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May 2005
Volume 69 |
Number 5 |
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National
Resident Matching Program Results for 2005:
Slight Increase in Recruitment
Alan
W. Grogono, M.D. |
| The 13th annual report about the anesthesiology
results of the National Resident Matching Program
(NRMP) shows a slight increase in recruitment
since last year despite a reduction in the number
of positions available. This increase was principally
due to the recruitment of graduating U.S. medical
school seniors. A significantly greater number
of programs (83 percent) filled every position
that they offered via the Match. |
 RMP
Results [Table 1 and Figure 1]: This year a
total of 1,230 were recruited via the Match, an increase
in recruitment of 2.5 percent. This is the greatest
total recruited into anesthesiology via the Match and
exceeds the 2003 peak by 19 and the 1992 peak by 205
(20 percent). The number of graduating U.S. allopathic
seniors matching into anesthesiology has changed little
in the last four years [Figure 2]. This year 6.22 percent
of the 14,719 U.S. senior students in the Match selected
anesthesiology [Table 2]. From 1996-04, the number of
non-U.S. allopathic seniors matching into anesthesiology
increased from 156 to 303. Continuing this trend, the
number rose again this year to 314, principally attributable
to 10 more international medical graduate (IMG)/non-U.S.
graduates, five more IMG/U.S. graduates and five more
sponsored graduates but offset by nine fewer osteopathic
graduates [Table 3].
Positions offered and unfilled: After nine
years of almost uninterrupted increases, this year the
total number of positions offered via the Match fell
by six to 1,283 (0.5-percent decrease). The number of
unfilled positions decreased by 68 percent from 89 to
53, equaling the number recorded in 2003, the fewest
unfilled positions recorded since the residency was
lengthened to three years [Figure 4].
Distribution of recruits [Table 3]: For six
years in a row, behind only U.S. allopathic graduates,
the osteopathic graduates have made the greatest contribution
to the anesthesiology Match; this year’s total
of 124 is nine fewer but close to the total for the
previous two years. Among the other non-U.S. allopathic
groups, the principal changes are that the number of
IMG/non-U.S. graduates rose to 83; the number of IMG/U.S.
graduates rose to 58; and the number of sponsored graduates
continues to rise and has now reached 45 [Figure 5].
Regional Distribution [Table 4]: The NRMP data
have again been compiled by state and ranked by the
number recruited into each state’s residencies
via the Match. For seven years now, the top six positions
have been occupied by the same six states (California,
Illinois, Massachusetts, New York, Pennsylvania and
Texas); and for the last three years, the numbers each
of these has recruited have changed little. Between
them the top two states recruited 293 (24 percent),
the top five states recruited 540 (44 percent) and the
top 10 recruited 784 (64 percent).
This year, for the first time, the numbers recruited
into each state’s residency programs have been
compared to the state’s population based on the
2000 census [Table 5]. The number matched in each state
is compared to that state’s population in millions.
For the states with applicants matching into anesthesiology,
the average per state is 30 matched with an average
population of 6.63 million (4.67 matched per million)
with a correlation coefficient of 0.83. The number matched
per million ranged from a high of 20.98 for the District
of Columbia to a low of 1.11 for West Virginia. Of the
six states consistently recruiting the most residents,
four recruited more than the average per million: Massachusetts,
14.02; New York, 9.06; Pennsylvania, 6.43; and Illinois,
5.23. Two recruit fewer than the average: Texas, 3.79;
and California, 3.57.
Unfilled Positions Compared to Number Matched:
The 124 residency programs were ranked by number matched
into each program and then grouped in quartiles of 31
programs [Table 6]. The programs in the first quartile
matched all 555 available positions with none remaining
unfilled. In the second quartile, 10 out of 368 positions
were unfilled (2.7 percent). In the third quartile,
eight out of 228 were unfilled (3.5 percent). In the
fourth, 35 out of 132 were unfilled (26.5 percent).
Comment: For the last three years,
the number of residents recruited into anesthesiology
via the Match has effectively reached a plateau with
no appreciable change in the overall number recruited.
Last year the number of allopathic U.S. seniors recruited
fell by 30. It has been followed this year with an increase
of 19. The average for the last four years is 911, and
the variation around this average is not significant.
Like any other specialty, recruitment into anesthesiology
will, inevitably, lack uniformity. Some programs, climates
or localities attract more candidates than others. Previous
articles have emphasized this lack of uniformity by
comparing the states to each other. This year the numbers
matched also have been compared to the population of
each state. This comparison reveals another variation
on the nonuniformity of the distribution. The District
of Columbia recruits 20.98 residents per million population,
nearly five times the average. This is put into perspective
by realizing that, in reality, this striking excess
represents only about nine additional residents. The
next two states are larger and, therefore, more critical:
Massachusetts recruited just over 14 residents per million
and New York just over nine per million. To reach the
average, these two states would, between them, have
to shed about 143 residents (59 for Massachusetts and
84 for New York).
By contrast, 10 states offer no residency positions
in anesthesiology, and a significant number of the smaller
programs have unfilled positions. These areas of the
country have to attract residents when they graduate
and persuade them to relocate after completing their
training. In theory it is desirable to distribute educational
programs to roughly match the population. In practice,
however, such uniformity is unattainable. We should
probably be grateful that the distribution is as uniform
as it is and that the Match works as well as it does.
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 the ASA NEWSLETTER in August 1993, May 1994,
June 1995, May 1996, 1997, 1998, 1999, 2000, 2001, 2002,
2003 and 2004.
Table 1 (click
to enlarge) |
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Figure 1:
Total Recruitment Into Anesthesiology via the
NRMP During the Years 1990-05 |
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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 1990-05 |
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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
1990-05 |
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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 During 1990-05 |
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Available positions
offered via the Match in 2005 fell by
six to 1,283. |
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Table
2 |
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The number of U.S. allopathic
medical students matching into anesthesiology
compared to the total number in the NRMP
for each year. |
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Table 3
(click to enlarge) |
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This table shows the distribution
into anesthesiology residencies from various
sources during the last 10 years. This
year the most significant changes were
increases in the numbers of U.S. allopathic
students, IMG/non-U.S. graduates, IMG/U.S.
graduates and sponsored graduates entering
anesthesiology. |
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Table 4 (click
to enlarge) |
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Table 5
(click to enlarge) |
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Table 6
(click to enlarge) |
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Match results for residency programs compiled by quartile based on numbers
matched into each program. |
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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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