From the Viewpoint of a Program Director: What You Need to Match into Pediatrics
The NRMP conducted a survey to determine what factors Program Directors consider when deciding which candidates to interview and rank for their residency program. The results were compiled into a “at a glance” tool, which is extremely helpful in gauging where your application packet stands compared to the applicant pool, and whether adding additional components, like a letter of recommendation (LOR) in the specialty, could give you a leg up as programs review your application.
The interactive tableau tool can be found here, and we recommend taking a look at the specialty you’ll be applying to before submitting your ERAS packet: https://public.tableau.com/profile/national.resident.matching.program#!/vizhome/PDSurvey_0/Desktoptablet
For Pediatrics specifically, major components of the survey you should pay attention to include: (from top to bottom of the page):
- Selection Criteria for an Interview – Step 1 and Step 2 CK scores (or COMLEX equivalents for DO grads) rank highly among the most important factors pediatric program directors cite when granting interview invitations — Step 1 and Step 2 were cited as most important, and notably any USMLE/COMLEX failure was ranked as the #4 most important factor. Beyond exams, clerkship performance (as reflected in the MSPE and grade in pediatric clerkship in particular) round out the top 5 at #3 and #5, respectively.
- Step 1 and Step 2 Scores:
- Step 1 – Score
- 235+ looks like a very solid score in Pediatrics, with the median score among applicants ultimately receiving an interview being 220.
- Range programs do NOT typically offer interviews: 210-220 seems to be the minimum threshold we would recommend for having a good chance at enough interviews. If you’re below 210-220 range, we suggest applying very broadly, and/or considering applying to a different specialty.
- Range programs DO typically offer interviews: 240+ seems to be the range at which you can feel comfortable in being offered interviews by a decent number of programs. If you’re in the 250+ range, you can likely be selective about where you apply.
- Step 2CK – Score
- 215-230 seems to be the minimum threshold at which programs will grant interviews
- Scores below 215 will likely place you in an unfavorable position to receive an interview
- Step 2CK – Timing of Taking the Exam
- Only 47% of programs required at least passing CK at the time of applying, although we do expect this number to grow. This means that for many, though certainly not all, programs, you may wait to take Step 2CK until after you have submitted ERAS. This may be advantageous if you have a particularly competitive Step 1 score and do not want to run the chances of marring your application by scoring more poorly on Step 2.
- Failing Step 1 or 2 will hurt you, but won’t sink your chances:
- Failing any step of the USMLE is a BIG deal in ANY specialty, and pediatrics is no exception. So, if you’ve failed an exam, you can still apply, but you should consider applying to MANY (40+) programs. 79% of programs seldom consider applicants who have failed Step 1 or Step 2, and 4 and 15% never consider those who fail Step 1 or 2, respectively.
- Types of Applicants Considered:
- International Grads (U.S. and non-U.S.) have more difficulty matching in pediatrics than domestic applicants, but it’s not impossible: Approximately one-third (36-37%) of programs consider interviewing or ranking U.S. IMGs on a routine basis, and approximately half (56-57%) seldom do; only 7% never do. For non-U.S. IMGs, chances are worse, but still possible: 30-32% routinely interview and rank non-U.S. IMGs, 55-58% seldom interview and rank them, while 12-14% never do. We recommend doing your homework to determine which programs may be more likely to consider IMGs to maximize your chances of success.
- Osteopathic graduates have a good chance of matching: 74-77% of programs will routinely interview and rank DO applicants, while only 3-4% never do. This still pales in comparison with U.S. seniors (97%), so it is still important to do your research to identify these programs so that you can best increase your chances of matching.
- Interviewees Get Ranked!: If you get an interview invitation, you are likely to end up on the rank list if you interview (in general, 178 applicants ranked for 190 applicants interviewed). We recommend ranking at least 8-10 programs, so once you receive 10 interview invitations, you can feel okay with starting to prioritize and cancel as more come in given you are likely to get ranked.
- Expect to receive interview invitations in September and October: 82% of the interview invitations will be sent out during September and October, and only 8% will be sent in December and January. If you have not heard from programs within several weeks of submitting your application, this likely means you are not a competitive applicant in pediatrics.
- Expect to interview in October-December: Only 15% of interviews will occur in January or later, which means you should plan to have free time in October-December to maximize your chances of being off during peak interview season. For further discussion on how to prep for your interview, see our blog post on how to Crush your Residency Interview: https://elitemedicalprep.com/preparing-for-your-residency-interview/
Certain factors less important for Pediatrics than for other programs:
- “Commitment to the specialty” is not ranked as highly by PDs in pediatrics as for other programs. This doesn’t mean that showing a concerted interest in pediatrics is irrelevant, but rather that it’s less important than other factors discussed above.
- Research isn’t particularly important for Pediatrics — again, it can strengthen an application, but was not in the top 10 most important factors listed by all PDs.
- AOA status isn’t as important in Pediatrics in other specialties. Again, it can certainly strengthen an application, and is likely important at more competitive programs, but is not expected or required to match.
- Having an LOR from a pediatrician is definitely important, but is not quite as important as some other fields (e.g., neurosurgery, dermatology). This likely means that a strong application could easily feature LORs from 1-2 pediatricians with additional letters from practitioners outside of the field.
Summary for Pediatrics Applications:
- A solid pediatrics application would include a 235+ on Step 1, 240+ on Step 2, overall strong clerkship performance and grades in pediatrics in particular, and at least one LOR from a pediatrician.
- Pediatrics is somewhat more IMG friendly, than other fields, but matching as an IMG is far from certain. Be sure to do your research to identify programs with active IMG residents and establish proper connections.
- If you’ve failed an exam, you can still apply in Pediatrics, but you should apply very broadly and consider applying for a back-up specialty.
- Expect Interviews in October-December. Reach out to programs you have high interest in if you haven’t heard from them by mid-November. Once you have about 10 interview invitations, you can consider being a bit more selective about which ones you actually take (but not before).
Good Luck! ☺