Charting Outcomes of the PAIN FELLOWSHIP Match 2017

[paintrain]

I've received a lot of questions lately about fellowship, interviews, the Match, etc. It's a very anxiety-provoking time and I remember thinking about it non-stop during my Match year. I wanted to give you guys some insight about the Match itself to further feed your obsession.

The NRMP releases the "Outcomes of the Match" report for subspecialties and Pain Medicine is nicely outlined. http://www.nrmp.org/wp-content/uploads/2017/02/Results-and-Data-SMS-2017.pdf

A few things to take away:
1. Pain medicine (besides the Internal Medicine subspecialties) typically has one of the highest number of applicants. Last year there was 401 total applicants.
2. Although competitive, it is not nearly as competitive as some of the other specialties. There were 316 spots for those 401 applicants. This equates to "potentially" 78.8% (316/401) of all applicants matching. Compare this to Hematology 15/84 (17.9%), Onc 8/16 (17.4%), Pulm Disease 24/100 (24%). Further, it has become slightly easier to match into Pain Medicine compared to past years. In 2014, there were 1.5 applicants per position. Last year, this fell slightly to 1.3 applicants per position. This correlates to an increased number of matched applicants from 64.3% (2014) to 77.1% (2017). So the odds are in your favor! (Table 1)
3. What happens if I don't match? It's not like residency where you can "scramble" into a spot. If you don't match, your chances of doing an ACGME-accredited fellowship are slim. Last year, there were only 7 unfilled positions (97.8% of all positions were filled when the Match emails went out, Table 1).
4. Almost 1/3 of filled positions were filled by non-traditional US Allopathic applicants. So for those coming from DO or international paths, there is still good opportunity (Table 2).
5. The majority of those who match end up at their 1st choice (58.3%, Table 5). And the majority of applicants who match will end up somewhere within their top 3 ranks (84.5%). This is great news for two reasons: 1) Applicants are getting their top choices and 2) You may not need that many rankings/interviews to match into a fellowship.
6. Unlike the RESIDENCY Charting Outcomes of the Match, there is no data corresponding to "contiguous ranks for matched applicants." This number of ranks/interviews was traditionally used as a the "magic number" of ranks/interviews needed to somewhat ensure a match. But just like point #5, the majority of applicants match their top choice and the vast majority will match within their top 3. Just because you only have a few interviews should not discourage you as there are many applicants who interview at multiple programs and end up only taking one of those positions. Last year, there were 2,203 total ranked positions (Table 1). This correlates roughly to the total number of interviews given out (rarely people will interview at a program and not rank them so that's why it is rough, not exact). This means the 93 programs who participated in the Match needed to send out 2,203 interviews to fill ~316 positions. In other words, each position requires ~7 interviews to fill 1 spot. What this tells me is that there are a lot of unnecessary interviews going out when in reality, each applicant only needs a few interviews to match (again, refer to #5). So don't be discouraged if you only have a few interviews. Knock them out of the park and you will be fine.

Good luck.

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[MaximusD]

I wish there was some differentiation between what the match rate was for anesthesia vs PM&R vs neuro etc applicants.

 

[Dog_luver]

I wish there was some differentiation between what the match rate was for anesthesia vs PM&R vs neuro etc applicants.

I don't see myself as matching. How badly will I fare compared to graduating from a pain program if I go non-ACGME pain or interventional spine? Is it even worth pursuing one of these options? I have pretty much given up at this time. I have no idea what could possibly be wrong with my app, but clearly something is wrong.

 

[MaximusD]

I don't see myself as matching. How badly will I fare compared to graduating from a pain program if I go non-ACGME pain or interventional spine? Is it even worth pursuing one of these options? I have pretty much given up at this time. I have no idea what could possibly be wrong with my app, but clearly something is wrong.

It's "early" until June.

 

[DrCommonSense]

I've received a lot of questions lately about fellowship, interviews, the Match, etc. It's a very anxiety-provoking time and I remember thinking about it non-stop during my Match year. I wanted to give you guys some insight about the Match itself to further feed your obsession.

