Abstract
Background
The competitiveness of internal medicine (IM) fellowships have not been well studied. Our novel competitiveness metric aims to estimate IM subspecialty fellowships entry competitiveness in a single, concise number that is easily accessible and understandable. Through this we hope to offer assistance to prospective fellowship applicants in making an educated and realistic fellowship choice.
Methods
Fellowship filled percentages, the percentage of applications from US medical graduates (USMGs), average matriculating USMLE Step 1 scores, and average post-fellowship salary were used to construct our metric. Procedural specialties included cardiology, pulmonary/critical care, and gastroenterology. Non-procedural specialties included hematology/oncology, rheumatology, endocrinology, infectious disease, and nephrology. Data were gathered from the National Resident Matching Program (NRMP) 2009 - 2018 reports, Medscape’s Physician Compensation Reports, and other sources used to corroborate salaries.
Results
2018 procedural FCI (25.92) was higher than non-procedural (15.61). Cardiology (FCI 28.72, salary $423,000, Step 1 237.67) was the most competitive field. Hematology/oncology leads non-procedural fields in FCI (28.02), USMG percentage (60%), and salary ($363,000). Nephrology fill rates have declined from 94.8% to 60.1% despite 32% salary increase, giving it the lowest FCI (7.04).
Conclusions
Calculations show procedural specialties are most competitive, with cardiology at the top. Hematology/oncology leads non-procedural fields and is approaching procedural competitiveness, as evidenced by multiple factors that rival or surpass gastroenterology and pulmonary/critical care. We believe that this metric is a simple, accessible, and valid measure of competitiveness of fellowship entry and with further manipulation can be generalized to residency competitiveness.
Serving as an Anatomy Laboratory Teaching Assistant was not Associated with Higher Scores on the USMLE Step 1 Exam
