Residency Application Research Articles

A Cross-Sectional Institutional Survey of Depression, Suicidal Ideation, and Stigma in Medical Students

Background: Due to high rates of depression and suicidal ideation among medical students, interventions, such as Pass/Fail grading systems and peer-mentorship, have been implemented, but their effects not reported. The purpose of this study was to explore variations in depression severity among medical students and to better understand the related stigma in healthcare over the past decade, with the aim of enhancing medical education. Methods: A cross-sectional survey was conducted on REDCap across students at the University of Illinois College of Medicine. The severity of depression was measured by the PHQ-9. Stigma was assessed utilizing Likert scale responses. Demographics of students who are most likely to experience depression were collected. Additionally, clinical diagnoses of depression, treatment modalities, and alcohol use were compared. Results: There were 178 respondents with a 15% response rate. Thirty-nine (22%) respondents were classified in the moderate-to-severe depression group. Thirteen students, all female, endorsed suicidal ideation. A majority of respondents reported that depressed medical students would provide inferior patient care (n=71, 58%), their application to residency would be less competitive (n=76, 54%), they would feel embarrassed (n=88, 61%), and that it would be risky to reveal they have depression on a residency application (n=153, 94%). Conclusions: Depression, suicidal ideation, and stigmatization remain prevalent in medical students and may have worsened since 2010. New, multi-faceted approaches such as giving medical students the choice of mental health providers, providing clear information about documentation, and implementing personal, well-being goals are needed to reduce depression and stigma experienced by medical students.

Can Artificial Intelligence Deceive Residency Committees? A Randomized Multicenter Analysis of Letters of Recommendation.

The introduction of generative artificial intelligence (AI) may have a profound effect on residency applications. In this study, we explore the abilities of AI-generated letters of recommendation (LORs) by evaluating the accuracy of orthopaedic surgery residency selection committee members to identify LORs written by human or AI authors. In a multicenter, single-blind trial, a total of 45 LORs (15 human, 15 ChatGPT, and 15 Google BARD) were curated. In a random fashion, seven faculty reviewers from four residency programs were asked to grade each of the 45 LORs based on the 11 characteristics outlined in the American Orthopaedic Associations standardized LOR, as well as a 1 to 10 scale on how they would rank the applicant, their desire of having the applicant in the program, and if they thought the letter was generated by a human or AI author. Analysis included descriptives, ordinal regression, and a receiver operator characteristic curve to compare accuracy based on the number of letters reviewed. Faculty reviewers correctly identified 40% (42/105) of human-generated and 63% (132/210) of AI-generated letters (P < 0.001), which did not increase over time (AUC 0.451, P = 0.102). When analyzed by perceived author, letters marked as human generated had significantly higher means for all variables (P = 0.01). BARD did markedly better than human authors in accuracy (3.25 [1.79 to 5.92], P < 0.001), adaptability (1.29 [1.02 to 1.65], P = 0.034), and perceived commitment (1.56 [0.99 to 2.47], P < 0.055). Additional analysis controlling for reviewer background showed no differences in outcomes based on experience or familiarity with the AI programs. Faculty members were unsuccessful in determining the difference between human-generated and AI-generated LORs 50% of the time, which suggests that AI can generate LORs similarly to human authors. This highlights the importance for selection committees to reconsider the role and influence of LORs on residency applications.

The Presence of Predatory and Open Access Journal Publications Among Canadian Plastic Surgery Residency Applicants

Introduction: As scientific publishing has transitioned online, open access and predatory publishers have surged. This study describes the frequency of publications in potentially predatory and open access journals among applicants to a Canadian plastic surgery residency program, and explores applicant characteristics associated with open access and predatory publishing. Methods: A retrospective review of plastic surgery resident applicants’ curriculum vitae (CVs) from 2015 to 2018 was performed. Published articles listed in CVs were reviewed by 2 authors to identify publication availability, publication year, and publisher. Open access publications were identified using the Directory of Open Access Journals. Predatory publications were identified using Beall's list of potentially predatory publishers. Published applicants’ characteristics were summarized. Applicant characteristics associated with open access and predatory publishing were explored using logistic regression. Results: Of the 186 applicants, 117 published 388 articles and were included in the final analysis. 156 (40.2%) articles were published in open access journals by 76 (40.8%) applicants. 14 (3.6%) articles were published in predatory journals by 14 (7.5%) applicants. Applicant characteristics associated with open access publishing included total number of publications (OR: 1.56, 1.18-1.93, P &lt; .001) and presence of at least one post-baccalaureate degree (OR: 0.36, 0.13-0.95, P = .038). Only an applicant's total number of publications (OR: 1.25, 1.06-1.48, P = .010) was significantly associated with publishing in a predatory journal. Conclusion: These findings stress the importance of raising awareness within the plastic surgery community, including medical students, about the deceptive nature of predatory journals.

