trends in demand for new physicians, 2012-2016...rank of family medicine, 2012 - 2016 trends in...

Trends in Demand for New Physicians, 2012-2016A Summary of Demand Indicators for 34 Physician Specialties

School of Public HealthUniversity at Albany, State University of New York

2016

Trends in Demand for New Physicians, 2012-2016A Summary of Demand Indicators for 34 Physician Specialties

Center for Health Workforce StudiesSchool of Public Health, University at AlbanyState University of New York1 University Place, Suite 220Rensselaer, NY 12144-3445

Phone: (518) 402-0250Web: www.chwsny.orgEmail: [email protected]

December 2017

ii Center for Health Workforce Studies

PREFACE

This data book presents profi les for 34 specialties. Each specialty profi le summarizes trends in 5 key

areas related to physician supply and demand: starting income, job off ers, having to change plans due

to limited practice opportunities, relative demand, and numbers of graduates. Data on starting income,

job off ers, having to change plans, and relative demand are based on responses to the Resident Exit

Survey in New York (for the years 2012 to 2016).

This report was prepared by the Center for Health Workforce Studies (CHWS) staff , David Armstrong,

Yuhao Liu, and Gaetano Forte, with layout design by Leanne Keough. Funding for this report was

provided by the New York State Department of Health.

Established in 1996, CHWS is an academic research organization, based at the School of Public Health,

University at Albany, State University of New York (SUNY). The mission of CHWS is to provide timely,

accurate data and conduct policy relevant research about the health workforce. The research conducted

by CHWS supports and promotes health workforce planning and policymaking at local, regional,

state, and national levels. Today, CHWS has established itself as a national leader in the fi eld of health

workforce studies.

The views expressed in this report are those of CHWS and do not necessarily represent positions or

policies of the School of Public Health, University at Albany, SUNY, or the New York State Department

of Health.

December 2017

iiiTrends in Demand for New Physicians, 2012-2016

ACKNOWLEDGMENT

The authors would like to express their appreciation to the GME administrators and directors at

participating teaching hospitals for their eff orts to ensure a high response rate to the Resident Exit

Survey each year. Without their assistance, this important data collection eff ort would not be possible.

Suggested citation:

Armstrong DP, Liu Y, Forte GJ. Trends in Demand for New Physicians, 2012-2016: A Summary of Demand

Indicators for 34 Physician Specialties. Rensselaer, NY: Center for Health Workforce Studies, School of

Public Health, SUNY Albany; December 2017.

iv Center for Health Workforce Studies

TABLE OF CONTENTS

BACKGROUND ............................................................................................................................1KEY FINDINGS..............................................................................................................................3

SPECIALTIES.................................................................................................................................5 Family Medicine ........................................................................................................................... 6 General Internal Medicine .......................................................................................................... 7 General Pediatrics.........................................................................................................................8 Internal Medicine and Pediatrics (Combined)..........................................................................9 Obstetrics/Gynecology................................................................................................................10 Cardiology....................................................................................................................................11 Critical Care Medicine.................................................................................................................12 Endocrinology and Metabolism.................................................................................................13

Gastroenterology........................................................................................................................14 Geriatrics .................................................................................................................................... 15 Hematology/Oncology .............................................................................................................. 16 Infectious Disease ...................................................................................................................... 17 Nephrology ................................................................................................................................. 18 Pulmonary Disease .................................................................................................................... 19 Rheumatology ............................................................................................................................ 20 General Surgery .......................................................................................................................... 21 Neurosurgery .............................................................................................................................. 22 Ophthalmology .......................................................................................................................... 23 Orthopedic Surgery .................................................................................................................... 24 Otolaryngology ........................................................................................................................... 25 Cardio-Thoracic Surgery ............................................................................................................ 26 Urology ........................................................................................................................................ 27 Anesthesiology ............................................................................................................................ 28 Pain Management ...................................................................................................................... 29 Pathology .................................................................................................................................... 30 Radiology .................................................................................................................................... 31 Adult Psychiatry .......................................................................................................................... 32 Child and Adolescent Psychiatry .............................................................................................. 33 Allergy and Immunology ........................................................................................................... 34 Dermatology ............................................................................................................................... 35 Emergency Medicine .................................................................................................................. 36 Neurology .................................................................................................................................... 37 Pediatric Subspecialties ............................................................................................................. 38 Physical Medicine and Rehabilitation ...................................................................................... 39

APPENDIX A..............................................................................................................................41APPENDIX B..............................................................................................................................47APPENDIX C..............................................................................................................................49

1Trends in Demand for New Physicians, 2012-2016

BACKGROUND

The Center for Health Workforce Studies (CHWS) conducts an annual survey of all physicians in New York

completing a residency or fellowship training program (the Exit Survey). The goal is to provide the medical

education community with useful information about the outcomes of training and the demand for new

physicians. The survey instrument (Appendix C) was developed by CHWS in consultation with the state’s

teaching hospitals and other key stakeholders.

Each year in the spring, CHWS distributes the Exit Survey to GME administrators at teaching hospitals in

New York. The Survey is then forwarded to individual programs where graduating residents and fellows

are asked to complete a 31-item questionnaire in the weeks prior to fi nishing their program. Completed

questionnaires are returned to CHWS for data entry and analysis. In 2016, with the excellent participation

of teaching hospitals, a total of 3,084 of the estimated 5,225 physicians fi nishing a residency or fellowship

training program completed the Exit Survey (59% response rate). Over the 17 years the survey has been

conducted (1998-2003, 2005, 2007-2016), 50,989 of 83,810 graduates have completed the survey (61%

cumulative response rate).

This data book presents profi les for 34 specialties. Each specialty profi le summarizes trends in 5 key areas

related to physician supply and demand: starting income, job off ers, having to change plans due to limited

practice opportunities, relative demand, and numbers of graduates. Data on starting income, job off ers,

having to change plans, and relative demand are based on responses to the Resident Exit Survey in New

York (for the years 2012 to 2016). Data on GME graduates are from the annual medical education issues of

the Journal of the American Medical Association (JAMA), and summarize the numbers of residents (or fellows)

completing allopathic GME training programs in the specialty in the US from 2006 to 2015.

Defi nitions of the 5 areas are as follows:

Starting income: The median starting income of survey respondents with confi rmed plans to

enter patient care/clinical practice in the US following completion of their training program.

Starting incomes included respondents’ base salaries plus their expected incentive/bonus

2 Center for Health Workforce Studies

income. Starting incomes in the years 2012–2016 were adjusted for infl ation to refl ect 2016

dollars and are reported in $1,000s.

