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Wood RS, Krumrey J. Examining differences in trends in the orthopedic surgery match for osteopathic and allopathic medical graduates after the transition to single accreditation. J Osteopath Med 2024; 0:jom-2023-0240. [PMID: 38511719 DOI: 10.1515/jom-2023-0240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 02/06/2024] [Indexed: 03/22/2024]
Abstract
CONTEXT The landscape of medical education in the United States has undergone significant changes, particularly with the rise of osteopathic medical students, constituting a substantial portion of medical school entrants. The merger of the Accreditation Council for Graduate Medical Education (ACGME) and the American Osteopathic Association (AOA) in 2020 opened residency slots to allopathic graduates that were previously historically allocated to osteopathic (Doctor of Osteopathic Medicine [DO]) physicians. This has impacted various medical specialties, notably orthopedic surgery. Despite an increase in orthopedic surgery applicants, the match rates for DO candidates have faced challenges, raising concerns about the impact of this merger on the future of orthopedic training for DO students. OBJECTIVES This research aims to analyze the trends in orthopedic surgery match rates for DO vs MD applicants since the single accreditation merger, which began in 2015 with a 5-year transition period that was finalized by 2020. By examining factors such as application numbers, research output, standardized test scores, and program director preferences, the study seeks to identify disparities and challenges faced by DO applicants in securing orthopedic surgery residencies. METHODS This study utilized publicly available data from the National Residency Match Program (NRMP) 2018, 2020, and 2022 reports. Data encompassed applicant characteristics, including standardized test scores, research experiences, and match outcomes. The study also incorporated insights from NRMP program director surveys, focusing on interview and ranking practices. The analysis involved comparisons of application numbers, match rates, research productivity, and test scores between DO and MD applicants. Statistical analysis was employed to identify any statistically significant differences among the examined variables for the 3 years included in the study. RESULTS The research revealed a consistent increase in orthopedic surgery applicants from both DO and MD backgrounds. However, MD applicants consistently had higher match rates compared to their DO counterparts, with the gap narrowing over the years. Notably, disparities persisted in research output, with MD applicants demonstrating a significant advantage in publications and presentations. Standardized test scores, although slightly higher for MD applicants, did not significantly impact the differences in match rates. MD applicants had statistically significantly higher numbers of applicants (P = .0010), number of publications (P = .0091), and number of research experiences (P = .0216) over the years examined. However, there was no statistically significant difference in the scores on Step 1 (P = .5038) or Step 2 (P = .4714) between MD and DO candidates. CONCLUSIONS Despite progress in the acceptance and ranking of DO applicants by program directors, the study highlights enduring challenges in orthopedic surgery match rates between DO and MD candidates. The lack of research opportunities for DO students stands out as a crucial area for improvement, necessitating systemic changes within medical education. Addressing this disparity and ensuring equal access to research experiences could mitigate the gap in match rates, promoting a more equitable environment for all aspiring orthopedic surgeons, regardless of their medical background. Such efforts are vital to fostering inclusivity and enhancing opportunities for osteopathic medical students pursuing competitive specialties like orthopedic surgery.
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Affiliation(s)
- Robert S Wood
- Department of Orthopedic Surgery, Samaritan Health Services 2696 , Corvallis, OR, USA
| | - Jacqueline Krumrey
- Department of Orthopedic Surgery, Samaritan Health Services 2696 , Corvallis, OR, USA
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2
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Mandle Q, Ream MA. Child Neurology and Neurodevelopmental Disabilities Program Directors' Opinions on Preference Signaling in the 2023-2024 National Resident Matching Program Match: A Survey. Pediatr Neurol 2024; 151:90-95. [PMID: 38141554 DOI: 10.1016/j.pediatrneurol.2023.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 11/11/2023] [Accepted: 11/29/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND Changes in residency recruitment have significantly altered how programs and applicants evaluate each other including virtual interviews, discontinuation of the United States Medical Licensing Exam Step 2 Clinical Skills exam, and transition of United States Medical Licensing Exam Step 1 to pass-fail scoring. To improve program-applicant fit, the Electronic Residency Application Service introduced supplemental application features including geographic preference, program signaling, and the opportunity to highlight impactful and meaningful experiences. We sought to evaluate child neurology (CN) and neurodevelopmental disabilities (NDD) program director's (PD) opinions regarding these changes. METHODS A 10-question anonymous survey was sent to CN (n=75) and NDD (n=8) PDs. The questions centered on PDs' opinions regarding components of the supplemental application, having a standard application review period and in-person recruitment activities. Answer choices to the questions were all close-ended. Respondents could select questions to complete. RESULTS Thirty-eight CN residency PDs (49%) and 4 NDD residency PDs (50%) responded to the survey. Among CN PDs, there was strong support for use of the supplemental application questions and for the use of 3 program signals per applicant. Most PDs supported a standardized application review period prior to programs sending interview offers; however, there was no consensus on the appropriate length of time. Nearly half agreed with virtual-only interviews, and 62% agreed with the option of in-person second-look visits. CONCLUSIONS CN PDs generally support many of the recent or proposed changes to residency recruitment. The impact of these changes on recruitment will be a topic of future investigation.
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Affiliation(s)
- Quinton Mandle
- Division of Neurology, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio
| | - Margie A Ream
- Division of Neurology, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio.
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3
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Yekula A, Sreeram S, Dhawan S, Sharma M, Sandoval-Garcia C, Huling JD, Suri A, Belani K, Park MC, Carter BS, Chen CC. Neurosurgery residency match for international medical graduates in the United States. J Neurosurg 2024; 140:291-298. [PMID: 37548564 DOI: 10.3171/2023.5.jns23556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 05/26/2023] [Indexed: 08/08/2023]
Abstract
OBJECTIVE Training of international medical graduates (IMGs) offers opportunities for the US neurosurgery community to engage the global talent pool and impact national and international healthcare. Here, the authors analyzed the time trend of IMGs matching into US neurosurgery programs and identified potential opportunities for enhancing IMG engagement. METHODS The authors analyzed the National Resident Matching Program (NRMP) match results, NRMP program director (PD) surveys, and applicant surveys from 2013 to 2022. Regression methods were used to analyze time trends. RESULTS Between 2013 and 2022, the number of US neurosurgery residency positions increased by 17.6% (from 204 to 240). During this period, the percentage of IMGs matching into neurosurgery increased from 3.5% to 7%, translating into a 6.8% increase in the likelihood of a successful IMG match per year (95% CI 0.3%-13.8%, p = 0.042). The likelihoods of a successful match for US MDs and IMGs scoring > 260 on the USMLE Step 1 were > 90% and approximately 55%, respectively. In PD surveys, approximately 90% of PDs indicated that they seldom/never interview or rank IMGs. In terms of factors that influenced the PD decision for interviewing/ranking, IMGs are disadvantaged in several categories, including the ability to secure an audition elective/rotation, and proper letters of recommendation, as well as the influence of the culture on the preconceived perception of poor interpersonal skills. CONCLUSIONS The number of IMGs matching successfully in neurosurgery has increased marginally during the past decade. The authors outline the challenges that IMGs encounter in this process and suggest strategies for considerations of IMG training in NRMP-associated institutions.
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Affiliation(s)
| | | | | | | | | | - Jared D Huling
- 3Division of Biostatistics, School of Public Health, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Ashish Suri
- 4Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India; and
| | - Kumar Belani
- 5Anesthesiology, University of Minnesota Medical Center, University of Minnesota Medical School, Minneapolis, Minnesota
| | | | - Bob S Carter
- 6Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Lakhani DA, Murugesan A, Patel S, Garg T, Balar AB, Sadovnikov I, Swaney KJ, Yedavalli V, Hogg JP, Yousem DM. Supplemental ERAS application for radiology residency match: A primer. Curr Probl Diagn Radiol 2024; 53:34-39. [PMID: 37940469 DOI: 10.1067/j.cpradiol.2023.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 10/18/2023] [Indexed: 11/10/2023]
Abstract
The supplemental ERAS application that includes three components: past experiences, geographic preferences, and program signals was introduced in 2022 to complement the standard ERAS CV material. The goal was to help programs identify optimal candidates to interview and to improve the chances of applicants being invited for interviews at programs that align with their goals and interests. Based on limited data, Program signal is the most emphasized component by the programs. Applicants should realize that programs have used signals to determine who to interview (aligned with AAMC guidance), and to determine the program's candidate rank list (contrary to AAMC guidance). We have herein suggested options for leveraging benefits from the ERAS supplemental application which has now been incorporated into the full ERAS application.
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Affiliation(s)
- Dhairya A Lakhani
- Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Radiology, West Virginia University, Morgantown, WV, USA.
| | - Arun Murugesan
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA
| | - Sahil Patel
- Department of Radiology, University of Texas School of Medicine, Houston, TX, USA
| | - Tushar Garg
- Division of Interventional Radiology, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Aneri B Balar
- Department of Radiology, West Virginia University, Morgantown, WV, USA
| | | | - Katie J Swaney
- Department of Radiology, West Virginia University, Morgantown, WV, USA
| | - Vivek Yedavalli
- Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jeffery P Hogg
- Department of Radiology, West Virginia University, Morgantown, WV, USA
| | - David M Yousem
- Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Yu N, Hoch JS, Martin AR, Shahlaie K. Trends in successfully matched neurosurgery residency applicants. J Neurosurg 2023; 139:1456-1462. [PMID: 37086164 DOI: 10.3171/2023.3.jns222397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 03/06/2023] [Indexed: 04/23/2023]
Abstract
OBJECTIVE The United States Medical Licensing Examination (USMLE) Step 1 recently transitioned to a pass/fail outcome, renewing interest in how programs select neurosurgical residents. This study investigates the association between match status and key academic metrics over time. METHODS Data are from the National Resident Matching Program from 2009 to 2022 for matched and unmatched US allopathic (MD) seniors. Investigated metrics included the mean number of contiguous ranks; mean number of distinct specialties ranked; mean USMLE Step 1 and Step 2 Clinical Knowledge (CK) scores; mean number of abstracts, presentations, and publications; mean number of research, work, and volunteer experiences; Alpha Omega Alpha status; attendance at a top 40 NIH-funded institution; PhD degree; and other degree. Multiple linear regression without an interaction term was used to evaluate how these have varied between the two groups during the study period and whether there is a difference between unmatched and matched MD seniors applying for a neurosurgical residency. Multiple linear regression with an interaction term was then used to test whether the difference in variables between the two groups changed over time. RESULTS Regardless of match status, MD senior neurosurgical residency applicants exhibited an increase in USMLE Step 1 and 2 scores; average research experiences; abstracts, presentations, and publications; and work and volunteer experiences (p < 0.001). The percentage of applicants from a top 40 NIH-funded school decreased (p = 0.018), and the percentage who held an additional degree increased (p = 0.007). Between groups, there were significant differences in all categories except work experiences and other degree obtained. Over time, the difference between USMLE Step 2 scores between matched and unmatched seniors diminished (p = 0.027); in contrast, the difference in abstracts, presentations, and publications between the two groups increased over time (p < 0.001). CONCLUSIONS From 2009 to 2022, neurosurgical residency applicants grew in their achievements across many metrics. In the advent of Step 1 becoming pass/fail, this study suggests that Step 2 is not viewed by programs as an adequate replacement. However, the Step 1 grading transition may serve as an opportunity for other factors to be considered that may better predict success in neurosurgical residency.
