Graduate Medical Education,

Transcription

1 APPENDIX Graduate Medical Education, Sarah E. Brotherton, PhD; Sylvia I. Etzel The American Medical Association (AMA) and the Association of American Medical Colleges (AAMC) sponsor and administer the National GME Census through GME Track, an internet-based AAMC product, and jointly maintain a database of information on training programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) and of the residents and fellows in those programs. From May until December 2016, all directors of programs accredited by the ACGME were asked to complete the program survey component of the Census on GME Track. Information on the educational characteristics of the training programs was added to FREIDA Online, the AMA Residency & Fellowship Editorial page 2303 Database, a public information source on GME programs that is available to Related article page 2360 medical students, residents, and fellows. Beginning in late July 2016, program directors were surveyed about their active, transferred, and graduated residents and fellows for academic year Program directors were provided with lists of residents and fellows from the current database and were asked to (1) confirm or modify the training status of trainees who were present in their programs the prior year; (2) add new physicians to their program who were not already in the database; and (3) confirm, edit, or add demographic information on all trainees. This demographic information includes sex, birthdate, country of birth, citizenship status, race, and Hispanic ethnicity. Information on race and Hispanic ethnicity for residents and fellows who had provided such information through various AAMC applications (eg, the Electronic Residency Application Service) was carried forward from those applications and included in the Census. We surveyed active programs, of which 9899 (95.7%) completed the program survey and 9005 (87.1%) confirmed the status of all their active physicians-in-training, accounting for (97.0%) activetrainees. Anadditional21programs (0.2%) confirmed some but not all of their trainees (n = 153 individuals, 0.1%), 377 confirmed that they did not have any trainees (3.6%), 492 programs (4.8%) confirmed the status of nonactive trainees (graduates and transfers) but did not have any currently active trainees, and 448 programs (4.3%) did not confirm the status of any physician training in the program (including 243 programs that apparently did not have any active trainees). A total of 96.7% of all physicians in our database had their status confirmed (eg, active, graduated, transferred, or withdrawn). Physicians whose status was not confirmed were advanced into the next year of training (n = 3533 [2.8% of active residents]) or graduated based on expected graduation date (n = 1223 [2.9% of graduated residents and fellows]). In total, we estimate that there were active residents in ACGMEaccredited programs during the academic year. The following tables include data from these surveys. Author Affiliations: Department of Data Acquisition Services, American Medical Association, Chicago, Illinois. Corresponding Author: Sarah E. Brotherton, PhD, Department of Data Acquisition Services, American Medical Association, 330 N Wabash Ave, Ste 39300, Chicago, IL (sarah.brotherton@ama-assn.org). Conflict of Interest Disclosures: The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported. Funding/Support: This research was funded solely by the American Medical Association, which employs Dr Brotherton and Ms Etzel. Table 1. ACGME-Accredited and Combined Specialty GME Programs and Resident Physicians According to Medical School of Graduation and Specialty and Subspecialty, No. (%) No. of programs No. of residents Total GY GY1 residents with no prior GME Medical school of graduation USMDs (65.6) (65.1) (65.7) (66.1) (66.4) (66.0) IMGs (26.7) (26.7) (25.9) (25.3) (24.5) (23.9) DOs 8615 (7.6) 9229 (8.0) 9727 (8.3) (8.5) (8.9) (10.0) Canadian 184 (0.2) 178 (0.2) 174 (0.1) 153 (0.1) 145 (0.1) 150 (0.1) Unknown/other (<0.1) Specialties Programs 4152 (45.6) 4207 (44.8) 4239 (44.1) 4286 (43.9) 4349 (43.7) 4642 (44.9) Residents (83.3) (82.5) (82.2) (82.4) (82.5) (82.9) 2368 JAMA December 19, 2017 Volume 318, Number 23 (Reprinted) jama.com