The NRMP releases the "Outcomes of the Match" report for subspecialties and Pain Medicine is nicely outlined. http://www.nrmp.org/wp-content/uploads/2017/02/Results-and-Data-SMS-2017.pdf

A few things to take away:
1. Pain medicine (besides the Internal Medicine subspecialties) typically has one of the highest number of applicants. Last year there was 401 total applicants.
2. Although competitive, it is not nearly as competitive as some of the other specialties. There were 316 spots for those 401 applicants. This equates to "potentially" 78.8% (316/401) of all applicants matching. Compare this to Hematology 15/84 (17.9%), Onc 8/16 (17.4%), Pulm Disease 24/100 (24%). Further, it has become slightly easier to match into Pain Medicine compared to past years. In 2014, there were 1.5 applicants per position. Last year, this fell slightly to 1.3 applicants per position. This correlates to an increased number of matched applicants from 64.3% (2014) to 77.1% (2017). So the odds are in your favor! (Table 1)
3. What happens if I don't match? It's not like residency where you can "scramble" into a spot. If you don't match, your chances of doing an ACGME-accredited fellowship are slim. Last year, there were only 7 unfilled positions (97.8% of all positions were filled when the Match emails went out, Table 1).
4. Almost 1/3 of filled positions were filled by non-traditional US Allopathic applicants. So for those coming from DO or international paths, there is still good opportunity (Table 2).
5. The majority of those who match end up at their 1st choice (58.3%, Table 5). And the majority of applicants who match will end up somewhere within their top 3 ranks (84.5%). This is great news for two reasons: 1) Applicants are getting their top choices and 2) You may not need that many rankings/interviews to match into a fellowship.
6. Unlike the RESIDENCY Charting Outcomes of the Match, there is no data corresponding to "contiguous ranks for matched applicants." This number of ranks/interviews was traditionally used as a the "magic number" of ranks/interviews needed to somewhat ensure a match. But just like point #5, the majority of applicants match their top choice and the vast majority will match within their top 3. Just because you only have a few interviews should not discourage you as there are many applicants who interview at multiple programs and end up only taking one of those positions. Last year, there were 2,203 total ranked positions (Table 1). This correlates roughly to the total number of interviews given out (rarely people will interview at a program and not rank them so that's why it is rough, not exact). This means the 93 programs who participated in the Match needed to send out 2,203 interviews to fill ~316 positions. In other words, each position requires ~7 interviews to fill 1 spot. What this tells me is that there are a lot of unnecessary interviews going out when in reality, each applicant only needs a few interviews to match (again, refer to #5). So don't be discouraged if you only have a few interviews. Knock them out of the park and you will be fine.

Good luck.

Not sure if you can determine the metric of being competitive by that analysis of applicants/spots from that data.

For GI medicine, there are 742 total applicants for 504 spots. So 504/742 is approximately 68% rate of success.

For Pulmonary/CC there were 742 applicants for 530 spots, with a 71% success rate.

For Cardiology there were 1,147 applicants for 866 spots with a 75% success rate

So by you logic, hematology and oncology separately are FAR more competitive than GI, Cards and Pulm/CC.

Doesn't fully add up there.

 

[paintrain]

Everyone knows cards/GI/pulmCC to be competitive specialties. But the hematology applicant will have a statistically more difficult time matching than a cards applicant. That's what I meant by competitive and that's just pure numbers. Compare it to OB anesthesia where there are more spots than applicants. I would consider that less competitive. And I expect everyone else would agree with that too. So yes, just looking at pure numbers within a specialty, you can get a sense of how competitive the specialty is. Obviously not comparing the average hematology applicant vs. average cards applicant. Well I guess not too obvious since you bring it up...

Yes I would still consider it early unless all the programs you applied to have already sent out their interviews. Then I'd say you have quite the uphill battle. I submitted my application in April during my year, which was probably on the late side, but many of the programs I applied hadn't sent out interviews by then. So it depends where you applied.

The majority of job listings that I come across are advertising specifically for board-certified or board-eligible pain physicians. And to be either, you have to have have fulfilled a 12-month ACGME-accredited pain medicine fellowship training program. I would agree that you would be at a disadvantage to train in a non-accredited program but I have less experience with this and I'm sure you could find a job if you looked hard enough. But your options may be limited.

The PM&R/neuro applicants are at a little bit of a loss. Last year the PM&R residents had their own thread of interview invites so they could compare themselves by their own specialty. Not sure if they have that this year. I will say that many of the programs are now actively seeking PM&R/neuro fellows to fill a few slots to encourage the "multidisciplinary approach" to pain medicine. I wholly believe that they add a different dimension/perspective to the fellowship and it benefits everyone. Definitely not as much of a stigma as there once was.


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[Dog_luver]

Everyone knows cards/GI/pulmCC to be competitive specialties. But the hematology applicant will have a statistically more difficult time matching than a cards applicant. That's what I meant by competitive and that's just pure numbers. Compare it to OB anesthesia where there are more spots than applicants. I would consider that less competitive. And I expect everyone else would agree with that too. So yes, just looking at pure numbers within a specialty, you can get a sense of how competitive the specialty is. Obviously not comparing the average hematology applicant vs. average cards applicant. Well I guess not too obvious since you bring it up...

