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Mean Step 1 is about to beAnything surgical basically.
Mean Step 1/2 for ENT: 250/257
Mean Step 1/2 for Plastics: 251/257
Good luck...
Mean Step 1 is about to beAnything surgical basically.
Mean Step 1/2 for ENT: 250/257
Mean Step 1/2 for Plastics: 251/257
Good luck...
There was never a scarcity of radonc. It’s just a matter of pure greed and tragedy of the commons. Not sure abt er.There was once a scarcity of EM and radonc, hence the increase in positions. I think psych has a higher ceiling overall though for total positions
I thought there was a shortage in the early 1980s? I could be mistakenThere was never a scarcity of radonc. It’s just a matter of pure greed and tragedy of the commons. Not sure abt er.
Not to my knowledge. In fact, in the 1990s an extra year was added on to residency because something like 1/3 of new grads were un or under employed.I thought there was a shortage in the early 1980s? I could be mistaken
Perhaps, but there is an increasing anti-work movement in these newer generations. That's why things like DR are climbing back up.I think we will see Step 2 averages for surgical subspecialties go up to ~265 in the next few years. A 255 is like 70th percentile right now, it's gonna get so much worse with CK acting as the new Step 1 starting this year/next year
Maldistribution is probably a bigger issue with psych than an absolute shortage. Which is kind of an issue across medicine in general.there is a scarcity of psychiatrists, unlike that in rad onc or EM
Good luck with that theory......less competitive, absolutely won't happen.Perhaps, but there is an increasing anti-work movement in these newer generations. That's why things like DR are climbing back up.
I see hardcore surgery getting less competitive in the future but it's really hard to say. Not sure what the CK numbers will be at though.
Perhaps, but there is an increasing anti-work movement in these newer generations. That's why things like DR are climbing back up.
I see hardcore surgery getting less competitive in the future but it's really hard to say. Not sure what the CK numbers will be at though.
I know Rad docs reading 120 to 150 cases a day. CT, US, MRI, MSK, Neuro, and eat lunch at their desks. This won't jive with the "Lifestyle" crowd.Radiology is anti-work? Lol. Radiology residency was more mental work than my IM internship year. My daily volume at work approaches 45-60 CTs/MRIs and 20-30 plain films/ultrasounds.
Meaning people are listing the abstract and the presentation as two separate items?ACG for GI abstracts. And they index it on pubmed
That’s how GI applicants have so much research. Each case report abstracts to ACG becomes 2 lines in your CV
Rads lifestyle probably still beats General Surgery in most settings, but it's not cush nowadays, especially as an attending making $500k (though radiology residency can be cushier than most other residencies). Some might have that perception of rads as that might have been the case in the early 2000s. With significantly decreased imaging reimbursements nowadays, and everyone ordering imaging for just about any complaint and expecting a fast report around the clock, the volumes and speed that radiology attendings have to read at is hitting its limits. And since EDs image patients 24/7 and need results back in a timely manner to dispo patients, some radiologists will have to work nights as well. And this is with all all the medico-legal liability that comes with reading at these high volumes and speeds (radiologist are responsible for all pathology on all their images, including incidental findings; and images never change and can be saved pretty much forever).Maybe it's just my perception, but the crowd that goes into Rads goes into it for lifestyle reasons rather than the love of Radiology. This is why a lot of surgery people jump ship to Rads expecting an easy ride to 500k or whatever. There's been more posts on reddit about people realizing how much work it ends up being, the lack of autonomy, taking people's orders all day long, etc.
Right now there's a significant need for psych (especially inpatient psych unless the hospital subsidizes their pay, since it's otherwise not lucrative as you end up seeing a lot of patients without insurance), but that doesn't mean it can't be saturated down the line from rapid residency expansion.Every field is expanding like crazy. Psych didn't expand much more than IM or medicine in general over the last 17 years. There were 983 spots filled in 2005, compared with 2,047 this year, a 108% increase. There were 4,768 IM positions in 2005, compared with 9,380 today, a 96.7% increase. Overall positions climbed from 22,221 to 39,205 in 2022, an increase of 76.5%. Psych had far more demand than most other fields, and unlike EM or radonc, doesn't require you to set up in a facility, which keeps you from having other people dictate your terms and driving your wages down artificially.