2 Table 1. ACGME-Accredited and Combined Specialty GME Programs and Resident Physicians According to Medical School of Graduation and Specialty and Subspecialty, No. (%) Subspecialties Programs 4959 (54.4) 5180 (55.2) 5374 (55.9) 5482 (56.1) 5608 (56.3) 5701 (55.1) Residents (16.7) (17.5) (17.8) (17.6) (17.5) (17.1) Abbreviations: ACGME, Accreditation Council for Graduate Medical Education; DO, doctor of osteopathy; GME, graduate medical education; GY1, graduate year 1 (the first year of education beyond medical school for which prior GME is not required); IMG, international medical graduate; USMD, US allopathic medical school graduate. Table 2. Resident Physicians on Duty in ACGME-Accredited and in Combined Specialty GME Programs, December 31, 2016 Resident Physicians, No. (%)b of Programs a Total Female USMD IMG Canadian Osteopathic Allergy and immunology (0.2) 191 (70.5) 202 (74.5) 49 (18.1) 1 (0.4) 19 (7.0) Anesthesiology (4.6) 2031 (35.4) 4403 (76.7) 676 (11.8) 4 (0.1) 657 (11.4) Adult cardiothoracic anesthesiology (0.1) 57 (31.3) 134 (73.6) 24 (13.2) 0 24 (13.2) Clinical informatics Critical care (0.1) 47 (28.0) 129 (76.8) 33 (19.6) 0 6 (3.6) Obstetric anesthesiology (<0.1) 17 (60.7) 22 (78.6) 4 (14.3) 1 (3.6) 1 (3.6) Pediatric anesthesiology (0.2) 101 (52.3) 146 (75.6) 21 (10.9) 2 (1.0) 24 (12.4) Colon and rectal surgery (0.1) 33 (41.8) 66 (83.5) 11 (13.9) 2 (2.5) 0 Dermatology (1.1) 858 (64.6) 1236 (93.1) 45 (3.4) 0 47 (3.5) Dermatopathology (0.1) 37 (53.6) 48 (69.6) 16 (23.2) 0 5 (7.2) Micrographic surgery and dermatologic oncology (0.1) 37 (51.4) 69 (95.8) 1 (1.4) 1 (1.4) 1 (1.4) Emergency (5.1) 2238 (35.1) 5035 (79.0) 350 (5.5) 3 (<0.1) 989 (15.5) Clinical informatics 3 5 (<0.1) 1 (20.0) 4 (80.0) 1 (20.0) 0 0 Emergency medical services (<0.1) 24 (45.3) 40 (75.5) 4 (7.5) 0 9 (17.0) Medical toxicology (<0.1) 23 (39.0) 43 (72.9) 10 (16.9) 1 (1.7) 5 (8.5) Pediatric emergency (0.1) 76 (66.1) 63 (54.8) 36 (31.3) 0 16 (13.9) Sports 7 10 (<0.1) 1 (10.0) 6 (60.0) 2 (20.0) 0 2 (20.0) Undersea and hyperbaric 7 10 (<0.1) 3 (30.0) 6 (60.0) 1 (10.0) 1 (10.0) 2 (20.0) Family (8.6) 5857 (54.8) 5156 (48.2) 3296 (30.8) 5 (<0.1) 2232 (20.9) Clinical informatics 2 6 (<0.1) 1 ( (100.0) Geriatric (<0.1) 29 (70.7) 17 (41.5) 16 (39.0) 0 8 (19.5) Sports (0.1) 53 (28.5) 87 (46.8) 46 (24.7) 0 53 (28.5) Hospice and palliative c (0.2) 167 (66.0) 129 (51.0) 67 (26.5) 1 (0.4) 56 (22.1) Internal (19.9) (42.8) (52.3) 9452 (38.4) 8 (<0.1) 2293 (9.3) Adult congenital heart disease 7 10 (<0.1) 4 (40.0) 7 (70.0) 2 (20.0) 0 1 (10.0) Advanced heart failure and transplant cardiology (0.1) 23 (27.7) 51 (61.4) 25 (30.1) 1 (1.2) 6 (7.2) Cardiovascular disease (2.1) 557 (21.3) 1378 (52.7) 1095 (41.9) 6 (0.2) 137 (5.2) Clinical cardiac electrophysiology (0.1) 25 (15.0) 87 (52.1) 75 (44.9) 0 5 (3.0) Clinical informatics (<0.1) 0 16 (80.0) 4 (20.0) 0 0 Critical care (0.2) 61 (29.3) 69 (33.2) 120 (57.7) 2 (1.0) 17 (8.2) Endocrinology, diabetes, and metabolism (0.5) 454 (71.3) 272 (42.7) 318 (49.9) 0 47 (7.4) Gastroenterology (1.2) 512 (34.0) 953 (63.3) 473 (31.4) 1 (0.1) 78 (5.2) Geriatric (0.2) 150 (67.9) 89 (40.3) 109 (49.3) 0 23 (10.4) Hematology 2 21 (<0.1) 7 (33.3) 16 (76.2) 5 (23.8) 0 0 Hematology and medical oncology (1.3) 711 (42.9) 878 (53.0) 697 (42.1) 4 (0.2) 78 (4.7) Infectious disease (0.6) 395 (54.6) 355 (49.0) 313 (43.2) 1 (0.1) 55 (7.6) Interventional cardiology (0.2) 29 (9.9) 127 (43.5) 153 (52.4) 1 (0.3) 11 (3.8) Nephrology (0.7) 292 (34.4) 215 (25.4) 558 (65.8) 0 75 (8.8) Medical oncology 7 55 (<0.1) 19 (34.5) 31 (56.4) 22 (40.0) 0 2 (3.6) Pulmonary disease (<0.1) 23 (37.1) 6 (9.7) 55 (88.7) 0 1 (1.6) Pulmonary disease and critical care (1.3) 528 (32.6) 814 (50.2) 672 (41.5) 1 (0.1) 134 (8.3) Rheumatology (0.4) 275 (60.2) 182 (39.8) 224 (49.0) 1 (0.2) 50 (10.9) Transplant hepatology (<0.1) 16 (44.4) 22 (61.1) 13 (36.1) 0 1 (2.8) jama.com (Reprinted) JAMA December 19, 2017 Volume 318, Number