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Affiliation(s)
- Nina Yu
- 1University of California, Davis, School of Medicine, Sacramento
| | - Jeffrey S Hoch
- 2Department of Public Health Sciences, Division of Health Policy and Management, Center for Healthcare Policy and Research, University of California, Davis, School of Medicine, Sacramento
| | - Allan R Martin
- 3Department of Neurological Surgery, University of California, Davis, Medical Center, Sacramento, California
| | - Kiarash Shahlaie
- 3Department of Neurological Surgery, University of California, Davis, Medical Center, Sacramento, California
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Wong GM, Cobourn K, Smith K, Covell MM, Dowlati E, Breton JM, Pivazyan G, Nair MN. Reducing implicit bias in the neurosurgery application and interview process: a single-institution experience. Neurosurg Focus 2023; 55:E14. [PMID: 37913534 DOI: 10.3171/2023.8.focus23414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 08/24/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE The neurosurgical match is a challenging process for applicants and programs alike. Programs must narrow a wide field of applicants to interview and then determine how to rank them after limited interaction. To streamline this, programs commonly screen applicants using United States Medical Licensing Examination (USMLE) Step scores. However, this approach removes nuance from a consequential decision and exacerbates existing biases. The primary objective of this study was to demonstrate the feasibility of effecting minor modifications to the residency application process, as the authors have done at their institution, specifically by reducing the prominence of USMLE board scores and Alpha Omega Alpha (AΩA) status, both of which have been identified as bearing racial biases. METHODS At the authors' institution, residents and attendings holistically reviewed applications with intentional redundancy so that every file was reviewed by two individuals. Reviewers were blinded to applicants' photographs and test scores. On interview day, the applicant was evaluated for their strength in three domains: knowledge, commitment to neurosurgery, and integrity. For rank discussions, applicants were reviewed in the order of their domain scores, and USMLE scores were unblinded. A regression analysis of the authors' rank list was made by regressing the rank list by AΩA status, Step 1 score, Step 2 score, subinternship, and total interview score. RESULTS No variables had a significant effect on the rank list except total interview score, for which a single-point increase corresponded to a 15-position increase in rank list when holding all other variables constant (p < 0.05). CONCLUSIONS The goal of this holistic review and domain-based interview process is to mitigate bias by shifting the focus to selected core qualities in lieu of traditional metrics. Since implementation, the authors' final rank lists have closely reflected the total interview score but were not significantly affected by board scores or AΩA status. This system allows for the removal of known sources of bias early in the process, with the aim of reducing potential downstream effects and ultimately promoting a final list that is more reflective of stated values.
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Affiliation(s)
- Georgia M Wong
- 1Department of Neurosurgery, Georgetown University School of Medicine
| | - Kelsey Cobourn
- 2Department of Neurosurgery, MedStar Georgetown University Hospital; and
- 3Department of Neurosurgery, MedStar Washington Hospital Center, Washington, DC
| | - Kitara Smith
- 1Department of Neurosurgery, Georgetown University School of Medicine
| | - Michael M Covell
- 1Department of Neurosurgery, Georgetown University School of Medicine
| | - Ehsan Dowlati
- 2Department of Neurosurgery, MedStar Georgetown University Hospital; and
- 3Department of Neurosurgery, MedStar Washington Hospital Center, Washington, DC
| | - Jeffrey M Breton
- 2Department of Neurosurgery, MedStar Georgetown University Hospital; and
- 3Department of Neurosurgery, MedStar Washington Hospital Center, Washington, DC
| | - Gnel Pivazyan
- 2Department of Neurosurgery, MedStar Georgetown University Hospital; and
- 3Department of Neurosurgery, MedStar Washington Hospital Center, Washington, DC
| | - M Nathan Nair
- 1Department of Neurosurgery, Georgetown University School of Medicine
- 2Department of Neurosurgery, MedStar Georgetown University Hospital; and
- 3Department of Neurosurgery, MedStar Washington Hospital Center, Washington, DC
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Bougioukas L, Heiser A, Berg A, Polomsky M, Rokkas C, Hirashima F. Integrated cardiothoracic surgery match: Trends among applicants compared with other surgical subspecialties. J Thorac Cardiovasc Surg 2023; 166:904-914. [PMID: 35461707 DOI: 10.1016/j.jtcvs.2021.11.112] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 11/21/2021] [Accepted: 11/29/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate trends, qualifications, race/ethnicity, and gender of applicants to integrated cardiothoracic (CT I-6) residency programs and compare them with other competitive surgical subspecialties. METHODS Data were collected from the National Residency Matching Program, Electronic Residency Application Service, and Association of American Medical Colleges for thoracic surgery, orthopedic surgery, neurological surgery, otolaryngology (ENT), plastic surgery, and vascular surgery for 2010 t0 2020. Applicant gender, race/ethnicity, Alpha Omega Alpha (AOA) membership, United States Medical Licensing Examination scores, research productivity, and graduation from a top-40 medical school were analyzed. RESULTS From 2010 to 2020, CT I-6 experienced growth in postgraduate year 1 positions (280.0%), total applicants (62.2%), and US senior applicants (59.2%). No growth in CT I-6 positions (38) or programs (29) occurred from 2016 to 2020. CT I-6 had the lowest match rates among total applicants (31.7%) and US seniors (41.0%) in 2020. CT I-6 had fewer female applicants compared with ENT (P < .001) and plastic surgery (P < .001), but more than orthopedic surgery (P < .001). Although most CT I-6 US applicants self-identified as White (75.0%), there were more Asian applicants compared with applicants for orthopedic surgery (P < .001), ENT (P < .001), plastic surgery (P < .001), and neurological surgery (P < .01). Matched applicants averaged the highest Step 2-Clinical Knowledge scores (255.1), AOA membership (48.5%), and graduation rates from top-40 medical schools (54.5%). CONCLUSIONS Despite tremendous growth in positions, CT I-6 has consistently been the most difficult surgical subspecialty to match. CT I-6 has recently attracted an increasingly diverse applicant pool. For the 2019 to 2020 National Residency Matching Program Match Cycle, successful applicants had the highest Step 2-Clinical Knowledge scores, AOA membership rates, and graduation rates from a top-40 medical school among all surgical subspecialties examined.
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Affiliation(s)
- Lauren Bougioukas
- Division of Cardiothoracic Surgery, Department of Surgery, Larner College of Medicine at The University of Vermont, Burlington, Vt
| | - Alyssa Heiser
- Division of Cardiothoracic Surgery, Department of Surgery, Larner College of Medicine at The University of Vermont, Burlington, Vt
| | - Adrian Berg
- Division of Cardiothoracic Surgery, Department of Surgery, Larner College of Medicine at The University of Vermont, Burlington, Vt
| | - Marek Polomsky
- Division of Cardiothoracic Surgery, Department of Surgery, The University of Vermont Medical Center, Burlington, Vt
| | - Chris Rokkas
- Division of Cardiothoracic Surgery, Department of Surgery, The University of Vermont Medical Center, Burlington, Vt
| | - Fuyuki Hirashima
- Division of Cardiothoracic Surgery, Department of Surgery, The University of Vermont Medical Center, Burlington, Vt.
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Luu Y, Gao W, Han J, Mihalic A, Vandergriff T. A perfect match: A cross-sectional analysis of couples matching in dermatology. J Am Acad Dermatol 2023; 88:914-916. [PMID: 37650450 DOI: 10.1016/j.jaad.2022.10.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/12/2022] [Accepted: 10/24/2022] [Indexed: 11/07/2022]
Affiliation(s)
- Yen Luu
- University of Missouri, Kansas City School of Medicine, Kansas City, Missouri
| | - Whitney Gao
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Joseph Han
- Icahn School of Medicine at Mount Sinai, New York City, New York
| | - Angela Mihalic
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Travis Vandergriff
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas.
