SS18. Is Vascular Surgery Residency Becoming Less Competitive?

Abstract

A shortage of vascular surgeons is expected in the near future, and we have emphasized the need to train more graduates to keep up with this demand. During the past decade, we have seen the initiation and maturation of the 0 + 5 integrated vascular surgical training pathway. It is well documented that the 0 + 5 pathway was highly competitive in the first few years after conception. However, it was unknown whether medical student interest would keep pace with the addition of residency positions and whether the specialty would remain competitive. We sought to evaluate trends in applications to the integrated vascular surgery residency program. A review of publicly available National Resident Matching Program data from 2008 to 2018 was performed. From 2008 to 2018, there was a 566.7% increase in the total number of 0 + 5 vascular residency positions (from 9 to 60). The total number of programs increased 642.9% (from 7 to 52). During the same period, the number of total applicants increased by only 193.5% (from 31 to 91), with U.S. graduating applicants increasing by only 190.5% (from 21 to 61). The number of applicants per position dropped −55.8% during this time (3.44 to 1.52). The number of U.S. graduating applicants per position also dropped by −56.2% (2.33 to 1.02; Fig). The total number of applicants has stagnated since 2015 and has actually dropped during the past 3 years. Compared with other specialties participating in the 2018 National Resident Matching Program match, the number of U.S. graduating applicants per position in vascular surgery was similar to that of general surgery (Table). Whereas we have worked to increase the number of available training positions, we have not successfully increased the number of applicants at the same rate. As a result, the integrated vascular surgery residency has become less competitive, with a trend toward fewer applicants per position in the past decade. Possible causes need further investigation but may include medical student perceptions of our field’s being associated with high rates of burnout, stress, and long work hours. Institutional and societal strategies to increase medical student exposure, mentorship, and interest in vascular surgery are needed for our specialty to attract more medical students to our field.Table2018 National Resident Matching Program match dataSpecialtyNo. of U.S. graduate applicants per positionDermatology7.56Interventional radiology6.20Diagnostic radiology5.06Physical medicine and rehabilitation2.04Thoracic surgery2.00Orthopedic surgery1.14Plastic surgery1.10Neurosurgery1.07General surgery1.02Vascular surgery1.02Otolaryngology0.95Anesthesia0.94Obstetrics-gynecology0.92Neurology0.91Emergency medicine0.81Psychiatry0.79Pediatrics0.70Family medicine0.54Internal medicine0.50Pathology0.39 Open table in a new tab