Analysis of "gap year" prevalence, productivity, and funding among radiation oncology residency applicants

Abstract

Medical students often take one or more years off during medical school (a “gap year”) to strengthen their applications for competitive specialties such as radiation oncology. This has a significant opportunity cost (delaying residency) and financial costs (for living expenses, if unfunded gap year). We characterized the prevalence, nature, and funding of gap years taken by radiation oncology applicants, and the association of gap years with research productivity. All ERAS applications (n=176) received by one residency program were reviewed and data was collected on gender, age, medical school rank (per U.S. News), and other graduate degree(s) obtained. Foreign graduates and those switching from other residency programs (n=9) were excluded. MD/PhD students were analyzed separately. A gap year was defined as any additional year during medical school not part of the standard four-year or MD/PhD program. We classified gap years by primary activity (clinical or lab research, masters’ degree, illness, or family/personal). If specified, funding source was noted. We collected the number of publications and inferred gap year productivity from timing of publications, and their authors. A total of 167 applicants were analyzed (72% male and 28% female). Their average age was 28.1 (IQR 26.1-30.1), with average of 5.5 publications. Of the non M.D./Ph.D. applicants, 24% took a gap year. Other characteristics are listed in the table. The most common gap year activity was research (67.7%, n=21), 12.9% (n=4) obtained an additional degree, 9.7% (n=3) had illness and 9.7% (n=3) had family/personal reasons. Fifteen of 31 (48.4%) applicants listed a source of funding (5 by medical school, 8 by grants, and 2 other). For the remaining 16, no source of gap year funding was apparent.Abstract TU_4_2930; Table: Comparison of applicants (95% Confidence Interval in parenthesis)No Gap YearGap YearM.D./Ph.D.Applicants1013135Average Age27.5 (26.9-28.1)26.3 (25.5-27.1)* *Adjusted for gap year30.2 (29.7-30.9)Average Medical School Ranking39.3 (33.0-45.6)14.8 (8.3-21.3)36.7 (26.4-47.0)Total Publications4.1(3.1-5.1)Pre-gap: 2.1 (1.4-2.8) Post-gap 6.4 (4.8-7.8)8.8 (7.2-10.5) Open table in a new tab Nearly a quarter of non-Ph.D. applicants take a gap year, usually for research, and this gap year results in a significant increase in publications. Gap year applicants are comparable in age but are more likely from higher-ranked medical schools. Nearly half of gap-year applicants may lack a source of funding to support their gap year, raising the question of whether the expectations to take a gap year favors applicants with existing financial resources. We are designing a survey to query applicants directly about their motivations and resources when deciding whether to take a gap year. This data may inform a broader discussion about how residency programs value research experience and the implicit burden this places on potential applicants.