Maybe it's just my perception, but the crowd that goes into Rads goes into it for lifestyle reasons rather than the love of Radiology. This is why a lot of surgery people jump ship to Rads expecting an easy ride to 500k or whatever. There's been more posts on reddit about people realizing how much work it ends up being, the lack of autonomy, taking people's orders all day long, etc.
It can become oversaturated, with time, as can most fields. That's why I try to encourage everyone to have their **** you money as soon as humanly possible so if things get bad they can walk, and to have unique skills. I'm in child fellowship because no one wants to do it, and even if general gets crushed child will still have a few years on the clock. I plan to have enough money to walk away entirely within 10 years, after which the entire medical system could implode and it wouldn't be my problem. Medicine constantly gets worse, so you should be eyeing the exits from day 1, just in case. I still enjoy what I do greatly, but there will likely come a day that the field changes in a way that makes it unbearable, be it pay, admin, or expected midlevel oversightRight now there's a significant need for psych (especially inpatient psych unless the hospital subsidizes their pay, since it's otherwise not lucrative as you end up seeing a lot of patients without insurance), but that doesn't mean it can't be saturated down the line from rapid residency expansion.
The EM job market saturation isn't only from rapid residency expansion, but also from increased reliance on PAs/NPs to staff ERs. It's more common now to see a more even mix of midlevels/attendings staffing EDs, with midlevels usually seeing the patients triaged as lower acuity and attendings being required to supervise them in addition to seeing their own patients, whereas in the past the majority of staffing was with just with attendings.
You're in Child Psych ? Or Critical Care / PICU ?It can become oversaturated, with time, as can most fields. That's why I try to encourage everyone to have their **** you money as soon as humanly possible so if things get bad they can walk, and to have unique skills. I'm in child fellowship because no one wants to do it, and even if general gets crushed child will still have a few years on the clock. I plan to have enough money to walk away entirely within 10 years, after which the entire medical system could implode and it wouldn't be my problem. Medicine constantly gets worse, so you should be eyeing the exits from day 1, just in case. I still enjoy what I do greatly, but there will likely come a day that the field changes in a way that makes it unbearable, be it pay, admin, or expected midlevel oversight
C&A psychYou're in Child Psych ? Or Critical Care / PICU ?
Your field and mine (FM) have some significant advantages that rad onc and EM (just to name a few) don't.It can become oversaturated, with time, as can most fields. That's why I try to encourage everyone to have their **** you money as soon as humanly possible so if things get bad they can walk, and to have unique skills. I'm in child fellowship because no one wants to do it, and even if general gets crushed child will still have a few years on the clock. I plan to have enough money to walk away entirely within 10 years, after which the entire medical system could implode and it wouldn't be my problem. Medicine constantly gets worse, so you should be eyeing the exits from day 1, just in case. I still enjoy what I do greatly, but there will likely come a day that the field changes in a way that makes it unbearable, be it pay, admin, or expected midlevel oversight
This is true but it’s still vulnerable to external forces. What if the government keeps slashing reimbursement? This is a good bet as it’s just keeping in line with the trend. Having to see 50 patients to make the same income as you did when you used to see 30? The worst part is that these cuts are subtle and gradual.We can open a solo practice pretty easily.
I honestly don't see Psych ever becoming a highly competitive specialty, unless its median salary levels rise to Derm levels, if not more. It's certainly not bad in terms of hours/pay/lifestyle, but I imagine that working long-term with the psych patient population is not as welcoming as most other outpatient specialties.
DPC, Concierge, UC are all still good options.This is true but it’s still vulnerable to external forces. What if the government keeps slashing reimbursement? This is a good bet as it’s just keeping in line with the trend. Having to see 50 patients to make the same income as you did when you used to see 30? The worst part is that these cuts are subtle and gradual.
