Internally Filled Fellowship Positions in Obstetrics and Gynecology Before and After 2020

To evaluate the proportion of internally filled obstetrics and gynecology fellowship positions before and after 2020.

This is a retrospective cohort study of filled training positions within obstetrics and gynecology fellowships to measure the likelihood of internally filled positions compared with externally filled positions 3 years before (2017-2019) and after (2020-2022) the transition to virtual interviews. All positions within gynecologic oncology, maternal-fetal medicine, reproductive endocrinology and infertility, and urogynecology and reconstructive pelvic surgery were included and divided into two match year cohorts. The primary outcome was proportion of internally filled positions. Univariable and multivariable logistic regression assessed the marginal effects of time on the type of filled position.

A total of 1,910 filled positions were identified (gynecologic oncology n=453, maternal-fetal medicine n=805, reproductive endocrinology and infertility n=340, urogynecology and reconstructive pelvic surgery n=312), with 21.4% filled internally (409/1,910). Proportions were similar before and after 2020 (21.3% [190/892] vs 21.5% [219/1,018], P=.91). Maternal-fetal medicine had the highest proportion of internally filled positions (26.1% [210/805]), followed by reproductive endocrinology and infertility (22.6% [77/340]), urogynecology and reconstructive pelvic surgery (17.0% [53/312]), and gynecologic oncology (15.2% [69/453]). There was no significant change in the proportion of internally filled positions over time (adjusted marginal change [aMC] 0.2%/year, 95% CI, -0.9 to 1.3%) or between cohorts (delta aMC 2.8%, P=.15).

Despite the widespread use of virtual interviews, the proportion of internally filled fellowship positions was similar before and after 2020 for all subspecialties, combined, and when assessed individually. This information provides reassurance to program directors and upcoming applicants that the interview format change has not affected internally filled positions.