Challenges and opportunities in the application process for fellowship training in pathology: an independent survey of residents and fellows demonstrates limited interest in an NRMP-style matching program

Cytopathology fellowship match: Pros and cons

A cytopathology fellowship match would create an enforced and structured recruitment timeline for the benefit of applicants and programs. Major benefits would include delaying fellowship applications to allow residents to explore different subspecialty areas, a standardized application process for administrative ease, and optimization of matches between applicants and programs based on ranked preferences rather than use of time-limited "exploding offers." The overall gains in efficiency and achieving the primary goals of supporting trainees and recruiting in an equitable and inclusive manner outweigh any downsides to instituting a cytopathology fellowship match. We aim to review the major discussions around this ongoing debate, arriving at the same conclusion as others in the literature that a pan-pathology fellowship match is ideal and that leadership from the Association of Pathology Chairs will be essential in unifying the fractured fellowship recruitment process.

The pathology fellowship application crisis: The current state and suggestions for remediation

Problems within the Pathology fellowship application process in the US have been recognized and reported for years. Recently, members of the Graduate Medical Education Committee (GMEC) of the Association of Pathology Chairs (APC) and collaborators collected survey data from the residents themselves and the fellowship programs, as represented by both the fellowship program directors (members of the Fellowship Directors Ad Hoc Committee, FDAHC) and the program administrators (members of the Graduate Medical Education Administrators Section, GMEAS). These data are presented and discussed, and potential steps to resolve some of the problems around fellowship applications in pathology are presented.

"What program directors think IV": Results of the 2017 Annual Survey of the Association of Program Directors in Radiology

RATIONALE AND OBJECTIVES

The Association of Program Directors in Radiology (APDR) regularly surveys its members to gather information regarding a broad range of topics related to radiology residency. The survey results provide insight into the opinions of residency program leadership across the country.

MATERIALS AND METHODS

This is an observational cross-sectional study using a web-based survey posed to the APDR membership in the fall of 2017. The final survey consisted of 53 items, 48 multiple choice questions and five write-in comments. An invitation to complete the survey was sent to all 319 active APDR members.

RESULTS

Deidentified responses were collected electronically, tallied utilizing Qualtrics software, and aggregated for the purposes of analysis and reporting at the 66th annual meeting of the Association of University Radiologists. The response rate was 36%.

CONCLUSION

Over the past 16 years, more PDs have assistant and APDs to administer growing residency programs, but the time allocation for these APDs has come from the PD's protected time. An overwhelming majority of PDs consider independent call beneficial to residents and most think a call assistant is desirable. The vast majority of PDs support a unified fellowship match and allow resident moonlighting. Most fourth year residents are actively or moderately involved in clinical work and teaching. The majority of PDs have lost or expect to lose DR training positions to the new IR/DR programs. In a competitive match, PDs do not rely on residency interviews in their selection process.

Pediatric Pathology Fellowship Recruitment-Report of a Survey Conducted by the Fellowship Committee of the Society for Pediatric Pathology

Pediatric pathology (PP) is a subspecialty of pathology encompassing disease states during human development from the fetus to the young adult. Despite the existence of ACGME-accredited fellowship programs and opportunity for pediatric pathology subspecialty board certification, many pediatric pathology fellowship positions remain unfilled in North America. We sought to understand the difficulties in recruitment to the PP training programs by conducting a survey. A 3-pronged survey targeting pathology residents (PR), PP fellows and recent fellowship graduates (F&G), and PP training programs was conducted. Three separate questionnaires were prepared, one for each group; and administered online via SurveyMonkey. There were 175 responses to PR survey, 29 to F&G and 19 to programs survey. The results of the PR and F&G survey revealed that trainees select a subspecialty early in their residency training, primarily based on their interest, followed by prospects of employment. Nearly half of resident respondents had discounted pediatric pathology subspecialty training without prior exposure to the specialty. Senior residents and faculty members were reported as the main source for fellowship information for residents choosing subspecialty training and the choice of the training program was mostly dictated by geographic location. Most fellow recruits are racially diverse, female, and American medical graduates. Pathology residents decide on subspecialty training based on their interest; however, many are not exposed to pediatric pathology early on in training. The survey results suggest that existing PP fellowship positions likely will continue to exceed demand for subspecialty training. The results of the study could aid in developing strategies to boost recruitment to PP.

