Does applying to multiple specialties decrease my chance of matching?

One reader asked “what would happen to my chance of matching if I applied to multiple specialties?”

Some of you may know that I like the idea of applying to a single specialty. Let me touch on this first and then discuss this reader’s question.

Why I think ranking a single specialty is preferable…

I think that there are many positives in applying to a single specialty including:

  • being able to tailor your CV towards a specific pathway
  • reducing the amount of research you need to do to search for programs
  • being able to convince program directors and interviewers that you are very interested in that specialty
  • making life easier for you and your LoR writers. Applying to more than one specialty may mean that you will need to write more than one personal statement and your LoR writers may need to write multiple specialty-specific letters.

If you’re ranking more than one specialty…

1. Think about obtaining specialty-specific LORs

applying-to-multiple-specialties

From the ECFMG ECHO website, “It is important to let your letter writer know which specialties you are considering for residency training and why, and to ask for his/her perspective on providing specialty-specific LoRs. A specialty-specific LoR is one that expresses to the program director that you are focused on pursuing a particular medical specialty. It should also directly recommend you for training in that specialty and explain why you are well-suited for that specialty. If a letter writer has recommended you for a position in a specific specialty, it is not advisable to use that LoR to apply for positions in other specialties. If you are submitting the LoR to more than one specialty, request your letter writer to provide a general letter applicable to all specialties, or request multiple, specialty-specific LoRs from that same letter writer.”

2. Think about writing multiple personal statements

From the 2015 My ERAS overview document, “you may create one or more personal statements; however, only one personal statement may be assigned and sent to an individual program.” So you can write as many personal statements as you would like, but this really takes a lot of time and energy.

3. Be aware of the data

While I think that applying to a single specialty is ideal, I do realize that many of you may be applying to multiple specialties for a variety of reasons. For example, if you’re applying to a competitive specialty such as radiology, where the chance of an IMG matching is very small, then it may actually be quite wise to think about a back-up plan. I wrote about this in a previous article. Other reasons may include trying to increase your chance for interviews or perhaps your interests and skills span different specialties equally.

Whatever the reason, there are some key take-home messages from the 2013 NRMP IMG match data that you should be aware of. Below are the most pertinent facts to know.

(i) You are more likely to match if you rank fewer specialties

mean-number-of-different-specialties-ranked

The above graph displays the average number of specialties ranked, by IMG applicant type, preferred specialty, and match outcome. It’s clear that in general you have a better chance of matching if you rank fewer specialties. Combining data across all specialties, successful IMGs ranked 1.3-1.4 programs, as opposed to 1.5-1.6 who were unmatched. You can take a look at the data for your preferred specialty. You can click on the image to enlarge it on your screen.

You should also look at the match data for a specific specialty to get more details. I’ve outlined an example below for Internal Medicine and Neurology.

Internal medicine :

Overall summary data shows that successfully matched U.S. IMG applicants applied to 1.3 programs and those who failed to match applied to 1.6 programs. For non-U.S. IMGs, these numbers were 1.3 and 1.4 respectively. Take a closer look at the numbers below.

U.S. IMG

  • 1 specialty ranked: 604 matched vs 405 unmatched (60% match rate)
  • 2 specialties ranked: 203 vs 259 (44% match rate)
  • 3 specialties ranked: 25 vs 70 (26% match rate)
  • 4 specialties or more: 9 vs 12 (43% match rate)

Non-U.S. IMG

  • 1 specialty ranked: 1317 matched vs 1268 unmatched (51% match rate)
  • 2 specialties ranked: 289 vs 432 (40% match rate)
  • 3 specialties ranked: 67 vs 123 (35% match rate)
  • 4 specialties or more: 11 vs 27 (29% match rate)

Neurology:

The drilled down data looks different for neurology.

U.S. IMG

  • 1 specialty ranked:  matched 30 vs 18 unmatched (63% match rate)
  • 2 specialties ranked: 17 vs 12 (59% match rate)
  • 3 specialties ranked: 10 vs 11 (48% match rate)
  • 4 specialties or more: 1 vs 3 (25% match rate)

Non-U.S. IMG

  • 1 specialty ranked: 64 matched vs 67 unmatched (49% match rate)
  • 2 specialties ranked: 63 vs 57 (53% match rate)
  • 3 specialties ranked: 16 vs 16 (50% match rate)
  • 4 specialties or more: 5 vs 6 (45% match rate)

Bear in mind that this is a single year’s data and trends can change year to year. It is up to you to decide how it impacts your decisions.

(ii) If you are ranking multiple specialties, you should try to rank as many programs as possible from your preferred specialty above programs in different specialties in order to increase your chance of matching.

The graph below shows the number of contiguous ranks in each specialty. “Contiguous ranks” in this case means the number of programs in the top specialty before a program in another specialty appears on the rank order list.

median-number-of-contiguous-ranks-2014

The take-home message here is that applicants with longer rank order lists in their preferred specialty are more successful than those with shorter ones. Again, take a look at the data for your preferred specialty. You will notice that unsuccessful IMGs have as low as 1 program ranked. This may (at least in part) be because noncompetitive IMGs may only have one program to rank in their preferred specialty due to lack of interview offers. These IMGs have a lower chance of matching.

Concluding thoughts

While applying to and ranking a single specialty has many advantages, you may find yourself wanting or needing to apply to multiple specialties for various reasons. In general, applying to more than one specialty does tend to reduce your chance of matching but not always dramatically (see analysis above). What matters more is the number of programs you rank in your preferred specialty before a program in your next-preferred specialty appears. Although I generally advise candidates not to get too caught up with statistics, it may be helpful for you to know the numbers to try to maximize your chance of success. I hope this article has given you some insight into these numbers. What do you think about the data? Does this change the way you are thinking about applying to multiple specialties?

You may also be interested to read a response by a program director to my comment about the implications of applying to multiple specialties on the Kaplan Residency Secrets blog (scroll down to the comments section).

Image courtesy of David Costillo Domici/freedigitalphotos.net 

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2 Replies to “Does applying to multiple specialties decrease my chance of matching?”

  1. Srujan

    Thanks for this post. I myself am caught up between GSurg and IM. A lot of the statistics online repeatedly mention the competitiveness of landing a GSurg spot. Would you be having any idea as to how competitive GSurg is at the moment? And what it takes to get in? (Apart from good step scores and USCE).

    Thanks again!

    Reply
    • Shinji Yasugi Post author

      Hi Srujan, I can point you to the NRMP data regarding competitiveness to get into Gen Surg, with regards to the actual numbers of IMG candidates who matched and who did not. I don’t have first-hand information right now about competitiveness but I can look into it for you.

      In the meantime, you may be interested in a journal article written by folks at University of Washington, who have an interesting surgical sub-internship program for IMGs. Here’s the article link: http://www.healthadvocates.info/IMG/articles_litreview/selecting_IMGs_for_training.pdf

      Reply

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