Assessing the pediatric subspecialty pipeline: it is all about the data source

Area of Science:

• Pediatric subspecialty workforce analysis
• Fellowship training pipeline assessment
• Medical education research

Background:

• National Resident Match Program (NRMP) data is commonly used to assess pediatric subspecialty training pipelines.
• Alternative data sources may offer improved accuracy in workforce analysis.

Purpose of the Study:

• To compare the accuracy of NRMP data with American Board of Pediatrics (ABP) data for evaluating pediatric subspecialty training.
• To determine the actual number of fellows entering pediatric subspecialty training from 2008 to 2020.

Main Methods:

• Analysis of NRMP and ABP data for 14 pediatric subspecialties (2008-2020).
• Calculation of fellowship positions offered, NRMP match rates, fill rates (actual fellows vs. positions), and matriculating fellows.
• Comparison of data sources to identify discrepancies in pipeline assessment.

Main Results:

• The fellowship fill rate consistently exceeded the NRMP match rate across all subspecialties and years.
• All subspecialties showed an increase in both relative and absolute numbers of first-year fellows.
• Emergency medicine and critical care experienced the largest growth (73.3% and 68.9%, respectively).
• Most subspecialties, except adolescent medicine, saw an increase in offered positions, with pulmonology leading at 32.1%.

Conclusions:

• NRMP data alone significantly underestimate the number of fellows entering pediatric subspecialty training.
• The pediatric subspecialty pipeline has expanded over time, contrary to perceptions based solely on NRMP data.
• Significant variations in pipeline growth exist among different pediatric subspecialties.