Thousands of doctors ready to continue their training celebrated Match Day for specialty fellowships on Nov. 30, but one group lamented its results: infectious diseases physicians. Despite its central role in the COVID pandemic, the infectious diseases specialty saw 44% of its training programs go unfilled.
"I'm bummed out," says Dr. Carlos Del Rio, a professor at the Emory School of Medicine and president of the Infectious Diseases Society of America. "I love my field, I love what I do. And it's upsetting to know that my field may not be as attractive to trainees as I would like it to be."
At the University of Washington, which has one of the nation's top-ranked programs, administrators were scrambling to find suitable candidates for two fellowship spots that were still open after the match process. "It feels unsettling," says Dr. Paul Pottinger, director of UW's infectious diseases fellowship training program, "Typically, we match our full eight slots on the first go." At Boston Medical Center, affiliated with Boston University, none of their three fellowship positions got filled in this year's Match – a "challenging" and unprecedented situation for Dr. Daniel Bourque, who runs their fellowship program: "There was a decrease in the number of applicants this year, and that decrease appears to be a trend."
Becoming an infectious diseases specialist takes years of training. Generally, after four years of medical school, followed by several years in a medical residency, an aspiring ID physician applies to a fellowship program of at least two years. The field hit a low point in recruiting for fellowships in 2016. In the past five years, it was somewhat stable, with around 65%-70% of training programs getting filled. But 2020 was the exception, when a flood of applicants yielded a record match rate – a phenomenon dubbed the "Fauci effect." As infectious diseases dominated the news, "a lot of us saw it as a [sign of] reinvigorated interest in ID" due to the pandemic, says Dr. Boghuma Titanji, an infectious diseases physician at Emory University. But the slide since then – capped off by this year's "alarming decline" – shows that the pandemic boost may have been a blip in the specialty's long-term struggles.
Despite guiding colleagues and the public through the COVID pandemic and the recent mpox outbreak; despite their lifesaving work in keeping hard-to-treat infections from spreading in hospitals; despite high job satisfaction and a profession that many described to NPR as "never boring": new doctors are not choosing to specialize in infectious diseases.
It's a decline that has the field's top experts searching for explanations.
