Alan W. Grogono, M.D.

This is the seventh in a series of articles on the National Residency Matching Program (NRMP) published annually in the NEWSLETTER since 1993 (August 1993, May 1994, June 1995, May 1996, May 1997 and May 1998). The article last year reported an increase in recruitment into anesthesiology, particularly by graduates of U.S. medical schools.

This year, from U.S. allopathic medical schools, 425 graduating seniors entered anesthesiology, an increase of 10 percent compared to 1998 [Figure 1]. The number of these students entering at the PGY1 level rose from 118 to 137 (16-percent increase), and the number entering at the CA1 level rose from 270 to 288 (7-percent increase). When recruits from other sources are included, the total number rose from 645 to 656 - less than a 2-percent increase. Therefore, there has been a moderate increase in the number of U.S. graduates recruited and a decline in the number of other recruits.

Results of the Match for Anesthesiology 1990 - 1999. "Students" are graduating seniors from U.S. allopathic medical schools. "All" includes these students plus non-U.S. citizen international medical graduates, osteopathic medical school graduates and U.S. citizen international medical graduates. "Available" represents the number of positions offered via the Match. "Unfilled" represents the difference between "Available" and "All."

Recruitment of Graduating U.S. Seniors, 1990 - 1999. For each year, the right hand column represents the sum of the left (PG1) and center (CA1).

U.S. Graduates Matching into Anesthesiology. For each year, the first column represents the PG1 positions; the second column the CA1 positions, and the third column the sum of the PG1 and CA1 columns. The lower (dark) section of each bar represents the number of graduating U.S. seniors from allopathic medical schools. The middle (pale) section represents the additional candidates from other sources, predominantly international medical graduates (see Table 2). The total number of positions available is indicated by the top of the white column.

The number of positions offered through the Match remains well below the all-time high of 1,386 in 1993 [Figure 2]. The 4-percent rise in the number of positions offered this year has raised the number of positions unfilled from 363 to 391, still well below the peak of 622 in 1996.

This year, the further rise in the number of U.S. graduates (388 to 425) is accompanied by an even greater reduction in the number of international medical graduates (201 to 152). Although the numbers are still fairly small, the number of recruits from osteopathic medical schools has roughly doubled for the second year in succession (from 7 to 17 to 35). In addition, the number of U.S. citizen international medical graduates has also risen over the same period (from 22 to 34 to 41). The number of Canadian graduates, having risen to two last year has declined back to zero again.

Using the same measure as last year, the relative percentages recruited from the available pools shows that anesthesiology appears to be attracting the highest percentage of recruits from graduates of U.S. medical and osteopathic medical schools. In these two categories, we recruit above our average of 2.54 percent of those available via the Match.

Distribution of People in the Match 1997, 1998 and 1999. Recruitment into anesthesiology (Anes) compared to the total number of candidates in the Match in that category (All).

This year, for the third time, the data has also been compiled by state and ranked by the number recruited via the Match for each state. This year, the two largest totals were California (87) and New York (61), which accounted for 23 percent of all candidates. The next three states recruited were Massachusetts (54), Texas (40) and Pennsylvania (35). These top five states recruited a total of 277 recruits (42 percent). The most notable change at the top of this table in the last two years is that Massachusetts has increased in popularity while Florida has declined.

Positions Available and Matched in Each State for 1998 and 1999. Ranked by number matched. 23 percent of the candidates went to the top two states, 42 percent to the top five and 62 percent to the top 10.

Key:TA = Total positions available; TM = Total positions matched.

After a stormy six years, it is reassuring to be sailing in calmer water. The level of recruitment does not always please everybody. When there are sufficient applicants to fill most of the available residency positions, we produce more graduates than we probably need. If the number falls to the level where jobs are readily available, some areas and departments find it difficult to recruit qualified applicants. Our medical students' faith in the future of the specialty is expressed by the numbers entering the specialty. They have managed to get it about right in the past. They are probably doing so now.

More detailed information about the numbers of students recruited into anesthesiology from each school and the numbers recruited into each residency program is available at <www.grogono.com/nrmp>.

It is a pleasure to thank John Woods of the NRMP for sending the data to me by e-mail. His making it available so promptly permits the rapid production of this article.

Alan W. Grogono, M.D., recently retired, is the former Chair and Meryl and Sam Israel Professor, Department of Anesthesiology, Tulane University School of Medicine, New Orleans, Louisiana.

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