27: A Deep Dive Into OB/GYN Residency Match Data

Specialty Stories

English - June 14, 2017 14:00 - 33 minutes - 22.7 MB - ★★★★★ - 207 ratings
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Previous Episode: 26: How to Think About Choosing a Residency & Specialty

Next Episode: 28: What is Trauma Surgery? Dr. Darko Shares His Story

Session 27

This week I'm breaking down and reviewing the match data for OB/GYN. There are a handful of surgical specialties thought to be a good mix of medicine and surgery specialties. OB/GYNE is one of them along with ophthalmology, urology, and ENT. If OB/GYN interests you, take a listen to this episode to see what you need to do!

[02:30] Match Summary

Table 1 of the NRMP Main Match Data 2017 shows the summary of the match and OB/GYN is listed separately from everything else having its own category. There are 241 OB/GYN programs. Compared to other specialties, Surgery has 267 programs, Internal Medicine has 467 programs, Emergency Medicine has 191 programs.

While OB/GYN has 241 programs, there only 1, 288 spots available compared to Emergency Medicine with 191 programs but there are 2,047 spots. That's almost 800 more spots even if there are 50 less programs. Hence, there are less spots per program in OB/GYN.

Out of those 1,288 spots, there were 1,202 U.S. Senior applicants. This means there are less of them applying than there are spots available which is a good thing. (For our conversation, U.S. Seniors based on this data specifically talks about allopathic medical students. The NRMP is the match for allopathic medical schools.)

There are a total of 1,753 students applying. Aside from U.S. Seniors, there could be physicians in another country applying for OB/GYN residency here in the U.S. They could be Caribbean grads, DO students, etc. Only 81.4% of the U.S. Seniors matched so out of 1,202 U.S. Senior applicants, only 1,049 matched and 153 did not match. There could be a number of reasons students are not matching for residency. Maybe they weren't competitive enough or they interviewed poorly. Or maybe they didn't apply to enough residencies or performed poorly on their audition rotations.

[05:45] SOAP and PGY-1

For OB/GYN total, 100% of spots were filled. If for some reason you're trying to Scramble, which is now called SOAP, for OB/GYN in 2017, there were no spots available.

There are only 19 PGY-1 OB/GYN spots, Typically, for OB/GYN spots, you have medicine, surgery, or a transitional year which is a mix of medicine and surgery. It's pretty interesting that OB/GYN has a prelim year. This is for the students that need to SOAP and the students that didn't match maybe they were able to get a PGY-1 spot. However, there is no discussion about OB/GYN having any PGY-2 positions. I'm wondering what happens to these students once they finish their PGY-1 spot.

So there were 19 programs and 23 positions offered, which seems to be just an extra spot for interns, and then 8 programs went unfilled. 142 U.S. Seniors applied and 202 total applicants and only 6 U.S. Seniors matched. As to why this is the case, they probably applied to both categorical OB/GYN spot and the prelim spot so you get a lot more applicants to the PGY-1 spot that hopefully matched in the categorical and didn't need to go onto the prelim year. If that's the case, they wouldn't have matched in terms of how the algorithm works because they are two different programs.

[09:00] Specific Applicants and Trends

Table 2 shows who matched in the specialty. For OB/GYN, there are 1,288 spots for the categorical programs and all spots were filled. 1,049 were filled by U.S. Seniors so 81.4% of all spots went to U.S. Seniors who are those still in school. 11 of those spots went to U.S. graduates who are students that went to an allopathic or MD school who aren't in school anymore that possibly reapplied or took a year off to do some research. There are 123 osteopathic/DO students matched into an allopathic OB/GYN categorical spot.

Outside of the U.S. allopathic and osteopathic students, 64 U.S. IMGs matched into an allopathic OB/GYN categorical spot and 41 non-U.S....

Session 27

[02:30] Match Summary

[05:45] SOAP and PGY-1

For OB/GYN total, 100% of spots were filled. If for some reason you're trying to Scramble, which is now called SOAP, for OB/GYN in 2017, there were no spots available.