Fostering Inclusivity in PM&R: A National Survey.

There is a persistent underrepresentation of women and multiple ethnic minority groups among medical school and residency applicants and trainees, particularly in Physical Medicine and Rehabilitation (PM&R). There is limited information on what causes these demographic disparities in PM&R and on strategies to increase interest in the field. To address this gap and improve early recruitment efforts, the authors conducted the first-ever national survey to gather information on pre-medical students' perceived barriers to medical school admissions, career interests, perceptions of PM&R, and strategies to increase interest in PM&R. The survey received 1093 responses from 236 colleges with a diverse representation of participants, including 53.3% (n = 583) from historically underrepresented groups such as those Underrepresented in Medicine (URiM), and those from rural communities, and/or low socioeconomic backgrounds. Only 31.2% (n = 313) knew the existence of PM&R. However, 60.0% (n = 568) of respondents were interested in learning more about PM&R through shadowing a PM&R physician (82.2%, n = 780), attending workshops (75.9%, n = 720), and mentorship (58.9%, n = 559). The national survey revealed limited exposure to PM&R at the pre-medical level but a strong interest in dedicated mentorship and workshops, suggesting effective strategies to address underrepresentation.

Application Discrepancies in the 2023-2024 Integrated Plastic Surgery Match.

The Plastic Surgery Common Application (PSCA) was introduced in the 2020-2021 integrated plastic surgery match cycle. We investigated the accuracy of medical student-reported quantitative metrics in the PSCA. Quantifiable data from 1 year of PSCA applications were compared between matched and unmatched students. Discrepancies were identified by reviewing publicly available data and from Electronic Residency Application Service (ERAS) applications. A total of 330 PSCAs were analyzed and divided into two groups: matched (n = 196) and unmatched (n = 134). Of the 71 medical schools with multiple applicants, 23.9% (17/71) and 31.0% (22/71) had contradicting reports of Alpha Omega Alpha and Gold Humanism Honor Society availability. Three matched applicants, with an average numeric Step 1 score of 228, reported scores as "pass." Four applicants did not disclose a prior failing Step 1 score. More matched students had research discrepancies than unmatched students for first author (56%, 111/196; 50%, 67/132; P = 0.24) and total publications (66.8%, 131/196; 53%, 71/134; P = 0.011). The mean discrepancy number between matched and unmatched students was similar for first author (3.0 vs 3.2, P = 0.61) and total publications (4.3 vs 4.5, P = 0.61). Reasons for discrepancies included counting accepted articles (20.2%), submitted articles (7.5%), non-peer reviewed (3.1%) articles, and other endeavors (6.2%) in publication counts, with 52% of applicants having multiple reasons for discrepancies. Matched and unmatched applicants applying to plastic surgery had honor society and Step 1 score discrepancies, and inaccurate research reporting. NBME score verification and PubMed indexing may be a warranted addition to PSCA applications to guarantee application consistency.

Optimizing the Evaluation of Letters of Recommendation for Obstetrics and Gynecology Residency Applicants

Optimizing the Evaluation of Letters of Recommendation for Obstetrics and Gynecology Residency Applicants

Why so slow? The advancement of females in neurosurgery: a 30-year analysis.

