National Resident Matching Program Data Research Articles

Trends in the Sports Medicine Match: An Analysis of the National Resident Matching Program Data from 2010 to 2021.

Sports medicine (SM) fellowship training has become popular among residents. Thus, an analysis was undertaken to assess data on matching rates from 2010 to 2021. The purpose of this study is to analyze trends in SM fellowship applications using National Resident Matching Program data. Retrospective study with analysis of applicants applying into accredited SM fellowships between 2010 and 2021. The number of accredited programs and fellowship positions have more than doubled from 2010 to 2021. There was a significant increase in match rates over time (P < 0.001); match rates were at 70% or below prior to 2015 and above 70% after 2015. The average number of applicants per position stayed consistent. The number of Doctor of Osteopathic Medicine applicants increased 110% whereas the number of U.S. born foreign and non-U.S. citizen applicants decreased 20.8%. SM fellowship training has increased since 2010. Acceptance rates and number of applicants have increased over time because of the growth in fellowship programs and accredited positions.

A Comparison of Match Rates to Orthopaedic Surgery Residency Programs Between First-Time Versus Repeat Applicants: An Analysis of the National Resident Matching Program Data from 2018 to 2022.

Data were obtained from the National Resident Matching Program from 2018 to 2022. For each year, the total number of applicants to orthopaedic surgery residency programs was obtained, as well as the number of applicants who successfully matched into orthopaedics. The match rate was compared between first-time vs repeat applicants. A subanalysis was performed on allopathic graduates (MDs) and osteopathic graduates (DOs)/international medical graduates (IMGs). In addition, the match rate for first-time applicants and reapplicants was compared between MD and DO/IMG applicants. Overall, there was a significantly higher match rate among first-time applicants (89.8%) vs. repeat applicants (22.5%, p < 0.0001). When substratified by MD and DO/IMG applicants, first-time applicants still matched at a significantly higher rate than reapplicants within each group (p < 0.0001 for each). Among first-time applicants, MDs (93.1%) matched at a significantly higher rate than DOs/IMGs (68.6%, p < 0.0001). Among reapplicants, DOs/IMGs (25.3%) matched at a significantly higher rate than MDs (20.1%, p < 0.01). First-time applicants to orthopaedic surgery residency programs have a significantly higher rate of matching compared with reapplicants, irrespective of degree. In recent years, first-time MD applicants have matched at a significantly higher rate than first-time DO/IMG applicants.

Evaluating Match and Attrition Rates for Women and African Americans in Neurosurgery.

Previous efforts to increase diversity in neurosurgery have been aimed primarily at female inclusion while little analysis of other under-represented groups has been performed. To evaluate match and retention rates of under-represented groups in neurosurgery, specifically Black and female applicants compared with non-Black and male applicants. Match lists, Electronic Residency Application Service data, and National Resident Matching Program data were retrospectively reviewed along with publicly available residency program information for successful matriculants from 2017 to 2020. Residents were classified into demographic groups, and analysis of match and retention rates was performed. For 1780 applicants from 2017 to 2020, 439 identified as female while 1341 identified as male. Of these 1780 applicants, 128 identified as Black and 1652 identified as non-Black. Male and female applicants matched at similar rates ( P = .76). Black applicants matched at a lower rate than non-Black applicants ( P < .001). From 2017 to 2020, neither race nor sex was associated with retention as 94.1% of male applicants and 93.2% of female applicants were retained ( P = .63). In total, 95.2% of Black residents and 93.9% of non-Black residents were retained ( P = .71). No intraregional or inter-regional differences in retention were found for any group. Although sex parity has improved, Black applicants match at lower rates than non-Black applicants but are retained after matriculation at similar rates. Neurosurgery continues to recruit fewer female applicants than male applicants. More work is needed to extend diversity to recruit under-represented applicants. Future studies should target yearly follow-up of retention and match rates to provide trends as a measure of diversification progress within the field.

