Early NRMP / ERAS Application numbers

Just before bed last night, I read this article about the 2022 Match. The early data suggests that medical students are applying to more residency programs than ever because of how competitive things have become. US and Canadian MD students applied to an average of around 68 programs apiece while US DO students are applying to about 92 programs each. IMG MD students are applying to 139 programs each. There are around 28,000 MD applicants to this years Match, 8,000 DO applicants, and 15,000 IMG applicants. I haven’t seen a number that indicates how many positions there are in this years Match but every year, the numbers of unmatched students seems to be incrementally creeping up. Personally, I know of a fair number of friends who are IMGs who have gone unmatched over the last few years and I know two US graduates who have gone unmatched. Scary.

This all scares me because when I. think about the fact that I will be 54 when I finish medical school (assuming that I decide to stay in medical school, I’m still considering my options in this regard), I know that age discrimination will be something that I will face. On the one hand, I understand why a residency program director might say, “Why should we take a 50+ year old resident who may only work 10-20 years after completing training as compared to a late-20s or early-30s applicant who may work 30 or 40 years after training?” Residency training costs programs a significant amount of time and money to train the resident and it makes sense as to why they may have a desire to train applicants who they may think will work longer. There is a EM program director on Twitter that I follow and he has been very open and honest about the sorts of discrimination that occurs within his field when it comes to selecting residents. He and I spoke about the age discrimination that occurs and he gave me some tips as to what I can do to try to increase my odds of earning a residency in EM: Make sure that I cut my hair and beard so that my gray hair won’t be showing (i.e., appear younger), be very high energy in the interviews, and while I am in medical school, do things that demonstrate that I have the energy and vitality that a younger applicant would have (i.e., involvement in research and other campus activities). Then he proceded to tell me that doing all of that may still not be enough…

This whole thing sucks because age and my ethnicity are two things that will never change about me. I am busting my ass to make the grades and I’m still involved in research; I recently presented a poster at the 2021 AMA Research Challenge and I have two manuscripts that are in publication. I’m still teaching for A.T. Still and am part of the MPH curriculum and accreditation committees (i.e., leadership), and I plan to get involved with a couple of community service activities here on campus at UIWSOM. Despite that, I could still find myself in a situation, down the road, where I have no residency and thus, no job. That is scary. My best friend is 55 and has been forced to make a career transition; he’d taught at Northern Arizona University for almost 17 years before the school decided not to renew his contract. He’s been out of work for the last two years. He’s got TONS of relevant and recent experience in public health program evaluation and development in addition to teaching, but he has not had any calls for any of the jobs that he is applying for. I can see the depression starting to eat at him and it sometimes makes me wonder if this is a possible future that is in store for me. At the least, it makes me wish that I could go back in time and do some things differently; I feel like things would have been a LOT better for me had I started medical school 10 or 15 years ago…