3 Table 2. Resident Physicians on Duty in ACGME-Accredited and in Combined Specialty GME Programs, December 31, 2016 Resident Physicians, No. (%)b of Programs a Total Female USMD IMG Canadian Osteopathic Medical genetics and genomics (0.1) 50 (66.7) 41 (54.7) 30 (40.0) 1 (1.3) 3 (4.0) Medical biochemical (<0.1) 7 (63.6) 3 (27.3) 8 (72.7) 0 0 genetics Molecular genetic pathology (<0.1) 16 (31.4) 33 (64.7) 16 (31.4) 0 2 (3.9) Neurological surgery (1.1) 242 (17.7) 1259 (92.1) 100 (7.3) 2 (0.1) 6 (0.4) 2 1 (<0.1) (100.0) 0 0 Neurology (2.0) 1049 (43.2) 1367 (56.3) 846 (34.8) (8.9) Brain injury Child neurology (0.3) 247 (67.9) 259 (71.2) 84 (23.1) 0 21 (5.8) Clinical neurophysiology (0.1) 80 (50.6) 77 (48.7) 73 (46.2) 1 (0.6) 7 (4.4) 1 2 (<0.1) 0 2 (100.0) Epilepsy (0.1) 33 (50.0) 37 (56.1) 23 (34.8) 1 (1.5) 5 (7.6) Neurodevelopmental 8 27 (<0.1) 20 (74.1) 23 (85.2) 4 (14.8) 0 0 disabilities Neuromuscular (<0.1) 36 (66.7) 32 (59.3) 18 (33.3) 1 (1.9) 3 (5.6) Vascular neurology (0.1) 39 (35.1) 50 (45.0) 51 (45.9) 3 (2.7) 7 (6.3) Nuclear (0.1) 22 (31.9) 17 (24.6) 50 (72.5) 0 2 (2.9) Obstetrics and gynecology (4.1) 4251 (82.7) 4035 (78.5) 541 (10.5) 1 (<0.1) 566 (11.0) Female pelvic (0.1) 110 (83.3) 104 (78.8) 15 (11.4) 0 13 (9.8) Gynecologic oncology (0.1) 54 (76.1) 68 (95.8) 2 (2.8) 1 (1.4) 0 Maternal-fetal (<0.1) 32 (66.7) 39 (81.3) 8 (16.7) 0 1 (2.1) Reproductive endocrinology 7 21 (<0.1) 15 (71.4) 18 (85.7) 2 (9.5) 0 1 (4.8) and infertility Ophthalmology (1.1) 551 (41.6) 1234 (93.1) 62 (4.7) 1 (0.1) 29 (2.2) Ophthalmic plastic 5 6 (<0.1) 2 (33.3) 6 (100.0) Orthopedic surgery (3.0) 550 (14.8) 3560 (96.0) 63 (1.7) 0 84 (2.3) Adult reconstructive (<0.1) 3 (7.7) 28 (71.8) 4 (10.3) 2 (5.1) 5 (12.8) orthopedics Foot and ankle 6 15 (<0.1) 3 (20.0) 11 (73.3) 1 (6.7) 1 (6.7) 2 (13.3) orthopedics Hand surgery (0.1) 33 (27.5) 111 (92.5) 3 (2.5) 3 (2.5) 3 (2.5) Musculoskeletal oncology (<0.1) 7 (53.8) 9 (69.2) 4 (30.8) 0 0 Orthopedic sports (0.1) 17 (10.5) 131 (80.9) 8 (4.9) 7 (4.3) 16 (9.9) Orthopedic surgery (<0.1) 2 (6.9) 23 (79.3) 5 (17.2) 1 (3.4) 0 of the spine Orthopedic trauma 9 13 (<0.1) 0 10 (76.9) 3 (23.1) 0 0 Pediatric orthopedics (<0.1) 12 (37.5) 21 (65.6) 6 (18.8) 3 (9.4) 2 (6.3) Osteopathic neuromusculoskeletal 3 2 (<0.1) (100.0) Otolaryngology (1.2) 528 (34.7) 1491 (97.9) 27 (1.8) 0 5 (0.3) Neurotology (<0.1) 6 (23.1) 26 (100.0) Pediatric otolaryngology (<0.1) 18 (52.9) 27 (79.4) 3 (8.8) 4 (11.8) 0 Pain d (0.2) 64 (22.1) 197 (67.9) 50 (17.2) 1 (0.3) 42 (14.5) Pathology-anatomic (1.8) 1126 (49.9) 1159 (51.4) 891 (39.5) 4 (0.2) 203 (9.0) and clinical Blood banking/transfusion (<0.1) 28 (53.8) 28 (53.8) 21 (40.4) 0 3 (5.8) Clinical informatics 3 9 (<0.1) 1 (11.1) 5 (55.6) 2 (22.2) 0 2 (22.2) Chemical pathology 3 2 (<0.1) 1 (50.0) 2 (100.0) Cytopathology (0.1) 81 (61.8) 59 (45.0) 62 (47.3) 0 10 (7.6) Forensic pathology (<0.1) 22 (62.9) 25 (71.4) 5 (14.3) 0 5 (14.3) Hematology (0.1) 64 (52.9) 60 (49.6) 51 (42.1) 0 10 (8.3) Medical microbiology (<0.1) 4 (30.8) 4 (30.8) 8 (61.5) 0 1 (7.7) Neuropathology (<0.1) 25 (48.1) 32 (61.5) 12 (23.1) 0 8 (15.4) Pediatric pathology (<0.1) 14 (63.6) 14 (63.6) 7 (31.8) 0 1 (4.5) Selective pathology (0.1) 82 (56.9) 47 (32.6) 84 (58.3) 3 (2.1) 10 (6.9) 2370 JAMA December 19, 2017 Volume 318, Number 23 (Reprinted) jama.com

