Demographic variations and temporal trends in the United States nephrology fellowship match: An analysis of the National Resident Matching Program from 2010 to 2024

Each year, the National Resident Matching Program (NRMP) releases match outcomes data, highlighting trends, match rates, and competitiveness for each specialty. However, research on the demographics, temporal trends, and disparities among Nephrology applicants remains limited. This retrospective study analyzed data from the NRMP for Nephrology fellowships from 2016 to 2024, including applicant demographics and match outcomes. Chi-square tests were used to assess differences and temporal trends were evaluated with Mann-Kendall tests, and statistical significance was set at p < 0.05. Although the total number of training programs (p < 0.001) and fellowship positions (p < 0.001) increased from 2010 to 2024, the percentage of filled positions significantly declined from 94.1% in 2010 to 65.8% in 2024 (p = 0.047). Females were less likely to apply for Nephrology compared to other fellowships (p = 0.002) and had a lower match rate (p< 0.001). White applicants were less likely to apply for Nephrology than for other fellowships (p < 0.001). US MD graduates had a significantly higher match rate than non-US MD graduates over the study period (p < 0.001). In conclusion, despite the annual increase in Nephrology training positions, declining applicant numbers have reduced fellowship competitiveness. Males, Asians, and non-US international medical graduates comprised the majority of trainees. Addressing pay, job opportunities, and gender disparities is crucial to sustaining the future Nephrology workforce in the United States.