Job off ers: The mean number of job off ers for employment/practice positions of survey

respondents who had actively searched for a practice position, excluding international

medical graduates (IMGs) on temporary visas. Respondents with temporary citizenship status

were excluded from this analysis because they were much more likely to experience diffi culty

in fi nding practice positions due to visa restrictions.

Having to change plans due to limited practice opportunities: The percentage of respondents

who had actively searched for a job (excluding IMGs on temporary visas) and who had to

change their plans due to limited practice opportunities.

Relative demand: Using several questions pertaining to the job market experiences and

perceptions of survey respondents who had actively searched for a practice position

(excluding IMGs on temporary visas), a composite score was computed to assign an

overall rank (or relative demand score) for each specialty in each year that the survey

was conducted. The percentages presented are the percentile rank of the specialty amongst

all specialties in a given year. A percentile rank of 100% identifi es the specialty highest in

demand, and the lowest percentile rank would correspond to the specialty with the lowest

relative demand score. Appendix A provides a detailed explanation of the methodology used

to assess relative demand.

Numbers of graduates of allopathic GME training programs in the US: The American Medical

Association’s (AMA) data on the number of residents completing training was compiled to

observe how the number of new entrants to the physician marketplace has changed over time.

Important Note:

For each specialty, the number of responses by year is listed at the bottom of the page in the report. Care

should be taken when interpreting outcomes based on small samples because the measures may

fl uctuate greatly from year to year.


Demand for primary care physicians* is stronger than the demand for non-primary care physicians.

Prior to 2008, the Exit Survey showed that demand for primary care physicians was lower compared to

demand for non-primary care physicians. Since 2008 the demand for primary care physicians has been

greater than the demand for non-primary care physicians. In 2016, primary care physicians received

more job off ers than specialists and were less likely to have to change plans due to limited

practice opportunities.

There are important diff erences in the job market experiences and assessments for

diff erent specialties.

Although the overall marketplace appears relatively good for new graduates, there exist important

diff erences in demand for individual specialties. In New York, specialties experiencing the strongest and

weakest relative demand were as follows:

Strongest relative demand: family medicine, emergency medicine, general internal medicine,

adult psychiatry, dermatology, and neurology.

Weakest relative demand: pathology, radiology, pediatric subspecialties, anesthesiology,

infectious disease, and cardiology.

* Primary care specialties include family medicine, general internal medicine, general pediatrics, and internal medicine and pediatrics (combined).

KEY FINDINGS

Specialties


Specialty: Family Medicine

Number of responses: 2012: n = 76, 2013: n = 72, 2014: n = 70, 2015: n = 92, 2016: n = 92. *Source: CHWS, Survey of Residents Completing Training in New York, 2012 - 2016.**Source: JAMA Medical Education Issues , 2006 - 2015.

Trends in Number of Graduates of Allopathic Family MedicineGME Programs in the US,** 2006 - 2015

Rank of Family Medicine, 2012 - 2016Trends in Relative Demand* - Percentile

Limited Practice Opportunities,* 2012 - 2016Trends in Having to Change Plans Due to

Trends in Median Starting Income,* 2012 - 2016 (in $1,000s of 2016 dollars)

Trends in Mean Number of Job O ers Received,* 2012 - 2016

3,083 3,107 3,068 3,109 3,097 3,188 3,158 3,1623,313 3,314

0

500

1,000

1,500

2,000

2,500

3,000

3,500

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$174$183$190 $196$193 $192$187 $195

$214 $207

$0

$50

$100

$150

$200

$250

Family Medicine Primary Care

4.04.2

4.9

4.34.2 4.24.5

4.0

4.8

4.3

0.0

1.0

2.0

3.0

4.0

5.0

6.0


11%11%

16%

12%

16%

11%

5%

9%

5%

10%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%


89%

74%

100%

84%

94%

81%

100%

79%

100%

84%

0%

20%

40%

60%

80%

100%

120%


Legend: 2012 2013 2014 2015 2016


Specialty: General Internal Medicine


Trends in Number of Graduates of Allopathic General Internal MedicineGME Programs in the US,** 2006 - 2015

Rank of General Internal Medicine, 2012 - 2016Trends in Relative Demand* - Percentile




6,408 6,587 6,598 6,697 6,635 6,739 6,708 6,838 6,6937,099

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$197$183

$205$196

$204$192

$213$195

$222$207

$0

$50

$100

$150

$200

$250

General Internal Medicine Primary Care

4.64.2

4.4 4.3

4.8

4.24.34.0

4.64.3

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5

5.0


12%11%

10%

12%

11% 11%

12%

9%9%

10%

0%

2%

4%

6%

8%

10%

12%

14%


80%74%

91%

84%

91%

81%

91%

79%

94%

84%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


Legend: 2012 2013 2014 2015 2016


Specialty: General Pediatrics


Trends in Number of Graduates of Allopathic General PediatricsGME Programs in the US,** 2006 - 2015

Rank of General Pediatrics, 2012 - 2016Trends in Relative Demand* - Percentile




2,507 2,562 2,618 2,573 2,649 2,685 2,618 2,6712,801 2,818

0

500

1,000

1,500

2,000

2,500

3,000

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$143

$183

$138

$196

$134

$192

$142

$195

$157

$207

$0

$50

$100

$150

$200

$250

General Pediatrics Primary Care

3.5

4.2

3.4

4.3

2.7

4.2

2.6

4.0

2.8

4.3

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5


10%

11%

16%

12%

8%

11%

8%

9%

13%

10%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%


46%

74%

49%

84%

49%

81%

47%

79%

62%

84%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%


Legend: 2012 2013 2014 2015 2016


Specialty: IM & Peds (Combined)


Trends in Number of Graduates of Allopathic IM & Peds (Combined)GME Programs in the US,** 2006 - 2015

Rank of IM & Peds (Combined), 2012 - 2016Trends in Relative Demand* - Percentile




340

309

365338

350 356341 336

350 356

0

50

100

150

200

250

300

350

400

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$201$183

$191 $196$189 $192$180

$195$196$207

$0

$50

$100

$150

$200

$250

IM & Peds (Combined) Primary Care

3.8

4.2

2.3

4.34.7

4.23.8

4.03.6

4.3

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5

5.0


10%11%

0%

12%

0%

11%

6%

9%

25%

10%

0%

5%

10%

15%

20%

25%

30%


80%74%

94%

84%89%

81%79% 79%79%84%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


Legend: 2012 2013 2014 2015 2016


Specialty: Obstetrics/Gynecology


Trends in Number of Graduates of Allopathic Obstetrics/GynecologyGME Programs in the US,** 2006 - 2015