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Lamberton T, Tung C, Kaji AH, Neville AL, Singer GA, Simms ER, Lona Y, Virgilio CD. Faculty Scoring of General Surgery Residency Interviewees: A Comparison of In-Person and Virtual Interview Formats. J Surg Educ 2022; 79:e69-e75. [PMID: 36253330 DOI: 10.1016/j.jsurg.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 08/29/2022] [Accepted: 09/10/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE With new rules regarding social distancing and non-essential travel bans, we sought to determine if faculty scoring of general surgery applicants would differ between the in-person interview (IPI) and virtual interview (VI) platforms. DESIGN A single institution, retrospective review comparing faculty evaluation scores of applicant interviewees in the 2019 and 2020 MATCH® application cycles (IPIs) and the 2021 and 2022 application cycle (VIs) was conducted. Faculty scored applicants using a 5-point Likert scale in 7 areas of assessment and assigned each student to 1 of 4 tiers (tier 1 highest). A composite score for the 7 assessments (maximum score 35) was calculated. Mean and composite scores and tiers were compared between VI and IPI cycles and adjusted for within-interviewer correlations. The variance of the 2 groups were also compared. SETTING Harbor-UCLA Medical Center, an academic, tertiary care hospital. PARTICIPANTS General Surgery applicants for the 2019 to 2022 MATCH® application cycles. RESULTS Four hundred forty-one faculty IPI ratings of General Surgery applicants were compared to 531VI ratings. No difference in mean composite scores, individual assessments, or tier ranking. Less variance was identified in the VI group for academic credentials (0.6 vs 0.6, p = 0.01), strength of letters (0.7 vs 0.4, p = 0.005), communication skills (0.4 vs 0.6, p = 0.01), personal qualities (0.2 vs 0.5, p = 0.02), overall sense of fit for program (0.6 vs 0.9, p = 0.01), and tier ranking (0.3 vs 0.4, p = 0.004). CONCLUSIONS Faculty ratings of General Surgery applicants in the VI format appear to be similar to IPI. However, faculty ratings of VI applicants demonstrated less variability in scores in most assessments. This finding is potentially concerning, as it may suggest an inability of VI to detect subtle differences between applicants as comparted to IPI.
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Affiliation(s)
- Tessa Lamberton
- Department of Surgery, Harbor-UCLA Medical Center, Torrance, California
| | - Christine Tung
- Department of Surgery, Harbor-UCLA Medical Center, Torrance, California
| | - Amy H Kaji
- Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, California
| | - Angela L Neville
- Department of Surgery, Harbor-UCLA Medical Center, Torrance, California
| | - George A Singer
- Department of Surgery, Harbor-UCLA Medical Center, Torrance, California
| | - Eric R Simms
- Department of Surgery, Harbor-UCLA Medical Center, Torrance, California
| | - Yazmin Lona
- Department of Surgery, Harbor-UCLA Medical Center, Torrance, California; The Lundquist Institute at Harbor-UCLA Medical Center, Torrance, California
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Bourdillon AT, Salehi PP, Wride M, Salehi P, Torabi S, Heiser A, Shah HP, Azizzadeh B, Judson B, Lee YH. Trends in Residency Applicant Volume in Otolaryngology-Head and Neck Surgery and Peer Specialties. Ann Otol Rhinol Laryngol 2022:34894221120303. [PMID: 36031814 DOI: 10.1177/00034894221120303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the 2020 to 2021 Otolaryngology residency application cycle in the context of recent trends. STUDY DESIGN Retrospective data analysis. SETTING Disruptions caused by the COVID-19 pandemic may significantly alter trends among residency applicants, especially in highly competitive and/or smaller specialties. METHODS Applicant and residency statistics from Electronic Residency Application Service (ERAS) and National Residency Matching Program (NRMP) were extracted from the 2016 to 2021 and 2011 to 2021, respectively. Trends in Otolaryngology-Head and Neck Surgery (OHNS) were compared to peer specialties (PS) including Dermatology, Neurological Surgery, Orthopedic Surgery, and Integrated Pathway for Plastic and Reconstructive Surgery (PRS). The ratio of the number of applicants per positions (APP) was used to reflect the degree of competition. RESULTS Between 2011 and 2021, the number of OHNS programs and positions expanded less than those of PS and General Surgery. The increase in the APP ratio was significantly greater for OHNS compared to those Dermatology, Orthopedic Surgery, General Surgery and all PGY1 residency positions for both US MD and all applicants (P < .01 for each). OHNS expansion of US MD (P = .046), but not all applicants (P = .169), outgrew that of Neurosurgery. CONCLUSION The 2020 to 2021 cycle affected by the COVID-19 pandemic saw a continuation of the recent trend in the expanding OHNS applicant pool. OHNS remains one of the specialties with the highest APP ratio and has observed a significant growth compared to PS since 2018. Understanding and anticipating trends in residency application cycles is critical for designing processes to optimize the best fit between applicants and programs.
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Affiliation(s)
| | - Parsa P Salehi
- Department of Surgery, Division of Otolaryngology, Yale School of Medicine, New Haven, CT, USA
| | - Mitchel Wride
- Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Pauniz Salehi
- Department of Nutritional Sciences, College of Human Ecology, Cornell University, Ithaca, NY, USA
| | - Sina Torabi
- Department of Otolaryngology - Head and Neck Surgery, University of California, Irvine, CA, USA
| | - Alyssa Heiser
- Larner College of Medicine, University of Vermont, Burlington, VT, USA
| | - Hemali P Shah
- Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Babak Azizzadeh
- Center for Advanced Facial Plastic Surgery, Beverly Hills, CA, USA.,Division of Head and Neck Surgery, Department of Otolaryngology-Head and Neck Surgery, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, CA, USA
| | - Benjamin Judson
- Department of Surgery, Division of Otolaryngology, Yale School of Medicine, New Haven, CT, USA
| | - Yan Ho Lee
- Department of Surgery, Division of Otolaryngology, Yale School of Medicine, New Haven, CT, USA
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11
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Chintapalli RTV, Shah M, Straus CM. Analysis of 10 Years of Diagnostic Radiology Match Data: Notable Changes and Their Potential Implications. Acad Radiol 2022; 29:456-464. [PMID: 33685791 DOI: 10.1016/j.acra.2021.01.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 01/20/2021] [Accepted: 01/20/2021] [Indexed: 11/01/2022]
Abstract
RATIONALE AND OBJECTIVES Identification of shifts in match metrics, such as applicant volumes, match rates, and interview patterns, stands to inform and empower both applicants and programs participating in the NRMP residency match. Residency programs rarely publish their internal data. Accordingly, we employed publicly available resources to evaluate changes in such metrics for the diagnostic radiology match from 2008 to 2018. MATERIALS AND METHODS Reports made available to the public by the NRMP, alongside student discussion on the AuntMinnie.com and StudentDoctor.net forums, were used to determine applicant volumes, interview volumes, program rank-order-list metrics, match rates, and interview invite patterns. Linear regression and correlation analyses were employed to identify statistically significant trends. RESULTS No statistically significant trends were identified across the selected timeframe for applicant volumes or match rates. Statistically significant upward trends were identified for total interview volumes, average interviews attended per applicant, and the fraction of programs inviting students to interview before October 1st, the MSPE release date (p < 0.05). A very strong and significant positive correlation was identified between average interviews attended per applicant and the average number of ranks needed by programs to fill a position (p < 0.01, R = 0.804). CONCLUSION Applicants pursuing a diagnostic radiology residency are attending more interviews, and programs are increasingly inviting students to interview based on incomplete applications. However, there has been no corresponding uptrend in match rates. Moreover, increased applicant interview attendance is highly associated with programs falling further down their rank lists. Given the expenses usually associated with the match process and forthcoming changes to USMLE scoring, these trends may be unsustainable.
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12
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Bernstein JD, Harmon M, Watson D. COVID-19 and the Otolaryngology Residency Match: Rising Incidence of Home Matches. Laryngoscope 2022; 132:1934-1938. [PMID: 35038190 PMCID: PMC9015343 DOI: 10.1002/lary.30028] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/21/2021] [Accepted: 01/09/2022] [Indexed: 11/20/2022]
Abstract
Objectives/Hypothesis To quantify the effect of the coronavirus disease 2019 (COVID‐19) pandemic upon the 2020 to 2021 residency match for Otolaryngology‐Head and Neck Surgery (OHNS). Study Design Retrospective cohort design. Methods Residency match outcomes for all applicants to our institution during 2020 to 2021 were collected from the National Residency Matching Program including medical school of origin and matched program. Matches were categorized as to home‐program, within‐region, or out‐of‐region and sorted by US geographic region. Matches from the 2020 to 2021 cycle were compared to those from 2019 to 2020, as well as averages and trends from match cycles 2016 to 2020. Statistical analysis included descriptive statistics and chi‐square testing. Results During 2020 to 2021, there were 436 applicants to our single OHNS program. From 2019–2020 to 2020–2021, the match rate decreased significantly for groups studied, including: All applicants (72.0% [268/372] to 64.7% [282/436]; P = .025); all US MD Senior applicants (76.5% [254/332] to 68.9% [262/380]; P = .024); and US MD Seniors specifically without a home program (77.5% [31/40] to 56.4% [22/39]; P = .046). The match rate for US MD Seniors with a home program did not change significantly (76.4% [223/292] to 70.4% [240/341]; P = .09). From 2019–2020 to 2020–2021, the proportion of US MD seniors who matched to home‐program increased significantly (22.0% [49/223] to 30.0% [72/240]; P = .05). Conclusion The COVID‐19 pandemic saw high volumes of OHNS applicants with an overall decreased rate of matching compared to previous years. These changes particularly affected applicants without home programs. Home‐program matching increased significantly, likely as a consequence of the limitations placed on in‐person away experiences including interviews. Laryngoscope, 132:1934–1938, 2022
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Affiliation(s)
- Jeffrey D Bernstein
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Diego Health, La Jolla, California, USA
| | - Matthew Harmon
- UCSD School of Medicine, University of California, San Diego, La Jolla, California, USA
| | - Deborah Watson
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Diego Health, La Jolla, California, USA
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13
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Zoorob D, Richardson K, Gaishauser K, Hinkel B, Moussa HN, Hook JV, Maxwell RA. Do medical student mental stress and burnout vary with virtual versus in-person residency interviews. Future Sci OA 2021; 7:FSO752. [PMID: 34840809 DOI: 10.2144/fsoa-2021-0046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 09/23/2021] [Indexed: 11/23/2022] Open
Abstract
Aim: This study aimed to identify medical student stressors and mitigation methodologies based on interview modality. Materials & methods: A survey was administered to obstetrics and gynecology applicants in in-person (IP) and virtual (VR) National Resident Matching Program cycles. This included demographics, the Mayo Clinic Medical Students Well-Being Index and stressor questions. Results: A total of 137 of 151 surveys were completed (91% response rate). Subjective stress was significant in 76% of IP and 57% of VR applicants (p = 0.07). The objective Mayo Clinic Medical Students Well-Being Index values were higher in the IP (2.47 ± 1.75) compared with the VR group (2.00 ± 1.55; p = 0.10), suggesting lower stress with VR interviews. More IP (53%) compared with VR applicants (44%) were deemed ‘at risk’ (p < 0.01). Conclusion: VR interviews may mitigate select stressors during interviews. Medical students encounter a significantly increasing amount of stress over the course of their training, with an acute rise noted when interviews occur near the conclusion of their undergraduate medical education. This study aimed to identify causes and potential mitigators of interview stressors based the modality of engagement, virtual or in person. Our survey results suggest that students subjectively felt and objectively encountered significant stress during both modalities; although, this was more pronounced during in-person interviews. Furthermore, the study suggests that virtual interviews may be the modality associated with less overall stress during the residency application cycles.
