It’s that time of year again—results of the 2022 National Resident Matching Program (NRMP) Medicine and Pediatric Specialties Match are out. Among 39 specialties (including adult, pediatric, addiction, and multidisciplinary specialties), a total of 3361 programs offered 8724 positions. Of all positions, 88% were filled, with cardiovascular disease, interventional pulmonology, and oncology filling all offered positions (1).
In 2009, nephrology’s “heyday,” 95% of 367 offered positions filled—with 89% of adult nephrology programs filling (2). These numbers reached a decade-nadir in 2016 with 59% of 466 offered positions filled and only 41% of programs filling. For the 2023 academic year (AY), 178 adult nephrology programs offered 493 positions (an increase of 9 from AY 2022), with 58% (a 7% increase from AY 2022) and 73% (a 5% increase from AY 2022) of programs and offered positions filling, respectively (1, 2). Out of 42 pediatric nephrology programs and 67 offered positions for this year’s match, 17 of 42 (40%) and 36 of 67 (54%) programs and offered positions were filled, respectively (1).
Among adult specialties, nephrology ranked 5th in offered positions, 6th in filled positions, 11th in percentage of programs filled, and 12th in percentage of positions filled in the 2022 Match (Figures 1 and 2). Since 2009, the number of nephrology offered positions has increased by over 30%, with the number of filled positions increasing by only 3% (2). The number of new spots included in the few years after the 2009 Match was likely a result of the “all in” match policy (3) and the inclusion of existing positions, which were not listed previously. Although the number of filled positions has modestly increased over the last few years, we have a clear supply-greater-than-demand mismatch. One potential solution, although with its own challenges, was outlined in a 2017 editorial: “We believe that these trends and hiring practices are not good for nephrology and that radical solutions are needed to reverse the ongoing disinterest in our field. We believe that the best way to save nephrology is to reduce the number of training program slots to <300” (4).
Adult specialty spots offered, filled, and percentage filled
Citation: Kidney News 15, 1
Adult specialty spots filled and percentage of programs filled
Citation: Kidney News 15, 1
A 2020 focus group study of 25 internal medicine residents (5) cited several well-known factors associated with lack of interest in nephrology as a subspecialty: high complexity; low compensation and prestige; and lack of exposure, advances, and mentors. Although the nephrology community’s efforts to address some of these challenges may be contributing to slowly recovering Match statistics, the supply of offered positions continues to increase. Let’s keep calm, keep recruiting, and think about innovative approaches to tackle the supply-demand inequality.
References
- 1.↑
National Resident Matching Program (NRMP). NRMP celebrates Match Day for its largest fellowship match—Medicine and Pediatric Specialties Match. November 30, 2022. Accessed December 5, 2022. https://www.nrmp.org/about/news/2022/11/nrmp-celebrates-match-day-for-its-largest-fellowship-match-medicine-and-pediatric-specialties-match/
- 2.↑
Pivert KA. First look: AY 2023 Match. ASN Data. November 30, 2022. Accessed December 5, 2022. https://data.asn-online.org/posts/ay_2023_match
- 3.↑
Ross MJ, Braden G; ASN Match Committee. Perspectives on the nephrology match for fellowship applicants. Clin J Am Soc Nephrol 2017; 12:1715–1717. doi: 10.2215/CJN.03220317
- 4.↑
Melamed ML, et al. Resizing nephrology training programs: A call to action. Clin J Am Soc Nephrol 2017; 12:1718–1720. doi: 10.2215/CJN.04740517
- 5.↑
Beck N, et al. Internal medicine residents’ perceptions of nephrology as a career: A focus group study. Kidney360 2020; 1:1052–1059. doi: 10.34067/KID.0003652020
