To investigate the influence of postgraduate medical education (US vs. international) and gender on applicant matching for postgraduate training across different urologic sub-specialties.
Match statistics of five societies that participated in the AUA fellowship match between 2010-2024 were retrospectively reviewed. Societies included: Endourology Society (EUS), Society for Urological oncology (SUO), American Society of Andrology (AMA), Society of Genitourinary Reconstructive Surgeons (GURS), and Society of Pediatric Urology (SPU). Candidates were classified based on gender (male/female) and their postgraduate medical education: local graduates from the United States or Canada (US/Ca) and international medical graduates (IMG). The match odds were analyzed using the Chi-square test, while trends were assessed through the Mann-Kendall test.
Overall, 2429 applicants applied for 1627 programs from 2010 to 2024, comprising 1998 males (81.8%), 399 females (16.4%), and 42 undisclosed (1.7%). There were 1486 US/Ca graduates (60.8%) and 953 IMGs (39.2%). 1471 (60.6%) applicants were matched with a program, compared to 958 (39.4%) unmatched. The likelihood of US/Ca graduates matching (83.8%) was significantly higher than IMGs (23.3%), OR = 17.5, 95% CI: (14.3, 21.5), p < 0.001. IMGs had the highest match rate with GURS (33.8%, 47/118) and the lowest with SPU (7%, 1/14). Female applicants had a significantly higher chance of matching 324/399 (81.2%) than male applicants 1139/1998 (57%), OR = 3.26, 95% CI: (2.5, 4.3), p < 0.001. US/Ca-to-IMGs ratios and the male-to-female ratios were stable throughout the match years.
Compared to IMGs, U.S./Ca graduates had remarkably higher matching rates. Matching outcomes were also significantly better for female applicants. Further assessment of international involvement and diversity in urological subspecialty roles is warranted.
Urology. 2024 Jul 03 [Epub ahead of print]
Kamil Malshy, Sari Khaleel, Keith Rourke, Borivoj Golijanin, Simone Thavaseelan, Gyan Parek, Dragan Golijanin
The Minimally Invasive Urology Institute, The Miriam Hospital, Warren Alpert Medical School of Brown University, Providence, RI, US. Electronic address: ., The Minimally Invasive Urology Institute, The Miriam Hospital, Warren Alpert Medical School of Brown University, Providence, RI, US. Electronic address: ., Division of Urology at the University of Alberta, Edmonton, Canada. Electronic address: ., The Minimally Invasive Urology Institute, The Miriam Hospital, Warren Alpert Medical School of Brown University, Providence, RI, US. Electronic address: ., The Minimally Invasive Urology Institute, The Miriam Hospital, Warren Alpert Medical School of Brown University, Providence, RI, US. Electronic address: ., The Minimally Invasive Urology Institute, The Miriam Hospital, Warren Alpert Medical School of Brown University, Providence, RI, US. Electronic address: ., The Minimally Invasive Urology Institute, The Miriam Hospital, Warren Alpert Medical School of Brown University, Providence, RI, US. Electronic address: .