Navigating the Ophthalmology & Urology Match with a Significant Other

Medical students with a significant other in medical school face challenges when applying for residency as they attempt to match in proximity to their partner. The National Resident Matching Program (NRMP) offers a Couples Match to aid such applicants. This system is not available for ophthalmology and urology because these specialties utilize match systems outside the NRMP and have an early match timeline. The purpose of this study is to analyze usage of the Couples Match and assess ophthalmology and urology applicant viewpoints on the Couples Match system. First, NRMP data on the Couples Match from 1987 to 2021 was reviewed. Second, an online survey was sent to 559 ophthalmology and 321 urology applicants to The Johns Hopkins University School of Medicine in the 2021 match cycle. 342 ophthalmology and urology applicants (39% response rate). There is increased usage of the Couples Match over time. In response to the survey, 89% of participants agreed that a Couples Match should be implemented in their specialty. 107 (31%) had a significant other in medicine. 78% of 68 respondents whose significant other also applied in 2021 reported that they would have used the Couples Match had it been available. 21% of those with a significant other considered not applying to ophthalmology or urology because there was no Couples Match. There are mixed responses regarding whether the early match timeline is beneficial to couples. Female applicants were more likely to report hesitancy about mentioning a significant other during the application process. The Couples Match is highly desired by applicants to ophthalmology and urology, and the lack of such a system is a deterrent to pursuing these fields. Future studies will help elucidate how the match system can be leveraged to aid individuals applying with a significant other.

Using Graduate Medical Education Institutional Data to Enhance Diverse Recruitment Strategies.

Using Graduate Medical Education Institutional Data to Enhance Diverse Recruitment Strategies.

Top of the Batch: Interviews and the Match

Most doctors in the National Resident Matching Program (NRMP) match with one of their most preferred internship programs. However, surveys indicate doctors’ preferences are similar, suggesting a puzzle: how can so many doctors match with their top choices when positions are scarce? We provide one possible explanation. We show that the patterns in the NRMP data may be an artifact of the interview process that precedes the match. Our study highlights the importance of understanding market interactions occurring before and after a matching clearinghouse. It casts doubts on analyses of clearinghouses that take reported preferences at face value. (JEL C78, I11, I18, J44)

Child and Adolescent Psychiatry Fellowship Program Participation in the National Resident Matching Program Match: Trends and Implications for Recruitment.

Recruitment is one of the most important missions for the Child and Adolescent Psychiatry (CAP) Caucus of the American Association of Directors of Psychiatric Residency Training, the American Academy of Child and Adolescent Psychiatry, and the American Association of Directors of Child and Adolescent Psychiatry. A review of the National Resident Matching Program (NRMP) Match data is needed to inform current and future practices. The NRMP, Accreditation Council for Graduate Medical Education, and Association of American Medical College databases were queried from 1996 to 2021. The NRMP data show that the number of programs participating in the Match has increased from 87 in 1996 to 106 in 2021 and that the percentage of programs that fill their positions in the Match is increasing and has increased from 41% in 1996 to 67% in 2021. However, each year, a percentage of programs do not fill their positions offered in the Match. The numbers indicate a surplus of positions for the number of applicants that appears to be increasing, and there are currently 49 more positions than applicants. Trends in the CAP Match are encouraging, and importantly, more programs and applicants are using the Match. One concerning trend is the surplus of positions while there is a great need for child psychiatrists. More research is needed on the incentives for programs and applicants to participate in the Match and how to increase interest in child and adolescent psychiatry.

Lower-Third Standardized Letters of Evaluation in Emergency Medicine: Does Gender Make a Difference in Match Outcome?

