Increasing lengths of rank order lists of applicants and programs of US medical residencies

2021 ◽  
pp. 000313482110508
Author(s):  
Kevin Newsome ◽  
Brendon Sen-Crowe ◽  
Dino Fanfan ◽  
Mark McKenny ◽  
Adel Elkbuli
Keyword(s):  
Retrospective Study ◽  
Training Programs ◽  
Rank Order ◽  
Temporal Trends ◽  
Residency Programs ◽  
The Past ◽  
Current State ◽  
Medical Programs ◽  
Over Time ◽  
Residency Match

Background To match medical students into residency training programs, both the program and student create rank order lists (ROLs). We aim to investigate temporal trends in ROL lengths across 7 match cycles between 2014 and 2021 for both matched and unmatched residency applicants and programs. Methods retrospective study of ROLs of 7 match cycles, 2014-2021. Residency match and ROL data were extracted from the NRMP database to assess the number of programs filled and unfilled, length of ROLs, position matched, and average ranks per position for osteopathic (DO) and allopathic (MD) medical programs. Results For filled residency programs, the average ROL length consistently increased from 70.72 in 2015 to 88.73 in 2021 ( P = .003), with ROL lengths consistently longer for filled vs unfilled residency programs ( P < .001). The average ROL length for matched applicants increased consistently from 10.41 in 2015 to 12.35 in 2021 ( P = .002), with matched applicants having consistently longer ROLs than unmatched applicants ( P < .001). From 2015 to 2021, in both MD and DO applicants, progressively lower proportions of applicants matched their first and second choices. Conclusion Trends across the past 7 residency match cycles suggest that ROL lengths for both programs and applicants have been increasing with matched programs and applicants submitting significantly longer ROLs than unmatched applicants. Additionally, fewer applicants are matching at their preferred programs over time. Our findings support the mounting evidence that the Match has become increasingly congested and we discuss the possible factors that may be contributing to the current state of the Match as well as potential solutions.

scholarly journals Osteopathic students and graduates matching into pathology residency, 2011–2020

2021 ◽  
Vol 121 (2) ◽  
pp. 149-156
Author(s):  
Ryan Philip Jajosky ◽  
Hannah C. Coulson ◽  
Abric J. Rosengrant ◽  
Audrey N. Jajosky ◽  
Philip G. Jajosky
Keyword(s):  
United States ◽  
Primary Care ◽  
Medical Education ◽  
Accreditation System ◽  
Senior Year ◽  
Medical Specialties ◽  
Residency Programs ◽  
The Third ◽  
The Past ◽  
Residency Match

Abstract Context In the past decade, two changes have affected the pathology residency match. First, the American Osteopathic Association (AOA) Match, which did not offer pathology residency, became accredited under a single graduate medical education (GME) system with the Main Residency Match (MRM), which offers pathology residency. Second, substantially fewer United States senior-year allopathic medical students (US MD seniors) matched into pathology residency. Objective To determine whether there were major changes in the number and percentage of osteopathic students and physicians (DOs) matching into pathology residency programs over the past decade. Methods Pathology match outcomes for DOs from 2011 to 2020 were obtained by reviewing AOA Match data from the National Matching Services and MRM data from the National Resident Matching Program (NRMP). The number of DOs that filled pathology positions in the MRM was divided by the total number of pathology positions filled in the MRM to calculate the percentage of pathology positions taken by DOs. Results Over the past decade, there was a 109% increase in the total number of DOs matching into pathology residency (34 in 2011 vs. 71 in 2020). During this time, there was a 23.3% increase in the total number of pathology positions filled in the MRM (476 in 2011 vs. 587 in 2020). Thus, the percentage of pathology residency positions filled by DOs increased from 7.1% in 2011 to 12.1% in 2020. The substantial increase of DOs in pathology occurred simultaneously with a 94.2% increase in the total number of DOs filling AOA/MRM “postgraduate year 1” (PGY-1) positions (3201 in 2011 vs. 6215 in 2020). Thus, the percentage of DOs choosing pathology residency has remained steady (1.06% in 2011 and 1.14% in 2020). In 2020, pathology had the third lowest percentage of filled PGY-1 residency positions taken by DOs, out of 15 major medical specialties. Conclusion The proportion of DOs choosing pathology residency was stable from 2011 to 2020 despite the move to a single GME accreditation system and the stark decline in US MD seniors choosing pathology. In 2020, a slightly higher percentage of DOs (1.14%) chose pathology residency than US MD seniors (1.13%). Overall, DOs more often choose other medical specialties, including primary care. Additional studies are needed to determine why fewer US MD seniors, but not fewer DOs, are choosing pathology residency.