Yes I would still consider it early unless all the programs you applied to have already sent out their interviews. Then I'd say you have quite the uphill battle. I submitted my application in April during my year, which was probably on the late side, but many of the programs I applied hadn't sent out interviews by then. So it depends where you applied.

The majority of job listings that I come across are advertising specifically for board-certified or board-eligible pain physicians. And to be either, you have to have have fulfilled a 12-month ACGME-accredited pain medicine fellowship training program. I would agree that you would be at a disadvantage to train in a non-accredited program but I have less experience with this and I'm sure you could find a job if you looked hard enough. But your options may be limited.

The PM&R/neuro applicants are at a little bit of a loss. Last year the PM&R residents had their own thread of interview invites so they could compare themselves by their own specialty. Not sure if they have that this year. I will say that many of the programs are now actively seeking PM&R/neuro fellows to fill a few slots to encourage the "multidisciplinary approach" to pain medicine. I wholly believe that they add a different dimension/perspective to the fellowship and it benefits everyone. Definitely not as much of a stigma as there once was.


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I would disagree with this statement. I'm a solid PM&R applicant and I have yet to receive an interview.

 

[Blitz2006]

Anybody have any thoughts/ideas on why pain is getting "slightly easier"? Lower reimbursements? Job market?

 

[BobBarker]

It is the stigma of opioids.

 

[MaximusD]

I would disagree with this statement. I'm a solid PM&R applicant and I have yet to receive an interview.

Give it time. Still only 20-30% thru invitations.

 

[swamprat]

I think you need to take into account if your an anaesthesiologist or not. Non-anaesthesiologist and non-pmr I think it's a crap shoot. This is coming from a non traditional speciality that matched but applied to more than half the programs in the country and got less than 10 interviews


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[BW15]

Thanks for the insight, its very helpful.

Can someone please help me with a question I have.

Until what date are you considered an early applicant? I know you can start submitting applications December 1st, but I read some programs won't even looks at applications for a while, so you miss out on potential things you can add to your application like letters of recommendation that come in later if you were to submit it early.

What would you guys do in a situation where someone is doing an elective pain rotation in December, so by the end of the rotation I would have to ask for a LOR and lets say it takes them 3-4 weeks to write it. At that point I would have to wait until the end of January/beginning of February to send my application. (In this case I would already have a LOR from the Chair of pain from my program, the other letter would be from an outside elective rotation).

In this case would you just send your application early (December 1st) with a note stating that you have one more LOR that you are waiting on and that you will update them once that LOR comes through? Or just wait for the final LOR before submitting your application, but then you will no longer be an early applicant.

 

[MaximusD]

You described my timeframe. I'll let you know how it goes.

 

[painfree23]

I've received a lot of questions lately about fellowship, interviews, the Match, etc. It's a very anxiety-provoking time and I remember thinking about it non-stop during my Match year. I wanted to give you guys some insight about the Match itself to further feed your obsession.

The NRMP releases the "Outcomes of the Match" report for subspecialties and Pain Medicine is nicely outlined. http://www.nrmp.org/wp-content/uploads/2017/02/Results-and-Data-SMS-2017.pdf

A few things to take away:
1. Pain medicine (besides the Internal Medicine subspecialties) typically has one of the highest number of applicants. Last year there was 401 total applicants.
2. Although competitive, it is not nearly as competitive as some of the other specialties. There were 316 spots for those 401 applicants. This equates to "potentially" 78.8% (316/401) of all applicants matching. Compare this to Hematology 15/84 (17.9%), Onc 8/16 (17.4%), Pulm Disease 24/100 (24%). Further, it has become slightly easier to match into Pain Medicine compared to past years. In 2014, there were 1.5 applicants per position. Last year, this fell slightly to 1.3 applicants per position. This correlates to an increased number of matched applicants from 64.3% (2014) to 77.1% (2017). So the odds are in your favor! (Table 1)
3. What happens if I don't match? It's not like residency where you can "scramble" into a spot. If you don't match, your chances of doing an ACGME-accredited fellowship are slim. Last year, there were only 7 unfilled positions (97.8% of all positions were filled when the Match emails went out, Table 1).
4. Almost 1/3 of filled positions were filled by non-traditional US Allopathic applicants. So for those coming from DO or international paths, there is still good opportunity (Table 2).
5. The majority of those who match end up at their 1st choice (58.3%, Table 5). And the majority of applicants who match will end up somewhere within their top 3 ranks (84.5%). This is great news for two reasons: 1) Applicants are getting their top choices and 2) You may not need that many rankings/interviews to match into a fellowship.
6. Unlike the RESIDENCY Charting Outcomes of the Match, there is no data corresponding to "contiguous ranks for matched applicants." This number of ranks/interviews was traditionally used as a the "magic number" of ranks/interviews needed to somewhat ensure a match. But just like point #5, the majority of applicants match their top choice and the vast majority will match within their top 3. Just because you only have a few interviews should not discourage you as there are many applicants who interview at multiple programs and end up only taking one of those positions. Last year, there were 2,203 total ranked positions (Table 1). This correlates roughly to the total number of interviews given out (rarely people will interview at a program and not rank them so that's why it is rough, not exact). This means the 93 programs who participated in the Match needed to send out 2,203 interviews to fill ~316 positions. In other words, each position requires ~7 interviews to fill 1 spot. What this tells me is that there are a lot of unnecessary interviews going out when in reality, each applicant only needs a few interviews to match (again, refer to #5). So don't be discouraged if you only have a few interviews. Knock them out of the park and you will be fine.

