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Saturday, January 6th 2007

Residency Competitiveness: The Balls


“In Other Words, Ron Burgundy Derm & Plastics Were The Balls.”

I truly believe these two specialties are in a class far and above all others right now in terms of how competitive they are.

1. Plastic Surgery (Integrated)
2. Dermatology

Plastic Surgery has two routes. General Surgery/Oto + Fellowship or the direct match integrated programs. In some ways the integrated programs are a bit of a failure. Most (if not all) surgical sub specialties used to require a general surgery residency but now things like ortho and neurosurgery are COMPLETELY separate training routes.

Not the case with plastics where the integrated approach still co-exists with the plastics fellowship.

In anycase, while still difficult, going through general surgery and then finding a fellowship is considerably “easier” (but not easy) than matching into these integrated programs.

These are the most difficult programs in the land.

Consistently less than 50% of U.S. Seniors match. That is by far the worst figure of any specialty. Now granted there is certainly less self selection going on here, because they know they have a “better” shot at going and doing general surgery and then plastics.

But even with a “de”flated matching percentage Plastic Surgery has the highest median Step 1 score for matched U.S. Seniors at 242 – 243. Think about that, the median student matching has a score above 240, more than 20 – 30 points higher than the national average on Step 1.

It also has the second highest AOA %.

The highest goes to Dermatology. Clearly Dermatologists love AOA. The percentage of students is so disproportionate to other specialties that it is clear they weigh that part of the application far more than any other specialty. It is disillusioning to even think about Derm without being AOA considering 50% are.

That might be surprising – only 50%? First, plenty of allopathic schools lack AOA. Second, consider that just 10 – 15% of the graduating class (from all schools) is AOA. Dermatology snatches up a hugely disproportionate (stop using that word!) number of those kids, it is easy to see.

The Step 1 median is no slouch either. It is the second highest coming in just under 240 last year.

Dermatology has much more self selection than plastics, yet its matching % for U.S. Seniors was consistently ~60% before last year (where it shot up somewhat).

I hope this little series has been interesting. Maybe even put some things in perspective.

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