Pyskir Nicholas, Sitler Collin, Miller Caela, Yheulon Christopher, Levy Gary
Tripler Army Medical Center, Honolulu, HI.
National Capital Consortium, Bethesda, MD.
AJOG Glob Rep. 2022 Sep 27;2(4):100107. doi: 10.1016/j.xagr.2022.100107. eCollection 2022 Nov.
The objective and relative competitiveness of obstetrical and gynecologic subspecialty training programs remain understudied. Traditional metrics, such as match rate or program fill rate, fail to standardize the application environment. This limits their applicability when examining demographic trends or when comparing data between different fellowship matches. The normalized competitive index was introduced to serve as a comprehensive metric of competitiveness by incorporating disparate indicators and normalizing to enable more detailed analyses.
This study aimed to analyze trends in the competitiveness across obstetrical and gynecologic subspecialty fellowship matches during the last decade.
The results and data reports from the National Resident Match Program fellowship for 2010 to 2019 were used to collect data on multiple metrics of competitiveness for 6 obstetrical and gynecologic subspecialties. These data were used to determine the normalized competitive index. Subanalyses were conducted to identify trends over the last decade.
Among fellowship programs in obstetrics and gynecology, the overall specialty match rate was 67.6%. The overall specialty program fill rate was 95.7%. According to the normalized competitive index metric, minimally invasive gynecologic surgery was the most competitive fellowship match (normalized competitive index=1.31; =.002). Maternal-fetal medicine was the least competitive (normalized competitive index=0.94; ≤.005). When comparing the first and second half of the decade, no specialty experienced a significant decrease in match rate. The only significant increase in match rates occurred for female pelvic medicine and reconstructive surgery (=.035). Subanalyses of the normalized competitive index metric and other indicators of competitiveness demonstrated a strong negative correlation between the normalized competitive index and the subspecialty match rate (=-0.9444) and a moderately positive correlation between the normalized competitive index and the program fill rate (=0.4047).
The normalized competitive index offers trainees a more quantitative understanding of the fellowship application environment. By incorporating multiple metrics and normalizing the result, it uniquely enables comparison between the subspecialty matches and the match process over time. The same standardization offers the potential for future comparisons of competitiveness within a single subspecialty match based on geographic region, applicant demographics, and other important determinants of a diverse and vibrant training environment.
妇产科亚专业培训项目的目标及相对竞争力仍未得到充分研究。传统指标，如匹配率或项目填补率，未能使申请环境标准化。这限制了它们在研究人口趋势或比较不同专科匹配数据时的适用性。引入标准化竞争指数是为了通过纳入不同指标并进行标准化，以作为竞争力的综合指标，从而实现更详细的分析。
本研究旨在分析过去十年间妇产科亚专业专科匹配的竞争力趋势。
利用2010年至2019年全国住院医师匹配项目专科的数据报告，收集6个妇产科亚专业多项竞争力指标的数据。这些数据用于确定标准化竞争指数。进行亚分析以确定过去十年的趋势。
在妇产科专科项目中，整体专科匹配率为67.6%。整体专科项目填补率为95.7%。根据标准化竞争指数指标，微创妇科手术是竞争最激烈的专科匹配（标准化竞争指数=1.31；P=.002）。母胎医学是竞争最不激烈的（标准化竞争指数=0.94；P≤.005）。比较十年的前半期和后半期，没有专科的匹配率出现显著下降。匹配率唯一显著上升的是女性盆底医学与重建外科（P=.035）。标准化竞争指数指标及其他竞争力指标的亚分析表明，标准化竞争指数与亚专业匹配率之间存在强负相关（r=-0.9444），标准化竞争指数与项目填补率之间存在中度正相关（r=0.4047）。
标准化竞争指数为学员提供了对专科申请环境更具量化的理解。通过纳入多个指标并对结果进行标准化，它独特地实现了亚专业匹配之间以及随时间推移的匹配过程的比较。同样的标准化为未来基于地理区域、申请人人口统计学以及多样化和充满活力的培训环境的其他重要决定因素，在单个亚专业匹配内进行竞争力比较提供了可能。