scholarly journals How predictable is extinction? Forecasting species survival at million-year timescales

2019 ◽  
Vol 374 (1788) ◽  
pp. 20190392 ◽  
Author(s):  
Peter Smits ◽  
Seth Finnegan
Keyword(s):  
Fossil Record ◽  
Human Impacts ◽  
Rank Order ◽  
Extinction Risk ◽  
Geographical Range ◽  
The Past ◽  
The Future ◽  
Out Of Sample ◽  
Extinction Events ◽  
Over Time

A tenet of conservation palaeobiology is that knowledge of past extinction patterns can help us to better predict future extinctions. Although the future is unobservable, we can test the strength of this proposition by asking how well models conditioned on past observations would have predicted subsequent extinction events at different points in the geological past. To answer this question, we analyse the well-sampled fossil record of Cenozoic planktonic microfossil taxa (Foramanifera, Radiolaria, diatoms and calcareous nanoplankton). We examine how extinction probability varies over time as a function of species age, time of observation, current geographical range, change in geographical range, climate state and change in climate state. Our models have a 70–80% probability of correctly forecasting the rank order of extinction risk for a random out-of-sample species pair, implying that determinants of extinction risk have varied only modestly through time. We find that models which include either historical covariates or account for variation in covariate effects over time yield equivalent forecasts, but a model including both is overfit and yields biased forecasts. An important caveat is that human impacts may substantially disrupt range-risk dynamics so that the future will be less predictable than it has been in the past. This article is part of a discussion meeting issue ‘The past is a foreign country: how much can the fossil record actually inform conservation?’

scholarly journals Education Research: Neuroradiology curriculum in neurology residency training programs

Neurology ◽  
2019 ◽  
Vol 92 (4) ◽  
pp. 199-203 ◽  
Author(s):  
Paul D. Johnson ◽  
Stefan Sillau ◽  
Joseph C. Masdeu ◽  
Douglas E. Ney ◽  
Pearce J. Korb
Keyword(s):  
Resource Availability ◽  
Training Programs ◽  
Program Directors ◽  
Residency Programs ◽  
The Past ◽  
Curriculum Guidelines ◽  
Service Training ◽  
Training Resources ◽  
American Academy Of Neurology ◽  
Question Survey

ObjectiveTo better understand how the essential skill of interpreting various neuroimaging studies is taught to neurology residents in Accreditation Council for Graduate Medical Education (ACGME)-accredited training programs.MethodsA 22-question survey was sent electronically to 150 ACGME adult neurology program directors. We collected data regarding the presence of a neuroimaging curriculum, frequency of review sessions and testing, resource availability, and program director confidence in neuroimaging skills of graduating residents. We collected average scores on the neuroimaging section of the Resident In-service Training Examination of graduating residents for the past 3 years, which we attempted to correlate with resource availability.ResultsOne-third of neurology residency programs do not have a neuroimaging curriculum, and half of training programs do not require a neuroimaging rotation. On average, trainees spend 1 hour per week reviewing imaging with radiologists. Program directors believed trainees receive insufficient neuroimaging training, with a median satisfaction rating on a Likert scale (0–100) of 35 (interquartile range 27–47). Few programs take advantage of online training resources.ConclusionOpportunities exist to improve neuroimaging education in neurology resident education. This can be done by closer adherence to the American Academy of Neurology neuroimaging curriculum guidelines, especially by expanding access to online resources and additional emphasis on imaging review with neurology subspecialists.

Impact of PhORCAS references on overall application score for postgraduate year 1 pharmacy residency candidates

2020 ◽  
Vol 77 (15) ◽  
pp. 1237-1242
Author(s):  
Sara A Atyia ◽  
Frank P Paloucek ◽  
Allison R Butts ◽  
Douglas R Oyler ◽  
Craig A Martin ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Application System ◽  
Average Characteristic ◽  
Residency Programs ◽  
Current State ◽  
Candidate Characteristics

