Reasons why specific fellowships don't fill?

[jaycache]

I'm currently interviewing for a 2022–23 HPM fellowship. There are quite a few programs in Texas. Some consistently fill every year while some don't get all their slots filled regularly. Does anyone have any particular insights as to why this is?

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[hihimedmed]

More prestigious/academic programs will generally have no problem filling, while the more community oriented programs generally do not. Since HPM is not a competitive specialty this is exacerbated somewhat. There was a program director survey from 2016 that showed that most programs get on average about 30-40 applicants. The applicant to position ratio is 1:1 generally as well every year (and there are usually the same amount of unfilled positions as there are unmatched applicants).