Geographic impact on relative locations of interventional spine and musculoskeletal medicine fellowships relative to residency and first job placement.

Abstract

Interventional spine and musculoskeletal medicine (ISMM) is a relatively new and rapidly evolving field that utilizes minimally invasive and novel techniques to treat spine and musculoskeletal pain. To analyze recent geographical trends of ISMM fellows since these fellowships became recognized by the North American Spine Society (NASS) in 2020 (2020 to 2024). The relative distance from residency to fellowship, residency to first job, and fellowship to first job were analyzed. Relative locations were categorized as within 100 miles, same state, same region, or different region. Odds ratios (ORs) were calculated for the relative locations of each geographical region. A total of 136 fellows from 26 of 28 (93%) NASS ISMM fellowship programs were included. The majority of fellows stayed within the same region from residency to fellowship (63%), residency to first job (67%), and fellowship to first job (65%). Fellows from the Northeast were more likely to stay within 100 miles (OR: 1.8), same state (OR: 2.1), and same region (OR: 2.6) as their residency. From residency/fellowship to first job, Northeast fellows had an increased likelihood of staying within 100 miles (p < .001/p = .021), same state (p < .001/p = .022), and same region (p = .002 for both). Fellows from the West, Midwest, and Southeast had a decreased likelihood of remaining nearby. ISMM fellows were more likely to stay within the same region as their residency and for their first job placement. Fellows from the Northeast had a greater likelihood of staying within 100 miles, same state, and in the same region.