Association between proportion of US medical graduates and program characteristics in gastroenterology fellowships

Figures & data

Table 1. Number of applicants per fellowship position for major internal medicine subspecialties (number of fellowship positions offered > 30) [1].

Subspecialty	No. of applicants per fellowship position
	US medical graduates	All applicants
Gastroenterology	0.80	1.54
Hematology and oncology	0.62	1.33
Pulmonary disease and critical care medicine	0.57	1.34
Cardiovascular disease	0.57	1.31
Hospice and palliative medicine	0.53	0.93
Rheumatology	0.46	1.41
Endocrinology, diabetes, and metabolism	0.43	1.20
Infectious disease	0.38	0.68
Geriatric medicine	0.24	0.55
Nephrology	0.18	0.64

Table 2. Proportion of US medical graduates in gastroenterology fellowship programs by regional location.

Region	States	No. of programs	Mean ± SD
1: Mid-Atlantic	New Jersey, New York, Pennsylvania	40	49.25 ± 36.59
2: East North Central	Illinois, Indiana, Michigan, Ohio, Wisconsin	23	53.40 ± 33.84
3: South Atlantic	Delaware, District of Columbia, Florida, Georgia, Maryland, North Carolina, South Carolina, Virginia, West Virginia	22	60.68 ± 29.25
4: Pacific	California, Oregon, Washington	14	85.76 ± 24.43
5: New England	Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont	14	73.76 ± 28.92
6: West South Central	Arkansas, Louisiana, Oklahoma, Texas	15	62.47 ± 28.23
7: West North Central	Iowa, Kansas, Minnesota, Missouri, Nebraska	9	48.81 ± 23.62
8: East South Central	Alabama, Kentucky, Mississippi, Tennessee	8	57.67 ± 27.80
9: Mountain	Arizona, Colorado, New Mexico, Utah	6	64.92 ± 17.45
10: Territory	Puerto Rico	2	70.37 ± 10.48
Total		153

Table 3. Baseline characteristics of the gastroenterology fellowship programs.

Program characteristics	Obs.	Mean ± SD or n (%)
US medical graduate (%)	153	59.42 ± 31.81
General information
Program size	153	3.23 ± 1.35
Program type
University-based	153	104 (67.97)
Community-based university-affiliated hospital	153	44 (28.76)
Community-based	153	5 (3.27)
Faculty and trainee information
Full-time paid female physician faculty (%)	153	24.06 ± 16.53
Ratio of full-time equivalent paid faculty to positions	153	1.66 ± 0.74
Female trainees (%)	153	34.08 ± 16.60
Work schedule information
Average hours/week on duty	152	55.01 ± 7.45
Maximum consecutive hours on duty	151	15.44 ± 5.38
Average number of 24 hour off-duty periods per week	152	1.61 ± 0.37
Educational environment
Average hours/week of regularly scheduled lectures/conferences	153	4.73 ± 1.46
Educational benefits
Formal program to develop teaching skills	153	138 (90.20)
Formal mentoring program	153	122 (79.74)
Formal program to foster interdisciplinary teamwork	153	86 (56.21)
International experience	153	12 (7.84)
Off-campus electives	153	107 (69.93)
Instruction in medical Spanish or other non-English language	153	28 (18.30)
Alternative/complementary medicine curriculum	153	39 (25.49)
MPH/MBA or PhD training	153	61 (39.87)
Educational features
Offers additional training beyond accredited length	153	47 (30.72)
Offers a research track/non-accredited fellowship	153	30 (19.61)
Offers another track	153	23 (15.03)
Employment policies and benefits
On-site child care	153	47 (30.72)
Subsidized child care	153	16 (10.46)
Placement assistance upon completion of program	153	40 (26.14)
Policy prohibits hiring smokers/users of nicotine products	153	17 (11.11)
Compensation and leave
Salary compensation^a (in 1000 USD)	142	60.35 ± 5.82
Vacation days^a	107	18.13 ± 3.39

^aPostgraduate year 4. Obs. = observation.