Rank of Obstetrics/Gynecology, 2012 - 2016Trends in Relative Demand* - Percentile




1,148 1,148 1,176 1,168 1,178 1,180 1,219 1,209 1,202 1,221

0

200

400

600

800

1,000

1,200

1,400

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$212$230

$208$231

$192

$234$222

$248

$220

$252

$0

$50

$100

$150

$200

$250

$300

Obstetrics/Gynecology Non-Primary Care

3.53.23.2

3.02.8

3.0

3.7

3.33.6

3.3

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0


9%

20%

15%

19%

15%

17%

16%

18%

16%

18%

0%

5%

10%

15%

20%

25%


57%

50%

63%

50%54%

50%

65%

48%

68%

48%

0%

10%

20%

30%

40%

50%

60%

70%

80%


Legend: 2012 2013 2014 2015 2016


Specialty: Cardiology


Trends in Number of Graduates of Allopathic CardiologyGME Programs in the US,** 2006 - 2015

Rank of Cardiology, 2012 - 2016Trends in Relative Demand* - Percentile




813850 882

921 921 944 945 952 973 1,000

0

200

400

600

800

1,000

1,200

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$334

$231$254

$224

$274

$214

$253$232

$283

$249

$0

$50

$100

$150

$200

$250

$300

$350

$400

Cardiology Medicine Subspecialties

3.93.6

3.03.2

2.5

3.23.5

3.73.63.3

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5


32%

24%

32%

23%

18%

26%26%24%

27%

22%

0%

5%

10%

15%

20%

25%

30%

35%


51%

47%

20%

44%

34%

49%

21%

47%

18%

44%

0%

10%

20%

30%

40%

50%

60%


Legend: 2012 2013 2014 2015 2016


Specialty: Critical Care Medicine


Trends in Number of Graduates of Allopathic Critical Care MedicineGME Programs in the US,** 2006 - 2015

Rank of Critical Care Medicine, 2012 - 2016Trends in Relative Demand* - Percentile




98

69

89 87

107 106110 113 116 117

0

20

40

60

80

100

120

140

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$289

$231

$269

$224

$280

$214

$321

$232

$303

$249

$0

$50

$100

$150

$200

$250

$300

$350

Critical Care Medicine Medicine Subspecialties

4.3

3.6

4.0

3.2

4.2

3.23.6 3.7

3.3 3.3

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5

5.0


11%

24%

0%

23%

15%

26%

11%

24%

32%

22%

0%

5%

10%

15%

20%

25%

30%

35%


74%

47%

66%

44%

80%

49%

85%

47%

32%

44%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%


Legend: 2012 2013 2014 2015 2016


Specialty: Endocrinology & Metabolism


Trends in Number of Graduates of Allopathic Endocrinology & MetabolismGME Programs in the US,** 2006 - 2015

Rank of Endocrinology & Metabolism, 2012 - 2016Trends in Relative Demand* - Percentile




234223 232

275

234

271 274 276300 297

0

50

100

150

200

250

300

350

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$181

$231

$176

$224

$190

$214

$172

$232

$207

$249

$0

$50

$100

$150

$200

$250

$300

Endocrinology & Metabolism Medicine Subspecialties

2.2

3.6

3.03.23.2 3.2

4.5

3.73.3 3.3

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5

5.0


5%

24%25%

23%

20%

26%

20%

24%

14%

22%

0%

5%

10%

15%

20%

25%

30%


74%

47%

57%

44%

71%

49%

56%

47%

74%

44%

0%

10%

20%

30%

40%

50%

60%

70%

80%


Legend: 2012 2013 2014 2015 2016


Specialty: Gastroenterology


Trends in Number of Graduates of Allopathic GastroenterologyGME Programs in the US,** 2006 - 2015

Rank of Gastroenterology, 2012 - 2016Trends in Relative Demand* - Percentile




365404 403

422448 450 449 452

487 477

0

100

200

300

400

500

600

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$281

$231$255

$224

$278

$214

$299

$232

$279

$249

$0

$50

$100

$150

$200

$250

$300

$350

Gastroenterology Medicine Subspecialties

4.3

3.63.53.2

4.1

3.23.0

3.73.8

3.3

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5

5.0


32%

24%

13%

23%

28%26%

21%

24%

17%

22%

0%

5%

10%

15%

20%

25%

30%

35%


57%

47%

57%

44%46%49%

59%

47%

56%

44%

0%

10%

20%

30%

40%

50%

60%

70%


Legend: 2012 2013 2014 2015 2016


Specialty: Geriatrics


Trends in Number of Graduates of Allopathic GeriatricsGME Programs in the US,** 2006 - 2015

Rank of Geriatrics, 2012 - 2016Trends in Relative Demand* - Percentile




304281 284 288

277300

279299 306

284

0

50

100

150

200

250

300

350

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$191

$231

$176

$224

$165

$214$202

$232

$199

$249

$0

$50

$100

$150

$200

$250

$300

Geriatrics Medicine Subspecialties

3.1

3.63.9

3.2

2.83.2

4.5

3.7

4.6

3.3

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5

5.0


25%24%

6%

23%21%

26%

15%

24%

29%

22%

0%

5%

10%

15%

20%

25%

30%

35%


63%

47%

69%

44%

60%

49%

76%

47%

56%

44%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%


Legend: 2012 2013 2014 2015 2016


Specialty: Hematology/Oncology


Trends in Number of Graduates of Allopathic Hematology/OncologyGME Programs in the US,** 2006 - 2015

Rank of Hematology/Oncology, 2012 - 2016Trends in Relative Demand* - Percentile




482 494 491520

548 542 529564 556 558

0

100

200

300

400

500

600

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$212$231

$255

$224

$250

$214

$285

$232

$271$249

$0

$50

$100

$150

$200

$250

$300

Hematology/Oncology Medicine Subspecialties

3.33.6

3.43.2

2.8

3.23.5

3.7

3.23.3

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0


21%24%

40%

23%

30%

26%25% 24%

8%

22%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%


31%

47%43% 44%

34%

49%

44%47%47%

44%

0%

10%

20%

30%

40%

50%

60%


Legend: 2012 2013 2014 2015 2016


Specialty: Infectious Disease


Trends in Number of Graduates of Allopathic Infectious DiseaseGME Programs in the US,** 2006 - 2015

