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

PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSION: Disparities in the retina fellowship match exist, with under-representation of women and URiM applicants. Monitoring trends can inform efforts to improve representation.