Table 4. Results of the univariate analysis between proportion of US medical graduates and program characteristics.

Program characteristics	Coefficient (SE)	p
Regional location
1: Mid-Atlantic	−13.7768 (5.7635)	0.018*
2: East North Central	−7.0954 (7.1960)	0.326
3: South Atlantic	1.4605 (7.3521)	0.843
4: Pacific	25.6831 (8.7010)	0.004*
5: New England	15.7744 (8.8559)	0.077
6: West South Central	3.3706 (8.6719)	0.698
7: West North Central	−11.2732 (10.9266)	0.304
8: East South Central	−1.8564 (11.5892)	0.873
9: Mountain	5.7125 (13.2837)	0.668
10: Territory	11.0886 (22.6972)	0.626
General information
Program size	7.9029 (2.0004)	< 0.001*
Program type
University-based	26.7683 (5.0826)	< 0.001*
Community-based university-affiliated hospital	−28.5071 (5.2066)	< 0.001*
Community-based	0.4177 (14.5112)	0.977
Faculty and trainee information
Full-time paid female physician faculty (%)	0.2258 (0.1555)	0.148
Ratio of full-time equivalent paid faculty to positions	18.0660 (3.1648)	< 0.001*
Female trainees (%)	0.5905 (0.1483)	< 0.001*
Work schedule information
Average hours/week on duty	0.7909 (0.3438)	0.023*
Maximum consecutive hours on duty	0.1670 (0.4862)	0.732
Average number of 24 hour off-duty periods per week	−9.0726 (6.9671)	0.195
Educational environment
Average hours/week of regularly scheduled lectures/conferences	3.6433 (1.7535)	0.039*
Educational benefits
Formal program to develop teaching skills	−13.7117 (8.6042)	0.113
Formal mentoring program	11.9057 (6.3453)	0.063
Formal program to foster interdisciplinary teamwork	−3.5764 (5.1922)	0.492
International experience	8.4764 (9.5718)	0.377
Off-campus electives	7.7129 (5.5915)	0.170
Instruction in medical Spanish or other non-English language	8.0323 (6.6403)	0.228
Alternative/complementary medicine curriculum	2.3487 (5.9171)	0.692
MPH/MBA or PhD training	23.4767 (4.9108)	< 0.001*
Educational features
Offers additional training beyond accredited length	24.5925 (5.2223)	< 0.001*
Offers a research track/non-accredited fellowship	23.5621 (6.2091)	< 0.001*
Offers another track	9.3445 (7.1789)	0.195
Employment policies and benefits
On-site child care	8.3725 (5.5510)	0.134
Subsidized child care	5.7865 (8.4182)	0.493
Placement assistance upon completion of program	4.3868 (5.8606)	0.455
Policy prohibits hiring smokers/users of nicotine products	−18.2618 (8.0740)	0.025*
Compensation and leave
Salary compensation^a (in 1,000 USD)	−0.4792 (0.4593)	0.299
Vacation days^a	−0.5552 (0.8034)	0.491

^aPostgraduate year 4. *p < 0.05.

Table 5. Multivariate analysis of proportion of US medical graduates and associated program characteristics.

Program characteristics	Coefficient (SE)	p
University-based program	21.1598 (4.5005)	< 0.001
Ratio of full-time equivalent paid faculty to positions	14.6650 (2.8311)	< 0.001
Female trainees (%)	0.3950 (0.1275)	0.002
Region 4: Pacific	15.3121 (7.3607)	0.039
Policy prohibits hiring smokers/users of nicotine products	−13.5399 (6.6119)	0.042

Adjusted R² of the model = 0.3663; number of observations = 153.

National Resident Matching Program. Results and data: specialties matching service 2016 appointment year. Washington (DC): National Resident Matching Program; 2016.

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