Danbury Hospital is a 456-bed hospital in Danbury, Connecticut serving patients in Fairfield County, Connecticut, as well as Westchester County and Putnam County, New York.The hospital has 3,300 employees and is part of the Nuvance Health system. John M. Murphy, M.D. is CEO of Nuvance Health, and previously served as president and CEO of Western Connecticut Health Network, which merged with Health Quest in early 2019 to form Nuvance Health.
BACKGROUND:Breast surgical oncology was the most competitive surgical fellowship match in 2025, with a record low of 61% of applicants successfully matched. Previous studies evaluated the attitudes of program directors on the selection and ranking criteria of candidates. This study evaluates the perspectives of both program directors and associate program directors on the selection and ranking process because of the increasing competitiveness of the field. METHODS:An anonymous, web-based survey was sent to all breast surgical oncology fellowship program leadership. The survey consisted of 24 questions. Survey analysis was performed using descriptive statistics. RESULTS:Of 65 programs, 76.9% responded; 50 program directors and 26 associate program directors participated. Over half of programs (57.9%) engaged in holistic review of applicants before offering an interview and did not have formal screening criteria. For most programs (84%), additional faculty members beyond program leadership contributed to the rank list. Interview performance was the most important factor (65.8%) in the formation of the rank list. DISCUSSION:Compared with prior years, breast surgical oncology fellowship directors reported fewer screening metrics before extending an interview. In rank list formation, there continues to be a strong majority consensus with previous years and among other surgical subspecialties that interview performance has the largest impact. An improved understanding of the application and rank list process enables both applicants and program directors to better prepare for a successful match.
Background:Peptic ulcer bleeding remains a significant cause of non-variceal upper gastrointestinal bleeding (NVUGIB). While over-the-scope clips (OTSC) are increasingly used as rescue therapy, their efficacy as first-line treatment remains unclear. The aim of this study is to evaluate the efficacy and safety of OTSC compared to standard endoscopic therapy (SET) as a first-line treatment in patients with bleeding peptic ulcer disease (PUD). Methods:A systematic literature search was conducted across MEDLINE, Embase, Scopus, and Web of Science databases up to March 13, 2026. Studies comparing OTSC and SET in bleeding PUD were included. Primary outcome was Clinical Success. Secondary outcomes included primary and technical success, need for surgery or re-therapy, mortality, hospital stay, and adverse events. Meta-analyses were performed using a random-effects model. Results:Six studies [3 randomized controlled trials (RCTs), 3 observational] comprising 454 patients were included. OTSC significantly improved clinical success [risk ratio (RR) =1.16, 95% confidence interval (CI): 1.06-1.27, P=0.002]. OTSC also significantly reduced overall bleeding (RR =0.46, 95% CI: 0.25-0.82, P=0.009). No statistically significant differences were observed in primary success, technical success, 7- or 30-day rebleeding, need for re-therapy, surgical intervention, in-hospital mortality, total mortality, adverse events, or hospital stay. Conclusions:OTSC is associated with significantly higher clinical success and lower overall bleeding rates compared to SET in bleeding PUD. Secondary outcomes, including rebleeding, re-intervention, and mortality, trended in favour of OTSC but did not reach statistical significance, likely reflecting limited power. These findings support OTSC as a promising first-line option. Further large-scale RCTs are warranted to confirm these results and guide clinical implementation.
