LAUSR

proportional to their percentage of independent applicants and then recalculate the fill rate (essentially moving them from the independent applicant to the USMG group), the correlation between specialty competitiveness and median salary is nearly identical (r = 0.70). As USMGs tend to match at higher rates than other applicants, if we are generous and allow prior USMGs to match at a rate twice that of their proportion of independent applicants, we again find the correlation essentially unchanged (r = 0.70). It is also worth mentioning that this group comprised less than 5% of the overall 2014 applicant pool. Second, Mr Sahin points out that the fill rate, for the same reasons stated above, does not include students who take a research year after graduating medical school before applying to the match. The size of this group is not known, but considering that 94.4% of US allopathic graduates matched successfully, and that only a subset of the remaining 5.6% took time off for research, this number is likely to be small and have minimal impact on the calculated fill rate.5 Third, Mr Sahin states that residencies “have the option of not ranking all the students who apply,” opting to leave unfilled residency slots rather than fill them with subpar applicants, in effect creating low fill rates for specialties that are actually competitive. We have no way of knowing how often this occurs. However, we suspect this happens infrequently as it would run counter to the purpose of residency programs, which is to train physicians—something that is impossible without residents. We appreciate this clarification to the fill rate; though our efforts were limited by our data sources, we believe the overall conclusion—the persistence of a strong, positive relationship between specialty competitiveness and median specialty salary—is unchanged. We look forward to future efforts to better understand this complex and changing relationship.