Interest In Vascular Surgery As A Specialty In A Climate Of Competitive Fields
Vinoth Birabaharan, MD, John Denesopolis, MD, John Phair, MD, Issam Koleilat, MD, Evan Lipsitz, MD, Jeffrey Indes, MD.
Montefiore, Bronx, NY, USA.
Objective: Vascular surgery is unique in that it combines intricate skill sets, involves almost every anatomic territory and crosses over with other subspecialties. Recent editorial publications have insinuated that the interest in our specialty is declining. We sought to examine the relative interest in vascular surgery compared to those of interventional cardiology (IC), cardiothoracic surgery (CT), and interventional radiology (IR).
Methods: Reviews of the National Residency Match Program (NRMP) and the American Board of Internal Medicine (ABIM) were performed for both fellowship and residency match data. Search terms were compared using Google trends. Job outlook was examined on the CTSNet, SVS, SIR, and the ACC websites.
Results: Applications to fellowship positions offered for CT experienced a 44% (1.37/0.95) increase from 2014 to 2018, while vascular surgery only experienced an 8% (1.07/0.99) increase. In the past year vascular surgery was the only field to experience a decline, 5% (1.12 to 1.07) while IC increased by 8% (1.01 to 1.09). In 2018, there were 2.0 US medical students applying to each CT position compared to 1.0 applying to vascular. Google trend data over the past ten years show that interest has remained higher for search terms "interventional cardiology fellowship," (average 41/100), and "interventional radiology fellowship," (average 39/100) compared to "vascular surgery fellowship," (25/100), and "cardiothoracic surgery fellowship," (18/100). One of the most often related query according to Google trends was salary. The average salary for a vascular surgeon in 2018 was $484,740, versus that of IR ($610,500 in 2016), IC ($612,910), and CT ($584,287). With regards to job outlook, there were most recently 108 jobs per 123 graduates currently posted for cardiothoracic surgeons, 112/225 for interventional radiologists, and 249/309 for interventional cardiologists, and 91/166 jobs posted for vascular surgeons.
Conclusions: The current interest in vascular surgery is on the decline while a concurrent increase in interest is occurring for CT, IC, and IR subspecialties. The reason for this is unclear, but needs to be examined to provide high quality trainees in a climate of continuous increasing demand and extreme competition from other subspecialties.
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