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<p>The growing population of adults with congenital heart disease has created a critical workforce shortage. This study analyzes recent trends in Adult Congenital Heart Disease (ACHD) fellowships and evaluates associations between applicants’ academic backgrounds and match outcomes.&#xa0;We conducted a retrospective cohort study using National Resident Matching Program data for Adult Congenital Heart Disease (ACHD) fellowship applicants in the United States from 2019 to 2025. Temporal trends in applicant volume, available positions, and match outcomes were evaluated using chi-square goodness-of-fit tests and Pearson correlation analyses.&#xa0;From 2019 to 2025, 113 applicants applied to Adult Congenital Heart Disease (ACHD) fellowships; 70 (53%) were U.S. MDs, all of whom successfully matched. A total of 151 positions were offered, of which 101 were filled. Over the study period, the total number of applicants increased (χ² = 14.3, <i>p</i> = 0.026), driven by significant growth in non–U.S. MD applicants (χ² = 17.1, <i>p</i> = 0.009). The number of unfilled programs also increased significantly (χ² = 7.71, <i>p</i> = 0.026). Among U.S. MD applicants, match rates were significantly correlated with matching within the top three choices (<i>r</i> = 0.842, <i>p</i> = 0.018) and first-choice programs (<i>r</i> = 0.823, <i>p</i> = 0.023), with no correlation observed for unmatched applicants (<i>r</i> = − 0.416, <i>p</i> = 0.353). In contrast, match outcomes for non–U.S. MD applicants were positively correlated with matching within the top three choices (<i>r</i> = 0.777, <i>p</i> = 0.040) and with unmatched applicants (<i>r</i> = 0.860, <i>p</i> = 0.013), and not with first-choice programs (<i>r</i> = 0.733, <i>p</i> = 0.061).&#xa0;The ACHD fellowship presented a period of stable growth in positions and programs. Despite this growth, the number of unfilled programs increased annually. Applicant trends suggest that individuals with diverse academic backgrounds represent a potential source of significant growth. However, their outcomes reflect a more competitive reality compared with their U.S. MD counterparts. Policies addressing these outcome disparities are recommended to help mitigate the workforce shortage in unfilled ACHD programs.</p>

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US Adult Congenital Heart Disease Fellowship Match Outcomes in the Context of the Global ACHD Workforce

  • 期刊论文

  • 发表日期：

    2026年7月23日

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  • Sebastian Balda,
  • Ivo Diaz-Djevoich,
  • Geovanna Minchalo-Ochoa,
  • Matias Panchana-Lascano,
  • Thomas Leone-Berry,
  • Rodolfo Kronfle-Cordovez

摘要

The growing population of adults with congenital heart disease has created a critical workforce shortage. This study analyzes recent trends in Adult Congenital Heart Disease (ACHD) fellowships and evaluates associations between applicants’ academic backgrounds and match outcomes. We conducted a retrospective cohort study using National Resident Matching Program data for Adult Congenital Heart Disease (ACHD) fellowship applicants in the United States from 2019 to 2025. Temporal trends in applicant volume, available positions, and match outcomes were evaluated using chi-square goodness-of-fit tests and Pearson correlation analyses. From 2019 to 2025, 113 applicants applied to Adult Congenital Heart Disease (ACHD) fellowships; 70 (53%) were U.S. MDs, all of whom successfully matched. A total of 151 positions were offered, of which 101 were filled. Over the study period, the total number of applicants increased (χ² = 14.3, p = 0.026), driven by significant growth in non–U.S. MD applicants (χ² = 17.1, p = 0.009). The number of unfilled programs also increased significantly (χ² = 7.71, p = 0.026). Among U.S. MD applicants, match rates were significantly correlated with matching within the top three choices (r = 0.842, p = 0.018) and first-choice programs (r = 0.823, p = 0.023), with no correlation observed for unmatched applicants (r = − 0.416, p = 0.353). In contrast, match outcomes for non–U.S. MD applicants were positively correlated with matching within the top three choices (r = 0.777, p = 0.040) and with unmatched applicants (r = 0.860, p = 0.013), and not with first-choice programs (r = 0.733, p = 0.061). The ACHD fellowship presented a period of stable growth in positions and programs. Despite this growth, the number of unfilled programs increased annually. Applicant trends suggest that individuals with diverse academic backgrounds represent a potential source of significant growth. However, their outcomes reflect a more competitive reality compared with their U.S. MD counterparts. Policies addressing these outcome disparities are recommended to help mitigate the workforce shortage in unfilled ACHD programs.