he major change this year is a significant increase in the number of residents in the CA-1 year. Other changes are less remarkable and show no unanticipated changes from last year. Accordingly, fewer tables and graphs accompany this year’s report.

Data Reporting: As in last year’s article, a resident’s postgraduate year (PGY) status is based on the number of months of training credited by the American Board of Anesthesiology (ABA). The more familiar terminology, however, is employed so that, for example, clinical anesthesiology year one (CA-1) is used instead of PGY-2.

Anesthesiology Residents in Training [Table 1]: This year the number of residents in the critical CA-1 year increased by 9.2 percent, from 1,439 to 1,572 making it the largest CA-1 group since 1994. The total remains smaller, however, than the peak of 1,904 recorded in 1992.

Table 1

The numbers graduating and in each year of anesthesiology residencies, 1985-05.

Figure 1

Graph showing the total number of medical graduates in anesthesiology residencies, 1960-05.

The size of the PGY-1 year (514), although of lesser significance than the CA-1 year, represents a comparable increase. This increase, however, merely returned the size of the PGY-1 year to the 2003 level, and also to the average for the last 10 years.

Anesthesiology Residents Graduating and Resident Annual Totals [Tables 1 and 2 and Figure 1]: Almost exactly the same number graduated this year (1,390) as did last year (1,393). This is close to the average for the last 17 years (1,402) but below the peak of 1,814 graduating in 1995. The number of residents potentially available to graduate in the next three years, without attrition, are 1,513, 1,557 and 1,572.

Attrition From Residencies [Table 1 and Figure 2]: The size of the CA-1 group in a given year, e.g., 2002, is compared to the value for the same cohort in 2005, i.e., the graduating group. In addition to attrition, however, the actual composition of this group also is affected by other factors, e.g., ill health, childbirth, relocation and being held back for additional training. For these reasons, the actual numerical values must be interpreted with caution. The data are presented here to show trends and comparisons between years.

Table 2

The number of medical graduates in anesthesiology residency programs, 1960-05.

Figure 2

Attrition from residencies. Each year plots the number starting in the CA-1 cohort for that year (CA-1) and the size of the same cohort three years later (Grad).

For a given year, e.g., 1995, one point shows the size of the CA-1 group for that year and another, just below it, shows the size of that cohort graduating, e.g., in 1998. In the early years, the number graduating three years later was close to the number in the CA-1 group. In the mid 1990s, the graphs diverged as fewer residents graduated than had started the training. This change occurred during a period of anxiety about employment opportunities; residents were leaving anesthesiology, and the attrition was largely voluntary. This loss was followed by a decline in the number of applicants, and this in turn was followed by a period of vigorous recruitment. The loss of residents continued, however, and appears to have been caused by compulsory attrition. Today the rate of attrition has declined but not yet to the levels of the late 1980s cohorts.

Gender [Table 3]: ABA has now collected data about the gender distribution in anesthesiology residencies for five consecutive years. For the first four years, the percentage of women being trained hovered around 27 percent with no evident trend. This year, however, the percentage of women in the PGY-1 year has risen to 33 percent and in the CA-1 year to 32 percent.

Table 3

The percentage of women in anesthesiology residency programs by year, 2000-05.

Discussion: This year the number of residency positions filled via the National Resident Matching Program rose to 1,230, the largest number ever recorded. This occurred despite a reduction in the number of places offered via the Match. This growth via the Match in March has now been followed by an additional growth in the size of the CA-1 year. For the five years, 2000 to 2004, the size of the CA-1 group changed relatively slightly and averaged 1,465. This year there were 1,572 residents in the CA-1 year, a jump of 133 and 107 (7.3 percent) above the average. The number of women entering the specialty (32 percent of the CA-1 year) appears to be rising, although it is still below the percentage of women entering medicine.
Attrition during the residency has changed little from last year and remains around 5 percent for the duration of the residency. This is only slightly above the low levels enjoyed 15 years ago.

Conclusion: The increase in the size of the CA-1 year is in contrast to recent years and would appear to be significant. It will be several years, however, before this increase can appreciably affect the size of the workforce. With a growing population and the continuing shortage of anesthesiologists, this is a welcome trend, as is the increase in the number of women selecting anesthesiology.

Nurse Anesthetist Data: From 2001 to 2004, this report included data about the number of nurse anesthetists graduating, being certified and working. This year the data have not been made available because they are derived from survey data, and the data are regarded as proprietary by the American Association of Nurse Anesthetists.

Acknowledgment: As usual it is a pleasure to thank Francis P. Hughes, Ph.D., of the American Board of Anesthesiology. His efficient help makes it possible to produce this report promptly.

Web Site: To see previous articles, additional data about the workforce and the results of the National Resident Matching Program, readers are invited to visit <www.grogono.com/nrmp>.

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.