Division of Vascular and Endovascular Surgery, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Mass.
Division of Vascular and Endovascular Surgery, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Mass.
J Vasc Surg. 2018 May;67(5):1618-1625. doi: 10.1016/j.jvs.2017.12.031. Epub 2018 Mar 1.
The demand for vascular surgeons is expected to far exceed the current supply. In an attempt to decrease the training duration and to address the impending shortage, integrated vascular surgery residencies were approved and have expanded nationally. Meanwhile, vascular fellowships have continued to matriculate approximately 120 trainees annually. We sought to evaluate the supply and demand for integrated vascular residency positions as well as changes in the quality of applicants.
We conducted a retrospective review of national data compiled by the Association of American Medical Colleges and the National Resident Matching Program regarding integrated vascular surgery residency programs (2008-2015) and fellowships (2007-2016). Variables reviewed included the total number of applicants, sex, U.S. vs international medical school enrollment, applications per program, and applicants per position. In addition, we conducted a retrospective review of applicants to the University of Massachusetts Medical School integrated vascular surgery residency program from 2008 to 2015 to examine these variables and United States Medical Licensing Examination Step 1 and Step 2 CK scores over time.
The number of vascular surgery integrated residency positions increased from 4 in 2008 to 56 in 2015. Concurrently, the number of integrated residency applicants grew from 112 in 2008 to 434 in 2015. This increase has been predominantly driven by a 575% increase in U.S. graduate applicants and a 170% increase in women applicants. The percentage of international medical graduates has decreased by 17% during the study period. The total number of applicants per residency position increased from 5.9 to 7.8. Meanwhile, the number of vascular surgery fellowship positions remained stable with an applicant to position ratio near 1:1. At the University of Massachusetts Medical School, the mean United States Medical Licensing Examination Step 1 (226 to 235) and Step 2 CK (237 to 243) scores among integrated residency applicants have improved annually and typically exceed the national average among U.S. applicants who have matched in their preferred specialty.
Since the approval of a primary certificate in vascular surgery and the subsequent rollout of integrated vascular residency programs, the number of residency programs and the quality of residency applicants have continued to increase. Demand from medical school applicants vastly outweighs the current supply of training positions by eightfold. In contrast, demand from fellowship applicants matches the supply of fellowship positions. The matriculation of additional trainees must be met with continued expansion of the integrated vascular surgery residency pathway to manage future public health needs.
预计对血管外科医生的需求将远远超过目前的供应。为了缩短培训时间并解决即将出现的短缺问题，已批准并在全国范围内扩大了综合血管外科住院医师培训计划。与此同时，血管外科研究员继续每年招收约 120 名学员。我们试图评估综合血管住院医师职位的供需情况以及申请人素质的变化。
我们对美国医学协会和全国住院医师匹配计划汇编的有关综合血管外科住院医师培训计划（2008-2015 年）和研究员计划（2007-2016 年）的全国数据进行了回顾性分析。审查的变量包括申请人总数、性别、美国与国际医学院入学情况、每个计划的申请人数以及每个职位的申请人人数。此外，我们还对 2008 年至 2015 年马萨诸塞大学医学院综合血管外科住院医师培训计划的申请人进行了回顾性审查，以研究这些变量以及美国医师执照考试第 1 步和第 2 步 CK 分数随时间的变化情况。
血管外科综合住院医师培训职位从 2008 年的 4 个增加到 2015 年的 56 个。同时，综合住院医师培训计划的申请人人数从 2008 年的 112 人增加到 2015 年的 434 人。这种增长主要是由于美国毕业生申请人增加了 575％，女性申请人增加了 170％。在研究期间，国际医学毕业生的比例下降了 17％。每个住院医师职位的申请人总数从 5.9 增加到 7.8。与此同时，血管外科研究员职位数量保持稳定，申请与职位的比例接近 1：1。在马萨诸塞大学医学院，综合住院医师培训计划申请人的美国医师执照考试第 1 步（226 至 235）和第 2 步 CK（237 至 243）分数每年都在提高，通常超过了在其首选专业中匹配的美国申请人的全国平均水平。
自批准血管外科学初级证书以及随后推出综合血管住院医师培训计划以来，住院医师培训计划的数量和住院医师培训计划申请人的素质一直在持续提高。医学院申请人的需求是目前培训职位的八倍。相比之下，研究员申请人的需求与研究员职位的供应相匹配。必须通过扩大综合血管外科住院医师培训途径来满足增加的培训人数，以满足未来的公共卫生需求。
