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How to Match into Anesthesiology in 2023

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by Alec Palmerton, MD in How to Match

Are you wondering how to match into anesthesiology? Or how many anesthesia residency programs are there? Do you want to know everything there is about anesthesia residency interviews? Need to know how many interviews to match in anesthesia?

In this article, you’ll learn everything you need to match into anesthesiology.

Summary:

  • Anesthesiology is moderately competitive, in part due to having so many programs and positions available
  • In part due to the volume of applications, anesthesiology residency programs use standardized screens to “weed out” applicants
  • The most successful applicants won’t fail any USMLE, have good USMLE scores, a stellar MSPE, and demonstrate lots of interest in programs
  • Historically, most anesthesia interview invites occur before October 31, and the vast majority before November 31

Table of Contents

How Competitive is it to Match into Anesthesiology?

How competitive is it to match into anesthesiology in the US? Here we have the unmatched % for US seniors by specialty. The “Unmatched %” means the % of US seniors who applied into anesthesiology who did not match during the given year.

This is one measure of specialty competitiveness – perhaps the most relevant if you want to match into anesthesiology.

For more on the competitiveness of anesthesiology relative to other medical specialties, see this article.

How Many Anesthesia Residency Programs Are There?

Before we discuss how many anesthesia residency programs there are in the US, let’s review some terminology. For many specialized residency programs (e.g., anesthesiology, dermatology, radiology, radiation oncology, etc.), the specialty training begins during their second year of residency. This second year is also known as the PGY-2 (post-graduate year 2, for the second year after graduating from medical school).

Categorical vs. Advanced vs. Physician Anesthesiology Programs

Anesthesiology has three different kinds of residency programs applicants can potentially enter: categorical, advanced, and physician (R).

Categorical refers to programs that include all years of residency training. Anesthesiology residency lasts four years. The first year of training, however, is a “preliminary” year that can be either internal medicine, surgery, or transitional (a sort of grab-bag that will depend on the hospital). Some programs include the PGY-1 “intern” year – these programs are known as “categorical” programs.

Others, however, require applicants to match separately into an intern year. These programs, which begin in the PGY-2 years, are referred to as “advanced” positions.

Finally, for others who have already completed at least a year of residency training, they may be eligible for a “physician” anesthesiology position. These positions allow applicants to move directly into the PGY-2 specialty training and skip the PGY-1 year. This arrangement may be ideal for those who want to complete residency sooner and not have to repeat their intern year.

How Many Anesthesia Residency Programs and Positions Are There?

In the 2022 NRMP Match, there were:

  • 165 anesthesiology programs offering 1,509 PGY-1 (categorical) positions,
  • 58 anesthesiology programs offering 346 PGY-2 (advanced) positions, and
  • 55 anesthesiology programs offering 114 Physician (R) positions

Thus, the total number of anesthesia residency positions in 2022 was 1,509 + 346 + 114 = 1,969. There were at least 165 anesthesiology programs in 2022. However, it is unclear how many more than that there were since many of the residency programs that offer advanced and/or physician positions also offer categorical ones.

See the 2022 Main Residency Match Results and Data for more information on anesthesiology match statistics.

How to Match into Anesthesiology: Impressing Program Directors

To match into anesthesiology, you must first be invited to interview. According to the most recent program director (PD) survey from 2021, PDs shared what they look for in candidates they hope to interview.

For anesthesiology, the top five most important characteristics for receiving an interview, according to program directors, were:

  • Any failed USMLE attempt
  • MSPE
  • USMLE Step 1 score
  • Perceived interest in program
  • Having overcome significant obstacles

Note that with Step 1 moving to pass-fail, Step 2 CK will almost assuredly take on greater importance for matching into anesthesiology in the future.

The same data are presented more fully in a table. Here you will see the % of program director respondents who cited a factor as important for granting an interview, as well as the mean importance score (out of 5).

To balance the breadth of program directors citing each factor with the importance given to each factor, a “composite score” was created. This composite score takes the average of the % respondents citing a factor with the importance score scaled to 100%. For example, if 80% of PDs cited a given factor, with a mean importance score of 5.0 (out of 5), the composite score would be 90%. (The average of 80% of PDs citing with 5/5 – or 100% – for the mean importance, for a composite score of 90%).

