Goyal Aman, Flesner Samuel L, Changez Mah I Kan, Shah Viraj, Mahalwar Gauranga, Brateanu Andrei
Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA.
School of Medicine, University of New Mexico, Albuquerque, NM, USA.
J Investig Med. 2025 May 30:10815589251348912. doi: 10.1177/10815589251348912.
Each year, the National Resident Matching Program (NRMP) releases match outcomes data, highlighting trends, match rates, and competitiveness for each specialty. However, research on the demographics, temporal trends, and disparities among Nephrology applicants remains limited. This retrospective study analyzed data from the NRMP for Nephrology fellowships from 2016 to 2024, including applicant demographics and match outcomes. Chi-square tests were used to assess differences and temporal trends were evaluated with Mann-Kendall tests, and statistical significance was set at p < 0.05. Although the total number of training programs (p < 0.001) and fellowship positions (p < 0.001) increased from 2010 to 2024, the percentage of filled positions significantly declined from 94.1% in 2010 to 65.8% in 2024 (p = 0.047). Females were less likely to apply for Nephrology compared to other fellowships (p = 0.002) and had a lower match rate (p< 0.001). White applicants were less likely to apply for Nephrology than for other fellowships (p < 0.001). US MD graduates had a significantly higher match rate than non-US MD graduates over the study period (p < 0.001). In conclusion, despite the annual increase in Nephrology training positions, declining applicant numbers have reduced fellowship competitiveness. Males, Asians, and non-US international medical graduates comprised the majority of trainees. Addressing pay, job opportunities, and gender disparities is crucial to sustaining the future Nephrology workforce in the United States.
每年，美国国家住院医师匹配计划（NRMP）都会发布匹配结果数据，突出各专业的趋势、匹配率和竞争力。然而，关于肾脏病学申请者的人口统计学特征、时间趋势和差异的研究仍然有限。这项回顾性研究分析了2016年至2024年NRMP中肾脏病学 fellowship 的数据，包括申请者的人口统计学特征和匹配结果。采用卡方检验评估差异，用曼-肯德尔检验评估时间趋势，设定统计学显著性为p < 0.05。尽管从2010年到2024年，培训项目总数（p < 0.001）和 fellowship 职位数（p < 0.001）有所增加，但填补职位的百分比从2010年的94.1%显著下降到2024年的65.8%（p = 0.047）。与其他 fellowship 相比，女性申请肾脏病学的可能性较小（p = 0.002），且匹配率较低（p < 0.001）。白人申请者申请肾脏病学的可能性低于申请其他 fellowship 的可能性（p < 0.001）。在研究期间，美国医学博士毕业生的匹配率显著高于非美国医学博士毕业生（p < 0.001）。总之，尽管肾脏病学培训职位每年都在增加，但申请者数量的下降降低了 fellowship 的竞争力。男性、亚洲人和非美国国际医学毕业生占 trainees 的大多数。解决薪酬、就业机会和性别差异问题对于维持美国未来的肾脏病学劳动力至关重要。