4 Table 2. Resident Physicians on Duty in ACGME-Accredited and in Combined Specialty GME Programs, December 31, 2016 Resident Physicians, No. (%)b of Programs a Total Female USMD IMG Canadian Osteopathic Pediatrics (7.1) 6401 (72.8) 6109 (69.4) 1614 (18.3) 4 (<0.1) 1071 (12.2) Adolescent (0.1) 71 (81.6) 70 (80.5) 10 (11.5) 1 (1.1) 6 (6.9) Child abuse pediatrics (<0.1) 36 (92.3) 31 (79.5) 5 (12.8) 0 3 (7.7) Clinical informatics 4 5 (<0.1) 1 (20.0) 4 (80.0) (20.0) Developmental-behavioral (0.1) 79 (83.2) 55 (57.9) 24 (25.3) 0 16 (16.8) pediatrics Neonatal-perinatal (0.6) 516 (71.4) 407 (56.3) 225 (31.1) 0 91 (12.6) Pediatric cardiology (0.4) 220 (50.0) 312 (70.9) 101 (23.0) 4 (0.9) 23 (5.2) Pediatric critical care (0.4) 317 (64.3) 334 (67.7) 109 (22.1) 3 (0.6) 47 (9.5) Pediatric emergency (0.3) 260 (68.8) 282 (74.6) 57 (15.1) 0 39 (10.3) Pediatric endocrinology (0.2) 179 (74.9) 124 (51.9) 105 (43.9) 1 (0.4) 9 (3.8) Pediatric gastroenterology (0.2) 184 (66.4) 165 (59.6) 86 (31.0) 0 26 (9.4) Pediatric hematology/oncology (0.4) 337 (69.9) 324 (67.2) 106 (22.0) 2 (0.4) 50 (10.4) Pediatric infectious diseases (0.1) 113 (66.1) 104 (60.8) 59 (34.5) 0 8 (4.7) Pediatric nephrology (0.1) 78 (72.9) 57 (53.3) 46 (43.0) 0 4 (3.7) Pediatric pulmonology (0.1) 97 (62.2) 92 (59.0) 52 (33.3) 0 12 (7.7) Pediatric rheumatology (0.1) 63 (76.8) 49 (59.8) 27 (32.9) 0 6 (7.3) Pediatric sports (<0.1) 14 (56.0) 18 (72.0) 3 (12.0) 1 (4.0) 3 (12.0) Pediatric transplant hepatology 11 8 (<0.1) 6 (75.0) 6 (75.0) 2 (25.0) 0 0 Physical and rehabilitation (1.0) 494 (39.3) 697 (55.5) 163 (13.0) 1 (0.1) 395 (31.4) Brain injury 9 5 (<0.1) 1 (20.0) 3 (60.0) 1 (20.0) 0 1 (20.0) Pediatric rehabilitation (<0.1) 21 (80.8) 17 (65.4) 6 (23.1) 0 3 (11.5) Spinal cord injury (<0.1) 7 (43.8) 11 (68.8) 2 (12.5) 0 3 (18.8) Sports (<0.1) 6 (33.3) 9 (50.0) 2 (11.1) 0 7 (38.9) Plastic surgery (0.2) 91 (29.7) 242 (79.1) 58 (19.0) 0 6 (2.0) Craniofacial surgery 10 8 (<0.1) 5 (62.5) 6 (75.0) 1 (12.5) 1 (12.5) 0 Hand surgery (<0.1) 8 (38.1) 19 (90.5) 1 (4.8) 1 (4.8) 0 Plastic surgery-integrated e (0.6) 310 (41.2) 715 (95.0) 34 (4.5) 0 4 (0.5) Preventive (0.2) 147 (48.2) 213 (69.8) 52 (17.0) 0 40 (13.1) Medical toxicology 1 5 (<0.1) 2 (40.0) 5 (100.0) Undersea and hyperbaric 1 3 (<0.1) 0 2 (66.7) 1 (33.3) 0 0 Psychiatry (4.3) 2744 (51.9) 3127 (59.2) 1500 (28.4) 2 (<0.1) 656 (12.4) Addiction psychiatry (0.1) 23 (33.8) 35 (51.5) 28 (41.2) 0 5 (7.4) Child and adolescent psychiatry (0.6) 507 (63.3) 418 (52.2) 276 (34.5) (13.4) Forensic psychiatry (<0.1) 19 (37.3) 30 (58.8) 15 (29.4) 1 (2.0) 5 (9.8) Geriatric psychiatry (<0.1) 30 (63.8) 21 (44.7) 20 (42.6) 0 6 (12.8) Psychosomatic (0.1) 34 (52.3) 34 (52.3) 21 (32.3) 2 (3.1) 8 (12.3) Radiation oncology (0.6) 214 (29.7) 696 (96.7) 10 (1.4) 0 14 (1.9) Radiology-diagnostic (3.6) 1163 (26.0) 3449 (77.1) 596 (13.3) 3 (0.1) 428 (9.6) Abdominal radiology (<0.1) 12 (33.3) 24 (66.7) 6 (16.7) 5 (13.9) 1 (2.8) 4 7 (<0.1) 1 (14.3) 3 (42.9) 4 (57.1) 0 0 Musculoskeletal radiology (<0.1) 2 (9.5) 20 (95.2) 1 (4.8) 0 0 Neuroradiology (0.2) 49 (20.3) 195 (80.9) 33 (13.7) 6 (2.5) 7 (2.9) Nuclear radiology 18 9 (<0.1) 2 (22.2) 5 (55.6) 3 (33.3) 0 1 (11.1) Pediatric radiology (<0.1) 26 (43.3) 43 (71.7) 12 (20.0) 1 (1.7) 4 (6.7) Vascular and interventional radiology (0.2) 40 (16.6) 192 (79.7) 27 (11.2) 0 22 (9.1) Interventional radiology-integrated e 61 8 (<0.1) 2 (25.0) 7 (87.5) 1 (12.5) 0 0 Sleep f (0.1) 62 (42.5) 55 (37.7) 85 (58.2) 0 6 (4.1) Surgery-general (6.8) 3249 (38.4) 6783 (80.2) 1271 (15.0) (4.8) Complex general surgical oncology (0.1) 42 (39.6) 83 (78.3) 14 (13.2) 6 (5.7) 3 (2.8) Hand surgery 1 8 (<0.1) 2 (25.0) 6 (75.0) 0 2 (25.0) 0 Pediatric surgery (0.1) 33 (40.2) 75 (91.5) 7 (8.5) 0 0 Surgical critical care (0.2) 111 (43.9) 189 (74.7) 33 (13.0) 5 (2.0) 26 (10.3) Vascular surgery (0.2) 68 (29.3) 164 (70.7) 49 (21.1) 2 (0.9) 17 (7.3) Vascular surgery-integrated e (0.2) 99 (36.3) 238 (87.2) 23 (8.4) 0 12 (4.4) jama.com (Reprinted) JAMA December 19, 2017 Volume 318, Number

5 Table 2. Resident Physicians on Duty in ACGME-Accredited and in Combined Specialty GME Programs, December 31, 2016 Resident Physicians, No. (%)b of Programs a Total Female USMD IMG Canadian Osteopathic Thoracic surgery (0.2) 48 (22.4) 163 (76.2) 35 (16.4) 4 (1.9) 12 (5.6) Congenital cardiac surgery 12 5 (<0.1) 2 (40.0) 3 (60.0) 2 (40.0) 0 0 Thoracic surgery-integrated e (0.1) 46 (26.1) 159 (90.3) 11 (6.3) 0 6 (3.4) Urology (1.0) 333 (25.7) 1179 (91.1) 49 (3.8) 1 (0.1) 65 (5.0) Female pelvic (<0.1) 19 (63.3) 28 (93.3) 1 (3.3) 1 (3.3) 0 Pediatric urology (<0.1) 22 (52.4) 41 (97.6) (2.4) Transitional year (0.8) 331 (33.9) 817 (83.6) 93 (9.5) 0 67 (6.9) Combined Specialties Diagnostic radiology/nuclear 3 4 (<0.1) 2 (50.0) 3 (75.0) 1 (25.0) 0 0 Emergency /family 2 20 (<0.1) 8 (40.0) 13 (65.0) 6 (30.0) 0 1 (5.0) Family /preventive 3 20 (<0.1) 8 (40.0) 12 (60.0) 3 (15.0) 0 5 (25.0) Internal /anesthesiology 5 17 (<0.1) 8 (47.1) 16 (94.1) 1 (5.9) 0 0 Internal /dermatology 7 35 (<0.1) 21 (60.0) 35 (100.0) Internal /emergency (0.1) 38 (31.1) 106 (86.9) 6 (4.9) 0 10 (8.2) Internal /emergency / 5 17 (<0.1) 5 (29.4) 15 (88.2) 1 (5.9) 0 1 (5.9) critical care Internal /family 2 12 (<0.1) 4 (33.3) 9 (75.0) 3 (25.0) 0 0 Internal /medical genetics and genomics 5 6 (<0.1) 3 (50.0) 4 (66.7) 2 (33.3) 0 0 Internal /neurology 2 3 (<0.1) 1 (33.3) 2 (66.7) (33.3) Internal /pediatrics (1.2) 849 (57.9) 1246 (85.0) 107 (7.3) (7.7) Internal /preventive 6 30 (<0.1) 16 (53.3) 16 (53.3) 14 (46.7) 0 0 Internal /psychiatry (0.1) 48 (52.2) 67 (72.8) 21 (22.8) 0 4 (4.3) Pediatrics/anesthesiology 7 40 (<0.1) 22 (55.0) 39 (97.5) 0 1 (2.5) 0 Pediatrics/emergency 4 38 (<0.1) 20 (52.6) 30 (78.9) 7 (18.4) 0 1 (2.6) Pediatrics/medical genetics and genomics (<0.1) 34 (68.0) 38 (76.0) 11 (22.0) 0 1 (2.0) Pediatrics/physical and rehabilitation 3 12 (<0.1) 8 (66.7) 9 (75.0) (25.0) Pediatrics/psychiatry/child and adolescent psychiatry 9 92 (0.1) 70 (76.1) 79 (85.9) 8 (8.7) 0 5 (5.4) Psychiatry/family 5 50 (<0.1) 35 (70.0) 45 (90.0) (10.0) Psychiatry/neurology 5 21 (<0.1) 8 (38.1) 15 (71.4) 2 (9.5) 0 4 (19.0) Total (100.0) Abbreviations: ACGME, Accreditation Council for Graduate Medical Education; GME, graduate medical education; IMG, international medical graduate; USMD, US allopathic medical graduate. a Total number of US GME programs accredited by the ACGME and combined specialty programs, as of December 31, 2016, surveyed by National GME Census during b Includes resident physicians on duty as of December 31, 2016, reported through the 2016 National GME Census. A total of 205 programs (2.0%) did not provide updated information on residents by March 1, For these nonresponding programs, resident physicians reported from the last received survey were moved into their next year in the program or graduated (45.7) (66.0) (23.9) 150 (0.1) (10.0) c Hospice and palliative is a subspecialty of anesthesiology, family, internal, pediatrics, psychiatry, or radiation oncology. d Pain is a subspecialty of anesthesiology, neurology, physical and rehabilitation, or psychiatry. e Integrated programs differ from subspecialty programs in that they include core surgical education. f Sleep is a subspecialty of anesthesiology, family, internal, neurology, otolaryngology, pediatrics, or psychiatry. Table 3. Total Number of Resident Physicians in Program Year 1 Positions and in Graduate Year 1 (GY1) Positions on Duty December 31, 2016, in ACGME-Accredited Programs and in Combined Specialty Programs No. of Residents in Program Year 1 No. of Residents in GY1 Positions of Residents a Positions b With Prior US GME c Without Prior US GME c Allergy and immunology Anesthesiology Adult cardiothoracic anesthesiology Critical care Obstetric anesthesiology Pediatric anesthesiology Colon and rectal surgery JAMA December 19, 2017 Volume 318, Number 23 (Reprinted) jama.com