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14
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Choi O. The Fellowship Application Process Must Be Reformed. J Am Acad Psychiatry Law 2021; 49:300-310. [PMID: 34417252 DOI: 10.29158/jaapl.210088-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Octavio Choi
- Dr. Choi is Clinical Associate Professor and Founding Director of the Stanford Forensic Psychiatry Fellowship Program, Stanford University, Stanford, CA.
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15
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Rajesh A, Asaad M, Elmorsi R, Ferry AM, Maricevich RS. The Virtual Interview Experience for MATCH 2021: A Pilot Survey of General Surgery Residency Program Directors. Am Surg 2021:31348211038555. [PMID: 34384253 DOI: 10.1177/00031348211038555] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Virtual interviews (VIs) for the 2020 residency application season were mandated as a result of the COVID-19 pandemic. We aimed to determine the perspectives of general surgery (GS) program directors (PDs) on the benefits and drawbacks of VIs. METHODS A 14-item survey was emailed to all GS PDs from programs identified on the American Council for Graduate Medical Education website. Program directors were asked about the cost-time benefit of VIs, its ability to assess candidates, and their thoughts on the future of VIs for evaluating residency applicants. RESULTS 60 PDs responded corresponding to a response rate of 21%. While 93% agreed/strongly agreed that VIs were less expensive, only 35% found VIs to be less time-consuming. 75% and 67%, respectively, disagreed/strongly disagreed that VIs allowed for an easier assessment of an applicant's fit, and personality and communication skills. Almost one-half of our survey respondents suggested that VIs made the selection committee rely more heavily on objective applicant data. Almost two-thirds of GS PDs suggested that they would adopt both VI and in-person interview formats for future application cycles. The median [interquartile range] cost saved through the implementation of VIs was US$ 4500 [1625 - 10 000]. CONCLUSION Remarkably, VIs have been swiftly imbibed by all residency programs and many aspects of the VI experience were positive. While MATCH 2021 has definitely proved to be one of its kind, the implementation of VIs has been met with overall broad success and a promising future awaits this novel modality of resident selection to GME programs in the United States.
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Affiliation(s)
- Aashish Rajesh
- Department of Surgery, 14742University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Malke Asaad
- Department of Plastic Surgery, 571198MD Anderson Cancer Center, Houston, TX, USA
| | - Rami Elmorsi
- Faculty of Medicine, 68780Mansoura University, Dakahlia, Egypt
| | - Andrew M Ferry
- Department of Plastic Surgery, Baylor College of Medicine, Houston, TX, USA
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16
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Secrest AM, Coman GC, Swink JM, Duffy KL. Limiting Residency Applications to Dermatology Benefits Nearly Everyone. J Clin Aesthet Dermatol 2021; 14:30-32. [PMID: 34840647 PMCID: PMC8570359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
With a 34-percent increase in dermatology residency applications in the past decade, residency programs are increasingly faced with the daunting task of reviewing more applications for a relatively fixed number of residency positions. Other specialty programs, including otolaryngology, orthopedics, plastic surgery, and ophthalmology, have called for limiting the number of residency applications. Dermatology programs have developed various ways to decrease the number of reviewed applications, from cutoffs for Step 1 board scores to Alpha Omega Alpha membership to secondary applications. While this can decrease the applicant pool, it limits a more holistic review of applications. We propose an application cap of 20 programs, which will decrease the number of applications each program receives 3- to 5-fold. Each applicant can approach the process more thoughtfully in choosing the best programs for them and will save money in application fees. As program directors rank "perceived interest" in their residency program as a primary factor for selecting applicants, a cap will allow program directors to know that all applicants are interested in their specific program. Ultimately, we contend that application caps would improve match outcomes with applicants receiving training in the best program for them, increasing the likelihood of successful fit for clinical training, opening the field to a more diverse set of applicants, and saving everyone time and money.
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Affiliation(s)
- Aaron M Secrest
- Drs. Secrest, Coman, and Duffy are with the Department of Dermatology at the University of Utah in Salt Lake City, Utah
- Dr. Secrest is also with the Department of Population Health Sciences at the University of Utah in Salt Lake City, Utah
- Mr. Swink is with the School of Medicine at the University of Utah in Salt Lake City, Utah
| | - Garrett C Coman
- Drs. Secrest, Coman, and Duffy are with the Department of Dermatology at the University of Utah in Salt Lake City, Utah
- Dr. Secrest is also with the Department of Population Health Sciences at the University of Utah in Salt Lake City, Utah
- Mr. Swink is with the School of Medicine at the University of Utah in Salt Lake City, Utah
| | - J Michael Swink
- Drs. Secrest, Coman, and Duffy are with the Department of Dermatology at the University of Utah in Salt Lake City, Utah
- Dr. Secrest is also with the Department of Population Health Sciences at the University of Utah in Salt Lake City, Utah
- Mr. Swink is with the School of Medicine at the University of Utah in Salt Lake City, Utah
| | - Keith L Duffy
- Drs. Secrest, Coman, and Duffy are with the Department of Dermatology at the University of Utah in Salt Lake City, Utah
- Dr. Secrest is also with the Department of Population Health Sciences at the University of Utah in Salt Lake City, Utah
- Mr. Swink is with the School of Medicine at the University of Utah in Salt Lake City, Utah
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17
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Bernstein JD, Shahrestani S, Shahrvini B, Watson D. Geographic Trends in the Otolaryngology Match (2016-2020). OTO Open 2021; 5:2473974X211022611. [PMID: 34212122 PMCID: PMC8216354 DOI: 10.1177/2473974x211022611] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 05/14/2021] [Indexed: 11/17/2022] Open
Abstract
Objective Presenting geographic matching trends over 5 match cycles (2016-2020) to serve as a context for changes in residency match outcomes due to the coronavirus disease 2019 (COVID-19) pandemic. Study Design Retrospective review. Setting Single academic institution-affiliated otolaryngology–head and neck surgery residency program. Methods Residency match outcomes for all applicants to our institution (2015-2019) were collected from the National Residency Matching Program, including medical school and matched program. Matches were categorized as home program, home region, or out of region and sorted by US geographic region. Statistical analysis included frequencies, totals, χ2 testing, and binary logistic regression. Results From 2016 to 2020, the US MD senior match rate was 84.9%: 18.9% to home programs, 35.7% to home region, and 45.3% to out of region. Rates were similar across regions and decreased over time. Westerners matched to home programs more than Southerners or Midwesterners (27.5% vs 16.0% and 16.0%, P < .01). Southerners and Westerners were more likely to match within their regions (South: 63.1%, P = .011, odds ratio [OR] = 1.296, 95% CI, 1.060-1.584; West: 42.0%, P = .018, OR = 1.462, 95% CI, 1.066-2.004). Matching from out of region was more likely in the West and less likely in the South (West: 58.0%, P = .017, OR = 1.379, 95% CI, 1.059-1.796; South: 36.9%, P < .001, OR = 0.584, 95% CI, 0.47-0.727). Conclusion From 2016 to 2020 in otolaryngology–head and neck surgery, about 1 in 5 matches were to home institutions, a trend that appeared to be more common in the West. Over 4 out of 5 trainees match to nonhome programs, and nearly half relocate to a new region for training. Changes to travel, rotations, and interviews due to COVID-19 may influence these trends.
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Affiliation(s)
- Jeffrey D Bernstein
- Department of Surgery, Otolaryngology-Head and Neck Surgery, University of California-San Diego, La Jolla, California, USA
| | - Shane Shahrestani
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Bita Shahrvini
- UC San Diego School of Medicine, La Jolla, California, USA
| | - Deborah Watson
- Department of Surgery, Otolaryngology-Head and Neck Surgery, University of California-San Diego, La Jolla, California, USA
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18
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Yaeger KA, Schupper AJ, Gilligan JT, Germano IM. Making a match: trends in the application, interview, and ranking process for the neurological surgery residency programs. J Neurosurg 2021; 135:1882-1888. [PMID: 34049279 DOI: 10.3171/2020.11.jns203637] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 11/19/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Neurosurgery is a highly competitive residency field with a match rate lower than that of other specialties. The aim of this study was to analyze trends associated with the residency match process from the applicants' and program directors' perspectives. METHODS Between 2010 and 2020, the National Residency Matching Program (NRMP) Applicant and Program Director Surveys, the NRMP Charting Outcomes reports, and the Accreditation Council for Graduate Medical Education (ACGME) Data Resource Books were analyzed to identify the number of applicants interviewed and ranked in US programs, the applicants' ranking preferences, the program directors' preferential factors in offering interviews, and rank list order. Applicants were divided between US senior medical students and independent applicants. Each cohort was dichotomized for matched and unmatched applicants. RESULTS Over the study period, 2935 applicants applied to neurosurgery residency, including 2135 US senior medical students and 800 independent applicants, with an overall match rate of 65%. Overall, matched applicants had a significantly higher number of publications (p < 0.05). Among US senior medical student applicants, the application-to-interview ratio more than doubled over the study period, yet the number of interview invitations received, interviews accepted, and programs ranked remained unchanged. In the US senior medical student cohort, the number of submitted applications, interview invitations, accepted interviews, and programs ranked did not significantly differ between matched and unmatched applicants. In both cohorts, applicants shifted ranking factors from a more academic focus in early years to more well-being in later years. Letters of recommendation and board scores were key factors for program directors while screening applicants for interviews and ranking. CONCLUSIONS Neurosurgery residency continues to be a highly competitive field in medicine, with match rates of 65%. Recently, applicants have placed greater importance on ranking programs that value residents' well-being, as opposed to strictly academic factors. A data-driven understanding of factors important to applicants and program directors during the match process has the potential to improve resident candidate recruitment and overall resident-program fit, thereby improving well-being during residency, reducing the attrition rate, and overall enhancing the diversity of the neurosurgery resident workforce.
