted by Applicant & Position Type

46 5 3 7 6 343 21 57 60 53 161 35 44 73 22 54 4 4 6 1

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

2,142 3,773 815 5,838 1,058

1,060 applicants accepted 1,129 positions

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Seniors in SOAP

2012 - 2015

1,816 605 600 337 2,076 595 602 591 2,050 609 623 506 2,142 653 645 606

500 1,000 1,500 2,000 2,500

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.

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Today’s Topics

  • Main Residency Match Trends
  • Is the Match Becoming More

Competitive?

  • Changes to Match Week 2016
  • NRMP National Conference
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PGY-1 Match Rates by Applicant Type

Overall 2015 Match Rate: 75%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

US Seniors Osteopathic Physicians US IMGs Prior US Grads IMGs

All In Policy

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Percentage of Programs Citing Each Factor in Interview Selection

53% 54% 55% 60% 60% 61% 61% 61% 62% 62% 63% 63% 67% 67% 68% 69% 69% 70% 71% 77% 81% 82% 48% 57% 65% 63% 56% 56% 54% 61% 34% 69% 69% 65% 69% 70% 84% 75% 61% 80% 70% 78% 86% 94%

0% 25% 50% 75% 100% Graduate of highly regarded U.S. medical school Perceived interest in program Evidence of professionalism & ethics Audition elective/rotation within your department Consistency of grades Other life experience Volunteer/extracurricular experiences Honors in clerkship in desired specialty Applicant flagged with match violation by NRMP Honors in clinical clerkships Perceived commitment to specialty Personal prior knowledge of the applicant Class ranking/quartile Gaps in medical education Medical Student Performance Evaluation Graduate of US allopathic medical school Grades in clerkship in desired specialty USMLE/COMLEX Step 2 score Grades in required clerkships Personal Statement Letters of recommendation in the specialty USMLE/COMLEX Step 1 score

2014 2012

Source: NRMP Program Director Survey

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Program Use of Step 1 Scores for Interview s

Scores Required?

36 63 1 31 68 1

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

Yes, pass only Yes, target score No

Consider applicants who fail 1st attempt?

26 61 13 26 63 11

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

Never Seldom Often

2012 2014

Source: NRMP Program Director Survey

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Reproduction prohibited without the written permission of the NRMP. Note: Step 1 scores are not available for the majority of osteopathic physicians included within the independent applicant category. Source: NRMP Data Warehouse and AAMC Data Warehouse.

Step 1 Scores Are Rising

By Preferred Specialty

200 210 220 230 240 250 260 270 2014 Median 2011 Median 2007 Median

Source: Charting Outcomes in the Match

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Program Use of Step 2 CK Scores for Interview Selection

Scores Required?

33 48 20 31 50 19

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

Yes, pass only Yes, target score No

Consider applicants who fail 1st attempt?

32 59 8 35 58 6

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

Never Seldom Often

2012 2014

Source: NRMP Program Director Survey

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Step 2 CK Scores Are Rising

By Preferred Specialty

Note: Step 1 scores are not available for the majority of osteopathic physicians included within the independent applicant category. Source: NRMP Data Warehouse and AAMC Data Warehouse.

200 210 220 230 240 250 260 270 2014 Median 2011 Median 2007 Median

Source: Charting Outcomes in the Match

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Program Use of Step 2 CS Scores for Interview s

Step 2 CS Scores Required?

77 23 78 22

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

Yes, pass only No

2012 2014

Source: NRMP Program Director Survey

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50% 51% 55% 55% 57% 57% 58% 60% 62% 64% 67% 68% 71% 74% 80% 82% 88% 93% 93% 0% 25% 50% 75% 100%

Passing USMLE Step 2 CS/Comlex Level 2 Grades in required clerkships Audition rotation within department Personal statement Graduate of U.S. allopathic medical school Class rank Personal prior knowledge of applicant Leadership qualities Perceived interest in program Evidence of professionalism Perceived commitment to specialty MSPE USMLE Step 2/Complex Level 2 Recommendation letters in specialty USMLE Step 1/Comlex Level 1 Feedback from current residents Interactions with housetaff during interview Interpersonal skills Interactions with faculty during interview

Factors in Ranking Applicants

It’s All About the Interview

Source: NRMP Program Director Survey

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Average Percentage Applications Rejected

30% 30% 32% 37% 39% 40% 45% 47% 48% 53% 54% 54% 55% 55% 57% 57% 62% 62% 68% 29% 26% 31% 33% 41% 39% 45% 46% 47% 51% 56% 58% 52% 61% 48% 48% 62% 61% 68%