ObjectiveThe purpose of this study was to determine whether gender influences the likelihood of receiving a lower-third global assessment (GA) on the standardized letter of evaluation (SLOE) submitted as part of the emergency medicine (EM) application process as well as the impact of gender on ultimate match outcomes for applicants receiving a lower-third GA ranking. Our hypothesis was that female applicants with a lower-third GA ranking have a higher risk of not matching.MethodsWe conducted a retrospective cohort study evaluating U.S.-based allopathic applicants to a single EM residency program in the Mid-Atlantic region during the 2017-2018 and 2018-2019 match cycles. GA SLOE rankings and gender for all applicants were extracted and compared to the National Resident Matching Program (NRMP) data for each applicant on match outcome. Comparative analyses were conducted between gender and SLOE GA rankings in order to obtain an odds ratio (OR) of gender and match outcomes.ResultsA total of 2,017 SLOEs were reviewed from 798 applicants in the 2018 and 2019 EM match cycles. Overall, 716 (90%) applicants successfully matched in EM, with 82 (10%) applicants failing to match into EM; 277 students had at least one lower-third GA ranking. For all applicants, having at least one lower-third GA ranking was associated with a significant risk of not matching (OR: 0.20; 95% CI: 0.12-0.34). Of the 277 students with at least one lower-third GA ranking, 85 (31%) were female and 192 (69%) were male. Of the female applicants with a lower-third GA ranking, 15 (18%) failed to match in EM, and 39 (20%) of the males failed to match in EM. For applicants with a lower-third GA ranking, female gender alone was not associated with a significantly increased risk of not matching (OR: 1.18; 95% CI: 0.61-2.21).ConclusionsFemale applicants receive a lower-third GA ranking less frequently than their male counterparts. One or more lower-third rankings on the GA significantly reduced an applicant’s chances of matching into an EM program. For those with a lower-third GA ranking, female gender alone does not significantly increase the risk of not matching into EM.

A 5-Year Analysis of the United States Radiation Oncology Job Market Using the ASTRO Career Center

Within United States (US) radiation oncology (RO), the physician job market remains an active area of interest. Herein we provide 5-year results of prospectively-collected RO job opportunities.Full-time RO job opportunities were prospectively collected using the American Society for Radiation Oncology (ASTRO) Career Center from March 2016 to February 2021. Jobs were categorized by US Census Bureau region, metro- or micropolitan size, and job type, where academic refers to any medical center with a residency training program, network locations included. Repeat postings were excluded. A chi-squared test was used to compare regional job availability by city size and position type. The number of graduating RO residents (2017-2021) per region was also collected using National Resident Matching Program data. Expected jobs were calculated based on the number of graduates and size of each region. A chi-squared goodness of fit test was used to examine if the listed jobs per region deviated from the expected jobs based on the proportion of graduates and region size.A total of 802 unique job offerings were recorded with the following regional distribution: Northeast, 166; Midwest, 200; South, 261; West, 175. Of the total pool, 337 positions (42.0%) were academic, of which 225 (66.8%) were at the main campus. The majority of jobs were located in metropolitan areas with a population > 1M (median: 1.3M [range: 1K-18M]). A difference was seen between academic and non-academic job availability, with the highest and lowest percentage of academic jobs noted in the Northeast and Midwest, respectively (P < 0.001). Additionally, a difference was seen based on city size, with the Northeast and Midwest demonstrating the highest and lowest percentage of jobs in cities with > 1M people (P < 0.001). A total of 920 RO residents graduated during the 5-year study period. A significant difference was seen when listed jobs per region were compared to expected jobs based on the proportion of graduates and region size with a notable trainee surplus seen in the Northeast. (P < 0.001).This is the first prospective long-term quantitative analysis of the RO job market. We found significant regional imbalances of jobs by type (academic vs. non-academic) and city size (> 1M vs. ≤1M). A disproportionately small number of job opportunities compared with graduates trained in the corresponding region was seen, with the largest gap in the Northeast.

Evaluation of National Resident Matching Program and Electronic Residency Application Service Data in the Integrated Plastic Surgery Match.