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Fatima R, Assaly AR, Aziz M, Moussa M, Assaly R. The United States Medical Licensing Exam Step 2 Clinical Skills Examination: Potential Alternatives During and After the COVID-19 Pandemic. JMIR Med Educ 2021; 7:e25903. [PMID: 33878014 PMCID: PMC8092027 DOI: 10.2196/25903] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 03/24/2021] [Accepted: 04/12/2021] [Indexed: 05/18/2023]
Abstract
We feel that the current COVID-19 crisis has created great uncertainty and anxiety among medical students. With medical school classes initially being conducted on the web and the approaching season of "the Match" (a uniform system by which residency candidates and residency programs in the United States simultaneously "match" with the aid of a computer algorithm to fill first-year and second-year postgraduate training positions accredited by the Accreditation Council for Graduate Medical Education), the situation did not seem to be improving. The National Resident Matching Program made an official announcement on May 26, 2020, that candidates would not be required to take or pass the United States Medical Licensing Examination Step 2 Clinical Skills (CS) examination to participate in the Match. On January 26, 2021, formal discontinuation of Step 2 CS was announced; for this reason, we have provided our perspective of possible alternative solutions to the Step 2 CS examination. A successful alternative model can be implemented in future residency match seasons as well.
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Affiliation(s)
- Rawish Fatima
- Department of Internal Medicine, University of Toledo Medical Center, Toledo, OH, United States
| | - Ahmad R Assaly
- College of Medicine and Life Sciences, The University of Toledo, Toledo, OH, United States
| | - Muhammad Aziz
- Division of Gastroenterology and Hepatology, University of Toledo Medical Center, Toledo, OH, United States
| | - Mohamad Moussa
- Department of Emergency Medicine, University of Toledo Medical Center, Toledo, OH, United States
| | - Ragheb Assaly
- Division of Pulmonary and Critical Care Medicine, University of Toledo Medical Center, Toledo, OH, United States
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20
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Virani S, Mitra S, Grullón MA, Khan A, Kovach J, Cotes RO. International Medical Graduate Resident Physicians in Psychiatry: Decreasing Numbers, Geographic Variation, Community Correlations, and Implications. Acad Psychiatry 2021; 45:7-12. [PMID: 33469891 DOI: 10.1007/s40596-020-01380-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 12/01/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES The number of International Medical Graduate (IMG) physicians matching into categorical psychiatry decreased steadily over the past decade. The authors sought to understand if this trend was occurring in other specialties, if US IMG physicians and non-US IMG physicians were equally affected, and if certain regions of the USA were more affected by this decrease than others. Finally, the authors compared the proportion of foreign-born individuals within a US census region to the proportion of non-US IMG physicians within that region. METHODS The authors analyzed data from the National Resident Matching Program from the years 2014-2020. Statewide data was aggregated into nine geographic regions, as per the US Census Bureau. The number of foreign-born individuals within each US census region was calculated from the 2018 American Community Survey data. RESULTS In comparison to eight other specialties, psychiatry saw the greatest decrease (46.3%) in IMG physicians matching into PGY-1 positions. Both US IMG physicians and non-US IMG physicians were equally affected. The percentage of IMG physicians decreased in each of the nine US census regions. In six out of nine geographic regions, non-US IMG physicians were under-represented when comparing their proportion to the number of foreign-born people that lived within that region. CONCLUSIONS Decreasing numbers of IMG physicians in psychiatry training may have long-term implications for cultural competency, serving underserved populations, and fellowship recruitment. We advocate for program directors to recognize IMG physicians as an important source of diversity and to recruit residents that reflect the communities they serve.
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Affiliation(s)
| | | | | | - Ayesha Khan
- American University of Integrative Sciences, School of Medicine, Bridgetown, Barbados
| | - Jessica Kovach
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
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Abstract
This article explores the current state of the residency match in 2020 with a focus on orthopedic surgery, analyzing the utility of current applicant screening methods in producing future generations of competent surgeons. Discussed are anticipated changes to the residency application process considering the COVID-19 pandemic and Step 1 becoming pass/fail in January 2022. Also explored are potential changes to improve the process for applicants and residency programs, such as identifying and using predictive factors of resident success in the applicant screening process, finding better ways to match applicants with programs, and increasing female and underrepresented minorities within orthopedics.
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Affiliation(s)
- Jennings H Dooley
- University of Tennessee Health Science Center College of Medicine, 1190 Isle View Drive, Memphis, TN 38103, USA
| | - Kristen A Bettin
- University of Tennessee Health Science Center College of Medicine, Departments of Pediatrics and Medical Education, 49 North Dunlap Street, FOB 149, Memphis, TN 38103, USA.
| | - Clayton C Bettin
- Orthopaedic Foot & Ankle Surgery, Department of Orthopaedic Surgery & Biomedical Engineering, University of Tennessee-Campbell Clinic, 1211 Union Avenue, Ste 500, Memphis, TN 38104, USA
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Ward B, Schultz JJ, Halsey JN, Hoppe IC, Lee ES, Granick MS. Mentorship Through Research: A Novel Approach to Increasing Resident and Medical Student Research Competency Through an Institutional Database. J Surg Educ 2020; 77:1331-1333. [PMID: 32505667 DOI: 10.1016/j.jsurg.2020.04.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 04/15/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND We describe a novel research database development project to increase resident and medical student scholarly ability and mentorship skills. We collected data on 3147 facial fractures treated at our institution over a 12-year period. This data was used to publish novel research on multiple types of facial fractures and outcomes. METHODS We learned about key database aspects that led to its high level of research quality and output volume through over 6 years of database development and expanded research output. A retrospective review was completed to compile the total research produced during this time period. RESULTS Research resulted in 20 manuscripts, 17 podium presentations, and 11 posters. 16 medical students, 5 residents and 3 faculty members were authors on at least one project. The average number of published manuscripts was 5.17 overall and 2.9, 7.0, and 14.0 for medical students, residents, and faculty, respectively. Four residents matched into fellowship, 7 medical students matched into residency, and one faculty member was promoted academically. CONCLUSIONS A database focused on a common and under-researched pathology can result in a high volume of novel research output. Additional program benefits include increased scholarly and mentorship ability in engaged residents and medical students.
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Affiliation(s)
- Brittany Ward
- Rutgers - New Jersey Medical School, Division of Plastic and Reconstructive Surgery, Newark, New Jersey
| | - Jerette J Schultz
- Rutgers - New Jersey Medical School, Division of Plastic and Reconstructive Surgery, Newark, New Jersey
| | - Jordan N Halsey
- Rutgers - New Jersey Medical School, Division of Plastic and Reconstructive Surgery, Newark, New Jersey
| | - Ian C Hoppe
- University of Mississippi Medical Center, Department of Surgery - Plastic and Reconstructive Surgery, University Hospital, Jackson, Mississippi
| | - Edward S Lee
- Rutgers - New Jersey Medical School, Division of Plastic and Reconstructive Surgery, Newark, New Jersey
| | - Mark S Granick
- Rutgers - New Jersey Medical School, Division of Plastic and Reconstructive Surgery, Newark, New Jersey.
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23
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Abstract
The Federation of State Medical Boards and the National Board of Medical Examiners recently announced a change in the United States Medical Licensing Examination Step 1 scoring convention to take effect, at the earliest, on January 1, 2022. There are many reasons for this change, including decreasing medical student stress and incentivizing students to learn freely without solely focusing on Step 1 performance. The question remains how this will affect the future of the otolaryngology-head and neck surgery match. By eradicating Step 1 grades, other factors, such as research, may garner increased importance in the application process. Such a shift may discriminate against students from less well-known medical schools, international medical graduates, and students from low socioeconomic backgrounds, who have fewer academic resources and access to research. Residency programs should try to anticipate such unintended consequences of the change and work on solutions heading into 2022.
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Affiliation(s)
- Parsa P Salehi
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Babak Azizzadeh
- Center for Advanced Facial Plastic Surgery, Beverly Hills, California, USA.,Division of Head and Neck Surgery, Department of Otolaryngology-Head and Neck Surgery, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California, USA
| | - Yan Ho Lee
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, School of Medicine, Yale University, New Haven, Connecticut, USA
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Maaz M. A Primer on the Game Theory Behind the National Resident Matching Program for the Medical Educator and Student. Med Sci Educ 2020; 30:965-969. [PMID: 34457754 PMCID: PMC8368266 DOI: 10.1007/s40670-020-00955-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Every year, medical students vie for American graduate training through the National Resident Matching Program (NRMP). Some students yet behave in ways that imply persistent misunderstandings about the matching algorithm. This paper explains the economic and mathematical literature underpinning it for a medical audience. The NRMP implements the Roth-Peranson algorithm, finding a stable match by having students propose to residency programs according to their preference ranking. This configuration favors students while disfavoring hospitals. Game-theoretic analysis shows us that students are unequivocally unable to "game the system" by misstating their preferences. Telling the truth is the optimal strategy.