[09:00] Specific Applicants and Trends

Outside of the U.S. allopathic and osteopathic students, 64 U.S. IMGs matched into an allopathic OB/GYN categorical spot and 41 non-U.S. citizen IMGs matched. So 105 graduates from a non-U.S. medical school matched.

Table 3 shows the growth of programs year over year (2013-2017). For OB/GYN, it's been growing around 4.5-4.7% every year and this is a good pace.

Table 8 shows the percentage of applicants filled by U.S. Seniors from 2013-2017. 81.4% of those that matched were U.S. Seniors in 2017, 77.5% in 2016, 79.8% in 2015, 76.5% in 2014, and 76.2% in 2013.

Table 9 shows how popular OB/GYN is compared to all of the other specialties. 4.7% of all applicants who matched, matched into OB/GYN. To give you an idea of what that looks like, 7.4% matched into Emergency Medicine, 4.1% into Anesthesiology, 5.4% into Psychiatry categorical.

Table 10 looks specifically at U.S. Seniors who matched by specialty. 6% of all U.S. Seniors matched into OB/GYN. This is a good number. Table 11 shows osteopathic students who matched into OB/GYN. 4.2% of all osteopathic medical students matched into OB/GYN.

Table 12 shows foreign-trained physicians (international medical graduates) and only 1.6% of IMGs matched into OB/GYN. This makes sense since more of the subspecialties are harder to match into as an international medical graduate. Now compare this to 46% of all IMG's matching into Internal Medicine.

Just to give you a comparison here for students who matched into Internal Medicine, Osteopathic students make up 23.5% (Table 11) and 25.6% for all applicants (Table 9) and 18.6% were U.S. Seniors. 25.6% of all applicants is kind of held up by the International Medical Graduates leaning into Internal Medicine.

[14:36] Applicant Choices by Specialty, Matched and Unmatched

Table 13 shows the applicant choices by specialty. For OB/GYN with 1,288 total positions available and all of them matched. 968 of U.S. Seniors that matched only ranked OB/GYN programs. 198 U.S. Seniors ranked OB/GYN as their first specialty and they had a different specialty after that. 36 students U.S. Seniors had a different specialty before OB/GYN. This is common but I personally can't understand ranking more than one career. This is your residency training. This is your specialty. While yes, it is possible to change careers at some point, don't you only want to do it once? I wonder how it feels like to open up your envelop seeing you matched into the specialty you didn't rank first. My advice is try to narrow it down to one program because the data shows that when you rank more than one program, it starts to work against you. There's probably some psychology working in there but it's interesting information.

Table 14 shows the ones that actually matched who ranked their specialty as their only choice. For OB/GYN, there are 890 that matched out of the 968 that applied as their only choice.

Figure 6 shows the percentages of unmatched U.S. Seniors and independent applicants who ranked their specialty as their only choice. OB/GYN is near the bottom for total unmatched percentage at 15.4%. This is pretty good since we covered Physical Medicine and Rehabilitation before and their unmatched rate is 27.5%. Family Medicine is 25.3%.

The majority of those unmatched applicants are the independent applicants. Unmatched U.S. Seniors is very small at 8.1% for OB/GYN (Pls. refer to Table 14). Compared to other specialties, this percentage is on the higher end of U.S. Seniors unmatched. Anesthesiology is only 0.9% of U.S. Seniors, Internal Medicine is 0.5%, PM&R is 7.1%. So even though the total unmatched rate is 27.5% for PM&R and OB/GYN is 15.4%, the U.S. Seniors unmatched is still pretty high at 8.1%.

Table 18 covers SOAP information for 2016-2017 and as mentioned earlier, the 1,288 spots available for OB/GYN went completely filled. When you look at this, Table 1 shows you all of those that matched pre-SOAP and if there are no programs available based on table 1 then obviously, no programs are available for the SOAP. With the OB/GYN prelim year (PGY-1), there were 8 programs, 9 spots available and 8 of those spots went filled.

[20:27] Charting the Outcomes 2016

Looking at Chart 5 of Charting the Outcomes 2016, the students that did not match were equal to or more than the number of different specialties ranked. Those that did not match rank more specialties in their match list than those that did match. So you're focusing your efforts on too many different places instead of honing in on one and putting all your cards on the table for one specialty. Based on the data, it shows that those who spread out too thinly and applied to more programs didn't match whereas those who applied to fewer programs actually matched. Hence, focus your energy on one specialty.

