UCLA Anesthesiology Class of 2012. aa77fa0e7e2471849ee1a7bf01791da22012_07_17_14_21_40.jpg
Hey there. I want to address the next step in the medical journey after medical school – Residency. How do you get there? It’s called the NRMP Match. It’s a national program that matches medical students with residency programs. US, International Medical Grads and Osteopathic Medical students can apply. In short, students apply to programs, through NRMP, they are granted interviews, then afterwards they rank the programs in order of preference. Programs rank candidates in their incoming class. On Match Day, medical students nationwide find out where they complete their medical training all at the same time. Most students have a ceremony that commemorates this monumental occasion. It’s a day full of excitement and emotions. The picture above is of my graduating class in Anesthesiology at UCLA. I’m the one in the black and white dress. I was so excited to be graduating finally and starting a career. I was so fortunate to Match in 2008 as my first choice program.
What happens if you don’t match? Things have changed since my time, but now there is a secondary match called SOAP. Students can rank programs from various specialties and the secondary match will Match most students. For example, after about 30 k positions nationwide, after SOAP 2017, 101 spots remained unfilled.
In spite of these statistics, I encounter students from the US or IMG students who fail to match. How does this happen? Often time what hinders students from matching involves below average Step 1 score, any comments or disciplinary actions or needing to repeat portions of a medical school curriculum among other factors. For IMG, the reputation of their medical schools can be a barrier. Programs look more favorably on IMG candidates who have 1 year clinical experience, especially those who completed an internship in the US and are applying for PGY 2 positions.
Let’s go over some stats from the 2017 Match. The 2017 Match showed many US medical grads matched their top 3 choices but only 48% matched first choice. Also more IMG from US matched than ever before in terms of percentage (about 50%) but overall numbers were lower. The key is that they matched PGY1. For US IMG – You must get the internship. However the rates of matching into categorical Family of Internal Medicine (20% and 14 %) are higher than many PGY 1 only spots (about 6%). You could match a categorical IM spot then you can try to get a PGY 2 Position in your specialty of choice.
For anesthesiology, 74/1200 matched at US IMG. About 6% Chance. People faired much better matching internal medicine or Family. Internal Medicine, Surgery or Transitional PGY 1 are accepted by most anesthesiology programs, but as stated above these are competitive.
Here is the link to the Match Data.
So what are the take home messages and what can you do to improve your chances of Matching?
1. Mentorship is key. You need mentors in your specialty of choice to give you a realistic view of whether you’d match and how to improve your chances. These faculty members can give you concrete numbers you need and look at your application. These usually are at your institution if in the US, or if an IMG, connecting with a US program director to meet with you and give you an honest opinion would be key. Ways to consider how to improve your application are research in the field, subinternships at reputable programs and letters from leaders in the field.
2. Having above board conduct and not too many academic red flags are important especially for competitive specialties. Programs do not want someone with ethics violations, problems following rules and order or those with academic problems. If you’ve had these, having additional research or clinical experience with people to vouch for you may help your situation. I found having 1 year of NIH research with pending publications greatly helped strengthen my application, and these programs are once in a lifetime opportunities. https://clinicalcenter.nih.gov/training/mrsp/
3. Audition rotations at programs of choice help. Most importantly performing well and forming relationship with leaders there help your case. If they remember you and like you, then you likely will match depending on specialty and competitiveness. This is general advice and every specialty has certain nuances to applying.
4. If you are an IMG, based on the numbers, it’s much easier to match Family or Categorical Internal Medicine. The key is to get your foot in the door. There are some IMG from US and outside who matched Anesthesiology. The rates were around 6-8% of applicants. These applicants likely were stellar in terms of their numbers. An above average and upper tier >235 Step Score is a must. If you are in the 218-234 range you have an uphill battle but it’s still possible. You must max out all applications in your specialty, all PGY 1 transitional, IM, Surgery and in my opinion apply for categorical IM and Family spots. The fact is specialties for US grads are competitive and more so for international grads.
I hope these tips help you all on your journey. Whether you are premed, first year medical student or are looking to Match, it’s good to know the process and ways to navigate it. IMG students don’t lose hope. This past year had a higher percentage of grads matching PGY 1 in a long time, and with some perseverance and strategic relationships you can navigate your way to success.
Candice Willams, MD