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Affiliation(s)
- Muhammad Maaz
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario Canada
- Department of Economics, McMaster University, Hamilton, Ontario Canada
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25
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McMackin KK, Caputo FJ, Hoell NG, Trani J, Carpenter JP, Lombardi JV. Trends in the 10-year history of the vascular integrated residency match: More work, higher cost, same result. J Vasc Surg 2020; 72:298-303. [PMID: 32037082 DOI: 10.1016/j.jvs.2019.10.066] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 10/25/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The purpose of this study was to examine trends in application submission, rank lists, and applicant quality for vascular surgery integrated residency. METHODS The National Resident Matching Program Results and Data reports and the Electronic Residency Application Service Statistics from 2007 to 2017 were compiled and mined for trends in terms of application submission and the number of applicants a program needed to rank to fill all residency positions. Applicant pool depth and percentage of programs applied to were calculated. Outcome data from the National Resident Matching Program were reviewed for 2014 and 2016 for United States Medical Licensing Examination Step scores and experiences. RESULTS During the last 10 years, the number of vascular surgery integrated residency spots rose from 9 to 60 per year. Most programs offer one spot per year; none offer more than two. The average number of applications received by programs rose from 17 applications in 2008 to 63.8 in 2017. The average rank list depth needed by programs to fill the spots has not increased (range, 2.5-5.1; standard deviation, 0.73). The proportional depth of the applicant pool decreased from 4.6 U.S. and Canadian applicants for every one residency spot in 2008 to 1.7 applicants for every one residency spot in 2017. Applicant quality metrics were available for 2 years (2014 and 2016). Step 1 scores (237/239), Step 2 scores (250/250), research experiences (3.7/4.2), and volunteer experiences (5.9/5.5) remained nearly unchanged. The number of contiguous ranks for matched applicants remained stable (12.3/12.8). CONCLUSIONS The current system promotes multiple inefficiencies, resulting in application glut. Fewer applicants are flooding programs with an increasing number of applications. More money is being spent on Electronic Residency Application Service applications without changes in the number needed to rank by applicants or programs to achieve a match. There is no improvement in the quality of the applicant. Should these trends continue, they represent an unsustainable model for resident selection.
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Affiliation(s)
| | - Francis J Caputo
- Department of Vascular Surgery, Cleveland Clinic, Cleveland, Cleveland, Ohio
| | - Nicholas G Hoell
- Department of Vascular Surgery, Cleveland Clinic, Cleveland, Cleveland, Ohio
| | - Jose Trani
- Division of Vascular Surgery, Cooper University Hospital, Camden, Camden, NJ
| | - Jeffrey P Carpenter
- Division of Vascular Surgery, Cooper University Hospital, Camden, Camden, NJ
| | - Joseph V Lombardi
- Division of Vascular Surgery, Cooper University Hospital, Camden, Camden, NJ.
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Dagher GA, Lewandowski C, Ali SS, Barsky C, Kazzi B, Cheaito MA, Lotfipour S, Kazzi A, Kazzi Z. The International Medical Graduate and Emergency Medicine. J Emerg Med 2020; 58:e99-e104. [PMID: 31812453 DOI: 10.1016/j.jemermed.2019.10.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 10/15/2019] [Indexed: 06/10/2023]
Abstract
International medical graduates (IMGs) are medical graduates who have received their degree from international medical schools. IMGs must undertake a 3-step process to apply to the National Residency Matching Program match. First, they must obtain a valid standard certificate from the Educational Commission for Foreign Medical Graduates. Following certification, they must apply for and secure a position in a residency training program. Third, they must obtain a visa that would enable them to commence their training. In this article, we delve thoroughly into these stepladders to provide IMGs with a clear roadmap of the process as well as contacts to key agencies that may provide more comprehensive assistance.
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Affiliation(s)
| | - Christopher Lewandowski
- Department of Emergency Medicine, Henry Ford Hospital and Wayne State University, Detroit, Michigan
| | - Syed S Ali
- Memorial Hermann Memorial City Hospital, Houston, Texas
| | - Carol Barsky
- Department of Emergency Medicine, Yale School of Medicine, Yale-New Haven Hospital, New Haven, Connecticut
| | - Brigitte Kazzi
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | | | | | - Amin Kazzi
- American University of Beirut, Beirut, Lebanon; University of California, Irvine, Rivine, California
| | - Ziad Kazzi
- American University of Beirut, Beirut, Lebanon; Department of Emergency Medicine, Emory University, Atlanta, Georgia
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Chakraborti C, Crowther JE, Koretz ZA, Kahn MJ. How well did our students match? A peer-validated quantitative assessment of medical school match success: the match quality score. Med Educ Online 2019; 24:1681068. [PMID: 31661427 PMCID: PMC6830230 DOI: 10.1080/10872981.2019.1681068] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 08/24/2019] [Accepted: 09/27/2019] [Indexed: 06/10/2023]
Abstract
Background: Assessment of an individual medical school's performance in the match is an important outcome of the educational program. Unfortunately, student rank lists are not public. A method to objectively gauge the quality of an institution's match regardless of student preference has not been described in the literature.Objective: This manuscript serves to determine the relative weights of included variables and derive a statistically valid Match Quality Score (MQS).Design: Between 2016 and 2018, student affairs experts derived from a national cohort validated the MQS by scoring factitious mini-match lists that covered three variables: student's Match Status, specialty Competitiveness, and residency program Reputation.Results: Of the variables assessed, only Match Status and Competitiveness were found to be significant. We derived the resulting coefficients for the Match Quality Score (MQS) as: [3.74A (# students successfully matched) + 2.34B (# students matching into their initial specialty in the SOAP process) + 1.77C (# students who secured a SOAP position in another specialty) + 0.26D (# students matching into a specialty where there are more applicants than spots)]/Total # students.Conclusions: The MQS is a potentially useful educational outcome measurement for US medical schools and may be considered as an outcome measure for continuous quality improvement to tailor future institutional changes to training, mentoring, and student-advising programs.
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Affiliation(s)
- Chayan Chakraborti
- Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - Jason E. Crowther
- Resident in Surgery, Harbor-UCLA Medical Center, Los Angeles, CA, USA
| | | | - Marc J. Kahn
- Office of Admissions and Student Affairs, Tulane University School of Medicine, New Orleans, LA, USA
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Garmel GM, Grover CA, Quinn A, Lotfipour S, Langdorf MI, Cheaito MA, Epter M, Kazzi A. Letters of Recommendation. J Emerg Med 2019; 57:405-10. [PMID: 31375370 DOI: 10.1016/j.jemermed.2019.04.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 04/09/2019] [Indexed: 11/19/2022]
Abstract
Letters of recommendation (LORs) are a central element of an applicant's portfolio for the National Resident Matching Program (known as the "Match"). This is especially true when applying to competitive specialties like emergency medicine (EM). LORs convey an applicant's potential for success, and also highlight an applicant's qualities that cannot always be recognized from a curriculum vitae, test scores, or grades. Traditional LORs, also called narrative LORs, are written in prose and are therefore highly subjective. This led to the establishment of a task force by the Council of Emergency Medicine Residency Directors in 1995 to develop a standardized LOR. Revisions of this form are now referred to as a standardized letter of evaluation. These evaluations in this format have proven to increase inter-rater reliability, decrease interpretation time, and standardize the process used by EM faculty to prepare evaluations for EM applicants. In this article, we will discuss LORs; address applicants' concerns, including from whom to request LORs (EM faculty vs. non-EM faculty vs. non-clinical faculty), number of LORs an applicant should include in his or her application materials, the preferred manner of requesting and the timing in which to ask for an LOR, as well as the philosophy behind waiving the right to see the letter.
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Zigrossi D, Ralls G, Martel M, Rothrock SG, Langdorf MI, Cheaito MA, Lotfipour S, Kazzi A. Ranking Programs: Medical Student Strategies. J Emerg Med 2019; 57:e141-e145. [PMID: 31279639 DOI: 10.1016/j.jemermed.2019.04.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 04/22/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Selecting a training program is one of the most challenging choices an applicant to the Match has to make. DISCUSSION To make an informed decision, applicants should do a comprehensive research and carefully plan their upcoming steps. Factors that might influence the applicants' decision include geography, program reputation, specific areas of academic focus, subspecialty interests, university-versus community-based training, length of training and interest in combined programs. Such information can be gathered from published material, websites, and personal advice (from faculty, residents and advisors). This process is time-consuming and stressful. CONCLUSION Therefore, in this article we elaborate on the above to facilitate this process for applicants.
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Affiliation(s)
- Dominic Zigrossi
- Department of Emergency Medicine, Orlando Regional Medical Center, Florida State University School of Medicine, Orlando, Florida
| | - George Ralls
- Department of Emergency Medicine, Orlando Regional Medical Center, Florida State University School of Medicine, Orlando, Florida
| | - Marc Martel
- Hennepin County Medical Center, University of Minnesota, Minneapolis, Minnesota
| | - Steven G Rothrock
- Department of Emergency Medicine, Orlando Regional Medical Center, Florida State University School of Medicine, Orlando, Florida
| | - Mark I Langdorf
- Department of Emergency Medicine, University of California, Irvine, California
| | - Mohamad Ali Cheaito
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Shahram Lotfipour
- Department of Emergency Medicine, University of California, Irvine, California
| | - Amin Kazzi
- Department of Emergency Medicine, University of California, Irvine, California; Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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Katzung KG, Ankel F, Clark M, Lawson LE, DeBlieux PMC, Cheaito MA, Hitti EA, Epter M, Kazzi A. What Do Program Directors Look for in an Applicant? J Emerg Med 2019; 56:e95-e101. [PMID: 30904381 DOI: 10.1016/j.jemermed.2019.01.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 01/11/2019] [Indexed: 11/19/2022]
Abstract
Program directors (PDs) are faced with an increasing number of applicants to emergency medicine (EM) and a limited number of positions. This article will provide candidates with insight to what PDs look for in an applicant. We will elaborate on the performance in the emergency medicine clerkship, interview, clinical rotations (apart from EM), board scores, Alpha Omega Alpha membership, letters of recommendation, Medical Student Performance Evaluation or dean's letter, extracurricular activities, Gold Humanism Society membership, medical school attended, research and scholarly projects, personal statement, and commitment to EM. We stress the National Resident Matching Program process and how, ultimately, selection of a residency is equally dependent on an applicant's selection process.
