What Behaviors Could Increase The Chances Of U.S. Senior Medical Students To Match Into Residency Programs? 

Match: This analysis of the National Resident Matching Program Applicant Survey responses of senior medical students in US allopathic medical schools (“U.S. seniors”) compares survey responses from students who matched into a residency program vs. those who did not, and contains much useful information for students and those who advise them.  The data is weakened by a 49% overall response rate and a fair amount of missing data; however the number of included students is high at 7,762 and the percentage of students in the cohort who were matched, 96%, is very similar to the overall percentage of US seniors who are matched at 94%.  Importantly, this matched percentage has not changed in the last few decades, despite increasing numbers of non-U.S. seniors applying during this time frame. Students were broken into 4 categories of “strength” based only on their self-reported USMLE Step 1 certifying examination score as compared to the mean and standard deviation (SD) of that score for US seniors who  matched into their preferred specialty.  Overall, “strong” or “solid” students who scored above the mean for their preferred specialty had only about a 2% risk of not matching, while “weak” students who scored below 1 SD of the mean had a 10% risk of not matching.  Unmatched students answered several survey questions quite differently (>10% differences) than students who matched, suggesting they had “a fundamental misunderstanding of how the matching algorithm works.”  For example, many fewer of the unmatched students ranked the programs in order of their preference, ranked all programs that they were willing to attend, or ranked a “safety net” program.  Surprising to this (older) reviewer were the sheer numbers of applications involved, which must be putting huge stresses on students and on residency programs.  Even “strong” students, with USMLE1  scores more than 1 SD over the mean, applied to an average of 31 programs.  Such large numbers of applications may not be necessary for most students, if they can utilize the Match more strategically. — Laura Willett, MD

Liang, Mei MS; Curtin, Laurie S. PhD; Signer, Mona M. MPH; Savoia, Maria C. MD, “Unmatched U.S. Allopathic Seniors in the 2015 Main Residency Match: A Study of Applicant Behavior, Interview Selection, and Match Outcome.” Academic Medicine Nov, 2016

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