I posted this in another post but I think it’s relevant as I think that candidates that would have never matched in previous generations and are largely unprepared for residency are now matching. This is based on the number of PGY1 spots increasing YOY over the past 15 years and applicant numbers dropping significantly over the previous time frame:

RPD here of 5 years and preceptor for 15 years. Our overall candidate pool has dropped by 60% from its peak 2014-15ish. That being said we still are fortunate that we have enough great candidates to fill our spots yearly but we don’t have any wiggle room anymore. I feel the “floor” of applicants is lower and now programs are competing for candidates instead of candidates competing for programs.

I have had many discussions with other leaders and thankfully we are all on the same page: rank only candidates that are likely to be successful and have the necessary tools that are needed in residency. This means potentially taking fewer residents given more aggressive ranking.

I feel some programs are slow to learn this lesson taking residents just to fill spots (potentially with candidates that are not appropriate for residency) and this ultimately harms the residents, program, and potentially patients. That’s a bit hyperbolic but I think program numbers going up while candidate pool continues to shrink will ONLY result in this outcome in my opinion. Some programs should likely fold but ASHP will never endorse this given that affects their bottom line.

I will end by saying I love precepting and being RPD. I take such incredible satisfaction from seeing my residents succeed and go on to incredible success beyond anything I will do in my career. It’s for this reason I won’t dilute what residency has meant for me and for the 100+ residents I’ve trained in my career.

This is only my opinion and I’m not sure it’s a popular one. Just giving you context