Schanzer Andres, Nahmias Jeff, Korenda Kathleen, Eslami Mohammad, Arous Elias, Messina Louis
University of Massachusetts Medical School, Worcester, Mass, USA.
J Vasc Surg. 2009 Dec;50(6):1513-8; discussion 1518. doi: 10.1016/j.jvs.2009.07.061.
The integrated vascular surgery residency training paradigm ("0 + 5") was first approved by the Accreditation Council for Graduate Medical Education (ACGME) in 2006, with the first residents beginning in 2007. We sought to evaluate the demand for these new positions and to better understand applicant pool demographics.
The Association of American Medical Colleges (AAMC) was petitioned for data on applicants to traditional vascular surgery fellowship and integrated vascular residency training programs (years 2006-2009). In addition, 111 applications received at a single academic institution for the year 2009 were reviewed in depth.
The number of traditional vascular fellowship applicants and the corresponding number of positions remained stable. In contrast, the number of integrated vascular resident applicants increased dramatically, with 152 applicants seeking to match into 19 available positions in 2009. For the year 2009, 88% of integrated vascular residency applicants did not match, while 16% of traditional fellowship positions went unfilled. The most notable difference between integrated residency and traditional fellowship applicants is the number of foreign medical graduates (68.7% vs. 26.7% in 2008, P < .001). Of the 111 integrated applicants applying for our single position (73% of entire 2009 applicant pool), the majority of applicants were residing in the United States (88.3%) and a sizable proportion (25.2%) had completed at least one full year of either surgical training or surgical research at an institution in the Unites States. Objective measures of academic success included mean United States Medical Licensing Examination (USMLE) Step 1 and Step 2 scores of 89.1 and 89.5, respectively. The mean number of peer-reviewed journal publications at the time of application was 2.8.
The number of integrated vascular surgery residency applicants far outweighs the number of available positions. Growing interest in more efficient and comprehensive vascular surgery training will continue to augment demand. As educators, vascular surgeons should seize this opportunity and aggressively expand the number of available integrated residency training positions.
血管外科住院医师整合培训模式（“0+5”）于2006年首次获得毕业后医学教育认证委员会（ACGME）批准，首批住院医师于2007年开始培训。我们旨在评估对这些新职位的需求，并更好地了解申请人的人口统计学特征。
向美国医学院协会（AAMC）申请获取传统血管外科进修项目和血管外科住院医师整合培训项目（2006 - 2009年）申请人的数据。此外，对2009年在一个学术机构收到的111份申请进行了深入审查。
传统血管外科进修项目的申请人数量和相应职位数量保持稳定。相比之下，血管外科住院医师整合培训项目的申请人数量急剧增加，2009年有152名申请人竞争19个可用职位。2009年，88%的血管外科住院医师整合培训项目申请人未成功匹配，而16%的传统进修项目职位无人填补。血管外科住院医师整合培训项目申请人与传统进修项目申请人之间最显著的差异在于外国医学毕业生的数量（2008年分别为68.7%和26.7%，P < 0.001）。在申请我们单一职位的111名血管外科住院医师整合培训项目申请人中（占2009年全部申请人的73%），大多数申请人居住在美国（88.3%），相当一部分（25.2%）在美国的机构完成了至少一整年的外科培训或外科研究。学术成就的客观指标包括美国医师执照考试（USMLE）第一步和第二步的平均成绩，分别为89.1分和89.5分。申请时同行评审期刊发表文章的平均数量为2.8篇。
血管外科住院医师整合培训项目的申请人数量远远超过可用职位数量。对更高效、全面的血管外科培训的兴趣不断增加，将持续增加需求。作为教育工作者，血管外科医生应抓住这一机遇，积极增加可用的住院医师整合培训职位数量。
