“Unveiling the Competition” Comprehensive Analysis of Hematology and Oncology Fellowship Trends through Nrmp Data (2011-2024) in United States (US)
Authors: Shahzad Moazzam , Basharat Ahmad , Javed Muhammad Jawad , Zulfiqar Fizza , Kasaeian Amir , Vutukuri Sireesha , Vyas Abhinav , Mumtaz Aqsa , Kaur Dania , Ahmed Faizan , Amin Muhammad Kashif , Chaudhary Sibgha Gull , Anwar Iqra , McGuirk Joseph P. , Mushtaq Muhammad Umair 
Published: December 2024

Background/Purpose:
This study aims to report the trends in the match results of AMGs (American medical graduates) and IMGs (international medical graduates) from 2011 to 2024 in Hematology-Oncology fellowship programs in the United States (US) using the National Resident Match Program (NRMP) database.
Methods:
The reports from NRMP data were accessed for the years 2011-2024 through their website. Data specific to programs and information concerning hematology-oncology fellowship match were retrieved for US MD, osteopathic (DO), US IMG, and non-US IMG applicants. Variables collected for each year included the number of positions, number of applicants in each group, positions filled/unfilled, and fill rate of each group. “Charting outcomes in the match” was used via the NRMP website to gather data on the detailed analysis of the applicants. Simple linear regression analysis was performed to determine the trends' significance over time; P &lt; 0.05 was considered significant.
Results:
The significant increase in the number of Hematology-Oncology programs by 59.68% within 14 years (P &lt; 0.001), from 124 in 2011 to 198 programs in 2024, with an average annual increase of 4.26%, indicates a growing interest and investment in this subspecialty. Similarly, the 64.85% increase in the number of Hematology-Oncology fellowship positions, from 458 to 755, within this timespan, with an average annual increase of 4.63%, suggests an increasing demand for these positions. The fill rate has increased by 1.08%, resulting in 99.34% of positions filled in 2024. The percentage of US MDs matched has increased from 32.11% to 50.92% (from 238 to 412), and the total number of MDs (US+US IMG +Canadians) matched has increased from 424 to 680 (P &lt; 0.001). The proportion of US DOs matched has increased from 5.68% (26 in 2011) to 9.27% (70 in 2024) (P &lt; 0.001). The year 2024 saw a 5.10% annual increase in total MDs compared to an 18.64 % annual increase in DOs relative to 2023. The total percentage of all IMGs matched (US, non-US, including Canadians) among number of applicants has increased from 25.10% in 2011 to 33.12% in 2024 (P=0.707), the percentage of US IMGs has increased (from 5.53% to 8.03%) (P = 0.060), and the percentage of non-US IMGs including Canadians has also increased from 19.57% to 25.09% (P = 0.690) none of the increases were statistically significant. The number of applicants who matched at their first choice increased by 59.59% (P &lt; 0.001), from 245 to 391, within this timespan, with an average annual increase of 4.26%. The number of applicants who went unmatched in oncology but matched in other specialties decreased by 58.82% within the same time (P = 0.034), from 54 in 2011 to 34 in 2024, with an average annual decrease of 4.20%. The number of unmatched specialty applicants remained unchanged (P = 0.893).
Conclusion:
Hematology-oncology has been growing as a subspecialty over the last 13 years, with an increase in the annual fill rate. This growth can be attributed to several factors, including the increasing prevalence of cancer, advancements in hematology-oncology research, and the aging population. Overall, the proportion of US DOs, US MDs, and US IMGs has increased over the years, reflecting the field's growing importance and the expanding opportunities for physicians within this specialty.