Abstract Purpose The disparity between the number of applicants for postgraduate year 1 (PGY1) pharmacy residency positions and the number of available residency positions increases the need to optimize how applicants are evaluated. The purpose of the study described here was to evaluate the correlation of ratings of residency candidate characteristics by academic and professional references listed on residency applications with overall application score, applicant ranking, and the likelihood of candidates receiving an invitation to interview. Methods A multicenter, retrospective study was conducted to evaluate the correlation of reference writers’ ratings of 13 candidate characteristics and their overall recommendations with program-determined outcomes (eg, final application score, applicant ranking, and invitation to interview) through analysis of PGY1 applications submitted through the Pharmacy Online Residency Centralized Application System (PhORCAS) from 2015 through 2018. Keywords and themes within the open-ended section of letters of reference were also analyzed for correlation with overall application score. Results A total of 5,923 references listed on 1,867 applications to 4 PGY1 pharmacy residency programs processed by PhORCAS were included in the analysis. For the majority of applicant characteristic ratings (ie, 74% of 56,872 ratings overall), reference writers rated candidates as exceeding expectations, and applicants were “highly recommended” by these evaluators in 91% of cases. References’ average characteristic ratings and overall recommendations were poorly correlated with final application score (R2 = 0.12 [P &lt; 0.0001] and R2 = 0.08 [P &lt; 0.0001], respectively), final ranking (R2 = 0.02 [P &lt; 0.0001] and R2 = 0.03 [P &lt; 0.0001], respectively), and invitation to interview (R2 = 0.07 [P &lt; 0.0001] and R2 = 0.04 [P &lt; 0.0001], respectively). For the themes evaluated, references’ use of teaching words best correlated with normalized final application score, although the correlation was poor (R2 = 0.007, P = 0.0001). Conclusion Reference writers’ ratings of PGY1 residency candidate characteristics in PhORCAS are poorly correlated with application score, applicant ranking, and invitation to interview. The results of this study suggest that the existing PhORCAS standardized form for submitting references is of limited utility in its current state.

scholarly journals TRADITIONAL NORTHERN SELKUP TOY

2021 ◽  
pp. 158-173
Author(s):  
Ольга Борисовна Степанова
Keyword(s):  
The Past ◽  
The North ◽  
Current State ◽  
Symbolic Meanings ◽  
Over Time ◽  
The Way

Традиционная игрушка северных селькупов, сегодня ими почти забытая, до сих пор никем не исследовалась. Между тем, она представляет собой яркий фрагмент традиционной селькупской культуры. Исследование ставило своей задачей вернуть селькупскому народу этот элемент его культуры в форме научного описания. На основе главным образом музейных материалов и отчасти полевых материалов автора были выявлены и рассмотрены пять типов игрушки северных селькупов, включая шесть видов куклы. Из-за нехватки селькупского материала в исследовании активно использовался метод научной реконструкции. Описания зафиксированных у селькупов типов и видов игрушки воссоздавались по материалам игрушки соседних народов. Попутно устанавливалось, какие традиции — западносибирские и восточносибирские — оказывали влияние на формирование облика того или иного типа/вида игрушки у селькупов. Был рассмотрен вопрос о связи североселькупской игрушки — вещи утилитарного значения — с сакральным или, иными словами, вопрос ее символических смыслов. Автор пришла к выводу, что все типы и виды селькупской игрушки в прошлом были сакральными обрядовыми предметами, и что в семиотическом статусе игрушки соотношение «знакового» и «вещного» со временем сдвинулось в сторону «вещного». Завершенный вид исследованию придали включенные в него материалы по современному состоянию традиционной североселькупской игрушки. The traditional toy of the northern Selkups, today almost forgotten by them, has not yet been studied by anyone. Meanwhile, it is a vivid fragment of the traditional Selkup culture. The research aimed to return this element of their culture to the Selkup people in the form of a scientific description. Based mainly on museum materials and partly from the author's field materials, five types of toys of the northern Selkups were identified and considered, including six types of dolls. Due to the lack of Selkup material, the method of scientific reconstruction was actively used in the study. Descriptions of the types and types of toys recorded by the Selkups were recreated based on the materials of toys of neighboring peoples. Along the way, it was established which traditions — West Siberian and East Siberian — influenced the formation of the appearance of a particular type / type of toy among the Selkups. The question of the connection between the North Selkup toy — a thing of utilitarian meaning — with the sacred, or, in other words, the question of its symbolic meanings, was considered. The author came to the conclusion that all types and types of Selkup toys in the past were sacred ritual objects, and that in the semiotic status of a toy, the ratio of “sign” and “thing” over time shifted towards the “thing”. The study was completed by the materials included in it on the current state of the traditional North Selkup toy.

Justice in Residency Placement: Is the Match System an Offense to the Values of Medicine?