As gender parity in medicine improves, neurosurgery lags behind. In pediatric neurosurgery, considered the most "female-friendly" subspecialty, determining the extent to which gender disparity has evolved over time, and how it compares to other subspecialties, can serve as an important benchmark for neurosurgery altogether. This study analyzed gender parity across different neurosurgical and subspecialty training stages to understand how female representation varies with training level and leadership positions. Data spanning from 1990 to 2023 were extracted from Association of American Medical Colleges (AAMC), Accreditation Council for Graduate Medical Education (ACGME), Accreditation Council for Pediatric Neurosurgical Fellowships (ACPNF), American Board of Neurological Surgery (ABNS), and American Board of Pediatric Neurological Surgery (ABPNS) databases and American Association of Neurological Surgeons (AANS)/Congress of Neurological Surgeons (CNS) subspecialty websites to examine the proportions of female-identifying trainees and neurosurgeons. Information regarding females in leadership roles was gathered from publicly available sources. Over the last 30 years, the proportion of female medical school graduates increased from 34.0% in 1990 to 51.9% in 2023 (0.45 graduates/year, R2 = 0.813). Female neurosurgery residency applicants increased from 10.5% in 1990 to 27.9% in 2023 (0.48 applicants/year, R2 = 0.694). Female neurosurgical residents increased from 7.3% in 1990 to 23.7% in 2023 (0.46 residents/year, R2 = 0.909). Female neurosurgeons obtaining ABNS certification increased from 5.0% in 1990 to 17.0% in 2023 (0.23 surgeons/year, R2 = 0.476). Female pediatric neurosurgery fellows increased from 0.0% in 1990 to 25.0% in 2023 (0.74 applicants/year, R2 = 0.369). The number of females obtaining ABPNS certification increased at a rate of 0.42 surgeons/year (R2 = 0.067). In neurosurgical academic leadership, female representation remains low: Society of Neurological Surgeons presidents at 0.98%, AANS presidents at 3.3%, CNS presidents at 0.0%, and departmental chairs at 1.5%. In pediatric neurosurgery, only 10% of division chiefs at top US News & World Report children's hospitals are female. Only 13.3% of past presidents of the AANS/CNS Section on Pediatric Neurosurgery were female; all American Society of Pediatric Neurosurgeons presidents have been male. There are higher proportions of female directors within ABPNS (33%) and the ACPNF board (43%). Other subspecialties have comparable female leadership representation, with 5.3% in spine, 5.1% in cerebrovascular, 5.9% in tumor, and 14.3% in functional/stereotactic. Despite encouraging growth in the number of females entering neurosurgery over the past 3 decades, there continues to be significant gender disparity that is most pronounced at advanced career stages-in both academic organized neurosurgery and pediatric neurosurgery. Pediatric neurosurgery, due to a separate fellowship accreditation and board certification, provides the most accurate view within the subspecialties. Because pediatric neurosurgery exhibits the lowest gender disparity among subspecialties, these findings suggest more pronounced female underrepresentation across the stages of other neurosurgical subspecialty trainings.

A Typology for Rural Residency Training

Abstract Until rural track program definitions were recently established in regulation and accreditation,1 there was no widely accepted classification system for rural graduate medical education (GME), making it difficult to conduct educational research, compare published results, or navigate the maze of options available to residency applicants. This typology for rural residency training, refined in use by rural medical educators, student applicants, and researchers2,3 over the past 2 decades, addresses varying degrees of required rurally located training, rural focus, and rural graduate placement outcomes. Acknowledging the range and differences across rural and frontier communities, this typology considers to be rural a geographic location that is rural by any 2 of the more than 75 federal definitions that exist (e.g., Core-Based Statistical Areas, Rural-Urban Commuting Area codes). For 8 common federal definitions, see RHIhub’s “Am I Rural?” Tool at https://www.ruralhealthinfo.org/am-i-rural.

Declining pain medicine fellowship applications from 2019 to 2024: A concerning trend among anesthesia residents and a growing gender disparity.

The fields of anesthesiology and pain medicine are experiencing significant changes driven by market forces and professional preferences. While demand for anesthesiologists is rising, pain medicine is facing a decline in fellowship applications. This study analyzed data from the Electronic Residency Application Service (ERAS) and the National Resident Matching Program (NRMP) from 2019 to 2023, focusing on trends in fellowship applications to pain medicine programs. Additionally, preliminary data from the 2024 match cycle were examined. There has been a notable decrease in anesthesiology residents applying to pain medicine fellowships, with applications dropping from 351 in 2019 to 193 in 2023. The overall decline in anesthesia-based applicants to pain medicine fellowships was 45%, signaling the highest detriment among anesthesiology applicants compared to other specialties. Gender disparities have been prevalent, with the absolute number of female applicants decreasing every year since 2019. Additionally, the 2023 match saw a significant number of unfilled programs, with 35 out of 115 programs failing to fill all positions. Preliminary data from the 2024 match cycle suggest this downward trend is continuing. The decline in pain medicine fellowship applications, particularly among anesthesiology residents, signals potential future workforce shortages and challenges in patient care. Recruitment strategies should include early exposure to pain medicine during residency, enhanced mentorship programs, and robust recruitment efforts (including virtual options). Addressing these issues is essential to ensure enough trained specialists to meet the growing need for pain specialists nationally.

