| |
May 1996
Volume 60 |
Number 5
|
| |
|
| National Residency
Matching Program (NRMP): Results for Anesthesiology, 1996 |
Alan W. Grogono, M.D.
NRMP Results for Medical Schools (Table 1)
Declining recruitment via the National Residency Matching Program
(NRMP) has been reviewed in a series of articles in the ASA
NEWSLETTER over the last three years.1-3 The results for 1996
show a continuation of this decline [Figure 1, page 25]. For many
years, the principal source of recruitment into our specialty
has been graduating seniors from U.S. medical schools. Recently,
there has been a steady decline in the number of graduating seniors
recruited into anesthesiology from the high of 945 (6.78 percent)
in 1991 to the low this year of 169 students out of the total
of 14,543 in the match (1.16 percent). This represents 40 percent
of the number of U.S. seniors recruited in 1995.
NRMP Results for Residency Programs (Table 2)
Total graduates recruited via the match into anesthesiology fell
by another 211 this year to 325 [Figure 2, page 25]. The number
of residency positions that training programs offered was reduced
by 197 to 946 this year. This reduction was not proportional to
the fall in the number of applicants and, as a result, the number
of positions matched fell to 34.3 percent.
NRMP Results for Applicants (Tables 3 and 4)
The preference expressed by NRMP applicants is reflected in the
ranking that they provided. In 1996, there were 183 U.S. graduates
who ranked anesthesiology as either their first choice or as an
alternative; 174 ranked anesthesiology as their first choice,
and a total of 169 matched. The comparable figures one year ago
were: 454 ranked anesthesiology, with 432 making it their first
choice and 423 actually matching. Although there is an overall
reduction in applicants, the proportions are similar.
International Medical Graduates
(Tables 3, 4 and 5)
The number of international medical graduates ranking anesthesiology
as their first choice rose from 114 in 1995 to 175 in 1996. This
is now the largest group ranking anesthesiology as their first
choice. Actually recruited through the match, however, American
graduates (169) still predominate over all the other groups combined
(156), which is composed of international medical graduates (141),
osteopaths (14) and Canadians (1).
As in recent years, it is almost certain that the final number
as well as the distribution of residents will be influenced most
by the recruitment that occurs outside the match. If recent trends
continue, the proportion of international medical graduates in
residency programs will rise further this year.
Trends in Programs (Table 6)
Voluntary reduction in recruitment via the match is now evident.
The number of positions offered (946) is 68 percent of the peak
(1,386) offered in 1993. In addition, there has been a critical
reduction in the number of positions offered in programs matching
completely. In 1994, 40 programs that completely matched absorbed
394 (47 percent) of the applicants. In 1995, 18 programs absorbed
178 (33 percent), and in 1996, 15 absorbed 93 (28 percent).
Because so few programs filled completely, candidates had a greater
chance of obtaining a position in their program of choice. Alone,
the data would also appear to suggest that diminishing recruitment
distributes applicants more uniformly. However, closer examination
shows the reverse [Table 7, page 24]; only 19 programs (those
who this year took six candidates or more) absorbed more than
half (52 percent) of the matched applicants, which is a greater
proportion than in recent years (in 1995, the top 19 took 44 percent;
in 1994, 37 percent). Therefore, it appears that a decline in
the number of applicants promotes uneven distribution of new residents
in favor of the larger programs.
The number of programs recruiting no applicants through the match
has risen from 19 in 1994, to 36 in 1995 and to 44 this year.
The number of positions sought via the match by these unfilled
programs rose during these three years from 82 to 210.
Comment
The dilemma posed by declining opportunities for anesthesiologists
and the implications for current graduating residents have generated
both concern and discussion. This discussion has effectively operated
to discourage recruitment at the resident level and probably explains
the trends reported here. Reduction was regarded as desirable
in the light of the reduced need for our services anticipated
in the Abt Associates Inc. report, "Estimation of Work Force
Requirements in Anesthesiology." The magnitude of this reduction,
however, and its implications demand careful evaluation.
The forces that discouraged students from entering the specialty
have almost certainly also discouraged potential future leaders
and researchers from joining us. As an army, we appear to have
adopted the remarkable strategy of preparing for future battles
by promoting a decline in numbers, and thus, a fall in strength.
If we fail to address the current trickle of American medical
graduates entering our specialty, a future shortage of strong
U.S. leaders at every level appears to be inevitable. We are going
to face stiff competition regardless of our strategies; stifling
recruitment will not eliminate our competitors. Continuing success
for anesthesiology and patient care demands that we always recruit
and that we recruit the best graduates.
References:
1. Grogono AW. Medical student recruitment: Match results for
anesthesiology, 1990-93. ASA NEWSLETTER. 1993; 57(8):35-38.
2. Grogono AW. Medical student recruitment: Match results for
anesthesiology, 1990-94. ASA NEWSLETTER. 1994; 58(5):25-27.
3. Grogono AW. Recruitment, residency size and match results for
anesthesiology, 1995. ASA NEWSLETTER. 1995; 59(6):24-27.
return to top
|