The National Resident Matching Program and Electronic Residency Application Service provide data for tracking trends among applicants in each specialty over the past 5 years. The purpose of this study was to examine this information and determine sex and race/ethnicity distribution over the past 5 years. The National Resident Matching Program and Electronic Residency Application Service databases were surveyed for trends in the following categories: number of positions, number of applicants, percent of applicants per position, and number of applicants by sex and self-identified race/ethnicity. This information was analyzed graphically for visual representation of the changes in the field. While there has been a steady increase in number of positions offered, there has also been a significant decrease in number of applicants, resulting in an increase in number of positions offered per applicant. While female and Asian applicants have increased in number, rates of applications from other diverse groups have remained stagnant. The number of plastic surgery positions offered has increased, whereas the number of applicants has decreased, resulting in a reduction in the number of applicants per position. Lack of racial diversity remains a significant issue in the applicant pool.

In Reply to Bowe et al.

We thank Bowe and colleagues for their comments regarding our article on a framework for inclusive graduate medical education (GME) recruitment strategies. The authors acknowledge there is evidence that non-White race is an independent predictor of lower likelihood for interview selection and matriculation in surgery residency, 1 which substantiates the concerns for bias in selection and matriculation we highlighted in our article. In addition, Bowe and colleagues raise concerns about the need for data to support initiatives to diversify training programs. We agree that data are an important driver of change and that changes to recruitment strategies are necessary nationwide to improve workforce diversity and inclusion. Our article was meant to provide a framework for inclusive recruitment strategies for individual GME programs, and in-depth program-level analysis is one way to assess individual programs and institutions for progress and opportunities for improvement. 1 However, Bowe and colleagues highlight that residency programs and the Accreditation Council for Graduate Medical Education have difficulty assessing progress in diversifying efforts on a larger scale. Some data exist to aide in specialty-specific analyses via the Association of American Medical Colleges (AAMC). For example, one of us (C.M.O.) coauthored a study using data from the AAMC GME Track survey 2 to investigate race disparities in nephrology fellowship training, highlighting trends in the racial makeup of medical student graduates, internal medicine trainees, and nephrology fellows. 3 However, using only the AAMC and GME track data that are currently available has its limitations, particularly in the applicant-to-matriculant stage, such as “Withdrew” and “No Rank List” categories, from the National Resident Matching Program (NRMP), as Bowe and colleagues have mentioned. Bowe and colleagues also bring to our attention that the currently available NRMP data show disparities in non-U.S. graduate Match rates. It is plausible that other disparities (e.g., ethnic, gender, and disability) exist in the Match, the Supplemental Offer and Acceptance Program, and matriculation rates. For instance, some ethnic minority groups are also disproportionately represented in the category of non-U.S. medical school graduates. It is unclear why the NRMP has limited its collection and reporting to “applicant-type.” Collection, analysis, and sharing of NRMP sociodemographic data, such as race, ethnicity, gender, disability, and geographic location, in collaboration with the currently available NRMP, AAMC, and GME Track data, is necessary as it enables programs, institutions, specialties, and organizations, such as the ACGME, to track trends and increase accountability for workforce diversity and inclusion efforts. Acknowledgments: The authors acknowledge Dr. James Appiah-Pippim for contributions to their framework and support.

Collaborative, Longitudinal Data Are Necessary to Support Diversity Efforts in Residency Recruitment and Selection.