Good luck.

That's pretty suprising...unfortunately I don't know how much of it I believe. >3/4 of residents who apply get a pain fellowship?? I know plenty of residents that didn't match....I think what doesn't add up with the math there is that there are some fellowships that reserve spots for PM&R or Anesthesia etc and you are competing for those fewer spots. I always here chronic pain is very competitive, with your math it makes it seem like a breeze? Just curious, not criticizing the math...you crunched the numbers , so thumbs up for that, just wondering the logic.

 

[Blitz2006]

I would disagree with this statement. I'm a solid PM&R applicant and I have yet to receive an interview.

That's pretty suprising...unfortunately I don't know how much of it I believe. >3/4 of residents who apply get a pain fellowship?? I know plenty of residents that didn't match....I think what doesn't add up with the math there is that there are some fellowships that reserve spots for PM&R or Anesthesia etc and you are competing for those fewer spots. I always here chronic pain is very competitive, with your math it makes it seem like a breeze? Just curious, not criticizing the math...you crunched the numbers , so thumbs up for that, just wondering the logic.

Well for fellowship that is relatively very competitive stat (75 not matching out 400 applicants, so close to 20% did not match last year). Compare that to most other fellowships, it is competitive. But what paintrain helped show that while it is competitive, it is not like matching into derm....as long as you have a relatively decent app, you have a decent chance of matching it appears. Unlike Derm where >250s on Steps and 10 pubs can still lead you being unmatched...

 

[sleypier]

That's pretty suprising...unfortunately I don't know how much of it I believe. >3/4 of residents who apply get a pain fellowship?? I know plenty of residents that didn't match....I think what doesn't add up with the math there is that there are some fellowships that reserve spots for PM&R or Anesthesia etc and you are competing for those fewer spots. I always here chronic pain is very competitive, with your math it makes it seem like a breeze? Just curious, not criticizing the math...you crunched the numbers , so thumbs up for that, just wondering the logic.

I'm wondering whether anyone knows which programs are heavily PM&R?? I'm an anesthesia applicant and starting to run out of time/money and struggling to determine how to rank interview invites. Thx!

 

[Osteoth]

Well for fellowship that is relatively very competitive stat (75 not matching out 400 applicants, so close to 20% did not match last year). Compare that to most other fellowships, it is competitive. But what paintrain helped show that while it is competitive, it is not like matching into derm....as long as you have a relatively decent app, you have a decent chance of matching it appears. Unlike Derm where >250s on Steps and 10 pubs can still lead you being unmatched...

So other than research & good LORs, what would make someone an attractive applicant?

 

[clubdeac]

Compare this to Hematology 15/84 (17.9%), Onc 8/16 (17.4%), Pulm Disease 24/100 (24%). .

These numbers can't be right. Only 15 hematology fellowship positions in the country each year?? And only 8 oncology positions?? Bull****

 

[paintrain]

These numbers can't be right. Only 15 hematology fellowship positions in the country each year?? And only 8 oncology positions?? Bull****

Yes these are outcomes of the Match. Takes a quick Google search to learn more about these fellowships. Any idiot can do it. Well I guess almost any...


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[MaximusD]

I guess number of interviews is largely a correlational factor as to what the overall strength of your application is and might indicate how high you are likely to be on interviewing institutions' match lists.

 

[clubdeac]

Yes these are outcomes of the Match. Takes a quick Google search to learn more about these fellowships. Any idiot can do it. Well I guess almost any...


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There are not only 8 oncology positions available in the nation every year. Maybe they are counting only strict onc positions and not hem/onc. You honestly believe there are only 8 positions in the nation annually. And thanks for calling me an idiot. Grow up or I'll get you kicked out of this forum.

