Interview To Ranking To Match: The Critical Choke Point For Residency Applicants.

Looking at all the IMG pertinent subjects as a follow up of the small series of articles called proportion of applicants interviewed, ranked and matched, I was not surprised to see the below funnel shape emerge. Look at the number of applicants interviewed on the left hand side of the figure. For sake of clarity the subjects have been stacked such that the scale represents the total number of applicants interviewed with each slice representing the respective specialty. 

Figure 1: attrition in number of interview, ranked and matched residency applicants. | source NRMP

The numbers of applicants ranked by the programs has been included as a way point in the center and finally the mean number of applicants matched to the specialty is shown on the right under ‘matched’ category. 

There are several important observations gleaned from the data 

1. Maximal overall attrition of applicant pool is seen in subjects like Internal medicine, pediatrics, emergency medicine (this was a surprising finding) followed by anesthesia 
2. Other specialties like psychiatry and family medicine along with neurology had less dramatic of attrition of applicant pool. 
3. The step down from interviewed to ranked applicant category was the most in subjects that demonstrated the least proportional fall in applicant numbers vix pathology, neurology, surgery and even FM and psych 
4. The step down from mean interviewed number to mean ranked number of applicants was gradual in IM, pediatrics and emergency medicine.

Implications 

1. Across the board for most part, all applicants that are interviewed for residency position are placed on the program rank order list. Which means that you must have to perform extremely poorly to be not considered for program ROL after the interview. This should help those folks who are afraid or concerned about their performance in interview. 
2. While most of the applicants that are interviewed are ranked, the above figure does not and cannot distinguish, where on the rank order list the applicants are spread. Program ROL
3. Programs like IM and pediatrics interview far more number of applicants than positions available while on the other hand, pathology, neurology etc are more discerning as to whom to invite for interviews. Their interview invitation list is tighter and the ranked applicant and matched applicant list is proportionally smaller. 

Conclusions

The data represented in this way should alert the prospective residency applicant of the attrition in numbers of applying (not shown), interviewed, ranked and matched applicants. 

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