To the Editor: We enthusiastically agree with Gonzaga and colleagues’ 5-point framework for diversifying residency training programs. 1 However, we feel that there was an underemphasis on the need for data to support this initiative, especially because the limited studies that exist on this topic tell a cautionary tale. When evaluating 10 general surgery residency programs, Jarman and colleagues found that self-identification as a non-White race/ethnicity was an independent predictor of a lower likelihood for interview selection. 2 Additionally, the orthopedic surgery community examined residency matriculation rates by race/ethnicity and found that enrollment of Black and Hispanic applicants were significantly lower than those of White, Asian, and other applicants. 3 Thus, a small body of evidence substantiates prior concerns regarding bias at both the interview and matriculation stages of residency selection. 1 Although in-depth analysis, such as that performed by Jarman and colleagues, 2 can occur at the program level, it is impossible to do this for specialties or the entire physician workforce because the National Resident Matching Program (NRMP) has an established policy to not collect any sociodemographic information from registrants. 2,4 This policy is concerning, however, because there is evidence of different selection outcomes based on the only NRMP data that are available, which are “applicant type.” 5 When examining the group of registrants in NRMP 2020 that either “Withdrew” or had “No Rank List,” only 2.3% (455/19,781) of U.S. MD seniors and 3.3% (230/6,811) of U.S. DO seniors were included, which is in stark contrast to 14.9% (266/1,785) of U.S. MD graduates and 19.7% (141/714) of U.S. DO graduates. 5 Therefore, U.S. MD seniors and U.S. DO seniors are more successful at reaching the interview, and subsequent ranking stage, as evidenced by the very low percentage who either “Withdrew” or had “No Rank List.” Logically, if this disparity exists for “applicant type,” the same situation could be occurring with respect to other sociodemographic indicators, including race/ethnicity. Without these data, it is harder to assess our efforts to diversify the physician workforce. The organizations that serve as integral elements along the resident selection pathway, including the NRMP, must recognize their unique role in supporting these initiatives. This includes an imminent need to collect baseline and longitudinal data and engage in collaboration with each other to share and study these data over time.

No Longer a Match: Trends in Radiation Oncology National Resident Matching Program (NRMP) Data from 2010-2020 and Comparison Across Specialties

To report trends in the number and types of applicants and matched trainees to radiation oncology in comparison to other specialties participating in the National Resident Matching Program (NRMP) between 2010 and 2020. Data from the NRMP and Electronic Residency Application System (ERAS) were obtained for 18 medical specialties between 2010 and 2020. We assessed the numbers and types of applicants and matched trainees relative to available positions in the NRMP and Supplemental Offer and Acceptance Program (SOAP). In the 2020 NRMP, 122 US MD senior graduates preferentially ranked radiation oncology, a significant decrease from a median of 187 between 2010 to 2019 (interquartile range [IQR], 170-192; P < .001). Across all 18 specialties, radiation oncology experienced the greatest declines in the 2020 NRMP cycle relative to 2010 to 2019, in both the number of ERAS applicants from the United States and Canada (-31%) and the percentage of positions filled by US MD or DO senior graduates (-28%). Of 189 available positions, 81% (n = 154) filled in the NRMP prior to the SOAP, of which 65% (n = 122) were "matched" by US MD senior graduates who preferentially ranked radiation oncology as their top choice of specialty, representing a significant decrease from a median of 92% between 2010 to 2019 (IQR, 88%-94%; P = .002). The percentages of radiation oncology programs and positions unfilled in the NRMP prior to the SOAP were significantly increased in 2020 compared with 2010 to 2019 (programs: 29% vs 8% [IQR, 5%-8%; P < .001]; positions: 19% vs 4% [IQR, 2%-4%; P <.001]). Despite >99% (n = 127 of 128) of US MD or DO senior applicants preferring radiation oncology successfully matching to a radiation oncology position in the 2020 NRMP, 16 of 35 remaining unfilled positions were filled via the SOAP. Radiation oncology was the top user of the SOAP across all specialties participating in the 2020 NRMP, filling 15% of total positions versus a median of 0.9% (IQR, 0.3%-2.3%; P <.001). The supply of radiation oncology residency positions now far exceeds demand by graduating US medical students. Efforts to nullify a market correction revealed by medical student behavior via continued reliance on the SOAP to fill historical levels of training positions may not be in the best of interest of trainees, individual programs, or the specialty as a whole.

