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Journal Club

December 23, 2019

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ID Fellowship Match Results: Slight Declines from Last Year

This year’s ID Fellowship Match brought similar results when compared with last year. While we are pleased that the Match did not experience sharp declines in applicants or positions filled, we should also recognize that maintaining the status quo is insufficient to meet the ever evolving patient and public health need for ID physicians. We must continue working to attract physicians to the subspecialty.

The number of applicants was largely stable at 328 (from 337 last year), and U.S. graduate interest in ID has largely been sustained, with 160 matched U.S. MD graduates (from 169 last year). U.S. MD graduates filled 49.7% of slots (from 51.8% last year). The remainder of filled positions went to international medical graduates (26.1%), osteopathic residents (12.4%), U.S. foreign educated (11.2%), and Canadian graduates (0.6%). The percentage of programs that filled decreased to 62.3% (from 68.6% last year, 66.2% two years ago, and 63.3% three years ago) and the percentage of positions filled also fell slightly to 79.3% (from 81.3% last year and 81.5% two years ago).

Fifty-eight programs (37.7%) failed to fill all available slots in the Match with 30 programs (19.0%) failing to fill any slots. Similar to the 2018 Match, the programs that did not fill all or some of their slots were not the same as last year and the geographic distribution of unfilled slots varied. The size of the unfilled programs varied, with some offering single positions and others as many as six positions; the majority of unfilled programs offered fewer than three positions. Ten applicants failed to match; it is not known yet whether those applicants obtained positions after the Match.

Fifty-three programs participated in the pediatric ID Match this year, similar to last year (N=54). Of the 73 positions offered (79 in 2018), 46 filled (63%) and 27 were unfilled. This represents a 16% increase from 46.8% filled last year. There were 2 unmatched applicants this year (0 in 2018). We typically see <1 candidate (range 0.5-.8) per open position for pediatric ID every year who go through the Match. Quite a few excellent training programs across the country did not fill.

Infectious Diseases is one of four Internal Medicine subspecialty fellowships that offers more positions than the available pool of applicants; the other fields are Geriatrics (in which 34.9% of programs and 54.0% of positions filled), Hospice and Palliative Medicine (in which 65.4% of programs and 76.6% of positions filled), and Nephrology (in which 41.4% of programs and 62.0% of positions filled). Other smaller sub-subspecialties faced with this issue include adult congenital heart disease, advanced heart failure and transplant cardiology, clinical cardiac electrophysiology, hematology (distinct from hematology-oncology), and oncology (distinct from hematology-oncology).

These data highlight the critical importance of including the initiative to “facilitate the growth and development of the ID workforce to meet emerging scientific, clinical, and leadership needs” as part of IDSA’s new strategic plan. Ongoing efforts to stimulate interest in our field include the new Grants for Emerging Researchers (G.E.R.M.) Program to engage medical students in a longitudinal clinical learning and/or research project for up to one year under the mentorship of an IDSA or HIVMA member, supported by the IDSA Foundation. The IDSA Foundation also continues to support ID student interest groups at medical schools across the globe, each of which strives to stimulate interest in varying aspects of infectious diseases careers, research, and clinical care. IDSA will also strengthen our advocacy for federal policies to ensure fair compensation for ID physicians, which is essential to ensure that this subspecialty is financially feasible for physicians who increasingly have significant student debt. And the IDWeek mentorship program continues to pair infectious diseases faculty mentors with medical students and residents-in-training in order to provide these junior learners with a bird’s eye view into the incredible IDWeek experiences, and to help them appreciate the remarkable richness of the many joys and opportunities of a career in ID.

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