Anesthesiology: Characteristics Considered
in Deciding Whom to INTERVIEW (% of Respondents Endorsing)
Anesthesiology: Characteristics Considered
in Deciding Whom to INTERVIEW (Mean Importance / 5)
Anesthesiology: Characteristics Considered for Interview Composite Score (Average of % Respondents Endorsing and Mean Importance / 5)
Any Failed USMLE Attempt83.3%4.788.7%
MSPE90.5%4.388.3%
USMLE Step 1 Score95.2%3.885.6%
Perceived Interest in Program85.7%4.284.9%
Having Overcome Significant Obstacles85.7%4.183.9%
Professionalism and Ethics76.2%4.583.1%
Class Ranking/Quartile85.7%482.9%
Perceived Commitment to Specialty78.6%4.382.3%
Leadership Qualities78.6%4.281.3%
USMLE Step 2 CK Score88.1%3.781.1%
Personal Statement (Overall)83.3%3.980.7%
Diversity Characteristics81.0%480.5%
Any Failed COMLEX-USA Attempt64.3%4.880.2%
Letters of Recommendation in Specialty78.6%479.3%
Grades in Required Clerkships83.3%3.778.7%
Other Life Experience76.2%3.775.1%
Personal Prior Knowledge of Applicant69.0%474.5%
Consistency of Grades64.3%4.173.2%
AOA Membership69.0%3.569.5%
Grades in Clerkship in Preferred Specialty61.9%3.869.0%
COMLEX-USA Level 1 score59.5%3.968.8%
COMLEX-USA Level 2 CE Score57.1%468.6%
GHHS Membership61.9%3.768.0%
Volunteer/Extracurricular Experience57.1%3.967.6%
Continuous Medical Education w/o Gaps54.8%467.4%
Medical School Reputation52.4%3.864.2%
Medical School Accreditation Status52.4%3.763.2%
Awards/Honors in Clinical Clerkships59.5%3.362.8%
Passing USMLE Step 2 CS47.6%3.962.8%
NRMP Flag for Match Violation21.4%560.7%
Audition Elective/Rotation in PD's Dept33.3%4.258.7%
Passing COMLEX-USA Level 2 PE31.0%455.5%
Awards/Honors, Clerkship in Preferred Specialty33.3%3.854.7%
Involvement and Interest in Research40.5%3.353.3%
Visa Status35.7%3.451.9%
Sigma Sigma Phi Membership31.0%3.449.5%
Ability to Work Legally w/o Visa28.6%3.448.3%
COMLEX-USA Level 3 Score4.8%442.4%
Awards/Honors in Basic Sciences21.4%340.7%
Away Rotation in Specialty Elsewhere14.3%3.239.2%
USMLE Step 3 Score7.1%3.538.6%
Interest in Academic Career11.9%336.0%
Fluency in Language of Pt Population9.5%2.731.8%
How Medical School Handled Virtual Rotations4.8%1.517.4%

Here are the composite scores for the criteria anesthesiology program directors use for grading interviews.

Anesthesiology Residency Program Director Interview Criteria (2021)

What Do Anesthesiology Program Directors Look for When Ranking Applicants?

Getting an interview is only part of the process of matching into anesthesiology. Program directors also rank the most important factors for creating their rank order list.

In the 2021 Program Director Survey, anesthesiology PDs rated these criteria as most important for deciding whom to rank:

  • Interpersonal skills
  • Interactions with faculty during interview/visit
  • Interactions with house staff during interview/visit
  • Feedback from current residents
  • Perceived interest in program

We can see the full list here:

