The Competitiveness of Obstetrics and Gynecology Fellowships: A 15-Year Assessment [ID: 1380331

Abstract

INTRODUCTION: While subspecialty competitiveness for obstetrics and gynecology fellowships has evolved over the last 15 years, objective competitiveness is poorly understood. This study aimed to assess the competitiveness of obstetrics and gynecology fellowships using the normalized competitive index (NCI). METHODS: Obstetrics and gynecology subspecialty match data for gynecologic oncology (GO), maternal–fetal medicine (MFM), reproductive endocrinology and infertility (REI), and female pelvic medicine and reconstructive surgery (FPMRS) were obtained from the National Resident Matching Program from 2008 to 2022. The competitive index (CI) was determined by the percentage of positions filled divided by the match rate (matched applicants/total). The NCI was determined by the yearly CI divided by the average CI of the particular subspecialty. Statistical analyses included univariate analysis and linear regression. RESULTS: Comparing 2008–2015 versus 2016–2022, fellowship applicants (335.2±27.1 versus 381.4±19.9, P<.01) and positions (225.1±23.6 versus 294.3±22.6, P<.01) significantly increased. Match rate significantly increased for GO, MFM, and FPMRS (0.62±0.05 versus 0.68±0.02, P=.02; 0.67±0.08 versus 0.78±0.08, P=.03; 0.66±0.10 versus 0.79±0.06, P=.01, respectively), but did not change for REI (0.62±0.06 versus 0.69±0.08, P=.06). The NCI decreased for MFM (R2=0.43, P<.01) and FPMRS (R2=0.60, P<.01), from 2008 to 2022 indicating decreased competitiveness. The NCI for REI (R2=0.24, P=.06) and GO (R2=0.09, P=.27) did not significantly change. CONCLUSION: Match rate increased for three of four obstetrics and gynecology subspecialties, but the NCI for MFM and FPMRS decreased, indicating decreased competitiveness in these subspecialties. Therefore, the NCI may be a useful metric, in addition to the match rate, for obstetrics and gynecology subspecialty fellowship applicants to determine program competitiveness.