In addition, I bet that New York, Massachusetts and California etc. will soon follow Oregon’s lead, establishing reimbursement parity for NPs and PAs. Yes, of course physicians who already graduated residency will be fine because these changes may take 10+ years to come to fruition but they’re definitely on the horizon and being able to open PP wouldn’t help much imo.
Perhaps, but there is an increasing anti-work movement in these newer generations. That's why things like DR are climbing back up.
I see hardcore surgery getting less competitive in the future but it's really hard to say. Not sure what the CK numbers will be at though.
Curious if you think your analysis above extends to General Peds as well ?Your field and mine (FM) have some significant advantages that rad onc and EM (just to name a few) don't.
First, we are not dependent on a radiation generating machine nor a physical ED for our jobs. We can open a solo practice pretty easily.
Second, both fields have massive numbers of doctors over age 55. It's around half of psychiatry and about 45% of FPs. That's a huge portion of the field that will retire in the next 10-15 years.
Third, demand for both is huge and getting bigger. In my area it often takes longer to see a psychiatrist than a dermatologist these days. And outside of brand new doctors, it's almost impossible to get a family doctor new patient appointment in less than 6 to 8 weeks.
Forth, in medicine in general, and our fields more specifically, lifestyle is becoming a big factor for younger physicians. Lots more folks our age in my field are not working five full days a week. We're also not seeing as many patients per hour on the whole as the older generations were doing. One of my wife's partners routinely sees upwards of 40 patients per full day. Most family doctors in my area are seeing around 25 a day. So it will take almost two full-time family physicians to replace the work he does when he retires.
Tl;Dr: while we are at risk of oversaturation just like literally any other job, I think we are much better protected from it then most of the rest of medicine.
It is something I find curious. My med school roommate used to see 40 to 60 patients a day before EMRs. Now he sees 35 to 40. I don't know how you see 25 a day,( 1 every 20 min), take 6 weeks vacation, pay student loans, mortgage, and keep the lights on at the office. I know of several new FM hires who were released after they could not produce what they cost in compensation. I'm just having trouble wrapping my arms around new grads busting their butts in training to then look to do the least amount possible.Your field and mine (FM) have some significant advantages that rad onc and EM (just to name a few) don't.
First, we are not dependent on a radiation generating machine nor a physical ED for our jobs. We can open a solo practice pretty easily.
Second, both fields have massive numbers of doctors over age 55. It's around half of psychiatry and about 45% of FPs. That's a huge portion of the field that will retire in the next 10-15 years.
Third, demand for both is huge and getting bigger. In my area it often takes longer to see a psychiatrist than a dermatologist these days. And outside of brand new doctors, it's almost impossible to get a family doctor new patient appointment in less than 6 to 8 weeks.
Forth, in medicine in general, and our fields more specifically, lifestyle is becoming a big factor for younger physicians. Lots more folks our age in my field are not working five full days a week. We're also not seeing as many patients per hour on the whole as the older generations were doing. One of my wife's partners routinely sees upwards of 40 patients per full day. Most family doctors in my area are seeing around 25 a day. So it will take almost two full-time family physicians to replace the work he does when he retires.
Tl;Dr: while we are at risk of oversaturation just like literally any other job, I think we are much better protected from it then most of the rest of medicine.
It IS generational. We considered downsizing a few years ago and had a home eval with a realtor. To sell a home, it has to be in move in condition. If not new construction, buyers will only consider a home with updated kitchen and bathrooms. She said the new buyers won't even pick up a paint brush. I'm not sure what this generation considers a terrible lifestyle. If you want a lifestyle, don't do general surgery. Patients requiring surgery often don't wait for convenient times to develop a surgical condition. My wife and I were 2 overpaid specialists who joined large groups and one of us was on call every 2nd or 3rd weekend. At least one of us was always at activities, sports, concerts, etc.. I didn't consider these arrangements onerous.It's my general perception that the newer generation absolutely does not want to work like the older generation did and have terrible lifestyles. But I haven't seen that impacting the specialty people pick as much. i.e. it's not "I don't want to have a terrible lifestyle, I'm not doing X surgical subspecialty" it's "I'm doing X surgical subspecialty, but as an attending, I won't take a job where I have a terrible lifestyle".
