The NRMP Residency Match: What Are the Expectations of Osteopathic Medical Students?

Ledergerber, J, Dong, F, Helf, S Western University of Health Sciences, College of Osteopathic Medicine of the Pacific

Purpose: Results: Median USMLE Step 1 Score Osteopathic medical students will be facing an ACGME match with Regarding the ACGME programs, all specialties showed an Specialty DO 2015-2017 (N) MD 2016 P-value USMLE scores at the forefront of their application. This project aims increased mean USMLE Step 1 score for successfully matched Anesthesiology 235.5 (30) 232 0.2874 to determine if USMLE Step 1 scores increased from 2009-2017 for COMP students from a per residency specialty cohort Diagnostic Radiology 229 (7) 241 N/A successfully matched Western University of Health Sciences perspective, from 2009-2017, as shown in Table 1. The mean Emergency Medicine 230.5 (28) 233 0.3654 Family Medicine 211 (140) 221 <.0001 College of Osteopathic Medicine of the Pacific (COMP) students successful USMLE Step 1 score for MD students from 2009- General Surgery 2016 is presented in Table 2 for comparison (2,3,4,5). 247 (7) 235 N/A from a per residency specialty cohort perspective. This project Internal Medicine 229 (108) 235 <.0001 attempts to analyze the rumors that DO students must score higher Neurology 230 (17) 232 0.1754 on the USMLE Step 1 than MD students to be offered similar Further analyzing the ACGME match, Table 3 compares the Obstetrics & Gynecology 231 (15) 229 0.8788 positions. successful median USMLE Step 1 scores for COMP seniors from Pathology 222 (4) 234 N/A 2015-2017 to allopathic seniors from 2016. All specialties with Pediatrics 215 (45) 230 <.0001 statistically significant differences in median scores show that Physical Medicine & Rehabilitation DOs from COMP matched to ACGME residency programs 227 (25) 227 0.6687 Psychiatry with lower scores than MDs. These include Family Medicine 211 (37) 223 0.0004 (FM), Internal Medicine (IM), Pediatrics, and Psychiatry. This Table 3: Median Successful USMLE Step 1 scores of COMP seniors (DO) data is represented graphically in Figure 1. and U.S. allopathic seniors (MD) in the ACGME Match

Note: Specialties with N less than 3 for DO cohort were not included to Specialty Mean Step 1 Score (N) SD Min Max protect student privacy. P-values were not calculated for N<15. MD data Anesthesiology estimated from Chart 6 on page 9 of 2016 NRMP Charting Outcomes in the 2009-2011 226.14 (14) 21.10 186 268 2015-2017 233.87 (30) 12.10 201 253 Match for U.S. Allopathic Seniors (5). Introduction: Emergency Medicine 2009-2011 228.10 (10) 13.84 212 255 2015-2017 230.43 (28) 15.58 194 258 Although the AOA and ACGME residencies are combining, the Family Medicine expectations for DO students taking the USMLE are not clearly 2009-2011 201.13 (55) 19.85 165 251 2015-2017 211.34 (140) 17.11 170 266 presented in the current National Resident Matching Program Internal Medicine (NRMP) data. There are ACGME residencies that state on their 2009-2011 212.80 (60) 17.53 172 247 2015-2017 225.34 (108) 15.29 184 253 websites that they will not accept the COMLEX or that they Obstetrics & Gynecology recommend students take the USMLE. With the upcoming 2009-2011 215.00 (6) 20.52 187 237 residency accreditation merger, this information may prove useful 2015-2017 226.80 (15) 15.29 189 243 Physical Medicine & for DO students. Rehabilitation 2009-2011 205.12 (17) 18.63 165 244 2015-2017 225.56 (25) 14.54 191 256 Pathology 2009-2011 216.33 (6) 11.31 205 235 2015-2017 222.00 (4) 24.55 192 252 Pediatrics 2009-2011 207.59 (17) 20.22 159 240 Figure 1: Median Successful USMLE Step 1 Scores of COMP Seniors (DO) 2015-2017 215.38 (45) 15.45 185 254 and Allopathic Seniors (MD) in the ACGME Match Psychiatry 2009-2011 194.32 (25) 18.74 158 232 2015-2017 213.19 (37) 15.90 173 249 General Surgery 2009-2011 229.00 (5) 19.04 213 260 Conclusions: 2015-2017 243.43 (7) 15.59 218 263 Methods: Table 1: Mean successful USMLE Step 1 scores of COMP seniors who COMP students taking the USMLE Step 1 and successfully matched ACGME matching to ACGME programs have increased scores over the past This is a retrospective study of USMLE scores from successfully decade. It may be helpful for students to prepare for the USMLE matched COMP graduates from 2009-2017. Data was collected with increasing averages in mind for ACGME programs. from ProgressIQ and de-identified to analyze COMP student Specialty 2009 2011 2014 2016 At least for COMP students, there does not appear to be an obvious licensing exams scores per specialty per year. COMP graduates bias against DOs in ACGME programs based on USMLE Step 1 matching to ACGME programs using USMLE Step 1 scores were Anesthesiology 224 226 230 232 Diagnostic Radiology 238 240 241 240 scores. Successfully matched COMP student USMLE scores are also compared to allopathic seniors using publically available EM 222 223 230 233 not statistically significantly higher than respective national NRMP data from 2009, 2011, 2014, and 2016. This was an IRB FM 214 213 218 221 averages for U.S. MD students per specialty (Table 3 and Figure 1). approved study that adhered to FERPA regulations. General Surgery 224 227 232 235 IM 225 226 231 233 For the purposes of this study, a successful match did not consider IM/Peds 225 230 233 236 the geographic location of residency, type of residency (e.g., Neurology 225 225 230 231 References: academic vs community), or residency position on the student’s Ob/Gyn 219 220 226 229 rank list. This study did not investigate if there are ACGME Ortho Sx 238 240 245 247 1. Weizberg M, Kass D, Husain A, Cohen J, Hahn B. Should Osteopathic Students Applying to Allopathic Pathology 227 226 231 233 Emergency Medicine Programs Take the USMLE Exam? Western Journal of Emergency Medicine. residency programs that do not interview or rank DO students for 2014;15(1):101-106. doi:10.5811/westjem.2013.8.16169. Pediatrics 219 221 226 230 2. Association of American Medical Colleges and National Resident Matching Program Charting Outcomes in the purpose of residency match. PM&R 214 214 220 226 the Match (2009). Available at: http://www.nrmp.org/wp- Psychiatry 216 214 220 224 content/uploads/2013/08/chartingoutcomes2009v3.pdf. Accessed July 13, 2017. 3. Association of American Medical Colleges and National Resident Matching Program Charting Outcomes in the Match (2011). Available at: http://www.nrmp.org/wp-content/uploads/2013/08/chartingoutcomes2011.pdf. Table 2: Mean Successful USMLE Step 1 Scores of Allopathic Seniors Accessed July 13, 2017. 4. Association of American Medical Colleges and National Resident Matching Program Charting Outcomes in in the ACGME Match 2009, 2011, 2014, 2016 (2,3,4,5) the Match (2014). Available at: http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014- Final.pdf. Accessed July 13, 2017. 5. Association of American Medical Colleges and National Resident Matching Program Charting Outcomes in the Match (2016). Available at: https://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-US- Allopathic-Seniors-2016.pdf. Accessed July 13, 2017.