0% 25% 50% 75% 100% Plastic Surgery Radiation Oncology Otolaryngology Dermatology Emergency Medicine Radiology-Diagnostic Physical Medicine and Rehabilitation Orthopaedic Surgery Anesthesiology Average for all specialties Pathology-Anatomic and Clinical Pediatrics Obstetrics and Gynecology Psychiatry Internal Medicine/Pediatrics Neurology General Surgery Internal Medicine Categorical Family Medicine

2014 2012

Source: NRMP Program Director Survey

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79 86 77 86 44 80 90 94 90 85 96 96 97 96 96 95 96 96 75 75 75 78 84 84 85 88 92 93 93 95 96 96 96 97 97 98 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

2011 2015

Match Rates By Preferred Specialty

Majority of Seniors Match

Source: NRMP Data Warehouse.

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  • 9,200 more PGY-1 positions than active seniors in

the Match

  • No change in seniors’ PGY-1 match rate
  • Little change in seniors’ match rates by preferred

specialty

  • Minimal change in percentage of applications

rejected

  • 2,300 DOs and 6,300 IMGs matched to PGY-1

positions

  • USMLE Step scores are rising
  • 600 seniors with no position post-SOAP

Is the Match More Competitive?

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Applicants must be eligible to enter GME on July 1:

  • U.S. senior eligibility determined by each medical school’s

graduation requirements

 Requirements vary on whether/when USMLE exams must be

taken and when diplomas can be conferred

 130 schools require passing at least one USMLE component

  • IMG eligibility determined by ECFMG

 IMGs must pass USMLE Steps 1 & 2 by ROL deadline

Food for Thought

Requirements for the Algorithm and SOAP

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  • 167 applicants not eligible for algorithm became SOAP-eligible

 38 U.S. seniors  32 DOs  10 prior-year U.S. graduates  87 IMGs

  • 17 applicants with ROLs in the algorithm became SOAP-ineligible

 12 U.S. seniors, 5 matched  5 DOs, 1 matched

  • +/- 40 waivers granted annually to U.S. seniors unable to begin

GME on time

1.

Should SOAP verification process continue?

2.

Should USMLE Steps 1 & 2 be a requirement for all applicants?

Food for Thought

Requirements for the Algorithm and SOAP

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Today’s Topics

  • Main Residency Match Trends
  • Is the Match Becoming More

Competitive?

  • Changes to Match Week 2016
  • NRMP National Conference
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Match Week 2016

Goal: Allow unmatched applicants more time to process their options before submitting SOAP applications Caveat: All programs must be on 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?

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Do you support the SOAP schedule change?

12 36 41 7 6 14 28 50 6 3 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Strongly support Support No preference Oppose Strongly oppose

DIOs PDs

Source: NRMP All In & SOAP Survey

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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

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Today’s Topics

  • Main Residency Match Trends
  • Changes to Match Week 2016
  • Is the Match Becoming More

Competitive?

  • NRMP National Conference
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  • How well are students prepared for residency?
  • Do we need more GME slots?
  • Can we obtain residency program-specific data?
  • What are the alternatives to clinical medicine?
  • Is the MSPE relevant for program directors?
  • Tracking unmatched applicants
  • Competency-based curricula
  • The human side of medicine

Transition to Residency: Conversations Across the Medical Education Continuum

October 1-3, 2015 www.nrmpconference.org

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  • Medical Decision-Making: Drs. Jerome Groopman & Pamela

Hartzband

  • Are Medical School Graduates Prepared to Practice Medicine?
  • Dr. Pauline Chen
  • The Institute of Medicine Report: Dr. Deborah Powell
  • Do We Need More GME Slots?: Drs. Richard (Buz) Cooper &

Fitzhugh Mullan in a Point-Counterpoint

  • The Human Side of Medicine: Dr. Abraham Verghese

Transition to Residency: Conversations Across the Medical Education Continuum

October 1-3, 2015 www.nrmpconference.org

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  • Undergraduate medical education

 Impact of competency-based curricula  Making the MSPE relevant for program directors

  • Residency selection and interview

 What predicts success in the Match?  Program-specific data for applicants

  • The unmatched applicant

 Preventive strategies for at-risk students  Tracking unmatched applicants  Alternative careers

  • Readiness for residency

 Linking EPAs and ACGME milestones

Transition to Residency: Conversations Across the Medical Education Continuum

Submit a Breakout Session Proposal

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