Disparate Responses in Match Outcome across Competitive Surgical Subspecialties to Pandemic Era Constraints: An Analysis of Impacts of Minimal Auditions

Abstract

Objective: The Covid-19 pandemic eliminated nearly all visiting sub-internships. We seek to uncover match rate disparities across plastic surgery, otolaryngology, urology, and neurosurgery subspecialties with respect to in-person appraisals. These data aim to highlight the common practices as well as subtle differences that each subspecialty may be displaying in selecting their respective residency candidates.

Design: We accessed publicly available online spreadsheets between March 24 to 27 specific to the following surgical subspecialties: plastic surgery, otolaryngology, neurosurgery, and urology. We collected available information including the matched applicants' medical school, the institution at which they matched, and whether they had previous communication with their matched program. This data was then used to record whether the applicant matched at their home institution.

Setting: N/A PARTICIPANTS: N/A RESULTS: There was a statistically significant increase in the number of plastic surgery and otolaryngology applicants who matched at their home programs during the 2020 to 2021 application cycle. 12.1% and 17.2% of plastic surgery applicants matched at their home program in the 2018 to 2019 and 2019 to 2020 application cycles, compared to 25.0% during the 2020 to 2021 application cycle (p = 0.0345). Overall, 23.4% and 22.2% of otolaryngology applicants matched at their home program in the 2018 to 2019 and 2019 to 2020 application cycles, compared to 31.3% during the 2020 to 2021 application cycle (p = 0.0482). Neurosurgery and urology applicants did not demonstrate statistically significant differences in home match rates during the 2020 to 2021 application cycle (p = 0.164 and p = 0.105, respectively).

Conclusions: Covid-19 related restrictions in the 2020 to 2021 match cycle led residency programs to utilize novel selection mechanisms to evaluate applicants. Without visiting sub-internships during the 2020 to 2021 match cycle, some programs appear to have intentionally favored candidates with whom they were previously acquainted. The significantly higher number of international medical graduates and non-senior medical graduates among neurosurgery and urology residencies, respectively, likely washed out the home matching effect among these specialties but does not discount the importance of in-person appraisals.

Keywords: Covid-19; away rotations; home program; match; residency; visiting sub-internships.