AY 2021 Nephrology Match—Preliminary Results

The First Pandemic-Era Match Saw Increase in Matched Candidates, Filled Training Tracks

I. Executive Summary

A total of 345 internal medicine residents will enter nephrology fellowship after the appointment year (AY) 2021 Match, a 19% increase over 2020. Despite the COVID-19 pandemic and a shorted, wholly virtual application cycle, 57% of nephrology training tracks filled, up 37% compared to last year according to data released by the National Resident Matching Program (NRMP).

Among the key data points:

• Candidate matches were up nearly across all categories, with international medical graduates (IMGs) ▲24%, US allopathic candidates (US MDs) ▲29%, and US IMGs (US IMGs) ▲18%, while osteopathic candidates declined slightly.
• While accredited training programs increased in 2020, tracks and positions offered in the Match were flat over AY 2020.
• A substantial number of positions (129 [27% of slots]) and training tracks (74 [44% of tracks]) remained unfilled, although these totals declined 28% and 25% over last year, respectively.

II. AY 2021 Nephrology Match Results

1. Programs

Advanced NRMP data reported increasing numbers of filled training tracks (57% filled vs. 41% in AY 2020) and nephrology fellowship slots (73% vs. 62%). With the number programs (170 tracks) and positions (474 slots) offered in AY 2021 similar to last year, unfilled tracks and slots were down, declining 28% and 25%, respectively (see Table 1).

Table 1: Nephrology Match—Training Tracks

Source: NRMP.

The Proportion of Filled Tracks Increased in AY 2021

Source: NRMP.

With 96 Training Tracks Filling, ▲37% over AY 2020

Source: NRMP.

2. Fellows

Of the 474 positions offered for AY 2021, 345 were filled (73%), the highest proportion since AY 2014 (see Table 2). Excepting osteopathic candidates (whose application numbers were down according to the Electronic Residency Application System [ERAS] see below), matched candidates were up over last year. While 93% of fellows preferring nephrology matched in the specialty, the ratio of matched fellows to fellowship positions in the Match, which has been <1 since AY 2016, edged up to .73.

Table 2: Matched Nephrology Fellow Characteristics

Source: NRMP.

73% of Positions Filled, Up 19% in AY 2021

Source: NRMP.

With Positions Flat, the Gap in Unfilled Slots Narrowed

Source: NRMP.

AY 2021 Saw an Increase in Nearly All Categories of Matched Fellows

Source: NRMP.

93% of Fellows Preferring Nephrology Matched

Source: NRMP.

Although the Ratio of Candidates/Position Increased to 0.74

Source: NRMP.

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III. ERAS Application Data

Application data from ERAS foreshadowed the Match Day results released by NRMP, showing a large increase year over year in both nephrology candidates and applications. As of October 31, 2020, the number of candidates was up 25% over AY 2020 and cumulative totals eclipsed were the highest since the AY 2015 application cycle. With safety measures imposed by the COVID-19 pandemic necessitating virtual interviews, nephrology (and other medical subspecialty) applications soared 52% over AY 2020. Excepting osteopathic candidates, IMGs (comprising both foreign IMGs and US IMGs) and US MDs were up substantially. While AY 2021 cross-registration data has yet to be released, last year’s totals show nephrology candidates continue to show a strong interest in critical care medicine.

Nephrology Candidates Increased 25% in AY 2021

Source: ERAS.

Candidate Totals for October 2020 Topped AY 2015

Source: ERAS.

Virtual Interviewing Contributed to a Dramatic Increase in Applications

Source: ERAS.

With Totals Outpacing the Past 6 Application Cycles

Source: ERAS.

IMG and US MD Candidates Increased in AY 2021

Source: ERAS.

Nephrology Candidates Cross-Register Most Frequently in Critical Care

Source: ERAS 2020 Cross-Registration Totals. Abbreviations: CRD = Cardiovascular; CCM = Critical Care; END = Endocrinology; GAS = Gastroenterology; GER = Geriatrics; HEM = Hematology; HMO = Hematology and Oncology; HSP = Hospice and Palliative Care; ID = Infectious Diseases; NPH = Nephrology; ONC = Oncology; PUL = Pulmonary; PCC = Pulmonary Critical Care; RHM = Rheumatology.

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IV. Current Fellows in Training

As the number of accredited training programs continues to grow (now 151 nephrology training programs), new data from the ASN Nephrology GME Census found a corresponding uptick in 1st-year fellows (partially due to inclusion of off-cycle trainees). Of note, 33% of current nephrology trainees (AY 2020-2021) entered fellowship through the post-Match scramble process, which lacks the structure of the ERAS application cycle and NRMP Match.

1st-Year Fellow Totals Remain Steady

Source: ACGME/ASN (2020).