6 Table 3. Total Number of Resident Physicians in Program Year 1 Positions and in Graduate Year 1 (GY1) Positions on Duty December 31, 2016, in ACGME-Accredited Programs and in Combined Specialty Programs No. of Residents in Program Year 1 No. of Residents in GY1 Positions of Residents a Positions b With Prior US GME c Without Prior US GME c Dermatology Dermatopathology Micrographic surgery and dermatologic oncology Emergency Clinical informatics Emergency medical services Medical toxicology Pediatric emergency Sports Undersea and hyperbaric Family Clinical informatics Geriatric Sports Hospice and palliative d Internal Adult congenital heart disease Advanced heart failure and transplant cardiology Cardiovascular disease Clinical cardiac electrophysiology Clinical informatics Critical care Endocrinology, diabetes, and metabolism Gastroenterology Geriatric Hematology Hematology and medical oncology Infectious disease Interventional cardiology Nephrology Medical oncology Pulmonary disease Pulmonary disease and critical care Rheumatology Transplant hepatology Medical genetics and genomics Medical biochemical genetics Molecular genetic pathology Neurological surgery Neurology Child neurology Clinical neurophysiology Epilepsy Neurodevelopmental disabilities Neuromuscular Vascular neurology Nuclear jama.com (Reprinted) JAMA December 19, 2017 Volume 318, Number

7 Table 3. Total Number of Resident Physicians in Program Year 1 Positions and in Graduate Year 1 (GY1) Positions on Duty December 31, 2016, in ACGME-Accredited Programs and in Combined Specialty Programs No. of Residents in Program Year 1 No. of Residents in GY1 Positions of Residents a Positions b With Prior US GME c Without Prior US GME c Obstetrics and gynecology Female pelvic Gynecologic oncology Maternal-fetal Reproductive endocrinology and infertility Ophthalmology Ophthalmic plastic Orthopedic surgery Adult reconstructive orthopedics Foot and ankle orthopedics Hand surgery Musculoskeletal oncology Orthopedic sports Orthopedic surgery of the spine Orthopedic trauma Pediatric orthopedics Osteopathic neuromusculoskeletal Otolaryngology Neurotology Pediatric otolaryngology Pain e Pathology-anatomic and clinical Blood banking/transfusion Clinical informatics Chemical pathology Cytopathology Forensic pathology Hematology Medical microbiology Neuropathology Pediatric pathology Selective pathology Pediatrics Adolescent Child abuse pediatrics Clinical informatics Developmental-behavioral pediatrics Neonatal-perinatal Pediatric cardiology Pediatric critical care Pediatric emergency Pediatric endocrinology Pediatric gastroenterology Pediatric hematology/oncology Pediatric infectious diseases Pediatric nephrology Pediatric pulmonology Pediatric rheumatology Pediatric sports Pediatric transplant hepatology JAMA December 19, 2017 Volume 318, Number 23 (Reprinted) jama.com

8 Table 3. Total Number of Resident Physicians in Program Year 1 Positions and in Graduate Year 1 (GY1) Positions on Duty December 31, 2016, in ACGME-Accredited Programs and in Combined Specialty Programs Physical and rehabilitation of Residents a No. of Residents in Program Year 1 Positions b No. of Residents in GY1 Positions With Prior US GME c Without Prior US GME c Brain injury Pediatric rehabilitation Spinal cord injury Sports Plastic surgery Craniofacial surgery Hand surgery Plastic surgery-integrated Preventive Medical toxicology Undersea and hyperbaric Psychiatry Addiction psychiatry Child and adolescent psychiatry Forensic psychiatry Geriatric psychiatry Psychosomatic Radiation oncology Radiology-diagnostic Abdominal radiology Musculoskeletal radiology Neuroradiology Nuclear radiology Pediatric radiology Vascular and interventional radiology Interventional radiology-integrated f Sleep g Surgery-general Complex general surgical oncology Hand surgery Pediatric surgery Surgical critical care Vascular surgery Vascular surgery-integrated f Thoracic surgery Congenital cardiac surgery Thoracic surgery-integrated f Urology Female pelvic Pediatric urology Transitional year jama.com (Reprinted) JAMA December 19, 2017 Volume 318, Number

