Medical Students Who Do Not Match to Psychiatry: What Should They Do, and What Should We Do?
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EDITORIAL
Medical Students Who Do Not Match to Psychiatry: What Should They Do, and What Should We Do? Richard Balon 1 & Mary K. Morreale 1 & John Coverdale 2 & Anthony P. S. Guerrero 3 & Rashi Aggarwal 4 & Alan K. Louie 5 & Eugene V. Beresin 6 & Adam M. Brenner 7
# Academic Psychiatry 2020
Although the evidence is anecdotal, it appears that psychiatry is facing a relatively new phenomenon: U.S. medical school graduates who are unable to match to psychiatry. Psychiatry has seen U.S. and International Medical Graduate (IMG) physicians not matching to psychiatry in the past, but not in the numbers seen lately. As noted by Bailey et al. [1], the difficulty in matching has been increasing, and for the most part, it has not been widely publicized and addressed.
Psychiatry’s Success Interestingly, the increased difficulty to match is happening while psychiatry is experiencing increases in the numbers of both available residency positions in psychiatry and U.S. allopathic and osteopathic seniors matching into psychiatry. In 2020, 1858 total psychiatric positions were offered in the Match (compared with 1740 offered in 2019 and 1384 offered in 2016) [2]. Of these, 1838 were filled: 1473 by U.S. senior medical students, 71 by physicians who graduated in earlier years, and 293 by U.S. and non-U.S. IMG physicians and one by “other” [2]. These numbers are certainly encouraging, especially for those of us who remember the 1990s, when match * Richard Balon [email protected] 1
Wayne State University, Detroit, MI, USA
2
Baylor College of Medicine, Houston, TX, USA
3
University of Hawai’i John A. Burns School of Medicine, Honolulu, HI, USA
4
Rutgers New Jersey Medical School, Newark, NJ, USA
5
Stanford University, Stanford, CA, USA
6
Harvard Medical School, Boston, MA, USA
7
University of Texas Southwestern Medical Center, Dallas, TX, USA
numbers were in the 400s for much of the decade [3, 4]. The percentage of allopathic seniors selecting psychiatry rose to 6.3% in 2020, from 5.9% in 2019 and 5.0% in 2016 [2]. Psychiatry is clearly attracting more medical students after years of lamenting that U.S. medical students are not interested in it. We do not have a full grasp of the reasons for the increased interest, but it appears probably multifactorial, and we can speculate that included factors may be competition for other specialty slots [3], increased advances in psychiatric research and new treatments (e.g., esketamine, transcranial magnetic stimulation, new psychotherapies), a very broad domain of topics of special interest and relevance (e.g., human trafficking and other forms of interpersonal violence and exploitation, ethics and philosophy in clinical psychiatric practice, looming mental health consequences of the COVID-19 pandemic, global mental health), availability of more time to spend with patients, new generations of physicians who are more focused on lifestyle, and medicine’s increased understanding of behavioral and mental issues and their ubiquitous presence in all of health care.
Unintended Conseque
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