Charting Outcomes in the Hand Surgery Fellowship Match

Abstract

The hand surgery fellowship match attracts applicants from general, plastic, and orthopedic surgery residency training. The purpose of this study was to understand recent trends in applications and match rates in the hand surgery fellowship match. The National Resident Matching Program provided program and applicant data from the hand surgery fellowship match (2012-2020). The primary outcomes of interest were match rates and number of unfilled fellowship positions by specialty. Trends over time and comparisons of the percentage of unfilled spots by specialty were observed. The total number of applicants decreased from 199 to 188 (5.5% decrease), while the number of available positions increased from 150 to 177 (18.0% increase) during the study period. The increase in available positions was driven primarily by orthopedic fellowships, which increased from 124 to 149 (20.2% increase). The percentage of applicants that did not match to a hand surgery fellowship decreased from 24.6% in 2012 to 5.9% in 2020. United States graduates had higher match rates than non-United States graduates during each year, but this disparity narrowed over time. Most applicants matched at one of their top 3 choices (first choice, 33.3%; second choice, 12.9%; third choice, 7.9%). Applicants matching at their first choice increased from 28.1% in 2012 to 39.4% in 2020. Plastic surgery hand surgery fellowships had a higher rate of unmatched positions relative to orthopedic surgery fellowships (6.1% vs 2.2%). Match rates in the hand surgery fellowship match have increased because of an overall increase in training positions and decrease in applicants. More research is needed to understand disparities in match rates by specialty. The diverse training experiences of hand surgeons historically have been viewed as a strength for the specialty. Understanding recent trends in the hand surgery fellowship match by specialty can help future applicants and faculty anticipate likely match outcomes.