Career Development - PM&R

One of the most common questions we get asked is “How do I know if I’m competitive for this specialty?” There are a lot of metrics that are provided by sources like the NRMP’s Charting Outcomes report that can help you gauge whether you are a competitive applicant, and help guide your choices of activities. 

The table below shows the 25^th percentile, the median and the 75^th percentile for a number of the more regularly used metrics to gauge competitiveness. It’s important for you to understand what these numbers represent, and why they may be different from the averages you might see elsewhere.

• The 25^th percentile represents the lower range of “normal” for a successful applicant in this specialty.
• The median represents an average for successful applicants in this specialty.
• The 75^th percentile represents the higher range of “normal” for a successful applicant in this specialty.

Medical students are usually over-achievers, who have exceeded expectations throughout their educational years. However, it’s important to realize that overachievement is not always a good thing when it comes to match. Instead, you should aim for “fit.” This means that you should fall somewhere between the 25^th and 75^th percentile on these metrics. Below the 25^th percentile, and you have a relatively low chance of match (25% chance, to be specific). Above the 75^th percentile, and you also have a lower chance of matching (again, 25% chance), as program directors are typically looking for candidates who “fit” their profiles more so than those who exceed those profiles.

Between the 25^th and 75^th percentiles is the sweet spot. This range spans 50% of successful applicants, with only 25% of successful applicants falling above the 75^th percentile and 25% of successful applicants falling below the 25th percentile. The closer you fall to the median (i.e., the 50^th percentile), the better! This doesn’t mean you’re average, but rather that you are fitting the demands of this specialty!

A note about medians vs. means as a measure of “average”: We use medians to determine competitiveness rather than means for a simple reason. Medians are not as warped as means by outliers, or those successful candidates who fall very much outside the average on a particular measure. You may have heard that the “average” Step 2 score or number of publications for a specialty are incredibly high (or low), and you may wonder how it’s even possible to hit this “average.” These unrealistic “averages” are typically means that have been influenced by just a very small number of people who have incredibly high (or low) scores or numbers of publications, and often those high numbers of publications in particular, are the result of having earned a research Ph.D. or having spent years in a research career! This is NOT the expectation, but rather an exception!