Session 23

Our episode with Dr. Chris Sahler was one of our most popular episodes. I decided to bring you the PM&R residency match data since many of you seem interested!

[02:33] NRMP Main Match Data for 2017 - PGY-1 & PGY-2 Positions

Table 1 shows the match summary for all the different specialties and Physical Medicine & Rehabilitation only has 32 programs under PGY-1 positions. This is also one of those specialties where you can match into a PGY-2 spot and you have to separately apply for your internship. This table shows there are 62 programs for PGY-2 positions and that gives you a total of 94 programs. Just be careful when looking at data since some specialties may have they PGY-1 built-in while some do not.

Looking at PGY-1 spots, there are 119 positions. This is a relatively smaller program with almost 3 and 3/4 per program. And out of those spots, only one program went unfilled. There are 294 U.S. Seniors applying out of 595 in total who applied. (Remember for the purposes of this podcast when talking about match data, U.S. Seniors refer to U.S. allopathic students so these are students who are still in medical school going through the normal timeline so they're not taking any gap years after medical school.) This implies that more than half them applying for these spots are U.S. Seniors. Interestingly, only 74 U.S. Seniors matched for Physical Medicine & Rehabilitation out of 118 that matched.

Only 62.2% of the students that matched were U.S. Seniors. Comparing this to other specialties, 78.2% of those that matched in Emergency Medicine were U.S. Seniors, Neurosurgery at 83.9%, Neurology at 50.6%, and OB-GYNE at 81.4%. There is a very wide spectrum of what percentages of students matching are U.S. Seniors.

For PGY-2 Positions, students also need to rank and match into a PGY-1 spot, whether it's a surgery year, a transitional year, or an internal medicine year. So these are three different prelim years you can choose from. Out of those 62 programs, there were 294 spots available so it's almost 4 and 3/4 per program. This is a little bit bigger compared to PGY-1 position programs. And out of those 294 programs, none of them went unfilled. Out of 633 total applicants, 306 were U.S. Seniors and only 61.16% of those that matched were U.S. Seniors.

[07:28] Matches by Specialty and Applicant Type

Table 2 of the 2017 NRMP Main Match Data shows us where the other people are coming from. For PGY-1 positions, 33 were osteopathic students out of 118 physicians that matched in PM&R. This is 27.97%

Compared to other specialties. Emergency Medicine had 283 matches for osteopathic students (a pretty big number for non-primary care) out of 2,041 total students. That's 13.9%. So PM&R is 14% higher than that which is very interesting.

Looking at this data, you can't say osteopaths are at a disadvantage because less osteopaths are matching into some of these surgical positions. But if a student goes to an osteopathic medical school because they believe in their philosophy and manipulation, then going into surgery maybe doesn't make sense and so is going into pathology. So you can't just look at the numbers. You have to look at what's the reasoning behind the numbers.

It's easy to hypothesize that osteopathic medicine fits very well with PM&R, which is basically, non-surgical orthopedics. You're dealing with people who have aches and pains and joint issues as well as other things and osteopathic medicine works with that. So these PM&R programs seem to be very open to osteopathic students. In fact, Dr. Sahler talked about this in Episode 13 that PM&Rs are very open to osteopathic physicians.

For PGY-2 spots, all 294 positions went filled. 181 were U.S. Allopathic Seniors, 5 were U.S. Grads (these are students outside of the normal timeline), and 83 were osteopathic students, which means 28.2% of osteopathic students actually matched. So if you're an osteopath and are interested in this stuff, you have a good shot to get a spot here. Moving on, 17 were U.S. International medical graduates, 8 were non-U.S. citizen international medical grads.

[11:40] Positions Offered, U.S. Seniors, All Applicants, Osteopaths (2013-2017)

Table 3 tells us how the the number of spots is growing and looking at PM&R, it's growing slowly over the last four year at 0.4% every year for PGY-1 while for PGY-2, it's been growing much faster at 11% in 2017 from 10.9% in 2016. If you're interested in it, it's obviously a growing field for you.

