Program Director Corner – November 2017
Richard Auchus, MD
Program Director & Professor
University of Michigan
rauchus@med.umich.edu
The Silver Lining
Being a Program Director is truly a thankless job, second only to Acting Division Chief as “worst jobs in academic medicine.” When I get depressed about my job, I think about a few observations that I had not expected.
Endocrinology is a cognitive specialty with few procedures and among the lowest salaries in medicine. Despite the limited financial incentive, some other numbers might surprise you. Since the 2013 interview season, the number of endocrinology programs in the match has grown by 4%/yr from 128 to 143, and the number of match positions has also grown 4%/yr from 261 to 291. In these 4 years, the pool has remained at 1.2 applicants/position – just about the right number – and <1% of positions do not fill in the match. Last year, the number of applicants hit 342, the highest since the 2012 interview season.
We first screen or filter our applicants based on standard parameters (maybe this would be a good topic for a future PD corner!) to divide the group roughly 40%-60%. Although I read all the applications, most of those that we interview come from the top 40%. About 3 years ago, we had to raise the bar to pull out only the top 40%. In my 6 years as PD, my impression this year was that the applicant pool is the best that I have seen. I have spoken to several other PD’s, including at our recent APDEM council teleconference, and uniformly other PD’s have the same impression.
Shockingly, more residents are applying to endocrinology, and by several measures, the quality of the applicants is improving. More importantly, their reasons for pursuing endocrinology are the right ones: the intellectual challenge, love of teaching, desire for long-term patient relations and patient education, and opportunities for research. So, we must be doing something right as PD’s if we are attracting more and better candidates to an underpaid field. By comparison, other cognitive subspecialties are not so fortunate. Infectious Disease has fallen to 0.7-0.8 applicants/position, and Nephrology was as low as 0.6 and now 0.7 applicants/position.
A few years ago, I was meeting with the graduate students in Pharmacology, and I asked them if they had any criticisms of the program. Several students said, “I wish the faculty were not so negative about the future.” The Endocrinology applicants are sending the same message. Well, it is November, which means Thanksgiving time, my favorite holiday. I am thankful for our Program Coordinator and staff, our fellows, and our field – Endocrinology is still the most exciting, challenging, and rewarding field of medicine.