2003 ◽  
Vol 12 (1) ◽  
pp. 66-77
Author(s):  
TIMOTHY F. MURPHY
Keyword(s):  
Medical School ◽  
Rank Order ◽  
Medical Practitioner ◽  
The United States ◽  
Obstetrics And Gynecology ◽  
Medical Residency ◽  
Specialty Training ◽  
List Ranking ◽  
Residency Programs ◽  
Residency Match

Medical residency—specialty training after the completion of medical school—is an essential component of medical education and is required in order to be a licensed, independent medical practitioner in most jurisdictions. As things currently stand in the United States, the match between medical school graduates and residency programs is governed by a match between rank-order lists prepared by candidates and residencies alike. An applicant picks a number of residency programs and ranks them according to order of interest. The residency program prepares a similar list, ranking the candidates it most wants in its program. A computer program compares the rankings and makes assignments according to a certain algorithm. Using these lists, the match system assigns approximately 24,000 applicants to approximately 21,000 training positions in pediatrics, obstetrics and gynecology, internal medicine, and the rest. These assignments are then announced to all parties on specific days. The system has been in place since 1952 and is overseen by the National Residency Match Program (NRMP), a nonprofit organization. This system has several advantages. First of all, it standardizes the timetable for decisions, and applicants are in no position to tie up offers while waiting to hear from other institutions. Institutions are not held captive, either, in making assignments while waiting to hear from particular parties.

scholarly journals Understanding the Interview and Ranking Behaviors of Unmatched International Medical Students and Graduates in the 2013 Main Residency Match

2015 ◽  
Vol 7 (4) ◽  
pp. 610-616 ◽  
Author(s):  
Mei Liang ◽  
Laurie S. Curtin ◽  
Mona M. Signer ◽  
Maria C. Savoia
Keyword(s):  
Rank Order ◽  
International Medical ◽  
First Year ◽  
School Students ◽  
The Past ◽  
Medical Licensing ◽  
Usmle Step 1 ◽  
Licensing Examination ◽  
Usmle Step ◽  
Residency Match

ABSTRACT Background  Over the past decade, the number of unfilled positions in the National Resident Matching Program (NRMP) Main Residency Match has declined by one-third, while the number of unmatched applicants has grown by more than 50%, largely due to a rise in the number of international medical school students and graduates (IMGs). Although only half of IMG participants historically have matched to a first-year position, the Match experiences of unmatched IMGs have not been studied. Objective  We examined differences in interview and ranking behaviors between matched and unmatched IMGs participating in the 2013 Match and explored strategic errors made by unmatched IMGs when creating rank order lists. Methods  Rank order lists of IMGs who failed to match were analyzed in conjunction with their United States Medical Licensing Examination (USMLE) Step 1 scores and responses on the 2013 NRMP Applicant Survey. IMGs were categorized as “strong,” “solid,” “marginal,” or “weak” based on the perceived competitiveness of their USMLE Step 1 scores compared to other IMG applicants who matched in the same specialty. We examined ranking preferences and strategies by Match outcome. Results  Most unmatched IMGs were categorized as “marginal” or “weak”. However, unmatched IMGs who were non-US citizens presented more competitive USMLE Step 1 scores compared to unmatched IMGs who were US citizens. Unmatched IMGs were more likely than matched IMGs to rank programs at which they did not interview and to rank programs based on their perceived likelihood of matching. Conclusions  The interview and ranking behaviors of IMGs can have far-reaching consequences on their Match experience and outcomes.

scholarly journals Temporal Trends in Prescribing of Bone-Directed Therapies in the United States, 2009–2020

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A250-A250
Author(s):  
Sara Cromer ◽  
Kristin M D’Silva ◽  
Elaine Wei-Yin Yu ◽  
Joan Landon ◽  
Rishi Desai ◽  
...  
Keyword(s):  
Zoledronic Acid ◽  
Temporal Trends ◽  
The United States ◽  
Medication Administration ◽  
First Line ◽  
Data Mart ◽  
The Past ◽  
First Line Therapy ◽  
Icd Codes ◽  
Over Time

