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Bryan Carmody Profile picture
@jbcarmody
Oct 15, 2021 • 11 tweets • 4 min read • Read on X
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Preliminary data from ERAS are out… looks like another record-setting year.

The average number of applications received by residency programs is up in most specialties - in some cases, by 30-40% versus 2019.

#ApplicationFever Graphic showing the percentage increase in number of applica
The average number of applications submitted by applicants is up, too.

Here are the current averages for each specialty (considering all applicant types - MDs, DOs, and IMGs). Mean number of residency applications per applicant, by spec
MD applicants in dermatology, otolaryngology, urology, and neurosurgery now submit a mean of around 80 applications or more - and the average MD applicant in orthopedics submits nearly 100 applications.
And here are the data for DO applicants.

In most specialties, DOs submit more applications than their MD peers. (The exceptions are a few highly competitive specialties, in which there are still programs that do not seriously consider DO applicants). Graphic showing the mean number of residency applications pe
As a reminder, the figures above show only the average *within that specialty.*

But these days, many applicants apply to more than one specialty… so the total number of applications submitted by each applicant is even higher than the figures above would suggest.
Here are the 2020 ERAS cross-specialty applicant data, which show the extent of multiple-specialty application.

e.g., 148 applicants applied to both ortho and otolaryngology programs; 126 applied in both derm and PM&R; 169 applied in both psychiatry and general surgery; etc. ERAS cross specialty applicant data for 2020. For instance,
Here’s how the average number of applications submitted has grown over time - doubling in little over a decade.

cureus.com/articles/47109… Graphic from the linked article demonstrating the rise in th
Think these trends are sustainable?

Me, neither.

Can I interest you in application caps?

thesheriffofsodium.com/2020/04/07/on-…
Or, if you prefer a video version…

thesheriffofsodium.com/2021/01/01/the…
ADDENDUM:

Lots of questions about why I compared 2021 to 2019 (not 2020) in the first graphic.

Application numbers vary over the course of the season - but the start of the 2020 season was delayed. So to to make an apples-to-apples comparison, I went back a year.
Also - these aren’t my data. They’re from the AAMC, and they’re available to anyone who wants to splice them a different way.

aamc.org/data-reports/i…

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More from @jbcarmody

Bryan Carmody Profile picture
May 11
For the past couple of days, my timeline has been full of headlines about how medical students are avoiding states with more restrictive abortion laws.

The headlines are tantalizing… but are they true?

I’m skeptical.

(🧵) Screenshot of NPR story: “Medical residents are starting to avoid states with abortion bans.”
If you’ve somehow missed all of this, here’s a typical article (which happens to be the one I screenshotted above).

npr.org/sections/healt…
…and here’s the analysis by the @AAMCtoday, which used Electronic Residency Application Service data to find a decrease in U.S. MD graduates applying to residency programs in states with more restrictions on reproductive health.

aamcresearchinstitute.org/our-work/data-…
Read 23 tweets
Bryan Carmody Profile picture
Feb 19
UPDATE:

Last week, a Nepali doctor filed a class action lawsuit against the National Board of Medical Examiners, alleging discrimination based upon national origin and requesting that invalidated USMLE scores be restored while examinees appeal.

Today, the NBME responded.

(🧵)
The court will issue a ruling by February 21 - so the outcome of the suit remains uncertain.

Still, the NBME’s filing provides additional details on the scope of the scandal, how the cheaters were caught, and what’s likely to happen in the future.
First, the NBME confirmed the number of examinees involved.

According to their filing, 832 examinees have had at least one of their USMLE scores invalidated… so far. Screenshot from the defendant’s filing, noting that 832 individuals had at least one USMLE score invalidated.
Read 16 tweets
Bryan Carmody Profile picture
Feb 15
A brief update on the USMLE cheating scandal:

This week, a Nepali doctor and Match applicant whose Step 1, Step 2 CK, and Step 3 scores were all invalidated has sued the NBME.