Rank of Infectious Disease, 2012 - 2016Trends in Relative Demand* - Percentile




286

323 318345 344 352

335

374 366351

0

50

100

150

200

250

300

350

400

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$158

$231

$165

$224

$162

$214$206

$232

$172

$249

$0

$50

$100

$150

$200

$250

$300

Infectious Disease Medicine Subspecialties

2.5

3.6

2.2

3.2

1.6

3.23.5

3.7

2.3

3.3

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0


13%

24%

19%

23%

33%

26%

18%

24%

44%

22%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%


17%

47%

14%

44%

14%

49%

21%

47%

18%

44%

0%

10%

20%

30%

40%

50%

60%


Legend: 2012 2013 2014 2015 2016


Specialty: Nephrology


Trends in Number of Graduates of Allopathic NephrologyGME Programs in the US,** 2006 - 2015

Rank of Nephrology, 2012 - 2016Trends in Relative Demand* - Percentile




399368

391 395 407433 439 448 441

460

0

50

100

150

200

250

300

350

400

450

500

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$185

$231

$186

$224

$179

$214$194

$232

$202

$249

$0

$50

$100

$150

$200

$250

$300

Nephrology Medicine Subspecialties

2.8

3.63.7

3.23.4

3.2

4.2

3.7

2.4

3.3

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5


40%

24%

67%

23%25% 26%

39%

24%

58%

22%

0%

10%

20%

30%

40%

50%

60%

70%

80%


20%

47%

26%

44%

26%

49%

35%

47%

29%

44%

0%

10%

20%

30%

40%

50%

60%


Legend: 2012 2013 2014 2015 2016


Specialty: Pulmonary Disease


Trends in Number of Graduates of Allopathic Pulmonary DiseaseGME Programs in the US,** 2006 - 2015

Rank of Pulmonary Disease, 2012 - 2016Trends in Relative Demand* - Percentile




407 422 430472

441479 490

516 528546

0

100

200

300

400

500

600

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$262

$231$239$224

$273

$214

$242$232

$258 $249

$0

$50

$100

$150

$200

$250

$300

Pulmonary Disease Medicine Subspecialties

4.8

3.63.53.2

3.8

3.23.7 3.7

3.03.3

0.0

1.0

2.0

3.0

4.0

5.0

6.0


11%

24%

8%

23%

36%

26%

20%

24%

9%

22%

0%

5%

10%

15%

20%

25%

30%

35%

40%


43%47%49%

44%

77%

49%44%

47%

62%

44%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%


Legend: 2012 2013 2014 2015 2016


Specialty: Rheumatology


Trends in Number of Graduates of Allopathic RheumatologyGME Programs in the US,** 2006 - 2015

Rank of Rheumatology, 2012 - 2016Trends in Relative Demand* - Percentile




173186 185

200 197 203214 210 210 204

0

50

100

150

200

250

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$200

$231

$190

$224$218 $214

$184

$232$216

$249

$0

$50

$100

$150

$200

$250

$300

Rheumatology Medicine Subspecialties

2.6

3.6

2.8

3.2

4.1

3.22.9

3.7

3.2 3.3

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5


29%

24%

8%

23%

57%

26%

46%

24%

0%

22%

0%

10%

20%

30%

40%

50%

60%


34%

47%

40%44%

46%49%

29%

47%44% 44%

0%

10%

20%

30%

40%

50%

60%


Legend: 2012 2013 2014 2015 2016


Specialty: General Surgery


Trends in Number of Graduates of Allopathic General SurgeryGME Programs in the US,** 2006 - 2015

Rank of General Surgery, 2012 - 2016Trends in Relative Demand* - Percentile




1,0901,042 1,047 1,045 1,062 1,089 1,100 1,088 1,076

1,137

0

200

400

600

800

1,000

1,200

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$278

$230

$335

$231

$326

$234

$370

$248

$357

$252

$0

$50

$100

$150

$200

$250

$300

$350

$400

General Surgery Non-Primary Care

3.43.2

3.0 3.02.7

3.02.7

3.3

2.6

3.3

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0


25%

20%

33%

19%

25%

17%

30%

18%

27%

18%

0%

5%

10%

15%

20%

25%

30%

35%


69%

50%

86%

50%

66%

50%

71%

48%

68%

48%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%


Legend: 2012 2013 2014 2015 2016


Specialty: Neurosurgery


Trends in Number of Graduates of Allopathic NeurosurgeryGME Programs in the US,** 2006 - 2015

Rank of Neurosurgery, 2012 - 2016Trends in Relative Demand* - Percentile




148

131 133

151 156149 148

167158

171

0

20

40

60

80

100

120

140

160

180

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$397

$281

$444

$318

$438

$305$275

$346

$437

$332

$0

$50

$100

$150

$200

$250

$300

$350

$400

$450

$500

Neurosurgery Surgical Subspecialties

5.9

2.9

2.2

3.4

2.42.8

3.32.8

1.8

3.2

0.0

1.0

2.0

3.0

4.0

5.0

6.0

7.0


0%

16%

20%

7%

20%

11%

25%

14%

25%

17%

0%

5%

10%

15%

20%

25%

30%


94%

59%

80%

60%57%52%

29%

43%

26%

49%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


Legend: 2012 2013 2014 2015 2016


Specialty: Ophthalmology


Trends in Number of Graduates of Allopathic OphthalmologyGME Programs in the US,** 2006 - 2015

Rank of Ophthalmology, 2012 - 2016Trends in Relative Demand* - Percentile




435 430 418 419 420440

463 459440

463

0

50

100

150

200

250

300

350

400

450

500

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$189

$281

$206

$318

$195

$305$285

$346

$166

$332

$0

$50

$100

$150

$200

$250

$300

$350

$400

Ophthalmology Surgical Subspecialties

2.3

2.9

1.3

3.4

2.4

2.8

1.3

2.8

2.3

3.2

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0


19%

16%

0%

7%

17%

11%

0%

14%14%

17%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%


23%

59%

31%

60%

34%

52%53%

43%

56%

49%

0%

10%

20%

30%

40%

50%

60%

70%


Legend: 2012 2013 2014 2015 2016


Specialty: Orthopedic Surgery


Trends in Number of Graduates of Allopathic Orthopedic SurgeryGME Programs in the US,** 2006 - 2015

