Pediatric Hematology/Oncology Fellowship Match Trends in the United States: Analysis From 2008 to 2025.

Abstract

Background: There is limited research characterizing the supply of pediatric hematology/oncology (PHO) specialists through fellowship training programs. This study examines trends in the PHO match, with a focus on applicant numbers, match outcomes, and representation.

Methods: We analyzed data from the National Resident Matching Program for PHO fellowships between 2008 and 2025. Match rates for programs and applicants were analyzed, and Pearson's coefficient was used to correlate continuous variables and time.

Results: During the study period, the number of available PHO fellowship positions increased from 129 to 194. The number of applicants rose between 2008 and 2016, but declined thereafter through 2025. From 2008 to 2025, the applicant-to-position ratio declined from 1.16 to 0.80 (r = -0.72, p = 0.0008). The overall number of PHO fellowship programs increased from 54 to 77. Between 2008 and 2025, the percentage of unfilled programs increased (r = 0.57, p = 0.01), while the match rate for applicants increased from 87.8% in 2008 to 97.9% in 2025 (r = 0.89, p < 0.0001). US allopathic graduates remained the largest group among matched applicants. The fraction of US allopathic graduates and US international medical graduates (IMGs) matching into PHO has been stable, while the fraction of US osteopathic graduates has overall increased, and that of non-US IMGs has decreased.

Conclusion: Over the past two decades, the applicant-to-position ratio declined in PHO fellowships in the United States, largely secondary to an increase in the number of positions. This growing disparity highlights a misalignment between training capacity and applicant interest, raising concerns about the sustainability of PHO fellowship programs and future workforce planning.