Disparities in Osteopathic Representation Within Gastroenterology Fellowships

Gastroenterology (GI) is a highly competitive fellowship with an overall match rate of approximately 60%, as of 2025. Despite representing roughly 11% of the United States (US) physicians, Doctors of Osteopathic Medicine (DOs) are underrepresented across numerous subspecialties. This study analyzed osteopathic representation among trainees and program leadership of GI fellowships in the US. We hypothesized that DOs would have less representation in training programs and that that trainee representation would correlate with leadership composition.

Cross-sectional analysis was conducted of current GI fellowships using publicly available data from fellowship program websites, program-affiliated social media, and Doximity. Faculty leadership data and fellow degree type were collected from each training class year. Statistical analysis was conducted and P values < 0.05 were considered statistically significant.

236 fellowship programs were included in this study of which 216 (91.1%) had data available for program leadership and 203 (86%) had data available for fellow composition. DOs were most prevalent in the Northeast region. 25 programs (11.5%) had at least one DO in a senior faculty role. Linear regression analysis demonstrated a strong positive association between regional DO leadership representation and DO fellow representation, with a 9.53% increase in DO fellows for each 1% increase in DO leadership representation (R = 0.9837).

Osteopathic physicians continue to remain underrepresented in gastroenterology fellowships nationwide. However, osteopathic representation at the fellow and leadership levels demonstrates a strong positive correlation, suggesting that leadership composition plays a meaningful role in fostering diversity within gastroenterology training programs.