So I think the step 2 scores will continue to climb for those specialties. Whether or not they actually get a nice lifestyle like they say they want, I have no idea. But I'm constantly surprised how many people are going into traditionally non-lifestyle specialties expecting they'll have a good lifestyle.
To an extent, although I don't know the demographics of the current peds workforce to comment on that part.Curious if you think your analysis above extends to General Peds as well ?
My wife HATES the focus on the colors of a house given how easy it is to hire a painter.It IS generational. We considered downsizing a few years ago and had a home eval with a realtor. To sell a home, it has to be in move in condition. If not new construction, buyers will only consider a home with updated kitchen and bathrooms. She said the new buyers won't even pick up a paint brush. I'm not sure what this generation considers a terrible lifestyle. If you want a lifestyle, don't do general surgery. Patients requiring surgery often don't wait for convenient times to develop a surgical condition. My wife and I were 2 overpaid specialists who joined large groups and one of us was on call every 2nd or 3rd weekend. At least one of us was always at activities, sports, concerts, etc.. I didn't consider these arrangements onerous.
If you know what you're doing, you can make a significant amount of money per encounter.It is something I find curious. My med school roommate used to see 40 to 60 patients a day before EMRs. Now he sees 35 to 40. I don't know how you see 25 a day,( 1 every 20 min), take 6 weeks vacation, pay student loans, mortgage, and keep the lights on at the office. I know of several new FM hires who were released after they could not produce what they cost in compensation. I'm just having trouble wrapping my arms around new grads busting their butts in training to then look to do the least amount possible.
Question about interpreting this chart... Should I be looking at the absolute numbers of pubs in these specialties, or is it the difference between matched/unmatched that's meaningful? For example, a large difference in the number of pubs between matched and unmatched in neurosurgery means that having publications is likely important for matching into neurosurgery, but in pediatrics, where they're essentially the same number, having research isn't important?I wonder how much of the DR bump comes from surgical subspecialty applicants using it as a backup. I think most people going for ortho, plastics, derm etc would choose DR over IM.
And this chart, as always, is ridiculous.
View attachment 357271
This only worsens the prestige bias. Someone going to Harvard can churn out high impact papers whereas someone going to a low tier MD or DO schools will be effectively screwedIf H-index becomes a factor in match, that obviously separates the wheat from the chaff -
Also, some of the journals with high impact factor require publication fees, e.g Nature Communications
Clearly anesthesiology and radiology being used as alternative to EM. Guessing these two will stay competitive for years to come. Looks like PM&R, is also getting more competitive.
Interestingly, neurology doesn’t seem to have become more popular despite many people saying that the treatments on the horizon have/will make it more enjoyable and lucrative.
Wonder why match rate increased for psych. Been hearing how competitive it has become
Why would you say neuro is not enjoyable and that we cannot treat patients currently. Figuring out extremely hard diseases is a typical day and it’s awesome.
I think thats true but that is most diseases in most fields (CHF, CKD, COPD, effectively DM, autoimmune diseases, etc)I’ve heard people say it on this forum and my impression is that it refers to the fact that many neurological disorders (especially Parkinson’s, MS, Alzheimer’s etc.) can’t be cured and therapies at best only slow their progressions. I might be wrong though.
It's honestly ridiculous that research is becoming essential for almost all specialties. Research is and should be mutually exclusive because we are going to be practitioners of clinical medicine, not research scientists. I have zero interest in research and am only doing the bare minimum to check the box. Not only just this, but we are also churning out papers that are essentially garbage. Research has become less about what you publish and more about how much you publish. Research should be left to those who have an interest in it and want to genuinely solve or identify a problem/trend. It should not be performed by people like me who are doing the bare minimum in order to be competitive for residency.
^^^ This is honestly my expectation no matter what people say. Unless you’re trying to be in a position/residency that values churning out research, there’s no reason for people to care. But idk - everyone has a different experience & knows different types of people.Some while back I was listening to a plastic surgeon pontificate on the utility of medical student research in applying to his field. They had crunched numbers and determined that, in terms of outcomes, when you got one "real" first author publication in a peer reviewed journal you reached the point of diminishing returns. Having zero hurt, but continuing to pile on more entries after the first one had little effect on the odds of matching.
