How Competitive are Integrated Vascular Surgery Residency Programs? A Ten-Year Comparison Using a Normalized Competitive Index

Background: Integrated vascular surgery residency (VS) programs have increased in popularity and offer an accelerated track compared to the traditional fellowship pathway. We sought to create a simple metric for medical students to better assess the competitiveness of VS training programs compared to general surgery (GS) programs. Methods: GS and VS programs were compared using the National Resident Matching Program match data from 2012 to 2021. Applicant metrics (board scores, research output and experiences, work experiences, and volunteer experiences) from 2015 to 2019 were obtained using the Association of American Medical Colleges Report on Residents. A competitive index (CI) was created (number of programs ranked per applicant divided by match rate) for each specialty and normalized (NCI) to a value of 1 to improve longitudinal comparisons. NCI and number of programs ranked per applicant were plotted across time and a linear regression was performed to evaluate a 10-year trend. Results: The match rate of both specialties was 52% and was similar for GS and VS programs. CI was higher for VS compared to GS (18.4 ± 3.0 vs. 14.5 ± 0.4; P < 0.001). The number of programs ranked per applicant was higher in VS compared to GS (9.4 vs. 7.7, P < 0.05). The linear regression revealed increasing NCI and number of programs ranked per applicant over time for VS programs compared to GS with all R² > 0.61 (P < 0.001). Conclusions: Matching into a VS programs is becoming increasingly competitive. The average CI was approximately 27% higher for VS programs compared to GS programs despite similar match rates. As VS programs continue to evolve, NCI may be a more useful metric for applicants.