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January 2015
From the President

Addressing the Decline in the Match: We Can Reverse the Trend

It has been 37 years since I chose to specialize in infectious disease, and I still feel the same commitment and passion for the field as I did when I started out. Few specialties offer the challenges, the variety or the opportunities to save lives and improve public health. Why then, does the number of medical students and residents choosing this field appear to be dwindling? I can assure you that this issue is of great concern to me personally and to IDSA. I also want to assure you that the leadership of IDSA is committed not only to examining the potential causes of the decline, but also to taking action to reverse the trend.

In the unlikely event that you have not seen the numbers, in the most recent cycle of the National Resident Matching Program, 99 of the 327 (30%) ID positions offered were not filled, continuing a trend we’ve seen in recent years. According to analysis by ID colleagues published in Clinical Infectious Diseases (CID), the contributing factors are the relatively low pay, a shrinking pool of international medical graduates, concerns about the job market, and the rise of the hospitalist. This analysis provides a solid basis for our efforts to address the match, but we also need to consider other data from the American College of Graduate Medical Education and the American Board of Internal Medicine showing that ID fellowships are, in fact, being filled—just not through the match.

IDSA is already engaged on many fronts in addressing what we do know is holding students and residents back from choosing ID, such as compensation and perceptions about career opportunities:

Medical Education:
IDSA is focusing on approaches to improve upon the way medical microbiology is taught in medical school in order to better demonstrate the appeal of a career in ID. This is an ongoing theme with the training program directors and the Education Committee. We are hopeful that this could be a way to impact early career decisions.

Mentorship: We know from IDSA’s own survey of fellows that having a mentor plays a tremendous role in choosing the field of ID. Nearly 90 percent of those surveyed said that mentors influenced their decision to choose the speciality, and 47 percent said they had a “great impact.” IDSA is committed to expanding our mentorship efforts. In addition to our two Fellows’ meetings every year, we launched a new Mentorship Program at IDWeek through which students, residents and fellows are teamed up with seasoned ID professionals to explore the meeting together. We also have expanded the number of scholarships under IDSA’s Medical Scholars program, which gives medical students the opportunity to work with an ID mentor.

Scholarships: The IDSA Education and Research Foundation supports medical students and young investigators with scholarships, fellowships, travel grants, and research funding to help recruit more young doctors into our specialty and to help with their early career development.

Compensation: All of our efforts to improve medical education and foster students and residents through mentorship programs are important, but we also know that improving compensation is critical. IDSA continues to advocate for better compensation for ID services and how to value their input differently under health reform. A valuable resource is available to all IDSA members to advocate for appropriate compensation through the Value Toolkit (member login required), a collection of presentations, videos and documentation using the data from The Value of the ID Specialist study published in CID. Using these tools, members can make the case to employers, hospital administrators and health plan executives that ID consults result in better outcomes and lower costs. We will also be undertaking in the near future a survey to IDSA members on their compensation, in order to get better data than that available through other sources, and help direct our efforts most appropriately.

Funding for Research and Public Health: IDSA’s policy and government affairs team works diligently, advocating for the reversal of federal funding cuts that impact our field and encouraging the White House and Congress to commit more funding to infectious disease research and public health. These are advocacy efforts that each and every IDSA member can lend a voice to by signing onto IDSA’s action alerts.

Our commitment to reversing this trend will not cease. I’m pleased to announce that the IDSA Board of Directors has approved the creation of a Task Force on ID Recruitment. Under the leadership of Wendy Armstrong, MD, FIDSA, chair of IDSA’s ID Training Program Directors Committee, this task force will be examining the match results and other existing data, reviewing current efforts to recruit young physicians into the field, and making recommendations on additional efforts the Society should undertake in the short and long term. We recognize that this effort is broader than medical education, and accordingly, the Task Force will seek input from other IDSA committees and task forces, including the Clinical Affairs, Research, Public Health and Education Committees among others.

We need specific and actionable ideas to address these issues, and we need to act as quickly as possible. It will take a commitment from each of us to get involved, to share our passion for our specialty with the bright, curious, driven and altruistic young doctors around us. If you have specific suggestions for actions we might take, please don’t hesitate to forward them to me directly and/or to Wendy Armstrong.

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