A study of fellowship application trends has found growing interest in interventional radiology fellowships, with many residents remaining unmatched due to increased competitiveness.

Interest in neuroradiology fellowships, on the other hand, has plateaued and a little more than one-fifth of positions has been unfilled for the past three years, according to results published online August 22 in the Journal of the American College of Radiology.

Jim Chen, MD, of the University of Pittsburgh Medical Center, and colleagues sought to use the number of positions per applicant to assess competitiveness in fellowship programs on a supply-and-demand basis. Positions per applicant for both interventional and neuroradiology fellowships were calculated using statistics from the National Resident Matching Program in Results and Data: Specialties Matching Service from 2008 to 2013.

Results showed the positions per interventional radiology application decreased every year over the study period, from 1.71 to 0.84. This increase in competitiveness was reflected by the fact that 52 applicants were unmatched in 2013, up from nine in 2008, while the number of unfilled positions decreased from 86 in 2008 to eight in 2013. Only about one-third of applicants are matched with their first-choice fellowship program.

“Presently, programs generally are not in danger of having unfilled positions and benefit from a large pool of high-quality candidates,” wrote Chen and colleagues. “The demand for future careers in [interventional radiology] outstrips the supply of fellowship positions. This is a golden opportunity for programs to recruit the best residents into their field.”

The authors wrote that the positions per neuroradiology applicant “waxed and waned” over the six-year period, but plateaued at 1.15, with the number of applicants never outpacing the number of positions. There have been at least 46 unfilled positions each year over the course of the study period, and Chen and colleagues suggested that neuroradiology fellowship programs consider reducing the number of fellowship spots. “It is still a buyer's market for residents, and more than half have received their first choice for fellowship.”

A newly devised interventional radiology/diagnostic radiology certificate could shake up the fellowship process, though Chen and colleagues weren’t able to confidently predict the competitiveness of this future resident program based on current data. “However, it will definitely change the landscape of [interventional radiology] training, and we predict that a significant number of [diagnostic radiology] residency positions will be reallocated into [interventional radiology] residencies.”