Friday, March 31, 2017

Surgical fellowship match results for 2017

Two weeks ago, I reviewed the preliminary results of the 2017 main NRMP match. Data for the specialty match, also known as the fellowship match, recently became available. Here are the outcomes for the subspecialties of general surgery.

For abdominal transplant surgery, 36 of 58 programs filled, comprising 51 of 74 positions. There were 75 applicants with 24 going unmatched. The number of transplant programs has dropped from 69 in 2013 with a concomitant decrease in the number of available positions from 84 to 74. Applicants numbered 116 in 2013, and except for a slight upturn in 2016, interest has steadily declined. Consistent with the previous four years, US grads filled 31% of the positions in 2017.

Colon and rectal surgery filled all 56 programs and all 95 positions; 35 of the 130 applicants failed to match. Colorectal has filled 100% of positions available in three of the last five years. US grads filled 75% of the slots which is fairly consistent with previous years.

Pediatric surgery’s 44 programs filled all but one of the 45 available positions. This is the first time in the last five years that pediatric surgery did not fill 100% of its slots through the match. There were 96 applicants this year, and 52 of them did not secure a position. US grads filled 80% of the slots which is a slightly lower percentage than previous years.

Thoracic surgery has seen a resurgence of interest. For the last two years all 67 programs filled. This year there were 84 slots for 115 applicants leaving 31 unmatched. For comparison, in 2013, 58 of 76 programs filled with 22 of 102 positions unfilled, and in 2013 and 2014, there were fewer applicants than there were positions. It appears that contracting the number of programs and positions has resulted in a right-sized specialty training. This year, 70% of the slots were filled by US graduates, up from 55% in 2013.

Of the 124 surgical critical care programs, 47 did not fill through the match, and of 254 positions offered, 69 did not fill. There were 195 applicants, 10 of whom did not match. Critical care is the only surgical specialty that had fewer applicants than positions. Fifty-eight percent of those who matched were US grads. The number of positions available in surgical critical care has steadily risen from 178 in 2013; yet since then, the number of applicants per position has never been above 0.8-0.9. In 2017, 13 more positions were offered, and the number of applicants dropped by 13. Maybe surgical critical care could take a lesson from thoracic surgery.

Surgical oncology filled all 27 programs and 57 slots with 84% US medical school grads. There were 81 applicants. With the exception of the percentage of US graduates which has steadily increased, the surg onc fill rate been consistently 98-100% since the specialty started participating in the match in 2014.

Vascular surgery saw 90 of 92 programs fill 115 of 117 available positions with 71% US graduates, an increase of 8% over 2016. Sixteen of 131 applicants did not match. Vascular surgery has had stable numbers over the years.

Summary

Over the last five years, the most competitive specialties have been pediatric surgery, surgical oncology, colon and rectal, and recently, thoracic surgery. Abdominal transplant surgery and surgical critical care are the specialties having the most trouble filling their available positions through the match. Vascular surgery is somewhere in the middle.

3 comments:

lp said...

Just curious if you have numbers for Plastics and Breast?

Skeptical Scalpel said...

If breast has a match, it's not run by the NRMP. Plastics is in the main match--73 programs, 2 didn't fill. 157 filled positions. 93% were filled by US seniors.

Vamsi Aribindi said...

http://www.jpedsurg.org/article/S0022-3468(16)00167-6/abstract

Pediatric Surgery's number of positions is low considering the demand, but its pretty high considering the falling case volume of serious "index" cases nationwide. Increasingly, complicated procedures are being concentrated in quaternary children's hospitals and community pediatric surgeons arent seeing them, raising questions about skill maintainence and if we are training too many ped surgeons.

Transplant surgery's match I think is also a special case- many transplant surgery fellowships are combined HPB/Transplant, and I have heard some transplant surgeons argue that even if a fellowship graduate never does transplant, the training and exposures done during the fellowship are beneficial for major liver resections. Other fellowships are almost exclusively transplant.

Ultimately, these numbers judge the fit of graduate demand to positions available, but I dont think they address the fit of the positions available to the needs of the country...

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