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    Today’s residents, by the numbers

    The AAMC’s 2019 Report on Residents provides a data-based look at trends in test scores, specialties, and professional practices.

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    As students go through medical school, chances are good that they’ll change their minds about what to specialize in.

    When they finish their residencies, most will enter practice not far from where they trained.

    About a quarter of new doctors will immediately practice in an area defined as in dire need of their services.

    These are among the findings in the 2019 Report on Residents, an annual AAMC compilation of data on the characteristics of medical school graduates and residents, including test scores, demographics, and post-residency professional activities.

    Here are some of the interesting facts:

    Specialties

    Only a quarter (25.6%) of students responding to the AAMC Medical School Graduation Questionnaire in 2019 indicated that they were graduating with the same specialty preference as they had indicated at the start of medical school, while half reported a different specialty. Those who plan to practice in orthopedic surgery and pediatrics are most likely to have stated preferences for those specialties when they began medical school: 44.8% of graduates intending to go into orthopedic surgery and 43% of those who plan to enter pediatrics cited those specialties at the start of school. See how specialty preferences change over time.  

    Step Scores

    Average USMLE step scores among entering residents vary according to specialty. For example, the average Step 1 test score for first-year otolaryngology residents was 246.7 (with scores in the 25th through 75th percentiles ranging from 241 to 255), while the average score for first-year physical medicine and rehabilitation residents was 224.9 (with the 25th through 75th percentile scores ranging from 213 to 237).

    On the Step 2 CK (Clinical Knowledge) exam, the average score among residents in neurological surgery was 247.8 (with scores in the 25th through 75th percentiles ranging from 239 to 257), while the average among residents in anatomic and clinical pathology was 234.5 (with scores in the 25th through 75th percentiles ranging from 221 to 247). This table shows test scores by specialty.

    Underserved Areas

    Nearly one-quarter (23.3%) of those who completed residency from 2009 through 2018 are practicing in medically underserved areas (MUAs). MUAs are defined by the Health Resources and Services Administration as “having too few primary care providers, high infant mortality, high poverty, or a high elderly population.” The rates vary significantly by state: More than half of those practicing in Alabama, Mississippi, and Puerto Rico are practicing in MUAs, while the figure is less than 3% in Utah, Nevada, and North Dakota. See a table of how many doctors practice in MUAs by state.

    State Retention

    More than half (54.6%) of those who completed residency training from 2009 through 2018 are practicing in the state where they did their training. Physician retention among states is highest in California (77.5%) and lowest in Delaware (36.4%). See the breakdown of retention rates by state.

    Dual Degrees

    In the most recent reporting year (2018), 3.4% of active residents who are graduates of U.S. MD-granting schools were MD-PhD graduates. Among general specialties, medical genetics has the highest rate of active MD-PhD graduates, at 18.9%. The report shows the numbers of residents with MD-PhDs by specialty.

    Gender

    Women make up a larger percentage of residents in family medicine, obstetrics and gynecology, pediatrics, and psychiatry, while men make up a larger percentage of residents in anesthesiology, emergency medicine, internal medicine, radiology, and surgery. See the gender distribution by specialty.

    Overall Numbers

    The overall number of active residents in the report increased in 2019, to 134,951. This number is up from 129,291 in 2018. The percentage of residents who are international medical school graduates has decreased each year since the inaugural report was released in 2015, from 25.9% to 23.3% in 2019. This table shows the numbers of active residents by type of medical school, graduate medical education specialty, and gender.