Physical Medicine and Rehabilitation Residency Applicants: A Decade of Change

Physical medicine and rehabilitation (PM&R) has been an expanding specialty in medicine since its induction into the American Medical Association in 1947. This article quantifies the growth of PM&R by analyzing the number of residency positions and applicants as well as the characteristics of the applicants. Review of the United States (US) National Residency Matching Program (NRMP) data from 2010-2020 shows that the number of PM&R residency positions has grown by 26%, while the number of applicants has grown by 37% with a decreasing ratio of allopathic to osteopathic matched applicants. Matched applicants have had increasing Step 1 and 2 scores, abstracts, presentations, publications, and volunteer experiences. In the last decade there has been a growing interest in PM&R that outpaces residency positions and with increasingly qualified applicants. This analysis can guide residency administration and future applicants on the trends in the PM&R residency selection process.

Trends in the Physical Medicine and Rehabilitation Match: Analysis of NRMP Data from 2007 to 2018.

We provide an updated analysis of data about U.S. Physical Medicine and Rehabilitation (PM&R) residency program applicants collected by the National Resident Matching Program (NRMP). Analyze trends within NRMP data for PM&R residency match rates, compare matched to unmatched applicants, and compare PM&R applicants to other medical specialties. Secondary analysis of NRMP data. NRMP data set. Residency program applicants who participated in the NRMP Match, 2007 to 2018. Not applicable. Number of applicants, match rates, difference in characteristics including rank order list (ROL), U.S. Medical Licensing Examination (USMLE) Step 1 and Step 2 Clinical Knowledge (CK) scores, publications, Alpha Omega Alpha (AOA) status, PhD degree, and experiences in research, volunteer, and work. Number of applicants and residency positions increased from 2007 to 2018. Length of ROL increased and was longer for matched compared to unmatched applicants, with maximum mean difference of 7.4 in 2016 (95% confidence interval [CI] 5.6-9.2). Matched U.S. Allopathic Seniors had higher USMLE scores compared to unmatched, with a mean difference of 12.7 for Step 1 (95% CI 8.3-17.0) and 12.6 (95% CI 8.6-16.6) for Step 2 CK (P< .001). Number of publications and volunteer experiences were higher for matched U.S. Allopathic Seniors (0.64, 95% CI 0.09-1.2 and 1.5, 95% CI 0.65-2.3, respectively). PM&R USMLE Step 1 and 2 CK scores increased at a significantly faster rate than for all other specialties, with estimated rate differences of 0.46 (95% CI 0.21-0.71) and 0.69 (95% CI 0.45-0.93) points per year, respectively. PM&R residency has become more competitive. USMLE Step 1 and 2 CK scores have outpaced the inflation of scores in other specialties. ROL length has increased, suggesting more ranked programs to successfully match. These analyses update our knowledge about PM&R residency applicants and suggest surrogate markers for a successful match.

Student Doctor Network: Fake News or Facts for Emergency Medicine Applicants?

IntroductionResidency applicants use multiple resources to guide their application process including the Student Doctor Network (SDN), a publicly available online forum for the discussion of various topics in medical education. In recent years, specialty-specific forums for residency applicants to self-report their own application information have become popular. These forums allow other applicants to review self-reported data from their peers to inform their own application process. The accuracy of this resource is unknown. To determine whether the SDN is an accurate source of information for emergency medicine (EM) applicants, we compared self-reported SDN data to objective data from the National Resident Matching Program (NRMP).MethodsWe retrospectively reviewed self-reported SDN data by DO and MD candidates from EM forums for the 2014, 2016, and 2018 residency application cycles. These data were compared to the NRMP charting outcomes for each respective year.ResultsA total of 360 EM applicants self-reported data on the SDN during the years reviewed. The majority of these applicants (79%) posted for the 2018 application cycle following transition to a Google Docs spreadsheet. For the first two years of analysis, mean United States Medical Licensing Examination (USMLE) scores were similar to SDN reports. For the most recent year studied, applicants who posted to SDN reported higher mean (USMLE) Step 1 (234, 95% confidence interval [CI], 233–236) and Step 2 scores (250, 95% CI, 248–251) when compared to NRMP data (231 and 241). Reported contiguous residency program ranks were similar to NRMP in all years, and the proportion indicating Alpha Omega Alpha Honor Medical Society membership was similar to NRMP only for the most recent year studied.ConclusionSelf-reporting on SDN showed a slight bias toward higher USMLE step scores in the most recent year when compared to objective NRMP data. Self-reporting on SDN has increased in recent years, but it is unknown whether this increase will lead to more accurate information for EM applicants. Given the self-reported nature of the SDN, applicants should use SDN forums with caution.