Rank of Orthopedic Surgery, 2012 - 2016Trends in Relative Demand* - Percentile




898 925 950 9811,026

1,063 1,0821,117 1,127 1,137

0

200

400

600

800

1,000

1,200

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$321

$281

$344$318$323

$305

$347 $346$360

$332

$0

$50

$100

$150

$200

$250

$300

$350

$400

Orthopedic Surgery Surgical Subspecialties

2.3

2.9

5.0

3.4

2.9 2.8

2.1

2.83.1 3.2

0.0

1.0

2.0

3.0

4.0

5.0

6.0


21%

16%

4%

7%6%

11%

17%

14%

18%17%

0%

5%

10%

15%

20%

25%


40%

59%60% 60%

51% 52%

38%

43%

38%

49%

0%

10%

20%

30%

40%

50%

60%

70%


Legend: 2012 2013 2014 2015 2016


Specialty: Otolaryngology


Trends in Number of Graduates of Allopathic OtolaryngologyGME Programs in the US,** 2006 - 2015

Rank of Otolaryngology, 2012 - 2016Trends in Relative Demand* - Percentile




273 265 257 260270 270

284272

289 293

0

50

100

150

200

250

300

350

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$276 $281

$223

$318

$254

$305

$271

$346

$240

$332

$0

$50

$100

$150

$200

$250

$300

$350

$400

Otolaryngology Surgical Subspecialties

4.2

2.9

2.3

3.43.6

2.8

3.8

2.8

3.8

3.2

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5


9%

16%

0%

7%

11% 11%

0%

14%

0%

17%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%


91%

59%

89%

60%

71%

52%

62%

43%

71%

49%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


Legend: 2012 2013 2014 2015 2016


Specialty: Cardio-Thoracic Surgery


Trends in Number of Graduates of Allopathic Cardio-Thoracic SurgeryGME Programs in the US,** 2006 - 2015

Rank of Cardio-Thoracic Surgery, 2012 - 2016Trends in Relative Demand* - Percentile




131124

118

97

8593

89 92

82 84

0

20

40

60

80

100

120

140

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$298$281

$325 $318

$274$305

$373$346

$329 $332

$0

$50

$100

$150

$200

$250

$300

$350

$400

Cardio-Thoracic Surgery Surgical Subspecialties

1.5

2.92.8

3.4

1.5

2.82.5

2.82.5

3.2

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0


17% 16%

20%

7%

0%

11%

0%

14%

0%

17%

0%

5%

10%

15%

20%

25%


3%

59%

11%

60%

9%

52%

9%

43%

24%

49%

0%

10%

20%

30%

40%

50%

60%

70%


Legend: 2012 2013 2014 2015 2016


Specialty: Urology


Trends in Number of Graduates of Allopathic UrologyGME Programs in the US,** 2006 - 2015

Rank of Urology, 2012 - 2016Trends in Relative Demand* - Percentile




255 255242

260 264 273 271 277292 284

0

50

100

150

200

250

300

350

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$406

$281

$319 $318$328$305

$350 $346$373

$332

$0

$50

$100

$150

$200

$250

$300

$350

$400

$450

Urology Surgical Subspecialties

4.0

2.9

2.3

3.4

4.4

2.82.5

2.8

4.7

3.2

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5

5.0


0%

16%

13%

7%

20%

11%

22%

14%

20%

17%

0%

5%

10%

15%

20%

25%


100%

59%

86%

60%

89%

52%

68%

43%

76%

49%

0%

20%

40%

60%

80%

100%

120%


Legend: 2012 2013 2014 2015 2016


Specialty: Anesthesiology


Trends in Number of Graduates of Allopathic AnesthesiologyGME Programs in the US,** 2006 - 2015

Rank of Anesthesiology, 2012 - 2016Trends in Relative Demand* - Percentile




1,427 1,471 1,473 1,513 1,5111,563 1,534 1,567 1,589 1,577

0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$297$281$284

$318$299 $305$301

$346

$283

$332

$0

$50

$100

$150

$200

$250

$300

$350

$400

Anesthesiology Surgical Subspecialties

2.4

2.9

2.3

3.4

2.2

2.82.8 2.82.6

3.2

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0


22%

16%

22%

7%

22%

11%

4%

14%16%

17%

0%

5%

10%

15%

20%

25%


60% 59%

29%

60%

23%

52%

24%

43%

18%

49%

0%

10%

20%

30%

40%

50%

60%

70%


Legend: 2012 2013 2014 2015 2016


Specialty: Pain Management


Trends in Number of Graduates of Allopathic Pain ManagementGME Programs in the US,** 2006 - 2015

Rank of Pain Management, 2012 - 2016Trends in Relative Demand* - Percentile




175

240216

232245 247

271285

303 298

0

50

100

150

200

250

300

350

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$246$230

$276

$231

$309

$234

$266$248

$338

$252

$0

$50

$100

$150

$200

$250

$300

$350

$400

Pain Management Non-Primary Care

3.2 3.2

2.83.0

2.93.0

3.3 3.33.2 3.3

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0


31%

20%

7%

19%

14%

17%

6%

18%16%

18%

0%

5%

10%

15%

20%

25%

30%

35%


26%

50%

40%

50%

40%

50%

32%

48%

44%

48%

0%

10%

20%

30%

40%

50%

60%


Legend: 2012 2013 2014 2015 2016


Specialty: Pathology


Trends in Number of Graduates of Allopathic PathologyGME Programs in the US,** 2006 - 2015

Rank of Pathology, 2012 - 2016Trends in Relative Demand* - Percentile




998 962 934 9681,014

1,063 1,099 1,114 1,143 1,120

0

200

400

600

800

1,000

1,200

1,400

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$194

$230

$181

$231

$203

$234

$187

$248

$185

$252

$0

$50

$100

$150

$200

$250

$300

Pathology Non-Primary Care

1.6

3.2

1.7

3.0

1.2

3.0

1.8

3.3

1.9

3.3

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0


48%

20%

43%

19%

38%

17%

43%

18%21%

18%

0%

10%

20%

30%

40%

50%

60%


11%

50%

6%

50%

3%

50%

3%

48%

3%

48%

0%

10%

20%

30%

40%

50%

60%


Legend: 2012 2013 2014 2015 2016


Specialty: Radiology


Trends in Number of Graduates of Allopathic RadiologyGME Programs in the US,** 2006 - 2015