9 Table 3. Total Number of Resident Physicians in Program Year 1 Positions and in Graduate Year 1 (GY1) Positions on Duty December 31, 2016, in ACGME-Accredited Programs and in Combined Specialty Programs No. of Residents in Program Year 1 No. of Residents in GY1 Positions of Residents a Positions b With Prior US GME c Without Prior US GME c Combined Specialties Diagnostic radiology/nuclear Emergency /family Family /preventive Internal /anesthesiology Internal /dermatology Internal /emergency Internal /emergency /critical care Internal /family Internal /medical genetics and genomics Internal /neurology Internal /pediatrics Internal /preventive Internal /psychiatry Pediatrics/anesthesiology Pediatrics/emergency Pediatrics/medical genetics and genomics Pediatrics/physical and rehabilitation Pediatrics/psychiatry/child and adolescent psychiatry Psychiatry/family Psychiatry/neurology Total a Includes resident physicians on duty as of December 31, 2016, reported through the 2016 National GME Census. A total of 205 programs (2.0%) did not provide updated information on residents by March 1, For these nonresponding programs, resident physicians reported from the last received d Hospice and palliative is a subspecialty of anesthesiology, family, internal, pediatrics, psychiatry, or radiation oncology. Pain is a subspecialty of anesthesiology, neurology, physical and rehabilitation, or psychiatry. survey were moved into their next year in the program or graduated. Integrated programs differ from subspecialty programs in that they include b Program year 1 refers to the first year of training within a specific program; this core surgical education. may not correspond to the graduate year. Sleep is a subspecialty of anesthesiology, family, internal c Graduate year 1 (GY1) refers to positions available the first year after, neurology, otolaryngology, pediatrics, or psychiatry. completing medical school; approximately 2.6% of resident physicians in GY1 positions have had some prior US graduate medical education (GME). Table 4. Programs and Resident Physicians on Duty December 31, 2016, by Number per and by Region and State Region and State per a Programs c Resident Physicians d No. of Resident Physicians 2016 State Population, in 1000s b No. (%) New England, subtotal (7.9) 9846 (7.9) Connecticut (1.7) 2338 (1.9) Maine (0.3) 332 (0.3) Massachusetts (4.3) 5616 (4.5) New Hampshire (0.5) 408 (0.3) Rhode Island (0.7) 840 (0.7) Vermont (0.4) 312 (0.3) Middle Atlantic, subtotal (20.1) (22.0) New Jersey (2.1) 2834 (2.3) New York (11.5) (13.1) Pennsylvania (6.5) 8189 (6.6) East North Central, subtotal (17.1) (17.2) Illinois (4.6) 6203 (5.0) Indiana (1.1) 1428 (1.2) Michigan (4.3) 5669 (4.6) Ohio (5.2) 6150 (5.0) Wisconsin (1.8) 1871 (1.5) 2376 JAMA December 19, 2017 Volume 318, Number 23 (Reprinted) jama.com

10 Table 4. Programs and Resident Physicians on Duty December 31, 2016, by Number per and by Region and State Region and State per a Programs c Resident Physicians d No. of Resident Physicians 2016 State Population, in 1000s b No. (%) West North Central, subtotal (6.9) 7958 (6.4) Iowa (0.9) 931 (0.8) Kansas (0.6) 830 (0.7) Minnesota (2.1) 2284 (1.8) Missouri (2.4) 2856 (2.3) Nebraska (0.7) 778 (0.6) North Dakota (0.1) 132 (0.1) South Dakota (0.1) 147 (0.1) South Atlantic, subtotal (17.1) (15.9) Delaware (0.3) 277 (0.2) District of Columbia (1.7) 1853 (1.5) Florida (4.0) 4656 (3.8) Georgia (2.0) 2365 (1.9) Maryland (2.2) 2796 (2.3) North Carolina (2.9) 3311 (2.7) South Carolina (1.1) 1360 (1.1) Virginia (2.2) 2346 (1.9) West Virginia (0.6) 745 (0.6) East South Central, subtotal (5.0) 5745 (4.6) Alabama (1.2) 1380 (1.1) Kentucky (1.2) 1214 (1.0) Mississippi (0.6) 647 (0.5) Tennessee (2.0) 2504 (2.0) West South Central, subtotal (9.3) (9.6) Arkansas (0.6) 770 (0.6) Louisiana (1.6) 2071 (1.7) Oklahoma (0.7) 872 (0.7) Texas (6.3) 8163 (6.6) Mountain, subtotal (4.4) 5120 (4.1) Arizona (1.4) 1691 (1.4) Colorado (1.2) 1367 (1.1) Idaho (0.1) 113 (0.1) Montana (<0.1) 80 (0.1) Nevada (0.3) 448 (0.4) New Mexico (0.6) 583 (0.5) Utah (0.8) 798 (0.6) Wyoming (<0.1) 40 (<0.1) Pacific, subtotal (11.6) (11.6) Alaska (<0.1) 32 (<0.1) California (8.8) (8.9) Hawaii (0.3) 426 (0.3) Oregon (0.8) 953 (0.8) Washington (1.5) 1979 (1.6) Puerto Rico (0.7) 785 (0.6) Total (100.0) (100.0) a Aggregate number of resident physicians per population. b 2016 State population is from Table 1 in the Annual Estimates of the Resident Population for the United States, Regions, States, and Puerto Rico: April 1, 2010 to July 1, 2016 (NST-EST ). Source: US Census Bureau, Population Division. Release Date: December 2016, /data/tables/2016/demo/popest/nation-total.html. Total population numbers include the District of Columbia and Puerto Rico. c Total number of US GME programs accredited by the Accreditation Council for Graduate Medical Education and combined specialty programs, as of December 31, 2016, surveyed by the National GME Census during d Includes resident physicians on duty as of December 31, 2016, reported through the 2016 National GME Census. A total of 205 programs (2.0%) did not provide updated information on residents by March 1, For these nonresponding programs, resident physicians reported from the last received survey were moved into their next year in the program or graduated. jama.com (Reprinted) JAMA December 19, 2017 Volume 318, Number

