Paradigm Shift in Vascular Surgery Training: Independent versus Integrated Match Outcomes

Abstract

Currently, 2 predominant pathways exist for vascular surgery training: integrated and independent training pathways. We hypothesized that match rates would increase with time and be higher in the independent pathway than in the integrated pathway. The National Resident Matching Program provided data from the Vascular Surgery Match (VSM) (2008-2021). Match rates were defined as the percentage of applicants who matched. Chi-squared tests were used to evaluate temporal trends and interpathway differences. Over the study period, the annual number of training positions increased for both the independent (119 to 129, 8% increase) and integrated (9 to 79, 778% increase) training pathways. From 2008 to 2021, the annual match rate was stable in the independent pathway (97% to 96%, P>0.05). In the integrated pathway, the annual match rate increased from 29% to 44% (P<0.001). During each year, match rates in the independent pathway exceeded those in the integrated pathway (P<0.001). US allopathic graduates had higher match rates than non-US allopathic graduates in both the independent (92% vs. 82%, P<0.001) and the integrated pathway (70% vs. 17%, P<0.001). In the independent pathway, the percentage of applicants that matched at 1 of their top 3 choices decreased from 67% to 58% (P<0.001). Over the study period, more training positions went unmatched in the Independent (n=130, 8%) versus the Integrated (n=17, 3%) pathway (P<0.001). VSM match rates have increased for the integrated pathway and remains competitive especially for non-US allopathic graduates. More research is needed to understand applicant variables that modulate match rates.