Costs of U.S. Allopathic Medical Students Applying to Neurosurgery Residency: Geographic Considerations and Implications for the 2020–2021 Application Cycle

Abstract

Although studies have evaluated the economic burden to medical students desiring a neurosurgery residency broadly, a detailed breakdown of costs has not been reported. Given that the Association of American Medical Colleges and Society of Neurological Surgeons have recommended neurosurgery residency programs for the 2021 residency application cycle cancel away rotations and in-person interviews, our objective was to evaluate cost savings to medical students applying during this time and the implications. Using the 2019-2020 Texas STAR Dashboard database, we queried responses from neurosurgery residency applicants. We recorded application costs, away rotation costs, interview costs, and total costs for medical school seniors applying to neurosurgery residency. Demographic information for applicants was also recorded. Mean and median costs were reported with percentile distributions and geographic comparisons. A Kruskal-Wallis H test was used to determine differences in mean costs by medical school region. Our cohort included 121 U.S. allopathic applicants to neurosurgery residency. Mean application costs were $1711, away rotation costs were $3840, interview costs were $6400, and total costs were $11,882. No significant difference was observed for mean total costs for applicants from schools in the central ($10,525/applicant), northeast ($11,311/applicant), south ($12,660/applicant) and west ($12,404/applicant) regions (P= 0.181). There was no significant difference in the mean application fees, away rotation costs, or interview costs among regions. In the COVID-19 era, neurosurgery residency applicants could save >$10,000 through the use of virtual interviews and lack of away rotations. There are potential geographic trends; however, further evaluation should be performed.