Abstract
BackgroundThe unique traits of residents who matriculate into subspecialty fellowships are poorly understood. We sought to identify characteristics of internal medicine (IM) residents who match into cardiovascular (CV) fellowships.MethodsWe conducted a retrospective cohort study of 8 classes of IM residents who matriculated into residency from 2007 to 2014. The primary outcome was successful match to a CV fellowship within 1 year of completing IM residency. Independent variables included residents’ licensing exam scores, research publications, medical school reputation, Alpha Omega Alpha (AOA) membership, declaration of intent to pursue CV in the residency application personal statement, clinical evaluation scores, mini-clinical evaluation exercise scores, in-training examination (ITE) performance, and exposure to CV during residency.ResultsOf the 339 included residents (59% male; mean age 27) from 120 medical schools, 73 (22%) matched to CV fellowship. At the time of residency application, 104 (31%) had ≥1 publication, 38 (11%) declared intention to pursue CV in their residency application personal statement, and 104 (31%) were members of AOA. Prior to fellowship application, 111 (33%) completed a CV elective rotation. At the completion of residency training, 108 (32%) had ≥3 publications. In an adjusted logistic regression analysis, declaration of intention to pursue CV (OR 6.4, 99% CI 1.7–23.4; p < 0.001), completion of a CV elective (OR 7.3, 99% CI 2.8–19.0; p < 0.001), score on the CV portion of the PGY-2 ITE (OR 1.05, 99% CI 1.02–1.08; p < 0.001), and publication of ≥3 manuscripts (OR 4.7, 99% CI 1.1–20.5; p = 0.007) were positively associated with matching to a CV fellowship. Overall PGY-2 ITE score was negatively associated (OR 0.93, 99% CI 0.90–0.97; p < 0.001) with matching to a CV fellowship.ConclusionsResidents’ matriculation into CV fellowships was associated with declaration of CV career intent, completion of a CV elective rotation, CV medical knowledge, and research publications during residency. These findings may be useful when advising residents about pursuing careers in CV. They may also help residents understand factors associated with a successful match to a CV fellowship. The negative association between matching into CV fellowship and overall ITE score may indicate excessive subspecialty focus during IM residency.
Highlights
The unique traits of residents who matriculate into subspecialty fellowships are poorly understood
Across graduate medical education, due to limited research on matriculation into fellowship programs, factors related to career choice and drivers of entry into subspecialty training remain poorly defined
We found that declaration of intention to pursue a career in CV on the residency application personal statement, choice of a CV elective, percentile score on the CV section of the PGY2 in-training examination (ITE), and publications during residency were positively associated with matching into a CV fellowship
Summary
The unique traits of residents who matriculate into subspecialty fellowships are poorly understood. We sought to identify characteristics of internal medicine (IM) residents who match into cardiovascular (CV) fellowships. Due to limited research on matriculation into fellowship programs, factors related to career choice and drivers of entry into subspecialty training remain poorly defined. Exposures to specific specialties during early training may impact career selection of those specialties [1, 2]. Internal medicine (IM) residents have reported that family and nonwork activities influence their career decisions [3]. A higher rank list position among general surgery residents may determine scholarly productivity and pursuit of an academic career [7]. Limited evidence links internal medicine resident performance, rotation experience, and career intentions with subspecialty fellowship choice
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