Trends in Neuroradiology Fellowship Match in the United States: Analysis of the 13-Year National Resident Matching Program Data

The neuroradiology fellowship match is conducted by the National Resident Matching Program (NRMP) every year. The purpose of this study is to report the trends in neuroradiology match results from 2008 to 2020 in the United States (US) using data available from the NRMP. The fellowship match data was obtained from the NRMP archives. Data specific to programs (number of programs and filled positions) were obtained. Using the NRMP's "Charting Outcomes in the Match: Specialty Matching Service'' report, a detailed analysis of applicant characteristics broken down for each specialty, was also obtained for neuroradiology for the year 2018. Neuroradiology programs in the NRMP Match increased from 71 to 77 and the number of positions increased from 158 to 270 between 2008 and 2020. The fill rate of fellowship spots has remained steady at 75.9% in 2008 and 74.4% in 2020. The proportion of US allopathic medical graduates (US MD) amongst the filled spots decreased from 79.2% (2008) to 64.2% (2020), while the proportion of international medical graduates (IMGs) increased from 11.7% to 25.4%. US MD and IMG fill trends did not reach statistical significance (P = 0.78 and P = 0.92, respectively). US MDs had a higher number of research experiences and publications (23.2 and 26, respectively) when compared to US IMGs (5 and 7) and non-US IMGs (6.8 and 14.2). To conclude, over the last 13 years, the neuroradiology fellowship programs in the US have increased in number and expanded in size, with an almost stable fill rate of around 75%.

An Analysis of Trends in National Residency Matching Program Match Data for Orthopedic Surgery.

Due to electronic residency applications, US Medical Licensing Examination Step 1 scores are frequently used by orthopedic surgery program directors to screen applicants. Prospective applicants therefore often use Step 1 scores as a proxy for specialty competitiveness. The goal of this investigation was two-fold: (1) to determine whether trends in Step 1 scores are indicative of trends in competitiveness of orthopedic surgery and (2) to report the characteristics that optimize a US medical student's match success. A retrospective review of published National Resident Matching Program data from 2009 to 2018 was performed for orthopedic surgery residency applicants. Additional data from the Charting Outcomes reports were used for specific analyses of applicant characteristics. From 2009 to 2018, the number of orthopedic surgery residency positions grew at an annual rate of 1.51% (95% confidence interval [CI], 1.37% to 1.64%; P<.001), accommodating the 1.26% (95% CI, 0.63% to 1.90%; P=.006) annual increase in the number of applicants who ranked orthopedic surgery as their preferred specialty choice (only choice or first choice). There were no significant changes in the applicant-to-position ratio (95% CI, -0.85% to 0.37%; P=.483) or the match rate for US seniors who ranked orthopedic surgery as their preferred choice (95% CI, -0.23% to 0.87%; P=.313). Increases in mean Step 1 scores of matched orthopedic surgery applicants parallel national Step 1 growth trends (0.49% vs 0.44%, respectively). Although orthopedic surgery is currently a competitive specialty to match into, this has been the case since 2009. Increasing Step 1 scores of matched applicants is not unique to orthopedic surgery and should not be misinterpreted as a proxy for increasing competitiveness of the specialty. [Orthopedics. 2020;43(6):e616-e622.].

