The 12th annual report about the anesthesiology results
of the National Resident Matching Program (NRMP) shows
the first decline in recruitment since 1999. This overall
decline was partially offset by an increase in the recruitment
of non-U.S. international medical graduates (IMGs).
This year fewer programs (only 72 percent compared to
81 percent in 2003) filled every position that they
offered via the NRMP.
Table 1 (click
to enlarge) |
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NRMP Results [Table 1] This year a total of
1,200 were recruited via the NRMP [Figure 1], a decline
in recruitment of 0.9 percent. This total is still well
above the 1992 peak of 1,025. This year’s slight
decline contrasts with the increases of recent years:
9 percent last year, 14 percent in 2002, 21 percent
in 2001 and 22 percent in 2000. The number of graduating
U.S. allopathic seniors matching into anesthesiology
decreased, however, from 927 to 897, a 3.2-percent decrease
[Figure 2]. This is 40 fewer than the 937 recruited
in 1990 and 1991 and represents 6.14 percent of the
14,609 U.S. senior students in the NRMP [Table 2], appreciably
less than the record of 6.7 percent that occurred in
1991.
Table
2 |
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The number of U.S. allopathic
medical students (Students) matching into
anesthesiology compared to the total number
in the NRMP for each year. |
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During the years 1996-03, the total number matching
in all the other categories (non-U.S. allopathic seniors)
increased from 156 to 284. This year the number rose
to 303, mostly attributable to the increase of 20 in
the number of IMG/non-U.S. graduates [Table 3].
Positions Offered and Unfilled
This year there was only a 2-percent increase in the
total number of positions offered via the NRMP (8-percent
increase last year and 6-percent increase the year before).
The total offered, 1,289, is 7 percent below the 1993
peak of 1,386. The number of unfilled positions increased
from 53 to 89 (68-percent increase), the first increase
since 1996 [Figure 4].
Figure 1:
Total Recruitment Into Anesthesiology via the
NRMP During the Years 1990-04 |
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The three columns
represent the numbers recruited into the
PG-1 year, the CA-1 year and the total. |
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Figure 2:
Graduating U.S. Seniors Recruited Into Anesthesiology
During the Years 1990-04 |
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The three columns
represent the numbers recruited into the
PG-1 year, the CA-1 year and the total. |
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Figure 3:
Recruits Other Than U.S. Allopathic Seniors
Matching Into Anesthesiology During the Years
1990-04 |
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The three columns
represent the numbers recruited into the
PG-1 year, the CA-1 year and the total. |
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Figure 4:
Number of Places Available Versus Total Number
Recruited (All) During 1990-04 |
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Available positions
in 2004 (1,289) is only 7 percent below
the 1993 peak of 1,386. |
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Distribution of Recruits [Table 3]
Distribution of Recruits [Table 3] For five years now,
second to U.S. allopathic graduates, osteopathic graduates
have made the greatest contribution to the anesthesiology
match; this year’s total of 133 is similar to
last year’s total of 126. Among the other non-U.S.
allopathic groups [Figure 5], the principal changes
are that the number of IMG/non-U.S. graduates increased
by 20 to 73, and the number of IMG/U.S. graduates decreased
by 11 to 53.
Table 3
(click to enlarge) |
|
This table shows the distribution
into anesthesiology residencies from various
sources during the last nine years. This
year the most significant changes were
a reduction in the number of U.S. allopathic
students and an increase in the number
of IMG/non-U.S. graduates entering anesthesiology. |
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Figure 5 |
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This graph is based on the larger
categories in Table 2. There is a slight
decline in recruitment from U.S. allopathic
medical schools and a slight increase
in IMG/Non-U.S. graduates. |
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Regional Distribution [Table 4]
The NRMP data for the last five years has again been
compiled by state and ranked by the number recruited
into each state’s residencies via the NRMP. For
five years now, New York and California have occupied
the two top positions, recruiting this year 162 (15
fewer) and 118 (4 fewer), respectively. These two states
recruited 23 percent of the total this year, down from
25 percent last year. Of the next three states, Massachusetts
recruited 89 (an increase of 9), Texas 81 (an increase
of 1) and Illinois 73 (an increase of 5). Between them,
the top five states recruited 523 (44 percent), and
the top 10 recruited 765 (64 percent).
In most of the other states, there was little or no
change in the number recruited this year. In the District
of Columbia, however, the number recruited fell by seven
(50-percent reduction), and in Washington state, the
number also fell by seven (30-percent reduction). This
year only 55 percent of the states filled every position
that was offered in anesthesiology via the NRMP compared
to 64 percent last year.
Table 4 (click
to enlarge) |
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Comment
Last year recruitment to anesthesiology via the NRMP
already appeared to be leveling off. This year there
has actually been a slight reduction, primarily associated
with the recruitment of fewer allopathic U.S. seniors.
This year’s decline was partially offset by
matching 20 more IMG/non-U.S. graduates. Despite this,
89 positions remained unfilled this year (an increase
of 36). Some of these unfilled vacancies can be explained
by the growth in the number of positions available
from 1,264 to 1,289.
In the last year or two, recruitment via the NRMP
has produced the majority of the recruits into anesthesiology.
If recent trends continue, for every four people recruited
via the NRMP, an additional one will be recruited
by the time the statistics are compiled about the
composition of the critical CA-1 year. Although the
NRMP data indicate that recruitment appears to be
slightly weaker this year, the final number recruited
will probably be unaffected. The decline serves, nevertheless,
to remind us that there is no cause for complacency.
We must maintain our efforts to ensure that we attract
excellent U.S. allopathic students into anesthesiology.
Web Site
This article, previous articles and additional information
about the numbers of students recruited into anesthesiology
from each school and the numbers recruited into, and
graduating from, each residency program are available
at <www.grogono.com/nrmp>.
Acknowledgments
This article was prepared primarily for publication
in the ASA NEWSLETTER, and I thank the editor,
Douglas R. Bacon, M.D., for his agreeing that it may
be simultaneously made available on the Web site.
I thank Mona Signer of the NRMP whose prompt response
permits the rapid production of this article.
Dr. Grogono’s past NRMP articles have appeared
in August 1993, May 1994, June 1995, May 1996, May
1997, May 1998, May 1999, May 2000, May 2001, May
2002 and May 2003 issues of the ASA NEWSLETTER.
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Alan
W. Grogono, M.D., now retired, is former Chair
and Meryl and Sam Israel Professor, Department
of Anesthesiology, Tulane University School of
Medicine, New Orleans, Louisiana. |
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