An increasing demand for integrated vascular residency training far outweighs the limited supply of positions.

OBJECTIVE: The integrated vascular surgery residency training paradigm ("0 + 5") was first approved by the Accreditation Council for Graduate Medical Education (ACGME) in 2006, with the first residents beginning in 2007. We sought to evaluate the demand for these new positions and to better understand applicant pool demographics.

METHOD: The Association of American Medical Colleges (AAMC) was petitioned for data on applicants to traditional vascular surgery fellowship and integrated vascular residency training programs (years 2006-2009). In addition, 111 applications received at a single academic institution for the year 2009 were reviewed in depth.

RESULT: The number of traditional vascular fellowship applicants and the corresponding number of positions remained stable. In contrast, the number of integrated vascular resident applicants increased dramatically, with 152 applicants seeking to match into 19 available positions in 2009. For the year 2009, 88% of integrated vascular residency applicants did not match, while 16% of traditional fellowship positions went unfilled. The most notable difference between integrated residency and traditional fellowship applicants is the number of foreign medical graduates (68.7% vs. 26.7% in 2008, P < .001). Of the 111 integrated applicants applying for our single position (73% of entire 2009 applicant pool), the majority of applicants were residing in the United States (88.3%) and a sizable proportion (25.2%) had completed at least one full year of either surgical training or surgical research at an institution in the Unites States. Objective measures of academic success included mean United States Medical Licensing Examination (USMLE) Step 1 and Step 2 scores of 89.1 and 89.5, respectively. The mean number of peer-reviewed journal publications at the time of application was 2.8.

CONCLUSION: The number of integrated vascular surgery residency applicants far outweighs the number of available positions. Growing interest in more efficient and comprehensive vascular surgery training will continue to augment demand. As educators, vascular surgeons should seize this opportunity and aggressively expand the number of available integrated residency training positions.