The NBME will respond by February 19, and the court will render a decision by February 21.

(🧵) Screenshot from the lawsuit, noting that the plaintiff requests a decision by February 21, 2024, so that she can participate in the 2024 Match. The NBME has asked to have until February 19 to file an opposition brief.
The suit alleges that the NBME did not follow its own policies by invalidating scores before the involved examinees had an opportunity to appeal. Screenshot from the lawsuit, describing the USMLE’s procedure for investigating whether a person cheated, and allowing an appeal. The quoted section does not provide for identifying cheaters before the process is completed.
The suit also alleges violations of the Civil Rights Act due to discrimination based on national origin and ethnicity, based on the USMLE’s initial statement that the scandal was “associated with Nepal.” “In a press release, NBME explained that its new policies applied to test-takers ‘associated with Nepal.’”
Read 12 tweets
Bryan Carmody Profile picture
Feb 9
It’s always messy when a residency program loses accreditation - but this one seems particularly messy.

An update on the Crozer Chester surgery residency program closure…

(🧵)
Some background:

On January 8, the ACGME withdrew the accreditation for the Crozer Chester Medical Center general surgery residency program.

The hospital was told that the program need to shut down by January 12 - just FOUR DAYS later.

beckershospitalreview.com/hospital-physi…
The hospital leadership - as well as the Pennsylvania Attorney General! - reached out to the ACGME and asked for an extension while they appealed.

They agreed on January 30, and an appeal was filed - which would not be decided until ~June 30.
Read 19 tweets
Bryan Carmody Profile picture
Dec 7, 2023
Big changes may be coming for internal medicine residency applicants in the 2024-2025 application cycle…

The @AAIMOnline is recommending:

-⬆️ preference signals from 7 to 15 (3 gold, 12 silver)

-capping interviews at 15

-no interviews before November 1
Increasing the number of signals will likely function as a soft application cap, as we’ve seen in other specialties.

Many IM programs will still evaluate/interview applicants who don’t signal - but many others will receive so many signaled applications that they’ll stop there.
This will shift the dominant application strategy from “Apply to as many programs as possible” to “How do I most effectively allocate my preference signals?”

Applicants who signal wisely will benefit… those who don’t will suffer.

More here:
Read 8 tweets
Bryan Carmody Profile picture
Nov 8, 2023
If you want to become a pediatric subspecialist, you’ve gotta do a fellowship.

For most subspecialties, that fellowship lasts 3 years.

But most of that time isn’t spent learning clinical medicine. It’s spent doing research.

Ever wondered why these fellowships last so long?

🧵


Screenshot from NRMP website, listing typical fellowship length for academic general pediatrics (2-3 years), child abuse (3 years), developmental-behavioral pediatrics (3 years), and neonatal-perinatal medicine (3 years).
Screenshot from NRMP website listing typical fellowship length for pediatric cardiology, pediatric critical care, pediatric emergency medicine, pediatric endocrinology, and pediatric gastroenterology. The length is 3 years for each subspecialty except for pediatric EM, which is 2-3 years.
Screenshot from NRMP website showing typical length of fellowship for pediatric hematology-oncology, pediatric hospital medicine, pediatric infectious disease, pediatric nephrology, and pediatric pulmonology. The length of fellowship is 3 years for each subspecialty except for pediatric hospital medicine, which is 2-3 years.
Screenshot from NRMP website, showing typical fellowship length for pediatric rheumatology (3 years) and pediatric transplant hepatology (1 year).
The short answer is, “because the American Board of Pediatrics requires it.”

But why?

For instance, in many specialties, a resident can choose between a 2-year clinical or a 3-year academic fellowship. The ABIM accepts either… but the ABP only accepts the latter.
To find the answer, we’ve gotta go back to the early 1980s.

At that point, peds heme-onc was a 2-year fellowship. But PDs felt trainees needed more training time to attain clinical proficiency.

So they asked the ABP if they could increase ⬆️ their fellowship from 2 to 3 years.
Read 13 tweets

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