Table 8 shows the percentages filled by U.S. Seniors versus all applicants from 2013-2017. It basically shows us a trend of what programs are doing, whether they prefer U.S. Seniors or U.S. Graduates or other students. Looking at PM&R for PGY-1, 62.2% in 2017 were U.S. Seniors, 61.16% in 2016, 60.7% in 2015, 56.3% in 2014, and 59.8% in 2013. So it has gone up pretty steadily over the last couple of years with more preference towards U.S. Seniors. For PGY-2, 61.6% U.S. Seniors matched, 52.8% in 2016, 45% in 2015, 53.7% in 2014, and 51.7% in 2013. There was a huge dip in 2015 which is really interesting.

Table 9 shows all applicants that matched by specialty. 0.4% of all students matched for PGY-1 spots matched into PM&R. Compared to other specialties, Surgery is 4.6%, Internal Medicine is 25.6%, Family Medicine is 11.6%, Anesthesiology is 4.1%.

Table 11 shows us osteopathic students matching into PGY-1 spots with 1.1% of all osteopathic medical students are matching into PM&R. Comparing that with the previous table of 0.4% by percentage, more osteopathics actually match into PM&R than allopathic students. This is very interesting yet it still goes with the fact that it does fit with osteopathic medicine.

[15:12] Unmatched and SOAP

Figure 6 of the 2017 NRMP Main Match Data shows the Percentages of Unmatched U.S. Seniors and Independent Applicants Who Ranked Each Specialty as Their Only Choice. PM&R is near the top of the list for total unmatched students at 27.5%. Internal Medicine (Prelim) is the highest followed by Dermatology, Psychiatry, and then PM&R. Majority of these students are independent applicants which means they are not U.S. Allopathic Seniors. You have osteopathic students, U.S grads who are already out of school and international medical graduates making up this number. This is a little scary since PM&R is higher on the list. Remember there was only one unfilled position so it's highly sought after for a specialty.

Table 18 is all about the SOAP (Supplemental Offer and Acceptance Program). Again, there was only one unfilled spot in all of PM&R. So for the SOAP, there was also only one spot available and as expected, it was filled through the SOAP.

[16:48] Charting the Outcomes 2016

Based on Charting the Outcomes 2016, Table PM-1 (Page 168 of 211) shows the number of contiguous ranks, Step scores, research, work experience, AOA, etc., to give you a picture of what these students look like for those who matched and did not match.

For U.S. allopathic Seniors, the mean number of contiguous ranks that matched are 14.2 programs while those that did not match were only 5.6. I can't stress enough the need for you to rank enough programs in order to match.

When you submit your rank list, you actually don't have to apply to only one specific residency program. You can apply to General Surgery and Orthopedic Surgery programs. For Physical Medicine & Rehabilitation, the mean number of distinct specialties ranked is 1.6 for those that matched and those that did not match were 2.2. Those ranking more programs are not going to be able to verbalize and communicate to these programs why they specifically want to go into PM&R because maybe they're out there ranking other programs.

Back on the data, the mean Step 1 score is 226, mean Step 2 score is 238. These are not terribly high Step scores. Those that did not match are 210 and 221 for Steps 1 and 2 respectively.

They have data for osteopathic students as well. Looking at Level 1 score for those that took the COMLEX, they have a 551 for those that matched and 492 for those that did not match, 563 for Level 2 that matched and 491 for Level 2 that did not match.

Charting the Outcomes 2016 Table PM-1 also looks at work experiences and volunteer experiences. AOA members comprised 6.2% of those that matched while 0% for those that were unmatched. (AOA in the allopathic world is for Allopathic medical students)

[21:10] Medscape Physician Lifestyle and Compensation Reports

Normally, I would also check on the Medscape Physician Lifestyle and Compensation Reports but PM&R is not included in the data probably because it's a smaller field so they didn't have enough respondents for it. So we do not have enough feedback to have the data here.

Links:

Specialty Stories Episode 13: What is Physiatry? (Physical Medicine & Rehabilitation)

MedEd Media Network

2017 NRMP Main Match Data

Supplemental Offer and Acceptance Program (SOAP)

2016 Charting the Outcomes - NRMP Medscape Lifestyle Report 2017

Medscape Physician Compensation Report 2017

AOA