Anesthesiology: Characteristics Considered
in Deciding Whom to RANK (% of Respondents Endorsing)
Anesthesiology: Characteristics Considered
in Deciding Whom to RANK (Mean Importance / 5)
Anesthesiology: Characteristics Considered for Rank Composite Score (Average of % Respondents Endorsing and Mean Importance / 5)
Interpersonal Skills88.1%4.892.1%
Interactions with Faculty During Interview/Visit83.3%4.889.7%
Interactions with House Staff During Interview/Visit78.6%4.786.3%
Feedback from Current Residents76.2%4.583.1%
Perceived Interest in Program73.8%4.379.9%
USMLE Step 1 Score73.8%476.9%
Diversity Characteristics69.0%4.276.5%
MSPE69.0%4.175.5%
USMLE Step 2 CK Score69.0%4.175.5%
Having Overcome Significant Obstacles69.0%4.175.5%
Perceived Commitment to Specialty64.3%4.375.2%
Class Ranking/Quartile66.7%4.174.4%
Professionalism and Ethics57.1%4.573.6%
Personal Statement69.0%3.872.5%
Any Failed USMLE Attempt47.6%4.770.8%
Leadership Qualities57.1%4.270.6%
Letters of Recommendation in Specialty64.3%3.870.2%
Personal Prior Knowledge of Applicant52.4%4.268.2%
Grades in Required Clerkships52.4%466.2%
Any Failed COMLEX-USA Attempt35.7%4.865.9%
COMLEX-USA Level 2 CE Score45.2%4.264.6%
AOA Membership50.0%3.964.0%
Consistency of Grades47.6%463.8%
Other Life Experience47.6%463.8%
COMLEX-USA Level 1 score42.9%4.263.5%
GHHS Membership38.1%4.160.1%
NRMP Flag for Match Violation23.8%4.758.9%
Other Post-Interview Contact31.0%4.257.5%
Volunteer/Extracurricular Experience40.5%3.757.3%
Passing USMLE Step 2 CS35.7%3.855.9%
Grades in Clerkship in Preferred Specialty28.6%454.3%
Medical School Reputation35.7%3.653.9%
Passing COMLEX-USA Level 2 PE23.8%4.253.9%
Audition Elective/Rotation in PD's Dept23.8%4.253.9%
Continuous Medical Education w/o Gaps31.0%3.752.5%
Ability to Work Legally w/o Visa14.3%4.249.2%
Involvement and Interest in Research26.2%3.548.1%
Sigma Sigma Phi Membership19.0%3.847.5%
Second Interview/Visit4.8%4.547.4%
Visa Status14.3%447.2%
Awards/Honors in Clinical Clerkships21.4%3.646.7%
Medical School Accreditation Status23.8%3.445.9%
Awards/Honors, Clerkship in Preferred Specialty16.7%3.745.4%
Fluency in Language of Patient Population11.9%3.844.0%
Applicant Facility with Meeting Platform Tech11.9%3.642.0%
USMLE Step 3 Score2.4%441.2%
Away Rotation in Specialty Elsewhere9.5%3.337.8%
Interest in Academic Career9.5%334.8%
Awards/Honors in Basic Sciences9.5%2.832.8%
How Medical School Handled Virtual Rotations2.4%331.2%
COMLEX-USA Level 3 Score2.4%1.2%

Finally, we can see the composite scores for criteria used to rank anesthesiology applicants.

Anesthesiology Residency Program Director Ranking Criteria (2021)

What Characteristics Do Successful Anesthesiology Applicants Share?

Here are the characteristics of matched vs. unmatched US seniors applying to anesthesiology.

MatchedUnmatched
Mean number of contiguous ranks, US Senior15.76.3
Mean number of distinct specialties ranked, US Senior1.41.9
Step 1, US Senior237221
Step 2, US Senior248231
Mean number of research experiences, US Senior3.73.1
Mean number of abstracts, presentations, and publications, US Senior6.64.4
Mean number of work experiences, US Senior3.53.4
Mean number of volunteer experiences, US Senior7.76.5
Percentage who are AOA members, US Senior12.31.7
Percentage who graduated from one of the 40 U.S. medical schools with the highest NIH funding, US Senior32.121
Percentage who have Ph.D. degree, US Senior20.9
Percentage who have another graduate degree, US Senior18.721.6
Match Into Anesthesiology: Pass the Screens with High USMLEs

Anesthesiology relies on standardized screens to weed out applicants. In the 2021 Program Director Survey, anesthesiology PDs respondents reported that 42% of applications were rejected via standardized screen. This ranked near the middle of residencies.

Anesthesiology Applicants Screened Out and Interviewed 2021 PD Survey

What Are the Step 1 and Step 2 CK Cut-Offs for Interviews in Anesthesiology?

As mentioned above, anesthesiology ranks near the middle of programs using standardized screens to eliminate applications. Many anesthesiology programs screen out applicants with failed USMLE Step 1 and Step 2 CK (see below). In addition, PDs use Step 1 and Step 2 CK score cut-offs to weed out applicants.

For Step 1, anesthesiology program directors reported Step 1 score cut-offs between 208 and 220 as 25% and 75%ile marks to screen out applicants.

Step 1 Interview Cut-Offs 2020

Similarly, anesthesiology program directors reported Step 2 CK scores between 220 and 230 as 25% and 75%ile cut-offs.

Step 2 CK Interview Cut-Offs 2020

For more on the USMLE cut-off scores for granting interviews – or weeding out applicants – see this article.

If I Fail Step 1, Can I Still Match Into Anesthesiology?

If you failed Step 1, you might wonder if you can still match into anesthesiology. In the most recent program director survey addressing this question, we can see that anesthesiology programs are relatively unforgiving if you’ve failed Step 1.

In 2020, anesthesiology 36% of PDs reported they “never” consider applicants who fail Step 1, while 60% would “seldom” consider it. Only 4% of anesthesiology programs “often” consider someone with a Step 1 fail.

If I Fail Step 1, Can I Still Match Into Anesthesiology? (2020 PD Survey)

Did you fail Step 1 and are wondering what you can do to recover? Read this article and consider scheduling a consultation.

If I Fail Step 2 CK, Can I Still Match Into Anesthesiology?

Similarly, you may wonder what your chances of matching into anesthesiology are if you fail Step 2 CK. Just like with Step 1, anesthesiology PDs are unforgiving for not passing Step 2 CK.