Abstract Multiple new osteoporosis therapies, including some with novel mechanisms of action, have been introduced in the past decade. However, little is known about temporal trends in prescribing these new medications. Using claims data from the Clinformatics Data Mart (Optum, Inc.), we determined the number of enrolled individuals over age 50 who were prescribed any osteoporosis medication during each quarter between January 1, 2009 and March 31, 2020. Of all individuals receiving therapy, we then calculated the percent receiving each medication. In subgroup analyses, we limited the population to (1) only those with ICD codes for osteoporosis in the current or previous three quarters and without codes for active malignancy during the current or previous quarter, and (2) only those with ICD codes from an oncology provider for active malignancy likely to metastasize to bone during the current or previous quarter. In the all-user cohort, a total of 15.48 million unique prescription or medication administration claims from 1.46 million unique individuals during the study period were analyzed. Of these, 89% were women and 71% over the age of 65, with a mean age of 69. Alendronate was the most common medication used, representing &gt;50% of all treated individuals, and its use increased over time. Percent of users receiving zoledronic acid doubled during this period but remained &lt;5%. Use of other bisphosphonates declined steadily. By comparison, after its approval in 2010, denosumab use increased rapidly, reaching 10% of users in 2015 and 15% of users in 2018. Percent of individuals treated with raloxifene declined after 2013. Use of teriparatide, abaloparatide, and romosozumab remained less than 2% throughout the study period. Trends in the osteoporosis cohort paralleled those in the all-user cohort. In the malignancy cohort, alendronate and zoledronic acid were each used in approximately 30% of individuals at the onset of the study, and both declined over the decade. By contrast, denosumab use rapidly increased after introduction and surpassed use of either bisphosphonate by 2013. Denosumab use continued to increase over time and reached approximately 50% of all bone-directed medication use in the malignancy cohort. Use of other medications, mainly alternate bisphosphonates, was low and declined throughout the study period. In a privately insured cohort between 2009–2020, denosumab use increased significantly in both osteoporosis and malignancy populations, outpacing gains in use of other agents, despite guidelines suggesting that either bisphosphonates or denosumab could be considered first-line therapy for osteoporosis.

scholarly journals Współczesna polska terminologia astronomiczna – dziedzictwo i przyszłość

2020 ◽  
Vol 2020 (5/2020(774)) ◽  
pp. 35-49
Author(s):  
Jadwiga Waniakowa ◽  
Wacław Waniak
Keyword(s):  
Web Portal ◽  
The Past ◽  
Current State ◽  
The Face ◽  
The Creation ◽  
Over Time

This text addresses the Polish scientifi c terminology of astronomy. This subject is relatively rarely discussed in the linguistic literature. The authors handle the divisions of astronomical terms by specifi c criteria, the process of coining the Polish astronomical terminology, and tendencies noticeable in its formation over time. They also deal with the old astronomical vocabulary, which has survived to date and is used as the basisfor modern terms. Furthermore, they analyse awareness of the language and terminology among astronomers in the past and in the present. Finally, they discuss the current state of the Polish astronomical terminology. In the conclusion, they postulate the creation of a web portal dedicated to it, which would not only be a useful terminographical solution but also improve its situation in the face of the dominance of English.

scholarly journals Education Research: The current state of neurophysiology education in selected neurology residency programs

Neurology ◽  
2018 ◽  
Vol 90 (15) ◽  
pp. 708-711 ◽  
Author(s):  
Kate M. Daniello ◽  
Daniel J. Weber
Keyword(s):  
Medical Education ◽  
Curriculum Design ◽  
Program Directors ◽  
Study Program ◽  
Learning To Read ◽  
Residency Programs ◽  
Educational Methods ◽  
Current State ◽  
Methods Of Learning ◽  
Over Time

ObjectivePrior research has illustrated there is a knowledge gap in neurology residents' neurophysiology education (EEG and EMG), and we sought to understand whether this is still an issue and to recognize the barriers in order to create solutions and improve education.MethodsSurveys were developed for adult neurology residents and one for program directors asking about confidence in neurophysiology knowledge, percent of graduates reaching level 4 ACGME (American Council of Graduate Medical Education) milestones in EEG and EMG, methods of learning used, interest in the subjects, and suggestions for improvements.ResultsTwenty-six program directors (19% responder rate) and 55 residents (from at least 16 different programs) completed the survey. Program directors thought that 85% of graduating residents met level 4 milestones in EEG and only 75% in EMG. Structured rotations and more time allocated to education of these topics were frequent barriers mentioned. Postgraduate year 4 residents were 60% and 67% confident in EEG and 64%, 59%, and 62.3% in EMG level 4 milestones. Learning to read EEGs was considered important throughout residents' training; however, this interest and value decreased over time with EMG.ConclusionIn our study, program directors suspect up to a quarter of residents may graduate not meeting level 4 ACGME milestones, and residents expressed lack of confidence in these areas. The educational methods used to instruct residents in EEG and EMG were similar as were the barriers they face across programs. This information hopefully will help fuel curriculum design and interest in these important neurology techniques.

Sign in / Sign up

Export Citation Format

Share Document