THE 2015 MATCH DATA PRESENTATION MAY 2015

Background on Participating in the Match  In 2014, ADGAP releases Geriatrics Fellowship Match Code of Ethics asking programs to be “all in.”  ADGAP membership endorses full transparency of match processes/data. Steps taken include:  Creation of Match Participation Agreement  Publishing of Institution Participation on ADGAP website (see next slide)  Fellowship Assessment Toolkit as Level 1 Member benefit  ADGAP continues to employ rigorous evaluation methods.  ADGAP moves up Match timeline for Geriatrics will be included in MSMP (Medical Specialties Matching Program) next cycle.  Hospice and Palliative Medicine announces it is joining the Match.  The 2015 Match Cycle ends with Geriatric Medicine at 85% of program participation and 78% of positions.

Institution Participation – ADGAP Website

Where does the Data Come From? ADGAP Surveys  2011 Survey to Gather Interest in Match (145 programs, 132 responses)  2012/2013 Match Registration Survey  2014 Post-Match Survey (145 programs, 122 responses)  2014 Match Participation Agreement (145 programs, 139 responses - July 2014)  2015 Post-Match Survey (145 programs, 120 responses) Survey is still open National Resident Matching Program (NRMP) Results Statistics  2013 Match Results (Published on January 8, 2014)  2014 Match Results (Published on January 7, 2015)

Slots Filled Academic Year (July 1 – June 30) ACGME Accredited Slots Available Slots* # of Slots Filled % of Available Slots Filled 2011**478n/a294n/a** % % % *Available slots are positions programs are actively seeking to fill. **We did not collect data on available slots for academic year 2011; % of total slots filled is 62%.

Available Slots & Our Fill Rate  Based on the data, geriatric medicine has filled an average of 296 slots per year since  This is consistent with data from the surveys conducted by Gregg Warshaw and Libbie Bragg.

Program & Position Results in the Match by Year National Resident Matching Program. Match Results Statistics, Geriatric Medicine. National Resident Matching Program Registration, Ranking, and Results (R3) system. Published January 8, 2014, January 7, Match Day – January 8, Match Day – January 7, 2015 Matched Applicants/Filled Positions Programs Positions Programs that Filled All Positions2827 Programs that Filled Some Positions3553 Programs that Filled No Positions46

Filled and Unfilled Slots by Size of Program Data Number of Available Slots NRMP Data on Slots Filled in Match Responding Program Slots Filled Outside Match Total Filled Slots Non- Responsive Program Slots Total Unfilled Slots Large: More than 10 Slots Medium: 5-9 Slots Small: 1-4 Slots Totals

Filled and Unfilled Slots by Size of Program Preliminary Data Number of Available Slots NRMP Data on Slots Filled in Match Responding Program Slots Filled Outside Match Total Filled Slots Available Slots Still Trying to Be Filled by Responding Programs Non- Responsive Program Slots Total Unfilled Slots Large: More than 10 Slots Medium: 5-9 Slots Small: 1-4 Slots Totals *Programs are still filling slots

Match Cycle Interviewing Experience as Compared to Prior Years # of Candidates Seen Match Participants (N = 103) 2014 Match Participants (N=109) 2015 Non-Match Participants (N = 19) 2014 Non-Match Participants (N=11) 2015 All Non and Match Participants (N = 122) 2014 All Non and Match Participants (N = 120) 2015 More Candidates 39%30%26%27%37%30% Same Number of Candidates 35%26%42%46%36%28% Less Candidates 24%40%32%27%25%38% No Response 2%4%0% 2%4%

Positions Filled Outside the Match (as of 4/28/15)  Programs have filled 80.5 positions outside of the Match.  31 positions were filled by a total of 24 programs that Did Not Participate in the Match  9 positions were filled prior to the Match by 6 programs that had commitments and stated so in their Participation Agreements  40.5 were filled after the Match by 96 Programs that participated in the Match  Of the 80.5 positions offered outside the Match, 9 of them were hybrid positions. 3 Geri-Pal 2 Geri-Onc 1 Geri-Hosp 3 Geri-Med

Fill Rates for University-based Programs Academic Slots Filled 2014 Total Slots Filled 2014 % Slots Filled 2014 Academic Slots Filled 2015 Total Slots Filled 2015 % of Slots Filled 2015 In the Match % % Outside the Match % % Totals

Fill Rates for Community-Based Programs Community Slots Filled Total Slots Filled % Slots Filled Community Slots Filled Total Slots Filled % Slots Filled In the Match % % Outside the Match %780.59% Totals

Program Participation for 2015 Match  When asked about participating in the 2015 match, programs responded as follows:  75% (90/120) will participate  19% (23/120) are undecided  3% (4/120) will not participate  1% (1/120) cannot participate (military program)  2% (2/120) closed program for 2016 (not accepting fellows)  The 90 programs that indicated they would participate have 317 ACGME accredited fellowship training slots.

Breakdown of Costs to Participate in the Match for 2015 Cycle Institution/Program Fees  Institution registration:$210 – regardless of the number of programs/tracks in the match  Program registration:$40 per program/track  Matched applicant fee:$40 per applicant Applicant Fees:  Applicant registration:$65  Couples:$15 per partner

Data Summary Slide  slots are filled; a 52% fill rate when calculated on available slots (448)  155 slots were filled in the Match and 80.5 slots were filled outside the Match  We have reached 79% of historical number of slots filled (296)  Survey respondents are still actively seeking to fill slots (154).  The 25 non-respondents represent 68 positions:  13 programs (38 positions) that participated in the Match  12 programs (30 positions) that did not participate in the Match

Conclusion  120 programs (83%) were "all in" for 2015 Match - signed code of ethics  Transparency - 24 non-NRMP participating programs listed on ADGAP website  In 2015, 24% increase in positions filled in match relative to 2014 (125 to 155)  Total number of fellows in training constant at around 300

How To Keep Moving Forward  ADGAP reached out to programs who are still undecided about the Match. Here are the concerns:  Local competition with programs not in Match creating an unfair advantage in recruitment  Fellows not wanting to pay applicant fees  Easier to recruit internally/locally  More flexibility in recruitment outside of Match  How can we help resolve these issues and convince ALL programs to be “all in”?

Next Steps  Geriatrics will join MSMP Match in 2016  In-service Exam for Level 1 Members  Code of Ethics Seal of Approval

Final Thoughts “Changes to the Match will not in themselves address the underlying problem of a limited pool of applicants. However, if the Match continues to erode—or vanishes entirely—the resulting chaos and stressful competition will drive away potential applicants. To enhance the profession, nephrology must provide a fair and equitable system for applicants and the programs that train them.” - Jonathan Himmelfarb, MD, FASN President, American Society of Nephrology