In 2020, anesthesiology 40% of PDs reported they “never” consider applicants who fail Step 2 CK, while 56% would “seldom” consider it. Only 4% of anesthesiology programs “often” consider someone with a Step 2 CK fail.

If I Fail Step 2 CK, Can I Still Match Into Anesthesiology? (2020 PD Survey)

Did you fail Step 2 CK and wonder what you can do to recover? Read this article and consider scheduling a consultation.

How Many Publications for Anesthesiology Residency in 2022

Research is an important characteristics for matching into many specialties, particularly the most competitive. So, how many publications do you need to match into an anesthesiology residency?

In 2022, the mean number of abstracts, presentations, and publications for US seniors who matched into anesthesiology was 6.6. The mean number of research experiences was 3.7.

How many publications for anesthesiology 2022
Do I Need an MD-PhD to Become an Anesthesiologist?

You may wonder how much an MD-PhD helps with matching into anesthesiology. It appears that having a PhD correlates with a modest advantage of 5% when applying into anesthesiology. Specifically, the match rate for those with a PhD is 5% higher than for those without one when applying into anesthesiology.

Should I get a PhD for anesthesiology 2022

Having a PhD correlated with a 5% match rate advantage for anesthesiology in the 2022 Match

Note that those with PhDs are relatively rare among anesthesiology residents. In fact, only 2% of matched applicants into anesthesiology had a PhD in 2022.

MD-PhD for Anesthesiology Residency 2022

2% of matched applicants to anesthesiology had an MD-PhD in 2022

Anesthesia Residency Interviews

When you apply to anesthesiology, you may be wondering what the chances of getting an interview are. Here we present the outcomes of applicants per the 2021 NRMP Program Director Survey.

Note that anesthesiology uses standardized screens to reduce the number of applicants. Roughly 42% of applicants that year were eliminated via a screen (e.g., Step 2 CK scores, visa status, failed a USMLE in the past, etc.).

When Are Anesthesia Residency Interview Invites Sent vs. Conducted?

When you apply to residency, you’ll be doing a lot of waiting. Specifically, you’ll be waiting to hear whether – and when – you will be able to interview.

Want to know when you might expect to hear from anesthesiology programs re: your residency application? Here are when programs typically extend and conduct interviews. Note that the most recent data are from 2020.

Here are the same data presented differently. Note that due to rounding, sometimes the percentages can add up to more than 100%.

How Many Interviews to Match in Anesthesia?

After applying to a program, applicants often wait anxiously to know whether they’ve received an interview invitation. Receiving – and attending – an interview allows applicants to “rank” that program on their match list. In other words, the more interviews you have, the more chances you have of matching into a given specialty.

So how many interviews to match in anesthesia with confidence?

For US Seniors, the magic number of interviews needed to match into anesthesia is 5-10. In 2022, having 5 interviews (and ranking them all on their match list) led to a 75-80% chance of matching. For even greater safety, though, having 10+ interviews led to a ≥93% chance of matching into anesthesiology for US seniors.

How Many Interviews to Match in Anesthesia US Seniors (2022 Match)

How Many Interviews to Match in Anesthesia as a DO?

For DO seniors, considerably more interviews were necessary to match into anesthesiology comfortably. To get to the 75% threshold, ≥ 9 interviews were needed. To reach the ≥ 90% threshold, 13+ interviews were needed in 2022.

How Many Interviews to Match in Anesthesia DO Seniors (2022 Match)

How Many Interviews to Match in Anesthesia as an IMG?

Similar to DOs, more interviews were necessary for IMGs to comfortably match into anesthesiology. To reach the 75% threshold, ≥8-9 interviews were necessary. Note that because of so few candidates with ≥ 9 interviews, the numbers become considerably “noisier,” and can’t be interpreted with much confidence. This is particularly true since only two matched successfully of the five non-US IMGs with 16+ interviews.

How Many Interviews to Match in Anesthesia IMGs (2022 Match)

Concluding Thoughts

Matching into anesthesiology is a challenging proposition. The challenge may feel more daunting if we have perceived weaknesses in our application, or if we want to match in a top program, a desirable location, and/or couples match.

The good news? How to match into anesthesiology depends largely on things you can control – your USMLEs, your clinical performance/MSPEs, whether you fail Step 1 or Step 2 CK, and how much interest you show to programs before, during, and after your interviews.

Looking for an Anesthesiology Residency Advisor?

Looking for an anesthesiology residency advisor? Want help writing your personal statement? Need effective strategies for interviewing? Do you have things on your application – e.g., low USMLE scores, failed USMLEs, no research, IMG status, or others – you need help overcoming?

Be sure to check out our Residency Advisor service.

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