Abstract

ObjectiveNeurosurgery is one of the most competitive specialties and navigating the match process is often challenging for aspiring applicants. Here, we analyze insights from the National Resident Matching Program (NRMP) Program Director Surveys, illustrating evolving trends in applicant selection for interviews and for the ranking process, and providing a comparison with other specialties. MethodsWe evaluated seven surveys administered from 2012 to 2022. Six biennial surveys reported on factors influencing interview and ranking processes, while all seven surveys included data about the program director (PD)’s attitude towards USMLE test scores. ResultsThe response rate of PDs decreased over the years. The most cited for interviews included specialty-specific recommendation letters (95%), USMLE Step 1 scores (91%), and interest in research (78%). A recent decline in emphasis on USMLE Step 1 scores coincided with a growing reliance on USMLE Step 2 scores. Award in basic science held significant esteem to a subset of programs. Personal characteristics dominated for ranking, with faculty interaction (89%), interpersonal skills (89%), and house staff interaction (85%) being the most important. Yet, PDs reported a difficulty in assessing interpersonal skills through virtual interviews. ConclusionOur analysis revealed the pervasive importance of specialized endorsements and academic achievements when screening applicants for the interview process. A shift in emphasis towards the USMLE step 2 became apparent. Personal characteristics, on the other hand, seemed crucial to make a match and rank high among the pool of interviewed applicants. We uncovered difficulties in assessing these characteristics through virtual interviews.

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