Effect of the COVID-19 pandemic on the residency match among surgical specialties

Abstract

Background: Despite unprecedented changes to undergraduate medical education and the residency selection process during the COVID-19 pandemic, there is little objective evidence on how the pandemic affected match outcomes such as matched applicant characteristics, interview distribution, geographic clustering, and associated costs. We investigated COVID-19's impact on the residency match by comparing surgery applicants' characteristics, interview distribution, and related costs from 2018 to 2020 to 2021.

Methods: Data from the Texas Seeking Transparency in Applications to Residency initiative were analyzed. Descriptive statistics, bivariate testing, and sensitivity analysis were performed to compare matched applicants in surgical specialties from 2018-2020 to 2021.

Results: This study included 5,258 applicants who matched into 10 surgical specialties from 2018 to 2021. In 2021, there was a decrease in proportion of students who reported a geographic connection to their matched program (38.4% vs 42.1%; P = .021) and no significant difference in number of interviews attended (mean [SD], 13.1 [6.2] vs 13.3 [4.7]; P = .136) compared to prior years. Applicants in 2021 had more research experiences and fewer honored clerkships (both P < .001), and these associations persisted in sensitivity analysis. Matched applicants in 2021 reported significantly lower total costs associated with the residency application process compared to 2018 to 2020 (mean [SD] $1,959 [1,275] vs $6,756 [4,081]; P < .001).

Conclusion: Although COVID-19 appeared to result in a reduction in number of honored clerkships, it may have provided more opportunities for students to engage in research. Overall, the adoption of virtual interviews and away rotations may have successfully mitigated some of the adverse consequences of the pandemic on the residency match for surgical specialties.

Graphical abstract

Figure 1

Histogram showing the distribution of interviews attended by matched applicants in 2021 compared to 2018 to 2020 (mean [SD]: 13.1 [6.2] vs 13.3 [4.7]; P = .136).

Figure 2

(A) Bar graph showing the percentage of applicants matching at a program where they did an away rotation or had a geographic connection by year. (B) General surgery applicants’ connections to programs at which they matched. (C) Neurosurgery applicants’ connections to programs at which they matched. (D) Obstetrics and gynecology applicants’ connections to programs at which they matched. (E) Ophthalmology applicants’ connections to programs at which they matched. (F) Orthopedic surgery applicants’ connections to programs at which they matched. (G) Otolaryngology applicants’ connections to programs at which they matched. (H) Plastic surgery applicants’ connections to programs at which they matched. (I) Urology applicants’ connections to programs at which they matched. (J) Vascular surgery applicants’ connections to programs at which they matched.

Figure 2

(A) Bar graph showing the percentage of applicants matching at a program where they did an away rotation or had a geographic connection by year. (B) General surgery applicants’ connections to programs at which they matched. (C) Neurosurgery applicants’ connections to programs at which they matched. (D) Obstetrics and gynecology applicants’ connections to programs at which they matched. (E) Ophthalmology applicants’ connections to programs at which they matched. (F) Orthopedic surgery applicants’ connections to programs at which they matched. (G) Otolaryngology applicants’ connections to programs at which they matched. (H) Plastic surgery applicants’ connections to programs at which they matched. (I) Urology applicants’ connections to programs at which they matched. (J) Vascular surgery applicants’ connections to programs at which they matched.