Analysis of hematology-oncology fellowship match outcomes (2007-2022) and cross-subspecialty comparisons: A retrospective cohort study.

person Sushrut Ingawale Quinnipiac University Frank H. Netter, MD, School of Medicine/St. Vincent's Medical Center, Bridgeport, CT info_outline Sushrut Ingawale, Vaidarshi Abbagoni, Abhiroop Verma, David Regelmann, Praveen Kollipara

Authors person Sushrut Ingawale Quinnipiac University Frank H. Netter, MD, School of Medicine/St. Vincent's Medical Center, Bridgeport, CT info_outline Sushrut Ingawale, Vaidarshi Abbagoni, Abhiroop Verma, David Regelmann, Praveen Kollipara Organizations Quinnipiac University Frank H. Netter, MD, School of Medicine/St. Vincent's Medical Center, Bridgeport, CT, St. Vincent's Medical Center, Bridgeport, CT, Fort Wayne Medical Oncology and Hematology, Fort Wayne, IN Abstract Disclosures Research Funding No funding sources reported Background: The four most sought-after fellowships following Internal Medicine, by volume, are: Hematology-Oncology (HO), Cardiovascular (CV), Gastroenterology (GI), and Pulmonology-Critical Care (PC). This analysis assesses the trends in match outcomes for HO compared to other fellowships, including subset National Residency Match Program (NRMP) outcomes based on applicant types [United States (US) and non-US medical graduates (MDs)]. Methods: This retrospective cohort study analyzes applicants who applied to HO, CV, GI, or PC fellowships for 2007-2022. The analysis is based on publicly available NRMP data for this time. Metrics analyzed include: number of applicants per position, number and type of applicants, number and type of successfully matched applicants, and, corresponding match rates (MR) within each subspecialty. Using the chi-square test, this analysis compared match outcomes between different applicant types. Results: Out of total 55,604 applicants, the distribution across subspecialties was as follows: HO (12,006), CV (19,950), GI (11,693), and PC (11,955). Despite the apparent differences in the total number of applicants for different subspecialties, the number of applicants per position was not statistically significantly different, and decreased from 2007 to 2022 for all subspecialties except PC (+6.7%). As the number of applicants increased, the number of available positions also increased to a substantially higher degree. In 2008, MR ranged from 50-64% across subspecialties, gradually increasing over the years, with HO achieving the highest MR at 73.5% in 2022, compared to PC at 60.7%. USMD graduates consistently had higher MRs compared to non-USMDs (p<0.001) across all subspecialties. Despite this persistent gap over the study's duration, this difference progressively narrowed across all subspecialties, with HO representing the lowest difference (22.1%) and GI the highest (37.2%) in match rates for 2022. Conclusions: The HO fellowship exhibited the highest match rates, closely followed by CV. The proportional increase in HO, CV and GI positions in response to the growing applicants has led to a reduction in the applicants per position, unlike in PC. HO fellowship consistently stands out with the lowest MR disparity among USMDs and non-USMDs. This may represent successful efforts towards equity, diversity and inclusion among programs. HO 2008 HO 2022 CV 2008 CV 2022 GI 2008 GI 2022 PC 2008 PC 2022 Positions 424 663 699 1120 325 616 374 721 Applicants 724 894 1264 1620 622 974 569 1182 USMD 312 412 550 653 319 446 206 452 Applicants per Position 1.7 1.4 1.8 1.5 1.9 1.6 1.5 1.6 Matched 416 657 693 1118 313 614 359 718 Matched USMD 241 352 438 568 230 371 182 351 Match Rate (MR) % 57.5 73.5 54.8 69 50.3 63 63.1 60.7 MR USMD % 77.2 85.4 79.6 87 72.1 83.2 88.3 77.7 MR Non-USMD % 42.5 63.3 35.7 56.9 27.4 46 48.8 50.3 MR Disparity % 34.7 22.1 43.9 30.1 44.7 37.2 39.5 27.4