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Thursday, January 4th 2007

Residency Competitiveness: Made With Bits Of Real Panther

60% Of The Time These Work Every Time

9. Ophthalmology
10. Surgery
11. Pathology
12. Emergency Medicine
13. Anesthesiology

Ophthalmology is a great specialty. The eye is actually pretty amazing and it is unfortunately something not a whole lot of medical students get to experience. (Is my interest seeping through?)

In anycase, it finds itself just outside of the broad “Whammy!” category. The average Step 1 for matched U.S. Seniors has traditionally found itself just lower than those for the other two surgical specialties which are (or were, in the case of ENT) early match as well.

Last year it broke 230 (at exactly 230) for the first time. The percent AOA hovers around 20%, which is typical for many surgical sub-specialties.

Surgery probably finds itself in the same boat as Internal Medicine. A highly ‘popular’ specialty, which attracts a very broad range of applicants (in terms of strength). I know I certainly heard from multiple sources the surprising finding that only a single general surgery spot went unfilled last year. In reality however surgery has always filled well.

That is a dermatology-esque finding. Still, despite the fact that the percentage of U.S. Seniors matching dropped double digits to 74% (not good for your chances!) last year, there are some keys which kept it out of the category above.

Like internal medicine it is a ‘popular’ specialty. Weaker candidates see it as safe (WRONG) because of the number of positions and other factors, while stronger candidates bring up the average Step 1 score. In any case the lack of self selection (that goes on for say – Orthopaedics) significantly lowers the U.S. Senior matching %.

Personally, I think that percentage will go back up to ~85% this year after weaker candidates freak out about last year’s results.

The Step 1 median for those who matched was 220 last year.

Pathology is surprising at #11. At least it is for me.The % AOA is right there with general surgery at about 15%. However, apparently pathologists favor standardized test as the median Step 1 score for U.S. Seniors approaches 225. That is pretty impressive for a specialty I’ve never heard any of my classmates give a second thought to.

Pathology has a significant number of unfilled spots every year (5-10% of available) which might be a strike against. However, this could be a sign of the programs’ desire to only take quality applicants (I wouldn’t imagine they absolutely need the legs for scut work as does, say, general surgery).

Emergency Medicine comes in next. We see a little drop off in Step 1 median to less than 220 at about the 218 – 219 range. We’re getting closer to the national average for the exam.

The specialty was particularly popular in 2005. I remember hearing about that, with some talk it would be a trend. It settled back to 90+% of U.S. Seniors matching as of last year. Last year IMGs made up a significant portion of the incoming class, with U.S. Seniors filling just 75% of the available positions.

Rounding out the “Made With Bits Of Real Panther” category is Anesthesiology. If you’ve never noticed this specialty seems like the poster child for the cyclic nature of the “popularity” of specialties. Why is it whenever anyone wants to make an example – “Well it isn’t popular/difficult right now but who knows how that will change…” they always say “…just look at Anesthesia.”

For all that talk of how it is on the up swing I was surprised to find that its median Step 1 score was around 217. Not that that is a disappointing median at all. Still the pundits are right between 2003 and 2004 the number of unmatched U.S. Seniors shot from 14 to 98.

Your chances of matching somewhere as a U.S. Senior are still better than 90% however.

Check beck tomorrow for the very competitive specialties under “Whammy!”

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