Perceptions of the laryngology Match: A survey of program directors and recent trainees

OBJECTIVES/HYPOTHESIS

Evaluate program director and recent trainee perceptions of the advantages and disadvantages of the laryngology Match.

STUDY DESIGN

Web-based survey study.

METHODS

A Web-based survey study was distributed to program directors and recent laryngology trainees to evaluate perceptions of the laryngology Match. A 15-item questionnaire with free-form, Likert, and multiple selection answers was emailed to 115 recent/current trainees and 22 laryngology directors.

RESULTS

Fifty-nine percent (13/22) of the program directors and 47% (54/115) of the recent trainees responded to the survey. There were significant increases in the number of programs applied to, interview offers received, and interviews attended by laryngology trainees who applied after adoption of the Match compared to those who applied prior to the Match. Seventy-one percent (22/31) of applicants after 2012 participated in the Match; those who did not accepted positions outside of the Match. Ninety-five percent (21/22) who applied through the Match successfully matched. Two-thirds of recent trainees and three-quarters of directors believe the Match process primarily benefits the applicant. The number of candidates interviewed per program approximately doubled from three to six after institution of the Match.

CONCLUSIONS

Overall, both program directors and recent or current laryngology trainees have a positive perception of the laryngology match process. The Match process increased the number of applicants and interviews per year, which both directors and trainees believe increases an applicant's chance at successfully matching.

LEVEL OF EVIDENCE

NA. Laryngoscope, 127:2818-2822, 2017.

The gynecologic oncology fellowship interview process: Challenges and potential areas for improvement

The application and interview process for gynecologic oncology fellowship is highly competitive, time-consuming and expensive for applicants. We conducted a survey of successfully matched gynecologic oncology fellowship applicants to assess problems associated with the interview process and identify areas for improvement. All Society of Gynecologic Oncology (SGO) list-serve members who have participated in the match program for gynecologic oncology fellowship were asked to complete an online survey regarding the interview process. Linear regression modeling was used to examine association between year of match, number of programs applied to, cost incurred, and overall satisfaction. Two hundred and sixty-nine eligible participants reported applying to a mean of 20 programs [range 1-45] and were offered a mean of 14 interviews [range 1-43]. They spent an average of $6000 [$0-25,000], using personal savings (54%), credit cards (50%), family support (12%) or personal loans (3%). Seventy percent of respondents identified the match as fair, and 93% were satisfied. Interviewees spent a mean of 15 [0-45] days away from work and 37% reported difficulty arranging coverage. Linear regression showed an increase in number of programs applied to and cost per applicant over time (p < 0.001) between 1993 and 2016. Applicants who applied to all available programs spent more (p < 0.001) than those who applied to programs based on their location or quality. The current fellowship match was identified as fair and satisfying by most respondents despite being time consuming and expensive. Suggested alternative options included clustering interviews geographically or conducting preliminary interviews at the SGO Annual Meeting.

Neuropathology training worldwide-evolution and comparisons

Training of neuropathologists varies worldwide. Systems range from highly organized specialist and subspecialist education with national certification, to regulated training with diploma recognition, to informal apprenticeships in neurological hospitals and no formal recognition. This overview compiles and summarizes the history of regulated training systems, the status of neuropathology within various countries' medical systems and the manner in which neuropathologists are trained. Anecdotal evidence suggests that countries with regulated systems of neuropathology training and an active professional organization are more likely to have an adequate supply of diagnostic specialists and a vibrant research community. The different training systems reflect the style of medical services delivery in the respective countries. In general, the existence of formal neuropathology training systems occurs only in countries with relatively high levels of per capita health expenditures, reflecting the development of medical specialization overall. Evolving diagnostic technologies and major international research endeavors, whose goals are to understand structure and function of the human brain, demand that neuropathology training is more than simply diagnostic histopathology.