Factors Associated with Matching into Retina Fellowship: A San Francisco Match Analysis.

Abstract

The retina subspecialty has previously shown the lowest rate of matched female and underrepresented in medicine (URiM) applicants. This study was conducted to examine trends in gender and racial/ethnic diversity in retina fellowship applicants and match outcomes from 2021 to 2023. Anonymized data of fellowship applicants from 2021-2023 San Francisco match was obtained and stratified by gender, racial/ethnic background, and URiM status. Continuous variables were summarized as median (IQR); categorical variables as counts and percentages. We compared groups with chi square or Fisher exact tests and Wilcoxon rank sum tests. A multivariable logistic regression model was used to assess the association of applicant characteristics with match outcomes. Among 583 applicants, 172 (29.5%) were female, and 74 (12.7%) were from URiM backgrounds. 398 applicants matched; 106 (26.6%) were female, and 47 (11.8%) had URiM status, with match rates of 61.6% for women and 71.3% for men. Matched applicants submitted more applications (median 34 vs 11, p<0.001) and completed more interviews (median 14 vs 2, p<0.001) than those who did not match. The proportion of matched female applicants declined from 38 (30.6%) in 2021 to 33 (23.6%) in 2023, with match rates declining from 62.3% to 56.9%. Female gender (OR 0.52, p = 0.002) was associated with decreased likelihood of matching. Disparities in the retina fellowship match exist, with under-representation of women and URiM applicants. Monitoring trends can inform efforts to improve representation.