I was surprised by this, but he generally knows what he's talking about.
We're talking about a handful of uber-competitive specialties. Not only do many people go to med school without research, many match residency and fellowship just fine with little to none. It's only de facto required for the people gunning for surgical subspecialties/derm, or competitive locations or hospitals. SDN definitely over samples from that crowdShould I be worried as a pre-med, that I’m behind somehow? I realize some people get into medical school with 0 research done, though.
As residencies get more competitive, how do they select from the applicant group? They will just make the criteria different. Itused to be step 1, now it is step 2 score. Before research wasnt required, now it is almost mandatory for some specialties, like plastics, neurosurg, ortho, derm, etc.. Med school used to be GPA and mcat. Now you have to show volunteering and service to others. Research also makes an applicant interesting. The game just keeps changing.So when it comes to the above post - I’m over here with research interests in something non-clinical/non-science (to the naked eye) that happen to eventually fall under something I’d likely research down the line as a physician (eventually making it science/medicine-related). I’m still a pre-med but I plan to do research in a foreign country next year (non-science) but that’s like the only thing besides some presentations & other volunteering, work, and shadowing stuff.
Should I be worried as a pre-med, that I’m behind somehow? I realize some people get into medical school with 0 research done, though.
^^^ This is honestly my expectation no matter what people say. Unless you’re trying to be in a position/residency that values churning out research, there’s no reason for people to care. But idk - everyone has a different experience & knows different types of people.
The Northwestern name will carry you.Is there any hope for a rising M2 interested in surgical subspecialties who just chilled and enjoyed life during the M1 summer instead of grinding out research... Asking for myself
Is there any hope for a rising M2 interested in surgical subspecialties who just chilled and enjoyed life during the M1 summer instead of grinding out research... Asking for myself
Residency is much easier than years ago in terms of hours protection and more shift work. This new generation wants lifestyle hours without productionIt is something I find curious. My med school roommate used to see 40 to 60 patients a day before EMRs. Now he sees 35 to 40. I don't know how you see 25 a day,( 1 every 20 min), take 6 weeks vacation, pay student loans, mortgage, and keep the lights on at the office. I know of several new FM hires who were released after they could not produce what they cost in compensation. I'm just having trouble wrapping my arms around new grads busting their butts in training to then look to do the least amount possible.
I would submit that adults are worse in that regard, especially those white collar workers over 30.Kida are very unhealthy as they are on screens all the time
We're talking about a handful of uber-competitive specialties. Not only do many people go to med school without research, many match residency and fellowship just fine with little to none. It's only de facto required for the people gunning for surgical subspecialties/derm, or competitive locations or hospitals. SDN definitely over samples from that crowd
As residencies get more competitive, how do they select from the applicant group? They will just make the criteria different. Itused to be step 1, now it is step 2 score. Before research wasnt required, now it is almost mandatory for some specialties, like plastics, neurosurg, ortho, derm, etc.. Med school used to be GPA and mcat. Now you have to show volunteering and service to others. Research also makes an applicant interesting. The game just keeps changing.
More than 30 years ago sure, majority of kids are still just fine.Kida are very unhealthy as they are on screens all the time
And they started it all as overweight deconditioned kids.I would submit that adults are worse in that regard, especially those white collar workers over 30.
If H-index becomes a factor in match, that obviously separates the wheat from the chaff -
Also, some of the journals with high impact factor require publication fees, e.g Nature Communications
Yep! And to give a word of reassurance for competitive specialties, I came into med school with no research and as a relatively average undergrad student and matched to my first choice in plastics with no research year. Knowing you're interested in something competitive just means you're going to need to plan more and earlier.We're talking about a handful of uber-competitive specialties. Not only do many people go to med school without research, many match residency and fellowship just fine with little to none. It's only de facto required for the people gunning for surgical subspecialties/derm, or competitive locations or hospitals. SDN definitely over samples from that crowd