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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
Nov 16
Aw jeez, not this again.

According to this consultant, hospitals now *lose* an average of $304,312 per physician per year.

🤦🏻

Guess it’s time for another thread on Budgetary Gerrymandering. Image
First, stop and think.

If indeed we truly lived in a world in which hospitals LOSE hundreds of thousands of dollars on each doctor they employ, then it begs a simple question.

Why employ doctors?

I mean, why not just fire them all and stop the bleeding?
On its very face, this can’t be true. Yet doctors hear this all the time.

Even at hospitals awash in money, many doctors have been successfully convinced that their service is a money-loser… so of course they can’t get a raise, and actually, they need to generate more RVUs.
Read 12 tweets
Bryan Carmody Profile picture
Oct 8
The AAMC shared preliminary data for the 2024-2025 residency application cycle.

For specialties that use ‘big signaling,’ applications per applicant are down ~35-40% from a couple of years ago.

I’ve got a couple of things to say about that… and the AAMC’s spin on it.

(🧵) Headline from MedPage Today - link to full article below
First, the data.

Here’s how much the number of applications submitted per applicant in certain specialties has changed from ERAS 2023 to ERAS 2025:

Otolaryngology -42.5%
Dermatology -42%
Orthopedic Surgery -40%
Urology -36%
Anesthesiology -26%
Each of these are relatively small, highly competitive specialties that give applicants a large number of signals.

This functions as a soft application cap: most programs will receive enough signaled applications to focus only on those applicants when deciding whom to interview. Image
Read 14 tweets
Bryan Carmody Profile picture
Oct 3
This year, OB-GYN applicants used a new system - ResidencyCAS - to apply to residency programs.

ACOG just released preliminary application data - and a couple of figures caught my eye.

(🧵)
First:

I thought there might be a few holdout programs, but no. *100%* of OBGYN programs used the new system.

(I don’t think the AAMC’s circle-the-wagons plan is working out so good.)
Second:

The average number of applications submitted per applicant is down:

2022: 75
2023: 64
2024: 59

But with ‘big signaling,’ I’m surprised it didn’t drop more. Screenshot from the article, noting drop in applications per applicant.
Read 11 tweets
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

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