Purpose: “The Match” as it is colloquially described among circles of seasoned medical students and residents remains the most controversial aspect of graduate medical education. The NRMP utilizes a “deferred acceptance” algorithm, implemented in 1952, to pair students with hospitals as it pertains to their individual preferences. The algorithm has been updated since the original “Boston Pool” to the current Roth-Peranson algorithm in 1998 that accommodates a match as favorable for applicants while producing stable outcomes. Therefore, in this retrospective analysis, we will examine if US IMGs are disproportionately disadvantaged in the NRMP match for an interventional radiology position.
Material and Methods: A retrospective analysis of the NRMP match data from 2021 revealed a total of 181 applicants, 120 US MD graduates, applying for 150 total positions at 68 different institutions. 141 of those positions were filled through the match. After a data analysis of the average ranked position, the US IMGs were surveyed for their responses pertaining to match likeliness, experience, and possible discrimination experienced during the process.
Results: Of the 141 positions that were filled, 11 were US IMGs (7.8%), 14 were non-US IMGs (9.9%), 103 were US MDs (73%), and 13 were US osteopathic (D.O.) medical graduates (9.2%). 120 total US medical graduates applied to interventional radiology fellowship and 103 (86%) obtained positions. The NRMP states that 87 (48% ) applicants matched their first choice, 16 (8.8%) to their second choice, 11 (6.1%) to their third choice, and 27 (15%) applicants to their fourth choice or higher. 34 of the applicants (18.8%) went unmatched. Of the 11 US IMGs, 7 were subsequently surveyed regarding their average rank position. The average match position was 5.8, whereas NRMP data reveals that 2/3 of the applicants match to a hospital within their top 3.
Conclusions: Preliminary data in our small retrospective study demonstrated that US IMGs disproportionately face discrimination in the match process. Furthermore, the odds of attaining a fellowship position are decreasing logarithmically as each year passes with subsequent training programs transitioning from the fellowship to the integrated training model. It is imperative to maintain a viable training pathway for future non-traditional residents who wish to pursue interventional radiology.