Inaugural Interventional Cardiology Match Completed This Week

After years of planning, the first interventional cardiology match completed Wednesday with 94% of applicants securing a fellowship through this process.

“I'm incredibly excited about how things went,” said Douglas Drachman, MD (Massachusetts General Hospital, Boston), co-chair of the Society for Cardiovascular Angiography and Interventions (SCAI) Match Task Force. “When we think back about what existed before the match, the old recruitment system was just totally unsustainable. It was a high-pressure, high-stakes, unfair situation that put everybody under pressure and didn't allow people to make a thoughtful, carefully considered, and informed decision.”

Until this year, the way potential candidates secured interventional cardiology fellowship spots varied by program, with many trainees and program directors alike participating in a mad rush of applications and interviews with chaotic competition ruling above all else.

In 2022, SCAI formed its task force with the goal of creating a more equitable and fair process. More than the requisite 75% of programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) committed to putting a minimum of 75% of their open positions on the match for the 2025 cycle, which enabled applications to open in July through the National Resident Matching Program (NRMP).

“This year felt different than any other,” Drachman commented. “It was surprisingly peaceful, like the process was not this firestorm [where] the application portal opens and you're off to the races—you have to rapidly scan, review, interview, make offers—and the candidates [are] similarly under pressure to respond so quickly. . . . That was gone.

“It was calm and controlled and it allowed us all to feel like we had a greater range to consider the candidates and allow the candidates to consider a broader range of programs,” he continued. “Ultimately, it really should, I hope, help support diversity within the field.”

In the inaugural interventional cardiology match, 164 programs committed 326 positions, which represented 89% of accredited training programs and 80% of available positions. Overall, 290 candidates applied for positions, with 272 securing one on match day. A statement from SCAI reports that the organization is closely working to place the remaining candidates into unfilled positions.

This represents the first time that the field of interventional cardiology can collect precise data on the number and backgrounds of people who apply for training in the field, and Drachman said this information will be able to provide “real transparency” going forward.

The shift forward by 6 months of the application portal opening also was a benefit to the process, according to Drachman. “[Applicants] are much more fully fledged, both in terms of their experience and their interest in interventional cardiology and their vision and knowing what it is that they want to obtain from fellowship.”

‘Right Thing to Do’

Reflecting on the journey to the match, Drachman said the community felt a “sense of compromise, but the mantra was: ‘It's the right thing to do.’”

Specifically, program directors had to “cede some control of the process” when moving to the match, he said. “Inevitably, there will be people who say, ‘I lost the ability to nail down exactly who I was going to get.’ But for me personally, I think that gets right back to the core of the whole system and the whole situation that it was. It's difficult to have one's cake and eat it too in that regard, and I vastly prefer the benefit that we had just achieved.”

Going through this process brought interventional cardiologists out of their respective “silos” to bring forth the change, Drachman continued. “To have an effort like this, that was so public, that brought people together, created a forum to bring the interventional community together with a united purpose, which was great.”

He said SCAI will continue to solicit feedback to evolve the process going forward.

“Everybody really has a voice in this, and we will really continue to learn as we move forward [about] things that we can do differently,” Drachman said. “My hope is that people will continue to see the value in this, that programs who didn't participate this year will feel inspired to participate next year, [and] that those that did participate—and even ones where they didn't fill their quota—will feel engaged in the process and committed to help to make this right within our society and our global community.”