Analysis of the National Resident Matching Program for Surgical Critical Care Training in the United States: 2008–2022

Abstract

BackgroundFew studies have assessed the pipeline for surgical intensivists despite projected shortages in the United States' critical care workforce. We had 3 primary objectives in analyzing the Surgical Critical Care Match: (1) understand growth in the number of applicants relative to training positions; (2) compare match rates for United States Allopathic Graduates versus non-United States Allopathic Graduates; and (3) analyze the number of unfilled training positions over time. MethodsThis was a national cohort study of Surgical Critical Care Match applicants (2008–2022). Annual match rates and applicant-to-training position ratios were calculated. Cochrane-Armitage tests elucidated temporal trends during the study period. ResultsThere was a greater increase in the number of annual applicants (276% increase) relative to training positions (128% increase) during the study period (P < .001). The applicant-to-training position ratio increased (0.5–0.9, P < .001). Annual match rates increased for both United States Allopathic (92%–97%, P = .015) and non-United States Allopathic (81%–96%, P < .001) Graduates. Match rates for United States Allopathic Graduates exceeded those for non-United States Allopathic Graduates (P < .05) but were similar from 2020 to 2022 (P > .05). The percentage of applicants that matched at their top fellowship choice decreased from 69%–50% (P < .001). From 2008 to 2022, fewer available training positions went unfilled (52%–13%, P < .001). ConclusionThe pipeline for surgical intensivists in the United States appears to be increasing along with rising interest in Surgical Critical Care training. Future research is needed to understand disparities in match rates by applicant and fellowship program characteristics.