Rank of Radiology, 2012 - 2016Trends in Relative Demand* - Percentile




1,611 1,6761,750 1,770 1,839 1,853

1,939 1,8811,978 1,933

0

500

1,000

1,500

2,000

2,500

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$312

$230

$325

$231

$311

$234

$314

$248

$316

$252

$0

$50

$100

$150

$200

$250

$300

$350

Radiology Non-Primary Care

2.0

3.2

1.7

3.0

1.6

3.0

2.0

3.3

2.2

3.3

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0


32%

20%

32%

19%

41%

17%

44%

18%

25%

18%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%


11%

50%

9%

50%

9%

50%

6%

48%

6%

48%

0%

10%

20%

30%

40%

50%

60%


Legend: 2012 2013 2014 2015 2016


Specialty: Adult Psychiatry


Trends in Number of Graduates of Allopathic Adult PsychiatryGME Programs in the US,** 2006 - 2015

Rank of Adult Psychiatry, 2012 - 2016Trends in Relative Demand* - Percentile




1,108 1,093 1,054 1,055 1,0581,156 1,138 1,155

1,234 1,201

0

200

400

600

800

1,000

1,200

1,400

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$192

$230

$177

$231

$165

$234

$182

$248

$207

$252

$0

$50

$100

$150

$200

$250

$300

Adult Psychiatry Non-Primary Care

3.7

3.2

3.7

3.0

4.7

3.0

4.0

3.3

3.8

3.3

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5

5.0


4%

20%

12%

19%

0%

17%

12%

18%

4%

18%

0%

5%

10%

15%

20%

25%


86%

50%

74%

50%

100%

50%

94%

48%

94%

48%

0%

20%

40%

60%

80%

100%

120%


Legend: 2012 2013 2014 2015 2016


Specialty: Child & Adolescent Psychiatry


Trends in Number of Graduates of Allopathic Child & Adolescent PsychiatryGME Programs in the US,** 2006 - 2015

Rank of Child & Adolescent Psychiatry, 2012 - 2016Trends in Relative Demand* - Percentile




376 365383 379

394 404 410429 431

410

0

50

100

150

200

250

300

350

400

450

500

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$184

$230

$175

$231

$175

$234

$197

$248

$216

$252

$0

$50

$100

$150

$200

$250

$300

Child & Adolescent Psychiatry Non-Primary Care

5.6

3.2

4.7

3.03.3

3.0

3.8

3.3

4.3

3.3

0.0

1.0

2.0

3.0

4.0

5.0

6.0


25%

20%

0%

19%

15%17%

28%

18%

15%

18%

0%

5%

10%

15%

20%

25%

30%


66%

50%

71%

50%

74%

50%

82%

48%

82%

48%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%


Legend: 2012 2013 2014 2015 2016


Specialty: Allergy & Immunology


Trends in Number of Graduates of Allopathic Allergy & ImmunologyGME Programs in the US,** 2006 - 2015

Rank of Allergy & Immunology, 2012 - 2016Trends in Relative Demand* - Percentile




121129

134141

135142

128 132140

148

0

20

40

60

80

100

120

140

160

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$167

$230

$127

$231

$169

$234

$184

$248

$191

$252

$0

$50

$100

$150

$200

$250

$300

Allergy & Immunology Non-Primary Care

3.3 3.2

1.8

3.0

2.3

3.0

2.7

3.3

3.03.3

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0


43%

20%

50%

19%

33%

17%

33%

18%

33%

18%

0%

10%

20%

30%

40%

50%

60%


29%

50%

26%

50%

23%

50%

12%

48%

21%

48%

0%

10%

20%

30%

40%

50%

60%


Legend: 2012 2013 2014 2015 2016


Specialty: Dermatology


Trends in Number of Graduates of Allopathic DermatologyGME Programs in the US,** 2006 - 2015

Rank of Dermatology, 2012 - 2016Trends in Relative Demand* - Percentile




425 424444 443 459 476 490

525551

523

0

100

200

300

400

500

600

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$296

$230$231 $231

$319

$234

$286

$248

$277$252

$0

$50

$100

$150

$200

$250

$300

$350

Dermatology Non-Primary Care

4.3

3.23.5

3.0

4.9

3.0

3.73.3

5.1

3.3

0.0

1.0

2.0

3.0

4.0

5.0

6.0


13%

20%

10%

19%

0%

17%

14%

18%

13%

18%

0%

5%

10%

15%

20%

25%


97%

50%

97%

50%

97%

50%

91%

48%

88%

48%

0%

20%

40%

60%

80%

100%

120%


Legend: 2012 2013 2014 2015 2016


Specialty: Emergency Medicine


Trends in Number of Graduates of Allopathic Emergency MedicineGME Programs in the US,** 2006 - 2015

Rank of Emergency Medicine, 2012 - 2016Trends in Relative Demand* - Percentile




1,3041,366 1,359

1,462 1,485 1,5381,599

1,670 1,726 1,758

0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$235 $230$252

$231

$260$234

$287

$248

$280

$252

$0

$50

$100

$150

$200

$250

$300

$350

Emergency Medicine Non-Primary Care

3.9

3.2

3.8

3.0

4.0

3.0

4.1

3.3

3.9

3.3

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5


8%

20%

6%

19%

1%

17%

4%

18%

5%

18%

0%

5%

10%

15%

20%

25%


83%

50%

80%

50%

89%

50%

100%

48%

97%

48%

0%

20%

40%

60%

80%

100%

120%


Legend: 2012 2013 2014 2015 2016


Specialty: Neurology


Trends in Number of Graduates of Allopathic NeurologyGME Programs in the US,** 2006 - 2015

Rank of Neurology, 2012 - 2016Trends in Relative Demand* - Percentile




652724 713

756799

850 854914

985 969

0

200

400

600

800

1,000

1,200

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$176

$230

$191

$231$213

$234$212

$248$238

$252

$0

$50

$100

$150

$200

$250

$300

Neurology Non-Primary Care

2.7

3.2

2.3

3.03.2

3.03.3 3.3

3.7

3.3

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0


33%

20%

25%

19%

0%

17%

5%

18%

13%

18%

0%

5%

10%

15%

20%

25%

30%

35%


37%

50%

34%

50%

63%

50%

74%

48%

88%

48%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


Legend: 2012 2013 2014 2015 2016


Specialty: Pediatric Subspecialties


Trends in Number of Graduates of Allopathic Pediatric SubspecialtiesGME Programs in the US,** 2006 - 2015

Rank of Pediatric Subspecialties, 2012 - 2016Trends in Relative Demand* - Percentile




