Dawn Abbott, MD, MSCAI, SCAI President-Elect and Interventional Cardiology Match Task Force Co-Chair 

Douglas E. Drachman, MD, MSCAI, SCAI Interventional Cardiology Match Task Force Co-Chair 

Srihari S. Naidu, MD, MSCAI, SCAI President 

In the days following the 2025 Interventional Cardiology Fellowship Match, it became clear that this was not just another recruitment cycle. The Match process worked, with applicants overwhelmingly securing positions. And yet, many programs were left with unfilled spots. That combination naturally raised questions and, in some cases, frustration.  

That is why SCAI convened the Town Hall on December 15. The goal was to share data transparently, listen carefully, and begin a collective discussion about what this moment means for interventional cardiology and how we move forward together. 

We heard from program directors worried about staffing, call coverage, and the sustainability of their training programs. We heard from fellows seeking clarity about what the numbers mean for the future of the specialty. And across these conversations, one theme was consistent: while the Match brought long-needed fairness and structure to recruitment, it also shed some much-needed light on workforce supply and demand trajectories. 

We have made the Town Hall available to watch online. In this post, we will dive into the key points and what we have learned from the data.  

Interest in Interventional Cardiology Remains Robust 

One point deserves emphasis at the outset: interventional cardiology continues to attract trainees. 

• Best available estimates suggest that approximately 350 fellows complete interventional cardiology training each year, a number that has slowly and consistently increased over time. 

• Despite well-known challenges, trainees continue to choose IC for its immediacy, technical rigor, expansion into disease processes beyond the coronaries, and the opportunity to make a life-saving difference for patients in critical moments. 

This steady growth matters. It tells us that interest in the field has not disappeared. Rather, trainees are approaching career decisions with greater deliberation about long-term sustainability. 

The Match Delivered for Applicants 

For the 2026 appointment year, 97 percent of applicants successfully matched. This occurred through a regulated, transparent, and equitable process, replacing the compressed and high-pressure recruitment environment that existed previously. 

For fellows, this structure represents a meaningful improvement, allowing thoughtful decision-making and promoting fairness across programs. 

What the Match Made Visible 

What surprised many was not applicant success, but what the Match revealed about training capacity. The Match now enables us to detect a dramatic mismatch between the number of U.S. fellowship positions compared with the number of applicants: 

• 153 programs participated 

• 307 fellowship positions were offered 

• 244 applicants entered the Match 

• 71 positions across 49 programs went unfilled 

These insights draw from NRMP Match data, ACGME-approved program and position counts, and ERAS applicant data. While some recruitment continues outside the Match, this represents the clearest national snapshot of the interventional cardiology workforce to date. 

These data do not reflect declining interest in interventional cardiology. Instead, they highlight how rapidly fellowship positions have expanded compared with the more measured growth of the applicant pool. 

Why Are Fellowship Positions Expanding? 

As discussed during the Town Hall, there is no single explanation for the expansion of fellowship positions. 

Programs may be expanding in response to local workforce shortages, increasing procedural complexity, institutional service demands, or anticipated future needs. These decisions are often thoughtful and well-intentioned. At the same time, they are not always aligned with national job market signals or geographic workforce distribution. 

This disconnect underscores the value of the Match in bringing transparency to workforce planning. SCAI will continue to evaluate procedural volumes, regional trends, procedure mix, and projected workforce needs across the United States to help inform responsible decision-making. 

Career Realities Shape the Pipeline 

A consistent message from fellows during the Town Hall was that career decisions are shaped less by interest and more by sustainability. 

Participants spoke candidly about radiation exposure, orthopedic strain from years in lead, STEMI call responsibilities, burnout, compensation, and work-life balance. These concerns mirror findings from SCAI’s 2023 Occupational Health Hazards Survey and reflect the lived experience of many in the field. 

Importantly, fellows are not turning away from interventional cardiology because they dislike the work – in fact, interest in the field continues to grow despite these. Nevertheless, they are rightly asking whether it is a career they can sustain over many decades.  

Moving Forward 

Addressing the concerns of programs and fellows is central to SCAI’s mission. Our priorities include: 

• Modernizing radiation protection and reducing physical strain 

• Addressing call expectations and fair compensation, including the unique demands of STEMI, PERT, shock, and other acute care 

• Advancing wellness, ergonomics, and pregnancy safety in the cath lab 

• Strengthening mentorship, early exposure, and diversity initiatives 

• Encouraging thoughtful evaluation and right-sizing of fellowship positions 

SCAI also continues to support an “all-in” culture for programs and applicants in the Match, recognizing that fairness, transparency, and trust in recruitment are essential to the health of the future workforce. 

SCAI will continue to evaluate the composition of the workforce, including PCI volumes, regional trends, types of procedures performed, and projected needs across the United States, and use this data to inform our interventional cardiology programs.  

Training programs may continue to evaluate their needs, such as “right-sizing” the number of fellowship positions to mirror the size of the recruitment class, identifying strategies to promote the advantages of their programs in order to stand out in a competitive recruitment market, and optimizing their yield in the Match by interviewing and ranking more applicants. 

The Town Hall demonstrated that our community is engaged and committed to the future of interventional cardiology. The work ahead will require collaboration and continued dialogue, and SCAI is committed to leading that effort to ensure we succeed together.