Objectives: Given recent projections for shortages in rheumatology workforce, we sought to define trends in the number of applicants, training positions, and unfilled training positions for rheumatology training in the United States (US).
Methods: This was a retrospective, cross-sectional study of all applicants for US rheumatology training over the past sixteen years (2009-2024). Data were obtained from the National Resident Matching Program and annual trends analyzed with linear regression.
Results: The annual number of rheumatology programs (99 to 127, 28.3 % increase, P < 0.001), training positions (181 to 276, 52.5 % increase, P < 0.001), and applicants (243 to 359, 47.7 % increase, P < 0.001) increased over the study period. However, the annual applicant-to-training position ratio did not change (1.3 to 1.3, P = 0.489). The annual rate of unfilled training positions decreased (7.2 % to 1.1 %, P < 0.001) and there were no significant changes in the annual match rate (69.1 % to 76.0 %, P = 0.781). The percentage of applicants that matched at their first-choice fellowship decreased (49.4 % to 33.4 %, P = 0.001) while the percentage of applicants that matched at their ≥ fourth-choice fellowship increased (5.8 % to 18.1 %, P < 0.001). There was no clear trend in the rate of unmatched applicants over the study period (29.6 % to 20.1 %, P = 0.316).
Conclusions: US rheumatology training remains competitive as demonstrated by an annual surplus of applicants relative to available training positions. These results suggest an ability to increase the number of US rheumatologists by increasing the number of training positions. Surveillance of future match outcomes remains critical given projected inadequacies in the US rheumatology workforce.
Keywords: Fellowship; Rheumatology; Shortage; Supply; Workforce.
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