Growth trends in neurology residency positions

[ZezKaiEll]

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****Updated 3/30/2020****

As I patiently await the start of intern year, I find myself with entirely too much free time. Today, I decided to look at the growth in neurology positions over the years.

I figured I may as well share the data I compiled.

All information is of course pulled from the report archives of the NRMP: Report Archives - The Match, National Resident Matching Program and the AOA: AOA Match Statistics with some help from the "waybackmachine."

Year	PGY-1	PGY-2	Physician (R)	AOA	Total positions	Yearly Growth
2007	160	379	--	?	539*	--
2008	177	398	--	12	587	8.9%*
2009	196	385	--	15	596	1.5%
2010	228	357	--	12	597	0.1%
2011	266	339	--	13	618	3.5%
2012	291	346	1	16	654	5.8%
2013	339	331	22	17	709	8.4%
2014	380	320	23	22	745	5.1%
2015	404	313	20	22	759	1.9%
2016	443	304	23	31	801	5.5%
2017	492	294	21	28	835	4.2%
2018	552	287	20	20	879	5.3%
2019	617	281	20	7	925	5.2%
2020	682	244	20	--	946	2.3%

Some notes:
-Data is for positions offered not positions filled. The numbers are usually close.
-Data starts at 2007 when there was a spike in neuro programs in the NRMP data. I assume this was the transition from SF Match to NRMP. I can't be sure if some programs stayed behind in the SF match for a few years after as they don't have a public archive.
-I am missing one data point on AOA positions for 2007* which prevents me from completing the first row and the last column of row 2.
-Physician (R) positions were included as a part of categorical numbers prior to 2012.
-I have no info on the military match and so it is not included. I imagine there are only a few programs with a handful of spots anyhow.
-There may be some discrepancy based on previous prematch programs now incorporated after the all-in policy. I believe this affected other specialties more.

As you can see, total neurology positions have seen an average annual increase of 4-5% lately. In total since 2008, we have seen a 61% increase in spots.

For comparison the following are the growth numbers for other specialties in that span (same conditions as above):
Anesthesiology: 1389 -> 1884 (36%)
Dermatology: 327 -> 538 (65%)
EM: 1595 -> 2665 (67%)
FM: 3190 -> 4662 (46%)
IM: 5185 -> 8697 (68%)
Neurology: 587 -> 946 (61%)
OBGYN: 1245 -> 1443 (16%)
Ortho: 709 -> 849 (20%)
Path: 508 -> 603 (19%)
Peds: 2439 -> 2864 (17%)
PM&R: 370 ->480 (30%)
Diag Radiology: 1108 -> 1146 (3%)
Gen Surg: 1168 -> 1536 (32%)

What, if anything, do you all make of these numbers? Do you expect the future years to have a similar growth rate? Does the recent growth seem proportionate to demand? Any observed changes to the job market over the span covered above?

 

[Ibn Alnafis MD]

This rate of increase is concerning and at some point we will saturate the market. Fortunately, I don't anticipate this happening any time soon.

Currently the shortage is severe and it will get even worse over the next few years as more and more aging neurologists start exiting the workforce, or at least switch to part time. I think currently there are ~18k practicing neurologists and it's probably safe to assume that at least 1/3 (6k) will exit the workforce over the next decade given that half of the practicing neurologists are over the age of 55. Meanwhile, ~9k fresh blood will enter the field. That's 3k net positive, but also you need to account for the already existing shortage, future increase in demand for neurologists (due to aging population and advancements in the field), and a newer generation of neurologists that value lifestyle and time off work much more than its predecessors.

That's my thought but ofc I could be wrong.

Anyways, I wouldn't be concerned with this now. You will have knowledge and skills that will always be in demand. One way or another.

 

[deathmerchant]

I personally don't think the rate of increase is that concerning.

I think there are 15k full time active neurologists right now. I remember reading in a trustworthy source that we need at least 25K neurologists presently and at least 30k-35k in the next 10 years.

Also those 15K are concentrated around big metropolitan areas and big academic centers and will continue doing so.

In addition, number of people over 65 (bread and butter neuro patient population) will increase by about 18 million (20%) in the next 10 years, combined with about 5K neurologists projected to retire in that time.

Finally, the demand for 24/7 inpatient neurology is increasing rapidly and majority of hospitals in smaller areas don't have that.

I think, if anything, I expect increased shortage and demand despite the increase in number of residents.

 

[ZezKaiEll]

I have updated all of the data for 2020. Small dip in the growth rate of neuro positions compared to recent history. Will CTM qYear.

 

[Ibn Alnafis MD]

I have updated all of the data for 2020. Small dip in the growth rate of neuro positions compared to recent history. Will CTM qYear.

Solid work man.

This growth of supply was necessary, not only for patients, but also for the survival of this field. Having a severe shortage of neurologists means less awareness of the specialty and of what we offer, which in turns means less referrals. The supply-demand relationship is complicated. Increasing supply works is a positive feedback. Just look at radiology for example. With each breakthrough, people thought this would reduce the volume of imagings and would in turn decrease need for radiologists. This couldn’t be further from truth.
With that said, if all the sudden we double the number of neurologists in the US, or increase residency positions by 10%+ every year for next 10 years or something, we will have a saturation of the job market.