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Affiliation(s)
| | - Felix Ankel
- University of Minnesota, Minneapolis, Minnesota
| | - Mark Clark
- Columbia University College of Physicians and Surgeons, New York City, New York; St. Luke's Roosevelt Hospital Center, Columbia University, New York City, New York
| | - Luan E Lawson
- Department of Emergency Medicine, East Carolina University, Brody School of Medicine, Greenville, North Carolina
| | - Peter M C DeBlieux
- Sections of Emergency Medicine and Pulmonary and Critical Care, Department of Medicine, Louisiana State University School of Medicine, New Orleans, Louisiana
| | - Mohamad Ali Cheaito
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Eveline A Hitti
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | | | - Amin Kazzi
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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Rozenshtein A, Gilet AG, Griffith B, Kamran A, Wiggins EF, Anderson JC. Radiology Residency Match: The Cost of Being in the Dark. Acad Radiol 2018; 25:1491-1496. [PMID: 29941399 DOI: 10.1016/j.acra.2018.04.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 04/26/2018] [Accepted: 04/27/2018] [Indexed: 11/18/2022]
Abstract
RATIONALE AND OBJECTIVES The Electronic Resident Application Service (ERAS) publishes monthly statistics before the match and the National Resident Matching Program publishes the match outcomes. We sought to determine whether early ERAS data influences applicant behavior and correlates with match outcomes. MATERIALS AND METHODS We searched the 2007-2017 ERAS archives for the applicant pool size (PS), the average number of applications per program (AP), and the average number of applications per applicant (AA) in November, before radiology match, and the 2007-2017 National Resident Matching Program archives for the average number of ranked applicants needed to fill each position (ANRA) and the number of unfilled positions (UP) in radiology match. Correlation coefficients were calculated for each pair. RESULTS PS correlated very strongly with AP (r = 0.80, p = 0.001708), UP (r = -0.92, p = 0.000063) and ANRA (r = -0.90, p = 0.000164). UP correlated strongly with ANRA (r = 0.76, p = 0.006349) and AP (r = -0.77, p = 0.005339). A trend to moderate correlation between AP and ANRA (r = 0.58, p = 0.062686) and AA (r = 0.53, p = 0.074395) did not reach statistical significance. There was no correlation between AA and PS in the same (r = -0.05, p = 0.878585) or the following year (r = 0.35, p = 0.297166), and AA and UP in the same (r = 0.13, p = 0.701983) or the following year (r = 0.32, p = 0.336136). CONCLUSION The real-time data reported by ERAS in November, before match, is a predictor of radiology match outcomes and can be used by all participants to limit their application and recruitment costs. Medical students applying to radiology do not consider either the real-time or historic data when submitting ERAS applications.
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Affiliation(s)
- Anna Rozenshtein
- Department of Radiology, Westchester Medical Center-New York Medical College, 100 Woods Road, Valhalla, NY 10595.
| | - Anthony G Gilet
- Department of Radiology, Westchester Medical Center-New York Medical College, 100 Woods Road, Valhalla, NY 10595
| | - Brent Griffith
- Department of Radiology, Henry Ford Hospital, Detroit, MI 48202
| | - Ali Kamran
- Department of Radiology, University of Kansas School of Medicine-Wichita, Wichita, KS 67214
| | - Ernest F Wiggins
- Department of Radiology, Monmouth Medical Center, Long Branch, NJ 07740
| | - James C Anderson
- Department of Radiology, Oregon Health and Sciences University, Portland, OR 97201
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Killian JT, Leeper JD, Xu Q, Sauer PF, Porterfield JR. A Predictive Model for a Reputation-Based General Surgery Residency Match and a Novel Online Calculator. J Surg Educ 2018; 75:846-853. [PMID: 29033024 DOI: 10.1016/j.jsurg.2017.09.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 09/12/2017] [Accepted: 09/12/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE This study aimed to identify medical student characteristics that predict a successful categorical match into a general surgery residency and a match based upon Doximity program rankings. DESIGN This was a retrospective study that analyzed academic and personal predictors of a successful general surgery residency match. SETTING This study was set at the University of Alabama at Birmingham School of Medicine, a public medical school. PARTICIPANTS This study included 173 fourth-year medical students at a public medical school who matched into general surgery residency programs. METHODS Our cohort comprised students graduating from our institution between 2004 and 2015 that matched into preliminary or categorical general surgery positions. We collected academic variables and performed univariate analyses and logistic regression to examine the likelihood of specific match outcomes. RESULTS Of 173 students, 132 (76%) matched into a categorical position and 41 (24%) matched into a preliminary position. Of all variables, clinical ranking quartile was most effective in predicting a categorical match (R2 = 0.35). Models for a match based upon Doximity ranking lacked the same predictive power. CONCLUSIONS This research identifies students that are at risk for not matching into a categorical position and predicts competitiveness for certain programs. It provides a novel calculator to give applicants easily interpretable match probabilities.
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Affiliation(s)
- John T Killian
- Department of Surgery, Section of Gastrointestinal Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
| | - James D Leeper
- The University of Alabama, College of Community Health Sciences, Tuscaloosa, Alabama
| | - Qiong Xu
- The University of Alabama, College of Community Health Sciences, Tuscaloosa, Alabama
| | - Paul F Sauer
- Department of Surgery, Section of Gastrointestinal Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - John R Porterfield
- Department of Surgery, Section of Gastrointestinal Surgery, University of Alabama at Birmingham, Birmingham, Alabama
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Abstract
The field of otolaryngology has historically enjoyed extreme interest among residency applicants. However, in the past few years, the number of applicants has precipitously dropped, so that there is no longer a significant excess of applications. It remains important for academic programs to promote student interest in otolaryngology, to break down barriers that may dissuade excellent candidates, and to widen the welcome.
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Affiliation(s)
- C W David Chang
- 1 Department of Otolaryngology-Head and Neck Surgery, University of Missouri, Columbia, Missouri, USA
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Cornett PA, Williams C, Alweis RL, McConville J, Frank M, Dalal B, Kopelman RI, Luther VP, O'connor AB, Muchmore EA. Problematic communications during 2016 fellowship recruitment in internal medicine. J Community Hosp Intern Med Perspect 2017; 7:277-281. [PMID: 29147467 PMCID: PMC5676963 DOI: 10.1080/20009666.2017.1381546] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 09/15/2017] [Indexed: 11/24/2022] Open
Abstract
Some internal medicine residency program directors have expressed concerns that their third-year residents may have been subjected to inappropriate communication during the 2016 fellowship recruitment season. The authors sought to study applicants’ interpersonal communication experiences with fellowship programs. Many respondents indicated that they had been asked questions that would constitute violations of the National Residency Matching Program (NRMP) Communications Code of Conduct agreement, including how they plan to rank specific programs. Moreover, female respondents were more likely to have been asked questions during interview experiences about other programs to which they applied, and about their family plans. Post-interview communication policies were not made clear to most applicants. These results suggest ongoing challenges for the internal medicine community to improve communication with applicants and uniform compliance with the NRMP communications code of conduct during the fellowship recruitment process.
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Affiliation(s)
- Patricia A Cornett
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Chris Williams
- Alliance for Academic Internal Medicine, Master of Public Health student, George Washington School of Public Health, Alexandria, VA, USA
| | - Richard L Alweis
- Rochester Regional Health, Clinical Associate Professor of Medicine, University of Rochester School of Medicine and Dentistry, Rochester General Hospital, Rochester, NewY, USA
| | - John McConville
- Department of Medicine, University of Chicago School of Medicine, Chicago, IL, USA
| | - Michael Frank
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Bhavin Dalal
- Department of Medicine, Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA
| | - Richard I Kopelman
- Department of Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Vera P Luther
- Department of Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Alec B O'connor
- Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Elaine A Muchmore
- Department of Medicine, University of California, San Diego, School of Medicine and VA San Diego Health System, San Diego, CA, USA
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Pfeifer CM. Evolution of the Preliminary Clinical Year and the Case for a Categorical Diagnostic Radiology Residency. J Am Coll Radiol 2016; 13:842-8. [PMID: 27162044 DOI: 10.1016/j.jacr.2016.02.034] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 01/06/2016] [Accepted: 02/26/2016] [Indexed: 11/19/2022]
Abstract
PURPOSE While other specialties traditionally utilizing a segregated clinical internship year have slowly progressed toward integrated training curricula, diagnostic radiology has been slow to adopt this path. The aim of this study was to analyze the trends in stand-alone preliminary clinical years as well as the shift toward categorical residencies currently being undertaken in other specialties. Advantages of mimicking the trends of other specialties and current integrated radiology programs are discussed. The perception of diagnostic radiology as a competitive specialty is explored, and the prospect of change as a recruiting tool is examined. METHODS Data assimilated by the NRMP from 1994 through 2016 were processed and analyzed. RESULTS The total number of postgraduate year (PGY) 1 preliminary year programs has remained relatively constant over the past 10 years despite a gradual increase in overall NRMP applicants. The proportion of these programs offered as a transitional year declined from 31% in 1994 to 20% in 2016. The proportion of categorical anesthesiology positions gradually rose from 43% in 2007 to 70% in 2016. The fraction of categorical neurology positions increased from 30% in 2007 to 59% in 2016. The percentage of diagnostic radiology programs beginning at the PGY 1 level has been relatively constant at 12% to 14% since 2007. Dermatology has increased advanced (PGY 2) positions while decreasing categorical (PGY 1) positions. Those matching in diagnostic radiology have performed at a high level compared with the composite NRMP average since 2007. In the 2015 match, there were 65 diagnostic radiology programs that did not fill all of their offered positions. Of the institutions housing these programs, only 22% of them had preliminary internal medicine or transitional year positions available after the match. CONCLUSIONS In response to the evolving nature of health care and graduate medical education, other specialties are gradually shifting toward curricular structures that begin at the PGY 1 level. By considering such a transition, diagnostic radiology would be well served to position itself as a valuable clinical specialty while maintaining a lesser dependence on other specialties to train its physicians.