814874 907 891

9921,039 1,078

1,126 1,147 1,170

0

200

400

600

800

1,000

1,200

1,400

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$165

$230

$178

$231

$172

$234

$194

$248

$205

$252

$0

$50

$100

$150

$200

$250

$300

Pediatric Subspecialties Non-Primary Care

2.2

3.2

2.2

3.0

2.3

3.0

2.3

3.3

2.5

3.3

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0


22%20%

37%

19%17% 17%

25%

18%

35%

18%

0%

5%

10%

15%

20%

25%

30%

35%

40%


14%

50%

20%

50%

17%

50%

21%

48%

9%

48%

0%

10%

20%

30%

40%

50%

60%


Legend: 2012 2013 2014 2015 2016


Specialty: Physical Medicine & Rehabilitation


Trends in Number of Graduates of Allopathic Physical Medicine & RehabilitationGME Programs in the US,** 2006 - 2015

Rank of Physical Medicine & Rehabilitation, 2012 - 2016Trends in Relative Demand* - Percentile




387363 375 379 384 395

423405 395

431

0

50

100

150

200

250

300

350

400

450

500

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

$189

$230

$185

$231

$170

$234

$204

$248

$213

$252

$0

$50

$100

$150

$200

$250

$300

Physical Medicine &Rehabilitation

Non-Primary Care

3.03.2

3.7

3.03.1 3.03.2 3.3

2.7

3.3

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0


Non-Primary Care

15%

20%

0%

19%

28%

17%

40%

18%

13%

18%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%


Non-Primary Care

51% 50%

57%

50%

40%

50%50% 48%

38%

48%

0%

10%

20%

30%

40%

50%

60%


Non-Primary Care

Legend: 2012 2013 2014 2015 2016

Appendix A


METHODOLOGY USED TO MEASURE RELATIVE DEMAND

The Resident Exit Survey cannot be used to determine absolute demand for new physicians in diff erent

specialties (ie, it cannot be used to determine the number of physicians necessary to serve a given

population). However, by analyzing several questions pertaining to job market experiences and

perceptions of new physicians and comparing responses over time, in diff erent geographical locations,

and between specialties, it is possible to assess whether respondents from certain specialties or in certain

locations are fi nding more or fewer practice opportunities (ie, it measures relative demand).

The implication is that while a specialty, such as pathology, may be in low demand relative to other

specialties in an absolute sense, there may still be good opportunities for pathologists, but not as good

or as many as another specialist that is seeing higher demand (such as child and adolescent psychiatry).

In addition, it is not possible to measure the magnitude of the diff erence in demand between diff erent

specialties. So, if the percentile rank of general internal medicine in New York in 2016 was 94% (ie, general

internal medicine had a relative rank equal to or better than 94% of the 34 specialties that were ranked),

and the percentile rank of pain management was 44%, this does not imply that demand for general

internal medicine was more than twice as strong as for pain management. The scale is at the ordinal level

of measurement.

To measure demand for a given year, a composite score was computed by taking the median of the ranks

(ie, where each specialty stood relative to all 34 specialties) scored by each specialty on each of the

demand indicators for data from the previous 4 years of the survey. Data from more recent years of the

survey received a greater weight than data from earlier years. For example, when calculating the

demand score for 2016, data from 2016 were weighted .40, data from 2015 were weighted .30, data from

2014 were weighted .20, and data from 2013 were weighted .10. The following variables were used as

indicators of demand:

Percentage of respondents having diffi culty fi nding a satisfactory practice position

Percentage of respondents having to change plans due to limited practice opportunities

Mean number of job off ers received by respondents

Respondents’ mean Likert score summarizing their assessment of the regional job market

Respondents’ mean Likert score summarizing their assessment of the national job market

Trend (ie, average annual change) in median starting income


None of these indicators used alone will provide a perfect picture of demand. However, considered

together, they provide a good picture of relative demand by specialty. There was a high degree of

correlation between the “percentage of respondents with diffi culty fi nding a satisfactory practice

position” variable and the “percentage of respondents having to change plans due to limited practice

opportunities” variable (ie, a respondent reporting “diffi culty…” was much more likely to also report

“having to change plans…”). There was also a high degree of correlation between respondents’

assessments of the “regional job market” and the “national job market.” To compensate for these

observed correlations, the “job off ers” variable and the “trends in starting income” variable were each

double weighted in computing a composite demand score.

Table 1 summarizes the rank of each specialty (ranked among 34 specialties) on each demand indicator.

The variables are:

Diffi culty: Rank of each specialty based on the percentage of respondents reporting diffi culty

fi nding a satisfactory practice position eg, the specialty with the lowest percentage of

respondents reporting diffi culty (emergency medicine) ranked #1 and the specialty with the

highest percentage of respondents reporting diffi culty (pathology) ranked #34.

Change Plans: Rank of each specialty based on the percentage of respondents that had to

change plans due to practice opportunities eg, the specialty with the lowest percentage of

respondents having to change plans (adult psychiatry) ranked #1 and the specialty with the

highest percentage of respondents reporting diffi culty (pathology) ranked #34.

Job Off ers: Rank of each specialty in terms of the mean number of job off ers received by

respondents (this variable was double weighted in computing the overall demand score)

eg, the specialty with the most job off ers (general internal medicine) ranked #1 and the

specialty with the fewest job off ers (plastic surgery) ranked #34.

Regional Market: Rank of each specialty in terms of the mean Likert score summarizing

respondents’ assessments of the regional job market for their specialty eg, the specialty

with the most positive assessment of the regional job market (emergency medicine) ranked

#1 and the specialty with the least positive assessment of the regional job market (pathology)

ranked #34.

National Market: Rank of each specialty in terms of the mean Likert score summarizing

respondents’ assessments of the national job market for their specialty eg, the specialty

with the most positive assessment of the national job market (adult psychology) ranked #1

and the specialty with the least positive assessment of the national job market (pathology)

ranked #34.


Income Trend: Rank of each specialty in terms the average annual change (or trend) in median

starting income levels of respondents from each specialty eg, the specialty with the

strongest trend in median starting income (general surgery) ranked #1 and the specialty with

the weakest trend in median starting income (cardio-thoracic) ranked #34.