First, note that there is an overlap with a lot of different specialties. For example, diagnostic radiology can be very similar to interventional radiology.

Chart 8 shows the mean number of research experiences from U.S. Allopathic Seniors and OB/GYN is higher for those that matched at 3.2, a decent number right in the middle of the pack. Orthopedic surgery is at 4 and Otolaryngology (ENT) is at 5.1. Those that did not match for OB/GYN had 2.8 so not a lot fewer.

Chart 12 shows the percentage of U.S. Seniors who are members of the AOA (Alpha Omega Alpha), the honor society for medical students. For OB/GYN, 15% matched while 2% of those that did not match were AOA.

[23:25] Contiguous Ranks, Step 1 & 2 Scores, Top 40 Schools

Moving down to the OB/GYN specific information Table OB-1 (Page 123), the mean number for contiguous ranks that matched was 12.5. If you've listened to any of these deep dives before, you will know that this is one of the key indicators of who's going to match and who's not. You are more likely to match when you rank more programs. Those did not match had 6.7 mean number of contiguous ranks. So those who matched almost doubled than those who did not match.

For those that matched, the mean Step 1 score of those that matched was 229 versus 214 for those that did not match. Mean Step 2 score was 244 for those that matched while 230 for those that did not.

The tenth on the list indicates the percentage who graduated from one of the 40 U.S. medical schools with the highest NIH funding. I get a lot of students asking if it matters where to go to medical school and the I always tell them it doesn't matter unless you have aspirations of being a top academic person at Harvard or Stanford and then think about going to some of those more elite schools. But for OB/GYN, specifically, 31.2% of those that matched came from one of those 40 schools. This goes to say that most of the students are coming from somewhere else. You don't have to go to an elite school to match into OB/GYN. On the other hand, 29.8% of those that did not match went to one of the top 40 U.S. medical schools based on NIH funding. To me, this doesn't tell anything about the quality of schools, it just means the school does a lot of research and it's good at writing grants for money.

[26:25] Medscape Lifestyle and Compensation Reports 2017

Looking at the Medscape Lifestyle Report, it tells us that OB/GYNs are pretty burned out, being the second highest on the list at 56% next to Emergency Medicine at 59%. Slide 3 shows the severity of burnout and OB/GYN is near the top at 4.3 in a scale of 1 to 7 (where 1 equals "It does not interfere with my life" and 7 equals "It is so severe that I am thinking of leaving medicine altogether.") When you look at all of the specialties listed here, none of them dropped below 3.9 so it seems everybody is on the way out. This is one of the questions for premeds out there, why do you want to enter this? You have to be ready to answer that question on your interviews. Slide 18 shows which physicians are the happiest, OB/GYN is right in the middle at 69% happy outside of work and 32% happy at work.

Moving on to the Medscape Compensation Report 2017, OB/GYN is near the middle but lower than half at $286K as the average annual physician compensation. Orthopedics is first at $489K and Pediatrics at the very bottom at $202K. Slide 18 shows which physicians feel fairly compensated and OB/GYn is near the bottom at 48%. Whether they would choose medicine again, OB/GYN is second from the bottom at 72%, just above Neurology at 71% while Rheumatology is on top at 83% followed by Psychiatry at 82%. Whether they would choose the same specialty again, OB/GYN is pretty near the bottom at 76%. It looks like not a lot of OB/GYNs are happy with their chosen specialty.

[29:30] Final Thoughts

With a lot of OB/GYN not very happy with their career, more so, not choosing the same specialty again. But information is power. Knowledge is power. So take this information and use it to your advantage. A lot of people go into specialties not knowing enough about the specialty or what their life is going to be like and this why we have this podcast. Take this information and use it so you can best make an informed decision.

Links:

NRMP Main Residency Match Results and Data

Charting the Outcomes 2016

Medscape Lifestyle Report

Medscape Compensation Report

MedEd Media Network