Background/Purpose:
            Rheumatology has been a less attractive career choice than most other medical subspecialties for many years. The 2015 American College of Rheumatology (ACR) workforce study, derived largely from rheumatology fellowship matching data from 2008 to 2013, projected a shortage of up to 4,729 full-time equivalent rheumatologists by 2030. However the attractiveness of rheumatology seems to have changed since 2014.

<>Goals/Objectives:
            We therefore compared more recent trends in application and match rates in rheumatology with other popular medical subspecialties.

Methods:
            We reviewed data from the National Resident Matching Program from 2008 to 2017, the ACR Rheumatology workforce study of 2015, and Medscape physician salaries from 2008 to 2017. We examined the numbers of applicants, numbers of fellowship positions, ratios of applicants-to-fellowship positions, percentages of offered positions filled, percentages of applicants who matched, percentages of US graduates in fellowships, and salary trends in rheumatology. We compared data for rheumatology with that for non-procedure-oriented medical subspecialties (endocrinology, hematology/oncology, infectious disease, and nephrology) and procedure-oriented medical subspecialties (cardiology, gastroenterology, and pulmonology/critical care medicine) and trends for 2008-2013 with those from 2014-2017.

<>Results:

<>For rheumatology, the total number of applicants from 2008 to 2013 decreased from 251 to 230 (-8%) with an average annual percentage change of -3.32 ± 2.8% (mean ± SEM) but from 2014 to 2017 increased from 230 to 332 (+44%) with an average annual percentage change of 21 ± 10.5% (p = 0.02) (Figure). For non-procedural medical subspecialties the total number of applicants from 2008 to 2013 decreased from 1,940 to 1,594 applicants (-18%) with an average annual percentage change of -5.42  ± 3.4% but from 2014 to 2017 increased from 1,594 to 1,714, (+8%) with an average annual percentage change of 0.9 ± 2.3%. For procedural medical subspecialties the total number of applicants from 2008 to 2013, increased from 2,455 to 2,562 (+4%) with an average annual percentage change of 0.6 ± 1.4% while from 2014 to 2017 the number of total applicants continued to increase from 2,562 to 2,631 (+3%) with an average annual percentage of 1 ± 1.1%. The increase for rheumatology from 2014-2017 was significantly greater than changes in non-procedural specialties (p  <  0.05) (Figure). Trends for the other parameters examined generally supported the increased attractiveness and competitiveness of rheumatology.

<>Conclusion:

<>Our observations complement and extend the 2015 ACR workforce report. While a few years and perhaps relatively small quantitative changes may not constitute a lasting tendency, analysis of recent trends suggests that rheumatology has become a more attractive career choice since 2014.

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