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Affiliation(s)
- Cory M Pfeifer
- University of Texas Southwestern Medical Center, Dallas, Texas.
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Sharafinski ME, Nussbaum D, Jha S. Supply/Demand in Radiology: A Historical Perspective and Comparison to other Labor Markets. Acad Radiol 2016; 23:245-51. [PMID: 26585785 DOI: 10.1016/j.acra.2015.10.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 10/05/2015] [Accepted: 10/05/2015] [Indexed: 11/17/2022]
Abstract
RATIONALE AND OBJECTIVES There has been attention on the job market recently and on radiology's supply/demand calculus. Supply is influenced by the number of trained radiologists, while demand is driven by demographics and technological innovation. We analyze the supply of radiologists historically and compare to other labor markets-medical and non-medical, domestic and foreign. MATERIALS AND METHODS We review National Resident Matching Program data in radiology and several other specialties from 1991 to 2015. We also review surveys, physician recruitment data, and peer-reviewed commentaries on medical specialty job markets. Trends are compared across specialties. The regulation of American medical training is compared to that in the United Kingdom and to a nonmedical labor market, unionized theatrical stage employees. RESULTS Radiology residency positions have increased since 1998 despite a downturn in the job market. This expansion coincides with a decreasing percentage of positions filled by domestic graduates. A similar trend has been seen in pathology, a notoriously oversupplied specialty. Conversely, other specialties have maintained their proportion of domestic graduates by way of limited supply or implicit demand. CONCLUSIONS The radiology job market is currently oversupplied, primarily a result of increasing residency positions despite indicators of decreasing demand. The percentage of residency positions filled by domestic graduates has decreased during the same period, suggesting that medical student interest is responsive to the market. Other specialties, particularly pathology, demonstrate the dangers of chronic oversupply. We advocate a reduction of radiology residency positions such that supply closely approximates demand without exceeding it. Additional measures may be taken, if necessary, to restore market equilibrium in the event of a mild undersupply.
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Affiliation(s)
- Mark E Sharafinski
- Department of Radiology, Medical College of Wisconsin Affiliated Hospitals, 9200 W Wisconsin Avenue, Milwaukee, WI 53226.
| | - David Nussbaum
- Union Radiology Associates, Union Hospital, Elkton, Maryland
| | - Saurabh Jha
- Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
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Abstract
The Fellowship Match process was designed to provide applicants and program directors with an opportunity to consider all their options before making decisions about post-residency training. In a Match, applicants can choose the programs that best suit their career goals, and program directors can consider all candidates before preparing a rank order list. The Match is a contract, requiring obligations of both programs and applicants to achieve success, ensure uniformity, and standardize participation.
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Affiliation(s)
- Chi-yuan Hsu
- University of California, San Francisco School of Medicine, San Francisco, California
| | - Mark G Parker
- Tufts University School of Medicine and Maine Medical Center, Portland, Maine
| | - Michael J Ross
- Icahn School of Medicine at Mount Sinai, New York City, New York
| | - Rebecca J Schmidt
- West Virginia University School of Medicine, Morgantown, West Virginia; and
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38
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Abstract
Otolaryngology is viewed as a competitive residency program, and as a result, a high number of applications are submitted by each applicant. A look at the data quantifies the cost and the challenges.
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Affiliation(s)
- C W David Chang
- Department of Otolaryngology-Head and Neck Surgery, University of Missouri, Columbia, Missouri, USA
| | - Benjamin F Erhardt
- Department of Otolaryngology-Head and Neck Surgery, University of Missouri, Columbia, Missouri, USA
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39
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Bhat R, Takenaka K, Levine B, Goyal N, Garg M, Visconti A, Oyama L, Castillo E, Broder J, Omron R, Hayden S. Predictors of a Top Performer During Emergency Medicine Residency. J Emerg Med 2015; 49:505-12. [PMID: 26242925 DOI: 10.1016/j.jemermed.2015.05.035] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 05/29/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Emergency Medicine (EM) residency program directors and faculty spend significant time and effort creating a residency rank list. To date, however, there have been few studies to assist program directors in determining which pre-residency variables best predict performance during EM residency. OBJECTIVE To evaluate which pre-residency variables best correlated with an applicant's performance during residency. METHODS This was a retrospective multicenter sample of all residents in the three most recent graduating classes from nine participating EM residency programs. The outcome measure of top residency performance was defined as placement in the top third of a resident's graduating class based on performance on the final semi-annual evaluation. RESULTS A total of 277 residents from nine institutions were evaluated. Eight of the predictors analyzed had a significant correlation with the outcome of resident performance. Applicants' grade during home and away EM rotations, designation as Alpha Omega Alpha (AOA), U.S. Medical Licensing Examination (USMLE) Step 1 score, interview scores, "global rating" and "competitiveness" on nonprogram leadership standardized letter of recommendation (SLOR), and having five or more publications or presentations showed a significant association with residency performance. CONCLUSION We identified several predictors of top performers in EM residency: an honors grade for an EM rotation, USMLE Step 1 score, AOA designation, interview score, high SLOR rankings from nonprogram leadership, and completion of five or more presentations and publications. EM program directors may consider utilizing these variables during the match process to choose applicants who have the highest chance of top performance during residency.
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Affiliation(s)
- Rahul Bhat
- Department of Emergency Medicine, MedStar Georgetown University, Hospital/MedStar Washington Hospital Center, Washington, DC
| | - Katrin Takenaka
- Department of Emergency Medicine, University of Texas, Houston, Texas
| | - Brian Levine
- Department of Emergency Medicine, Christiana Care Health System, Newark, Delaware
| | - Nikhil Goyal
- Department of Emergency Medicine, Henry Ford Hospital, Detroit, Michigan
| | - Manish Garg
- Department of Emergency Medicine, Temple University Hospital, Philadelphia, Pennsylvania
| | - Annette Visconti
- Department of Emergency Medicine, New York Methodist Hospital, Brooklyn, New York
| | - Leslie Oyama
- Department of Emergency Medicine, University of California at San Diego, La Jolla, California
| | - Edward Castillo
- Department of Emergency Medicine, University of California at San Diego, La Jolla, California
| | - Joshua Broder
- Division of Emergency Medicine, Department of Surgery, Duke University Hospital, Durham, North Carolina
| | - Rodney Omron
- Department of Emergency Medicine, Johns Hopkins University Hospital, Baltimore, Maryland
| | - Stephen Hayden
- Department of Emergency Medicine, University of California at San Diego, La Jolla, California
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40
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Abstract
The paper focuses on the past five years of National Residency Match Program (NRMP) information in the Unites States with a comparison point of twenty years ago utilized because of a referenced article. It is well known to our students going through the match that it is more competitive than in prior years. To rank enough programs for your field, take Step 2 early to maximize your score, to get quality letters and to practice mock interviews. The 99% match rate has remained steady over the past five years despite an increase in all primary care disciplines particularly Internal Medicine. Family Medicine and Internal Medicine work with, on average, about half U.S. seniors and half from other groups including Osteopathic and IMG (U.S. citizen and non-U.S. citizen). This can create a holistic experience for residents with a sharing of ideas from students from varied backgrounds. While the Supplemental Offer and Acceptance Program appear as an initial success, the student's goal should be to avoid such a step altogether. The key twenty years ago and today is the existence of appropriate numbers of resident and faculty role models. This is a stressful goal considering the demands on faculty for billing and patient care due to the shiftwork nature of the new work hours.
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Affiliation(s)
- Michael T Flannery
- 12901 Bruce B Downs Boulevard, MDC Box 19 Room L1041, Tampa, FL 33612, United States.
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41
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Karnes JM, Mayerson JL, Scharschmidt TJ. Is orthopedics more competitive today than when my attending matched? An analysis of National Resident Matching Program data for orthopedic PGY1 applicants from 1984 to 2011. J Surg Educ 2014; 71:530-542. [PMID: 24836166 DOI: 10.1016/j.jsurg.2014.01.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Revised: 11/07/2013] [Accepted: 01/07/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE This study evaluated supply and demand trends for orthopedic postgraduate year 1 (PGY1) positions from 1984 to 2011 for the purpose of estimating national intercandidate competition over time. DESIGN National Resident Matching Program (NRMP) data for orthopedic surgery from 1984 to 2011 were collected. Proxy variables including (total number of orthopedic applicants/number of orthopedic PGY1 positions), (number of US senior applicants to orthopedics/number of orthopedic PGY1 positions), (number of US seniors matching into orthopedics/number of US senior orthopedic applicants), (total number of matched orthopedic applicants/total number of orthopedic applicants), and (total number of US applicants who fail to match into orthopedics/total number of US senior applicants into orthopedics) as well as average United States Medical Licensing Examination Step 1 scores were used to gauge the level of competition between candidates and were compared over time. SETTING Academic medical center in the Midwestern United States. PARTICIPANTS Medical professors and medical students. RESULTS The NRMP data suggested that the number of positions per applicant decreased or remained stable since 1984 and that the percentage of applicants who did not match was no higher now than in the past. This finding was primarily because of the relative decrease in the ratio of applicants to available PGY1 positions, which stems from the number of positions increasing more rapidly than the number of applicants. CONCLUSIONS The NRMP data from 1984 to 2011 supported our hypothesis that intercandidate competition intensity for orthopedic PGY1 positions has not increased over time. The misconception that orthopedics is becoming more competitive likely arises from the increased number of applications submitted per candidate and the resulting relative importance placed on objective criteria such as United States Medical Licensing Examination Step 1 scores when programs select interview cohorts.
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Affiliation(s)
- Jonathan M Karnes
- Department of Orthopaedics, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Joel L Mayerson
- Division of Musculoskeletal Oncology, The Ohio State University, Columbus, Ohio
| | - Thomas J Scharschmidt
- Department of Orthopaedics, West Virginia University School of Medicine, Morgantown, West Virginia; Division of Musculoskeletal Oncology, The Ohio State University, Columbus, Ohio.
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