Can't say why ACGME decided to officially make ep a 2 year fellowship. I can only offer my experience of why I chose a 2 year program. I applied when ep was still only a 1 year accredited fellowship with some places offering 2 years, and chose to do 2 years. Foremost, not all 2 year programs are equal, i.e. some are 2 years clinical, some are 1 year clinical 1 year research or 1 1/2 year clinical 6 months research, etc. For me, I felt trying to learn all ep procedures and become proficient at the end of your training within 1 year was pushing it. This is especially true if you had no ep experience at all from your general fellowship, i.e. no device implant experience, no diagnostic EP study experience.
I would say you could probably do 1 year ep fellowship and be alright if you knew ahead of time you were not going to pursue doing certain procedures i.e. scar-based VT's, epicardial VT's, lead extractions, etc and only confined yourself to afibs, svt's, devices. I chose to do 2 years to try and learn everything. Will I be doing epicardial VT's in practice? Probably not, but I felt I needed to learn the experience.
I hear this year not all programs are in the match, but I think from '19 onwards, all programs are supposed to be in the match system.
