美国国际医学毕业生进入骨科手术住院医师培训项目的匹配率下降：一项为期17年的分析。
Declining Rate of International Medical Graduates Matching Into Orthopedic Surgery Residency Programs in the United States: A 17-Year Analysis.
作者信息
Tyagi Anisha, Sudah Suleiman Y, Whitelaw Kathryn, Haislup Brett D, Joshi Tej, Sanchez-Urgelles Pablo, Sanchez-Sotelo Joaquin, Menendez Mariano E
机构信息
Department of Orthopedic Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.
Department of Orthopedic Surgery, Monmouth Medical Center, Long Branch, New Jersey.
出版信息
JB JS Open Access. 2024 Sep 20;9(3). doi: 10.2106/JBJS.OA.24.00095. eCollection 2024 Jul-Sep.
INTRODUCTION
International medical graduates (IMGs) continue to play an important role in the US health care system, but little is known about their trends of matching into highly competitive residencies such as orthopedic surgery. The purpose of this study was to analyze temporal trends of IMG applicants matching into US orthopedic residency programs between 2008 and 2024 and compare them with US allopathic (MD) and osteopathic (DO) graduates.
METHODS
Orthopedic residency specific data for years 2008 to 2024 was obtained from the National Resident Match Program and Electronic Residency Application Service. Variables collected included total number of programs, total positions offered, number of applicants (MD, DO, and IMG), positions filled, and fill rate for each group. Trends were examined using simple linear regression modeling.
RESULTS
The number of orthopedic residency programs increased from 160 (2008) to 218 (2024), with total positions increasing from 636 (2008) to 916 (2024). The IMG fill rate decreased from 2.99% in 2008 to 0.87% in 2024 ( < 0.01 for linear trend; β -0.069). This corresponds to an absolute number decrease of 19 IMGs in 2008 to 8 in 2024. More specifically, the proportion of US IMGs decreased from 0.94% to 0.66%, and the proportion of non-US IMGs decreased from 2.04% to 0.21%. Over the 17-year study period, a total of 105 US IMGs and 110 non-US IMGs matched into orthopedic surgery. The US MD applicant fill rate decreased significantly from 96.5% to 85.0% ( < 0.001; β -0.944). The DO applicant fill rate increased significantly from 0.31% to 13.97% ( < 0.0001; β 0.990).
CONCLUSION
The declining rate of IMGs matching into orthopedic residency programs in the United States underscores the growing challenges faced by IMGs in accessing training in this competitive specialty. The notable increase in DO graduates securing orthopedic residency positions likely reflects the integration of a unified accreditation system for MD and DO residency programs established in 2020.
LEVEL OF EVIDENCE
Retrospective Cohort Study; IV.
引言
国际医学毕业生（IMGs）在美国医疗保健系统中继续发挥着重要作用，但对于他们进入竞争激烈的住院医师培训项目（如骨科手术）的趋势了解甚少。本研究的目的是分析2008年至2024年期间匹配到美国骨科住院医师培训项目的IMG申请人的时间趋势，并将其与美国的全科医学（MD）和骨科医学（DO）毕业生进行比较。
方法
从国家住院医师匹配计划和电子住院医师申请服务中获取2008年至2024年的骨科住院医师培训特定数据。收集的变量包括项目总数、提供的总职位数、申请人数量（MD、DO和IMG）、填补的职位数以及每组的填补率。使用简单线性回归模型检查趋势。
结果
骨科住院医师培训项目的数量从2008年的160个增加到2024年的218个，总职位数从2008年的636个增加到2024年的916个。IMG的填补率从2008年的2.99%下降到2024年的0.87%（线性趋势<0.01；β -0.069）。这相当于IMG的绝对数量从2008年的19人减少到2024年的8人。更具体地说，美国IMG的比例从0.94%下降到0.66%，非美国IMG的比例从2.04%下降到0.21%。在17年的研究期间，共有105名美国IMG和110名非美国IMG匹配到骨科手术。美国MD申请人的填补率从96.5%显著下降到85.0%（<0.001；β -0.944）。DO申请人的填补率从0.31%显著增加到13.97%（<0.0001；β 0.990）。
结论
美国IMG匹配到骨科住院医师培训项目的比例下降凸显了IMG在进入这个竞争激烈的专业进行培训时面临的日益增长的挑战。DO毕业生获得骨科住院医师职位的显著增加可能反映了2020年建立的MD和DO住院医师培训项目统一认证系统的整合。
证据水平
回顾性队列研究；IV级。
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