Factors associated with matching into pediatric ophthalmology and strabismus fellowship: a San Francisco Match analysis

PURPOSE: To identify factors associated with matching into pediatric ophthalmology and strabismus fellowships.

METHODS: We analyzed deidentified San Francisco Match data from 2021-22 to 2023-24. Categorical variables were compared using χ 2 or Fisher exact tests. Continuous variables were summarized as medians with interquartile ranges. Factors associated with match outcome were assessed with multivariable multinomial logistic regression.

RESULTS: We analyzed 217 applicants, of whom 129 (59%) matched into pediatric ophthalmology, 29 (13%) matched into other ophthalmology subspecialties, and 59 (27%) did not match. Matched applicants were predominantly female (n = 89 [70.6%]) and US graduates (n = 72 [55.8%]). Applicants who matched had more interviews (median, 17 [IQR, 8-32]) than those who did not match (8 [4-16] [P < 0.001]). Underrepresented in medicine (URiM) applicants submitted fewer applications (median, 9 [1-18] [P = 0.008]) and completed fewer interviews (median, 2 [1-8] [P = 0.126]) than non-URiM applicants. Males had more interviews than females (median, 20 [10-36] vs 11 [8-23] [P = 0.003]). US graduates submitted fewer applications than international medical graduates (IMGs) (P = 0.0007) but completed more interviews (P < 0.0001). The proportion of IMG applicants varied: 61.4% in 2021-22; 54.9% in 2022-23; 75.0% in 2023-24 (P = 0.04). Being an IMG was associated with higher odds of not matching (OR = 6.99, P = 0.027).

CONCLUSIONS: Across cycles, the IMG share of applicants and pediatric matches increased. Recognizing the shifting landscape in applicants is key to attracting the best candidates to pediatric ophthalmology, as well as promoting efforts to increase the appeal of pediatric subspecialty training among US residents through all pathways.