11 Table 5. Citizenship Status of International Medical Graduates With No Prior US Graduate Medical Education (GME) in the First Year of GME on Duty December 31, 2016 a US Citizen US Permanent Resident Non-US Citizen Unknown Citizenship/ Foreign Born Total Anesthesiology Emergency Family Internal Neurological surgery Neurology Obstetrics and gynecology Orthopedic surgery Otolaryngology Pathology-anatomic and clinical Pediatrics Physical and rehabilitation Plastic surgery-integrated b Psychiatry Radiology-diagnostic Surgery-general Vascular surgery-integrated b Thoracic surgery-integrated b Transitional year Combined Specialties Emergency /family Family /preventive Internal /emergency Internal /pediatrics Internal /preventive Internal /psychiatry Pediatrics/medical genetics and genomics Pediatrics/psychiatry/child and adolescent psychiatry Total, No. (%) 2525 (39.8) 804 (12.7) 1823 (28.7) 1198 (18.9) 6350 (100.0) a Includes only international medical graduate resident physicians (IMGs) entering US GME for the first time; graduates of Canadian medical schools are b Integrated programs differ from subspecialty programs in that they include core surgical education. not considered IMGs JAMA December 19, 2017 Volume 318, Number 23 (Reprinted) jama.com

12 Table 6. Race and Hispanic Ethnic Origin of Resident Physicians on Duty December 31, 2016, by Type of Medical School From Which They Graduated a No. (%) US and Canadian Allopathic Race b School US Osteopathic School Non-US School Total Black 4841 (70.1) 223 (3.2) 1841 (26.7) 6905 American Indian/Alaskan Native 133 (87.5) 9 (5.9) 10 (6.6) 152 White (74.2) 8718 (12.2) 9662 (13.6) Asian (53.1) 2214 (6.6) (40.3) Native Hawaiian/Pacific Islander 59 (36.9) 19 (11.9) 82 (51.2) 160 Multiracial 2590 (70.8) 266 (7.3) 802 (21.9) 3658 Other/unknown 3936 (44.9) 929 (10.6) 3903 (44.5) 8768 Ethnic origin b Hispanic 5962 (63.4) 364 (3.9) 3083 (32.8) 9409 Non-Hispanic (66.3) (10.5) (23.2) Total c (66.1) (10.0) (23.9) a Includes resident physicians on duty as of December 31, 2016, reported through the 2016 National GME Census. A total of 205 programs (2.0%) did not provide updated information on residents by March 1, For these nonresponding programs, resident physicians reported from the last received survey were moved into their next year in the program or graduated. b The 2016 National GME Census imported self-designated race/ethnicity from Association of American Medical Colleges databases where available. Multiracial refers to residents who have self-identified as more than 1 race. A person of Hispanic ethnicity may be of any race. c These total data apply to each subsection separately (ie, total for race and total for ethnic origin). Table 7. Citizenship/Visa Status of All Resident Physicians and International Medical Graduates (IMGs) on Duty in ACGME-Accredited and in Combined Specialty Programs, December 31, 2016 Citizenship/Visa Status Resident Physicians a Native US citizen (70.3) 7567 (25.5) Naturalized US citizen 9863 (7.9) 3757 (12.6) Permanent resident 7514 (6.1) 4774 (16.1) B-1, B-2 temporary visitor 37 (<0.1) 35 (0.1) F-1 student 426 (0.3) 5 (<0.1) H-1, H-1B, H-2, H-3 temporary worker 2869 (2.3) 2588 (8.7) J-1, J-2 exchange visitor 6996 (5.6) 6816 (22.9) Refugee/asylee/displaced person 74 (<0.1) 68 (0.2) Other 345 (0.3) 219 (0.7) Unknown citizenship/foreign born 8493 (6.8) 3890 (13.1) Unknown citizenship/unknown birth country 276 (0.2) 0 Total a Includes resident physicians on duty as of December 31, 2016, reported through the 2016 National GME Census. A total of 205 programs (2.0%) did not provide updated information on residents by March 1, For these Total IMGs b nonresponding programs, resident physicians reported from the last received survey were moved into their next year in the program or graduated. b Does not include graduates of Canadian medical schools. jama.com (Reprinted) JAMA December 19, 2017 Volume 318, Number

13 Table 8. Race and Ethnic Origin of Resident Physicians in ACGME-Accredited and in Combined Specialty Graduate Medical Education (GME) Programs on Duty December 31, 2016, by Specialty No. of Resident Physicians a,b American Native Indian/ Hawaiian/ Alaskan Pacific Multiracial Other/ Hispanic Black Native White Asian Islander Unknown Origin Total Allergy and immunology Anesthesiology Adult cardiothoracic anesthesiology Critical care Obstetric anesthesiology Pediatric anesthesiology Colon and rectal surgery Dermatology Dermatopathology Micrographic surgery and dermatologic oncology Emergency Clinical informatics Emergency medical services Medical toxicology Pediatric emergency Sports Undersea and hyperbaric Family Clinical informatics Geriatric Sports Hospice and palliative c Internal Adult congenital heart disease Advanced heart failure and transplant cardiology Cardiovascular disease Clinical cardiac electrophysiology Clinical informatics Critical care Endocrinology, diabetes, and metabolism Gastroenterology Geriatric Hematology Hematology and medical oncology Infectious disease Interventional cardiology Nephrology Medical oncology Pulmonary disease Pulmonary disease and critical care Rheumatology Transplant hepatology Medical genetics and genomics Medical biochemical genetics Molecular genetic pathology JAMA December 19, 2017 Volume 318, Number 23 (Reprinted) jama.com

14 Table 8. Race and Ethnic Origin of Resident Physicians in ACGME-Accredited and in Combined Specialty Graduate Medical Education (GME) Programs on Duty December 31, 2016, by Specialty No. of Resident Physicians a,b American Native Indian/ Hawaiian/ Alaskan Pacific Multiracial Other/ Hispanic Black Native White Asian Islander Unknown Origin Total Neurological surgery Neurology Child neurology Clinical neurophysiology Epilepsy Neurodevelopmental disabilities Neuromuscular Vascular neurology Nuclear Obstetrics and gynecology Female pelvic Gynecologic oncology Maternal-fetal Reproductive endocrinology and infertility Ophthalmology Ophthalmic plastic Orthopedic surgery Adult reconstructive orthopedics Foot and ankle orthopedics Hand surgery Musculoskeletal oncology Orthopedic sports Orthopedic surgery of the spine Orthopedic trauma Pediatric orthopedics Osteopathic neuromusculoskeletal Otolaryngology Neurotology Pediatric otolaryngology Pain d Pathology-anatomic and clinical Blood banking/transfusion Clinical informatics Chemical pathology Cytopathology Forensic pathology Hematology Medical microbiology Neuropathology Pediatric pathology Selective pathology jama.com (Reprinted) JAMA December 19, 2017 Volume 318, Number

