Annual ID Match Day post: Someone get a fire extinguisher!

Last year I described the ID Match as a dumpster fire. Subsequent posts discussed why the specialty of infectious diseases is in trouble, and what we might do about it. I re-read those posts tonight, and I have nothing to add to them. My only question is: how does this end? The trend in unfilled programs, below, is shocking, with about 60% of fellowships now going unfilled, and 117 unfilled ID training positions. I’ve reviewed the list of unfilled programs, and without naming institutions I can tell you that it includes many of the top programs in the country, from coast to coast. 
The problem now is that busy internal medicine residents who are interested in ID may consider their options and decide it is best to skip the match entirely, and to grab one of the many excellent training opportunities available after the match is over. Once this happens, the whole system begins to break down. My prediction is that the NRMP will kick our specialty to the curb sometime in the next couple years, and we’ll be back to recruiting trainees the old fashioned way.


  1. In a Twitter post yesterday, I read: "Love being an ID doc, but until taking an extra 3 years of training does not lead to a pay cut this will persist." This is the entire problem captured in <140 characters. We're witnessing the death of a medical specialty right before our eyes, while its own professional society remains disinterested and unengaged.

  2. IDSA is clearly irrelevant when it comes to the future of ID.
    Take PQRS for instance. Many ID docs are taking the Medicare penalty, because they cannot meet any of the criteria. IDSA apparently let it happen. Worse, IDSA does not provide any advice on how ID docs can meet these irrelevant criteria.
    If IDSA can't help ID docs with PQRS, it probably can't help with any systematic issues.
    Bundled payments represent a potentially enormous threat to ID practitioners. I have seen nothing on IDSA regarding this possible coming storm.
    I have given a lot of thought to dropping out of the Society, which seems focused on writing guidelines and urging companies to make new abx. I am all for both, but what happened to advocacy?
    Stephen M. Smith, MD

  3. This is an artefact of having an insane and bizarre health system. Even in other countries with similarly poor (or poorer) prospects for trainees to secure consultant/attending jobs at the completion of training, ID remains popular because it is the most interesting and best medical subspecialty. Mass shootings and under-matched ID programs are a US specialty.

  4. Is there a NRMP appoint 2016 list of the programs for interested applicants wanting to target unfilled programs?


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