Your Residency Application: Five Factors to Prioritize When Creating your Rank List

Creating your Match rank list can be absolutely agonizing because it feels like so much is at stake. Sometimes it helps to step back and look at the big picture. Below, I briefly note a few important considerations when making your list:

1. Make sure you understand how the NRMP algorithm works. See my previous blog post regarding errors to avoid at all costs. The key is to rank in the order you want - first goes first, second goes second, etc.
2. Consider your happiness and life balance. Blasphemy perhaps, but I would argue that they are more important than the strength of the training program.
3. Reflect on the culture, geography, size, and even maturity/age of the program. Think about whether you will fit in.
4. Consider whether you could spend your whole life at the institution or in that program's location. It's a lot to grapple with, but many residents graduate and stay for the rest of their careers.
5. Decide whether you liked the program director, chairperson, and faculty generally. They could make or break your happiness and success.

How Race and Gender Affect Medical Specialty

The AAMC published an interesting piece recently showcasing the results of their Physician Specialty Data Report on the interplay of race, gender, and specialty. 

It's worth combing through the data yourself, but here are a few takeaways:

Doctors from underrepresented groups are more concentrated in primary care fields. These specialties are extremely needed and noble, but since primary care is less well remunerated than surgical specialties, it's worth thinking about the disproportionate density of minority physicians.

Women make up the majority of medical school students for the fourth year in a row.  

Women represent a significant minority in surgical specialties like orthopedic surgery (5.9%), thoracic surgery (8.3%) and neurosurgery (9.6%). Ouch.

Focusing on another demographic, the doctor workforce has grown older. Over 46% of active U.S. doctors are 55+. That number was ~38% in 2007. 

For more details, read the report here.

What to Know about the AAMC Fee Assistance Program

Now that the 2022-23 medical school application process is on the horizon, I want to remind candidates about the Association of American Medical Colleges' (AAMC) Fee Assistance Program (FAP) and Insider Medical Admissions' available discount for those with a current FAP. The FAP is designed to offer help to individuals with financial limitations who cannot pay the MCAT registration and/or AMCAS application fees without financial support. (Of note, there also exists an FAP for  dental school candidates through the American Dental Education Association.)

If you think you are eligible, it's worth applying for an FAP grant early: When applicants submit their AMCASes prior to receiving decisions on their FAP applications, those candidates are ineligible to receive the FAP benefits for the AMCAS even if their FAP grants are approved. In other words, the FAP is not retroactive. You snooze, you lose.

For more information on the FAP, please click here. I offer a significant discount on one non-package service for any applicant who can demonstrate financial hardship through a current AAMC FAP grant. After researching the issue, I believe Insider Medical Admissions is the only medical consulting company that currently supports a discount for FAP grant recipients. (I apologize if I'm missing a company.) Once you have been granted the FAP and thus, can prove receipt, please feel free to contact me for more information.

Medscape's Annual Physician Burnout Report is Out and - As Usual - It's Disturbing

Every year Medscape surveys physicians about career satisfaction. The last few annual reports have been pretty upsetting. Unfortunately, 2022's results are not happy either.

This year emergency physicians (my colleagues) reported the highest burnout rates of all specialties at 60%. Last year this number was 43%, so there was a large jump in already-high dissatisfaction levels. Next in line were critical care physicians at 56%. But even the specialty with the smallest percentage of burned out physicians – public health and preventive medicine – had rates at 26%. So even in the happiest cohort, one in four surveyed doctors reported burnout.

Looking at gender, fifty-six percent of female physicians surveyed reported burnout; men seemed less dissatisfied, but they were at 36% so that's not so great either.

Bureaucratic tasks were perceived to be the biggest contributor to physician burnout by their own assessment.

It's important for those who are considering a career in medicine to approach it with eyes wide open: Take a look at the Medscape National Physician Burnout & Suicide Report 2022 slide deck yourself for more details, and check out my Kevin MD piece on EM burnout here.