15 Table 8. Race and Ethnic Origin of Resident Physicians in ACGME-Accredited and in Combined Specialty Graduate Medical Education (GME) Programs on Duty December 31, 2016, by Specialty No. of Resident Physicians a,b American Native Indian/ Hawaiian/ Alaskan Pacific Multiracial Other/ Hispanic Black Native White Asian Islander Unknown Origin Total Pediatrics Adolescent Child abuse pediatrics Clinical informatics Developmental-behavioral pediatrics Neonatal-perinatal Pediatric cardiology Pediatric critical care Pediatric emergency Pediatric endocrinology Pediatric gastroenterology Pediatric hematology/oncology Pediatric infectious diseases Pediatric nephrology Pediatric pulmonology Pediatric rheumatology Pediatric sports Pediatric transplant hepatology Physical and rehabilitation Brain injury Pediatric rehabilitation Spinal cord injury Sports Plastic surgery Craniofacial surgery Hand surgery Plastic surgery-integrated e Preventive Medical toxicology Undersea and hyperbaric Psychiatry Addiction psychiatry Child and adolescent psychiatry Forensic psychiatry Geriatric psychiatry Psychosomatic Radiation oncology Radiology-diagnostic Abdominal radiology Musculoskeletal radiology Neuroradiology Nuclear radiology Pediatric radiology Vascular and interventional radiology Interventional radiology-integrated e Sleep f JAMA December 19, 2017 Volume 318, Number 23 (Reprinted) jama.com

16 Table 8. Race and Ethnic Origin of Resident Physicians in ACGME-Accredited and in Combined Specialty Graduate Medical Education (GME) Programs on Duty December 31, 2016, by Specialty No. of Resident Physicians a,b American Native Indian/ Hawaiian/ Alaskan Pacific Multiracial Other/ Hispanic Black Native White Asian Islander Unknown Origin Total Surgery-general Complex general surgical oncology Hand surgery Pediatric surgery Surgical critical care Vascular surgery Vascular surgery-integrated e Thoracic surgery Congenital cardiac surgery Thoracic surgery-integrated e Urology Female pelvic Pediatric urology Transitional year Combined Specialties Diagnostic radiology/nuclear Emergency /family Family /preventive Internal /anesthesiology Internal /dermatology Internal /emergency Internal /emergency / critical care Internal /family Internal /medical genetics and genomics Internal /neurology Internal /pediatrics Internal /preventive Internal /psychiatry Pediatrics/anesthesiology Pediatrics/emergency Pediatrics/medical genetics and genomics Pediatrics/physical and rehabilitation Pediatrics/psychiatry/child and adolescent psychiatry Psychiatry/family Psychiatry/neurology Total c Hospice and palliative is a subspecialty of anesthesiology, family, internal, pediatrics, psychiatry, or radiation oncology. d Pain is a subspecialty of anesthesiology, neurology, physical and rehabilitation, or psychiatry. e Integrated programs differ from subspecialty programs in that they include a Includes resident physicians on duty as of December 31, 2016, reported through the 2016 National GME Census. A total of 206 programs (2.0%) did not provide updated information on residents by March 1, For these nonresponding programs, resident physicians reported from the last received survey were moved into their next year in the program or graduated. b The 2016 National GME Census imported self-designated race/ethnicity from Association of American Medical Colleges databases where available. Multiracial refers to residents who have self-identified as more than one race. A person of Hispanic ethnicity may be of any race. core surgical education. f Sleep is a subspecialty of anesthesiology, family, internal, neurology, otolaryngology, pediatrics, or psychiatry. jama.com (Reprinted) JAMA December 19, 2017 Volume 318, Number

17 Table 9. Resident Physicians Who Completed a Graduate Medical Education (GME) Program or Preliminary Year During a No. Completing a Program No. Completing a Preliminary Year Allergy and immunology Anesthesiology Adult cardiothoracic anesthesiology Critical care Obstetric anesthesiology 39 0 Pediatric anesthesiology Colon and rectal surgery 84 0 Dermatology Dermatopathology 73 0 Micrographic surgery and 66 0 dermatologic oncology Emergency Clinical informatics 1 0 Emergency medical services 41 0 Medical toxicology 28 0 Pediatric emergency 33 0 Sports 9 0 Undersea and hyperbaric 7 0 Family Geriatric 46 0 Sports Hospice and palliative b Internal Advanced heart failure and transplant cardiology 68 0 Cardiovascular disease Clinical cardiac electrophysiology Critical care Endocrinology, diabetes, and metabolism Gastroenterology Geriatric Hematology 5 0 Hematology and medical oncology Infectious disease Interventional cardiology Nephrology Medical oncology 33 0 Pulmonary disease 35 0 Pulmonary disease and critical care Rheumatology Transplant hepatology 34 0 Medical genetics and genomics 32 0 Medical biochemical genetics 7 0 Molecular genetic pathology 49 0 Table 9. Resident Physicians Who Completed a Graduate Medical Education (GME) Program or Preliminary Year During a No. Completing a Program No. Completing a Preliminary Year Neurological surgery Neurology Child neurology Clinical neurophysiology Epilepsy 48 0 Neurodevelopmental disabilities Neuromuscular Vascular neurology Nuclear 35 0 Obstetrics and gynecology Female pelvic 41 0 Ophthalmology Ophthalmic plastic 3 0 Orthopedic surgery Adult reconstructive orthopedics 41 0 Foot and ankle orthopedics 13 0 Hand surgery Musculoskeletal oncology Orthopedic sports Orthopedic surgery of the spine Orthopedic trauma 17 0 Pediatric 35 0 orthopedics Otolaryngology Neurotology 13 0 Pediatric 28 0 otolaryngology Pain c Pathology-anatomic and clinical Blood banking/transfusion 46 0 Chemical pathology 2 0 Cytopathology Forensic pathology 46 0 Hematology Medical microbiology 10 0 Neuropathology 21 0 Pediatric pathology 19 0 Selective pathology JAMA December 19, 2017 Volume 318, Number 23 (Reprinted) jama.com