Table 1. Summary of Ranks and Demand IndicatorsChange Job Regional National Income Median Overall Percentile

Specialty Di culty Plans O ersa Market Market Trendsa Rank Rank Rankb

Family Medicine 9 5 1 2 3 7 4.0 1.0 100%General Internal Medicine 5 9 2 6 5 16 5.5 3.0 94%

General Pediatrics 12 8 24 9 14 18 16.0 14.0 62%Internal Medicine and Pediatrics (Combined)

1 12 9 8 22 29 10.5 8.0 79%

Ob/Gyn 13 14 14 10 13 24 14.0 12.0 68%Cardiology 25 26 18 29 29 34 27.5 29.0 18%

Critical Care Med 23 23 12 23 16 23 23.0 24.0 32%Endocrinology and

Metabolism17 18 10 13 18 12 12.5 10.0 74%

Gastroenterology 20 22 11 16 12 28 18.0 16.0 56%Geriatrics 21 21 4 14 15 22 18.0 16.0 56%

Hematology/Oncology 26 19 19 25 17 5 19.0 19.0 47%Infectious Disease 29 30 27 28 32 14 27.5 29.0 18%

Nephrology 31 34 17 27 31 20 23.5 25.0 29%Pulmonary Disease 16 16 16 24 8 27 16.0 14.0 62%

Rheumatology 18 27 20 20 24 17 20.0 20.0 44%General Surgery 7 28 26 21 6 4 14.0 12.0 68%Neurosurgery 24 25 30 31 21 3 24.5 26.0 26%

Ophthalmology 4 10 32 15 11 21 18.0 16.0 56%Orthopedic 19 13 23 22 25 15 20.5 22.0 38%

Otolaryngology 14 1 13 11 20 33 13.5 11.0 71%Cardio-Thoracic Surg 27 3 31 30 23 10 25.0 27.0 24%

Urology 8 20 8 12 10 32 11.0 9.0 76%Anesthesiology 10 15 28 17 27 31 27.5 29.0 18%

Pain Management 22 11 21 19 26 1 20.0 20.0 44%Pathology 34 33 34 34 34 30 34.0 34.0 3%Radiology 30 31 33 32 33 26 31.5 33.0 6%

Adult Psychiatry 3 4 7 1 1 19 5.5 3.0 94%Child and Adolescent

Psychiatry15 17 5 4 7 11 9.0 7.0 82%

Allergy and Immunology 33 32 25 26 28 8 25.5 28.0 21%Dermatology 6 7 3 5 9 25 6.5 5.0 88%

Emergency Medicine 2 2 6 3 4 9 5.0 2.0 97%Neurology 11 6 15 7 2 2 6.5 5.0 88%

Pediatric Subspecialties 28 29 29 33 30 6 29.0 32.0 9%Physical Medicine and

Rehabilitation32 24 22 18 19 13 20.5 22.0 38%

a The job o ers variable and the income trend variable were each double weighted in computing the median rank.b The percentile rank is the percentage of all 34 specialties with a median demand rank equal to or lower than each specialty.


The following example illustrates how the demand score was calculated for General Internal Medicine in

New York in 2016:

Median RankGIM = median (diffi culty, change plans, job off ers, job off ers, regional market, national market,

income trends, income trends)

Median RankGIM = median (5, 9, 2, 2, 6, 5, 16, 16)

Median RankGIM = 5.5

With a median rank of 5.5, General Internal Medicine ranked 3rd out of 34 specialties.

The percentile rank is computed as:

%rankGIM = { 1 – (RankGIM / #Specs) + (1 / #Specs) }

“#Specs” = the number of specialties being ranked

In New York in 2016, there were 34 specialties being ranked, so the percentile rank of General Internal

Medicine is:

%rankGIM = { 1 – (5.5/ 34) + (1 / 34) } = 94%.

Appendix B


SPECIALTY COMPARISON GROUPS

Specialty Comparison Groupa

Family Medicine Primary CareGeneral Internal Medicine Primary CareGeneral Pediatrics Primary CareInternal Medicine and Pediatrics (Combined) Primary CareObstetrics/Gynecology Non-Primary CareCardiology Medicine SubspecialtiesCritical Care Medicine Medicine SubspecialtiesEndocrinology and Metabolism Medicine SubspecialtiesGastroenterology Medicine SubspecialtiesGeriatrics Medicine SubspecialtiesHematology/Oncology Medicine SubspecialtiesInfectious Disease Medicine SubspecialtiesNephrology Medicine SubspecialtiesPulmonary Disease Medicine SubspecialtiesRheumatology Medicine SubspecialtiesGeneral Surgery Non-Primary CareNeurosurgery Surgical SubspecialtiesOphthalmology Surgical SubspecialtiesOrthopedic Surgery Surgical SubspecialtiesOtolaryngology Surgical SubspecialtiesCardio-Thoracic Surgery Surgical SubspecialtiesUrology Surgical SubspecialtiesAnesthesiology Non-Primary CarePain Management Non-Primary CarePathology Non-Primary CareRadiology Non-Primary CareAdult Psychiatry Non-Primary CareChild and Adolescent Psychiatry Non-Primary CareAllergy and Immunology Non-Primary CareDermatology Non-Primary CareEmergency Medicine Non-Primary CareNeurology Non-Primary CarePediatric Subspecialties Non-Primary CarePhysical Medicine and Rehabilitation Non-Primary Care

cardiology is compared against the average percentile rank of all medicine subspecialties.

a In each specialty pro le, statistics for the specialty are presented next to the average of all specialties in the group to which the specialty belongs (ie, the comparison group). As an example, the starting median of family practice is compared to the median starting income of all primary care. Likewise, the relative demand (or percentile rank) of

Appendix C


NY RESIDENT EXIT SURVEY INSTRUMENT

School of Public Health | University at Albany, SUNY1 University Place, Suite 220 | Rensselaer, NY 12144-3445

www.chwsny.org

About the Authors

Gaetano J. Forte

Director of Center Operations, Center for Health Workforce Studies

Mr. Forte is a veteran health services researcher having spent nearly 2 decades studying the health workforce. As Director of Operations, Mr. Forte oversees all research projects at CHWS, working with the project directors to ensure that research is conducted at the highest level of quality, in a timely manner, and in accordance with the agreements between CHWS and its funders.

David Armstrong, PhD

Project Director, Center for Health Workforce Studies

Dr. Armstrong oversees CHWS projects which monitor the supply and distribution of the health workforce in New York and other states. In collaboration with professional health organizations in the state, he also administers provider recruitment and retentionsurveys to monitorhealth workforce demand. Dr. Armstrong also is the director of the Health Workforce Technical Assistance Center, which provides technical assistance to individuals, hospitals, and various states and organizations.

Yuhao Liu, MPA

Research Associate, Center for Health Workforce Studies

Mr. Liu specializes in data collection, analysis, and visualization, as well as relationaldatabase management, public policy research, and fi nancial analysis. He holds an MPAwith concentrations in Statistics and Information Strategy and Management from theUniversity at Albany, SUNY.

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