AUTHOR REPLY

Abstract

We thank Dr. Lanzotti and Dr. Ellis for their comments and insight. They note that several studies have already looked at the impact of COVID-19 and virtual interviews on the geographical distribution of matched applicants in urology as well as in other specialties; however, ours is the first to consider the size of the residency program during the pandemic. As mentioned, it would be interesting to combine our “small program effect” with the variables studied in previous studies into one analysis. This includes both applicant factors, such as board scores, hometown, and subinternship locations (even if virtual), as well as program factors, such as prestige and location in a city vs a suburb. Some further studies to consider would be to include other small surgical specialties in which away rotations and letters of recommendation hold weight, like urology, in the interview offers and ultimate match. We agree with the commenters that it would be compelling to see if this “small program effect” is isolated to urology during the initial pandemic years, or if other specialties and times also see these trends. As discussed in our study, 2022 also marked the introduction of preference signaling into the urology match cycle, which could account for part of the return in geographic diversity that was compromised especially in smaller programs during the first pandemic match cycle. Signaling allowed applicants to formally express interest in a program or geographic location even if there were no previous geographic ties, and applicants were more likely to receive an interview from a program they signaled. 1 Traxel E. Richstone L Brown J Mirza M Greene K Thavaseelan S Preference signaling pilot in the urology match: outcomes and perceptions. Urology. 2022; 170: 27-32https://doi.org/10.1016/j.urology.2022.08.034 Google Scholar This would require surveys of applicants and a substantial response rate to build the variable into the statistical model.