Radiation Oncology Resident Quality by National Resident Matching Program Metrics From 2007 to 2018

To quantify how the quality of US medical students accepted to radiation oncology (RO) training programs, as defined by National Resident Matching Program (NRMP) metrics, has changed over time. We examined NRMP data of senior US medical students matched into RO training programs from 2007 to 2018. Metrics include United States Medical Licensing Exam (USMLE) Step 1 and 2-Clinical Knowledge scores, research output, percentage with PhD, and percentage in Alpha Omega Alpha (AOA), among others. Linear regression analysis assessed the statistical significance of changes in available metrics of matched RO residents over time. The Student t test and χ2 test compared quality metrics between matched students in RO versus all other specialties. From 2007 to 2018, the mean USMLE Step 1 and 2-Clinical Knowledge for RO residents significantly increased from 235 to 247 (1.0 point/year; 95% confidence interval [CI], 0.70-1.52; P = .002) and from 237 to 253 (1.3 points/year; 95% CI, 1.27-1.62; P <.001), respectively. The mean number of research experiences and abstracts/presentations/publications increased from 3.7 to 6.1 (0.2/year; 95% CI, 0.12-0.29; P = .003) and from 6.3 to 15.6 (0.78/year; 95% CI, 0.60-1.04; P <.001), respectively. The percentage of RO residents inducted into AOA increased from 24.2% to 35.2%, whereas those with a PhD remained stable (∼21%). Matched RO residents had statistically superior metrics versus all other specialties for USMLE Step 1 scores (mean +13.5 points; 95% CI, 7.26-19.67; P <.001), research experience (mean +2.04; 95% CI, 1.11-2.97; P <.001), abstracts/presentations/publications (mean +6.80; 95% CI, 3.38-10.22; P = .001), percentage with a PhD (22.2% vs 4.1%; P <.001), and percentage in AOA (29.5% vs 15.8%; P <.001). RO resident quality, defined by routinely reported NRMP metrics, increased from 2007 to 2018. Furthermore, RO resident quality is significantly higher than in all other specialties combined for most metrics. Whether the recent decline in medical student interest in RO will correlate with reduced NRMP quality metrics is unknown.

Trends in the 10-year history of the vascular integrated residency match: More work, higher cost, same result

ObjectiveThe purpose of this study was to examine trends in application submission, rank lists, and applicant quality for vascular surgery integrated residency. MethodsThe National Resident Matching Program Results and Data reports and the Electronic Residency Application Service Statistics from 2007 to 2017 were compiled and mined for trends in terms of application submission and the number of applicants a program needed to rank to fill all residency positions. Applicant pool depth and percentage of programs applied to were calculated. Outcome data from the National Resident Matching Program were reviewed for 2014 and 2016 for United States Medical Licensing Examination Step scores and experiences. ResultsDuring the last 10 years, the number of vascular surgery integrated residency spots rose from 9 to 60 per year. Most programs offer one spot per year; none offer more than two. The average number of applications received by programs rose from 17 applications in 2008 to 63.8 in 2017. The average rank list depth needed by programs to fill the spots has not increased (range, 2.5-5.1; standard deviation, 0.73). The proportional depth of the applicant pool decreased from 4.6 U.S. and Canadian applicants for every one residency spot in 2008 to 1.7 applicants for every one residency spot in 2017. Applicant quality metrics were available for 2 years (2014 and 2016). Step 1 scores (237/239), Step 2 scores (250/250), research experiences (3.7/4.2), and volunteer experiences (5.9/5.5) remained nearly unchanged. The number of contiguous ranks for matched applicants remained stable (12.3/12.8). ConclusionsThe current system promotes multiple inefficiencies, resulting in application glut. Fewer applicants are flooding programs with an increasing number of applications. More money is being spent on Electronic Residency Application Service applications without changes in the number needed to rank by applicants or programs to achieve a match. There is no improvement in the quality of the applicant. Should these trends continue, they represent an unsustainable model for resident selection.