Competitiveness amongst Military and Civilian Residencies by Specialty: A Comparative Analysis
Location
Suwanee, GA
Start Date
6-5-2025 1:00 PM
End Date
6-5-2025 4:00 PM
Description
Intro/Background:
Military service remains an option for medical students to pursue medical careers. However, there is a lack of comparative data on competitiveness and availability of training, especially for students who are certain of their specialty choice early in medical education. This can often obscure decision-making and expectations. The purpose of this study is to 1) compare the competitiveness of civilian and military residencies between 2018 and 2024, and 2) determine if competitiveness has changed over the course of the study period.
Methods:
We used publicly available NRMP data and Army annual GME report data from 2018 to 2024. T-tests estimated whether there were significant differences in the average 6-year competitiveness between civilian and military residencies stratified by specialty. To minimize type 1 error, we performed a Bonferroni correction for performing 16 t-tests, setting the new p-value at 0.003125 The primary outcome was the competitiveness factor: a multiple of 1) the specialty’s ratio of applicants to positions and 2) the ratio of positions filled for the respective application year, a continuous variable for which values are greater than zero.
Results:
Sixteen specialties between 2018-2024 (112 specialty-years) were included in the analysis: Anesthesiology, Dermatology, Emergency Medicine, Family Medicine, General Surgery, Internal Medicine, Neurosurgery, Neurology, Obstetrics and Gynecology, Otolaryngology, Orthopedic Surgery, Pathology, Physical Medicine and Rehabilitation, Psychiatry, and Diagnostic Radiology. Overall, there was no difference in the aggregate competitiveness between civilian and military programs. However, specialty-specific analyses showed civilian residencies were more competitive than military amongst Anesthesiology (1.75 vs 1.18, p = 0.001), Dermatology (8.77 vs 1.16, p = 0.000), Family Medicine (1.41 vs 0.78, p = 0.000), General Surgery (1.83 vs 1.26, p = 0.000), Internal Medicine (1.46 vs 0.62, p = 0.000), Neurology (1.88 vs 1.03, p = 0.000), Pathology (1.52 vs 0.66, p = 0.001), and Diagnostic Radiology (7.92 vs 1.21, p = 0.000) residencies. There was no difference in civilian and military competitiveness amongst Emergency Medicine (1.12 vs 1.26, p = 0.227), Neurosurgery (1.61 vs 1.43, p = 0.732), OBGYN (1.41 vs 1.28, p = 0.080), Otolaryngology (1.33 vs 1.42, p = 0.597), Orthopedic Surgery (1.50 vs 1.42, p = 0.410), Pediatrics (1.24 vs 0.77, p = 0.013), and Psychiatry (1.51 vs 1.08, p = 0.015). There were no residencies where the military was more competitive than civilian.
Conclusion:
To our knowledge, this is the first study comparing specialty match competitiveness both between military and civilian residencies and across time. Further research should include data on Navy and Air Force and anecdotal information about the benefits and risks of military medical service with respect to an individual’s long term plans.
Embargo Period
5-19-2025
Competitiveness amongst Military and Civilian Residencies by Specialty: A Comparative Analysis
Suwanee, GA
Intro/Background:
Military service remains an option for medical students to pursue medical careers. However, there is a lack of comparative data on competitiveness and availability of training, especially for students who are certain of their specialty choice early in medical education. This can often obscure decision-making and expectations. The purpose of this study is to 1) compare the competitiveness of civilian and military residencies between 2018 and 2024, and 2) determine if competitiveness has changed over the course of the study period.
Methods:
We used publicly available NRMP data and Army annual GME report data from 2018 to 2024. T-tests estimated whether there were significant differences in the average 6-year competitiveness between civilian and military residencies stratified by specialty. To minimize type 1 error, we performed a Bonferroni correction for performing 16 t-tests, setting the new p-value at 0.003125 The primary outcome was the competitiveness factor: a multiple of 1) the specialty’s ratio of applicants to positions and 2) the ratio of positions filled for the respective application year, a continuous variable for which values are greater than zero.
Results:
Sixteen specialties between 2018-2024 (112 specialty-years) were included in the analysis: Anesthesiology, Dermatology, Emergency Medicine, Family Medicine, General Surgery, Internal Medicine, Neurosurgery, Neurology, Obstetrics and Gynecology, Otolaryngology, Orthopedic Surgery, Pathology, Physical Medicine and Rehabilitation, Psychiatry, and Diagnostic Radiology. Overall, there was no difference in the aggregate competitiveness between civilian and military programs. However, specialty-specific analyses showed civilian residencies were more competitive than military amongst Anesthesiology (1.75 vs 1.18, p = 0.001), Dermatology (8.77 vs 1.16, p = 0.000), Family Medicine (1.41 vs 0.78, p = 0.000), General Surgery (1.83 vs 1.26, p = 0.000), Internal Medicine (1.46 vs 0.62, p = 0.000), Neurology (1.88 vs 1.03, p = 0.000), Pathology (1.52 vs 0.66, p = 0.001), and Diagnostic Radiology (7.92 vs 1.21, p = 0.000) residencies. There was no difference in civilian and military competitiveness amongst Emergency Medicine (1.12 vs 1.26, p = 0.227), Neurosurgery (1.61 vs 1.43, p = 0.732), OBGYN (1.41 vs 1.28, p = 0.080), Otolaryngology (1.33 vs 1.42, p = 0.597), Orthopedic Surgery (1.50 vs 1.42, p = 0.410), Pediatrics (1.24 vs 0.77, p = 0.013), and Psychiatry (1.51 vs 1.08, p = 0.015). There were no residencies where the military was more competitive than civilian.
Conclusion:
To our knowledge, this is the first study comparing specialty match competitiveness both between military and civilian residencies and across time. Further research should include data on Navy and Air Force and anecdotal information about the benefits and risks of military medical service with respect to an individual’s long term plans.