 

[paintrain]

There are not only 8 oncology positions available in the nation every year. Maybe they are counting only strict onc positions and not hem/onc. You honestly believe there are only 8 positions in the nation annually. And thanks for calling me an idiot. Grow up or I'll get you kicked out of this forum.

Again, these are outcomes of the MATCH based on NRMP data. May or may not reflect total positions nationally but it does not claim to. Not sure why this is so hard to understand. But if you don't, it's okay. No reason to get angry and make threats. Good luck!

 

[MaximusD]

Ok stop the pissing match

 

[Orin]

Looking at these data, some quick things to point out.

The ? really isn't about how many folks matched to specialty X/Y/Z. In specialties like IM, you might apply to a few different specialties to cover your butt or for other reasons like specific programs within an overarching theme. Hem/Onc (544 spots) is a real bad one to use to discuss things, as there are now Hematology only (15 spots) and Oncology only spots(8 spots) now, so you for the 84 folks applying for Hematology, they might also be in the 729 people applying for Hem/Oncology, but probably not in the 46 people applying for Oncology only spots.

Regardless, the number that's probably more important to look at in Table 5 for example, is the % unmatched as those are the folks who wanted to be in an ACGME fellowship and aren't at the end of this process. I don't think it really matters for Anesthesiologist what that % is in internal medicine or surgery, but for the folks applying for pain from Anesthesia, PM&R, Psych, Neurology, etc, most fellowships are in the 5-15% range. Pain is in the 20% range and has been as bad as 40% range for unmatched folks when it first went to ACGME. That's about the same if not worse than cardiac anesthesia which goes through the SFMatch process.

The % unmatched and applicants per position is decreasing, but I suspect that's more a function of the # of positions entering the match increasing, with 50 more spots entering the ACGME match from the initial in 2014. The number of applicants per year is about the same at 400, which does suggest perhaps pain isn't as hot as it used to be, as the corresponding data from the CT match shows a jump of about 20% in rank lists with a growth of 18% for positions.

Regarding interview #, that varies every year and my fellowship was using 10:1 as the number for interviewees to spots. Places that have internal candidates might only do 5 or whatever, as they've got those internal candidates for fall backs. PM&R only spots also make it kinda complicated to understand, as some of the 309 seats are flagged for just PM&R applicants. So just a crap shoot, but I'd rather waste time/money on an interview than not match if you really want it.

 

[Blitz2006]

Looking at these data, some quick things to point out.

The ? really isn't about how many folks matched to specialty X/Y/Z. In specialties like IM, you might apply to a few different specialties to cover your butt or for other reasons like specific programs within an overarching theme. Hem/Onc (544 spots) is a real bad one to use to discuss things, as there are now Hematology only (15 spots) and Oncology only spots(8 spots) now, so you for the 84 folks applying for Hematology, they might also be in the 729 people applying for Hem/Oncology, but probably not in the 46 people applying for Oncology only spots.

Regardless, the number that's probably more important to look at in Table 5 for example, is the % unmatched as those are the folks who wanted to be in an ACGME fellowship and aren't at the end of this process. I don't think it really matters for Anesthesiologist what that % is in internal medicine or surgery, but for the folks applying for pain from Anesthesia, PM&R, Psych, Neurology, etc, most fellowships are in the 5-15% range. Pain is in the 20% range and has been as bad as 40% range for unmatched folks when it first went to ACGME. That's about the same if not worse than cardiac anesthesia which goes through the SFMatch process.

The % unmatched and applicants per position is decreasing, but I suspect that's more a function of the # of positions entering the match increasing, with 50 more spots entering the ACGME match from the initial in 2014. The number of applicants per year is about the same at 400, which does suggest perhaps pain isn't as hot as it used to be, as the corresponding data from the CT match shows a jump of about 20% in rank lists with a growth of 18% for positions.

Regarding interview #, that varies every year and my fellowship was using 10:1 as the number for interviewees to spots. Places that have internal candidates might only do 5 or whatever, as they've got those internal candidates for fall backs. PM&R only spots also make it kinda complicated to understand, as some of the 309 seats are flagged for just PM&R applicants. So just a crap shoot, but I'd rather waste time/money on an interview than not match if you really want it.

The % unmatched and applicants per position is decreasing, but I suspect that's more a function of the # of positions entering the match increasing, with 50 more spots entering the ACGME match from the initial in 2014. The number of applicants per year is about the same at 400, which does suggest perhaps pain isn't as hot as it used to be, as the corresponding data from the CT match shows a jump of about 20% in rank lists with a growth of 18% for positions.

This is encouraging....