Artificial intelligence-created personal statements compared with applicant-written personal statements: a survey of obstetric anesthesia fellowship program directors in the United States

BackgroundA personal statement is a common requirement in medical residency and fellowship applications. Generative artificial intelligence may be used to create a personal statement for these applications. MethodsTwo personal statements were created using OpenAI’s Chat Generative Pre-trained Transformer (ChatGPT) and two applicant-written statements were collected. A survey was sent to obstetric anesthesia fellowship program directors in the United States to assess the perceived readability, authenticity, and originality of the four personal statements. In addition, the survey assessed perceptions of applicants who use artificial intelligence to write a personal statement, including their integrity, work ethic, reliability, intelligence, and English proficiency. ResultsSurveyed fellowship directors could not accurately discern whether statements were applicant-written or artificial intelligence-generated. The artificial intelligence-generated personal statements were rated as more readable and original than the applicant-written statements. Most program directors were moderately or extremely concerned about the applicant’s integrity, work ethic, and reliability if they suspected the applicant utilized ChatGPT. ConclusionsProgram directors could not accurately discern if the statements were written by a person or artificial intelligence and would have concerns about an applicant suspected of using artificial intelligence. Medical training programs may benefit from outlining their expectations regarding applicants’ use of artificial intelligence.

Mitigating Harm to Residency Applicants in Pursuit of Holistic Healing

Mitigating Harm to Residency Applicants in Pursuit of Holistic Healing

Assessment of Postgraduate Year 1 Residency Program Director Preferences and Priorities in Evaluation of Pharmacy Residency Candidates

ObjectiveLimited and conflicting evidence exists evaluating how components of pharmacy residency applications are prioritized by residency program directors (RPDs). This study aims to identify what pharmacy residency programs prioritize when selecting candidates to interview given the incorporation of new American Society of Health-System Pharmacists Pharmacy Residency Standards. MethodsA Qualtrics survey was distributed to postgraduate year 1 RPDs across the United States. Programs were identified using the American College of Clinical Pharmacy and American Society of Health-System Pharmacists residency directory. Data were collected from October 23, 2023 to December 4, 2023, and priorities were captured using percentage weighting and rank order lists. ResultsOf the 1389 survey links disseminated, a total of 254 programs submitted responses for a response rate of 18.2%. According to RPDs, the highest weighted section of a residency application was the curriculum vitae (CV), with an average weight of 51.7%, followed by letters of recommendation, letter of intent, and supplemental application (if applicable) in descending order. Within the CV, programs valued work, leadership, and rotation experiences most. Ability to organize and manage time was reported to be the most important characteristic within letters of recommendation. ConclusionBased on the results of this study, when reviewing pharmacy residency applications, postgraduate year 1 RPDs prioritize the CV, followed by letters of recommendation and letter of intent. These findings could be used by RPDs when assessing current scoring rubrics and may help to inform the efforts of students and letter of recommendation writers when preparing individual components of an application.

Abstract 4136636: Analysis of Racial Disparities in the Training Path to Cardiology: Trends from 2012 to 2022

Introduction: Substantial evidence indicates that racial and ethnic diversity among the physician workforce bridges cultural gaps and improves patient care. Trends in racial diversity across the full training pipeline from undergraduate to practicing cardiologist are not yet well-characterized. Aims: We analyze racial disparities at each stage of training towards becoming a practicing cardiologist, and identify changes in these disparities between 2012 and 2022. Methods: We conducted a retrospective analysis of data specifying the racial composition of medical trainees acquired from the Association of American Medical Colleges, Accreditation Council for Graduate Medical Education, and Electronic Residency Application Service. Population data was acquired from the US Census Bureau. We computed the representation quotient (RQ) for each racial group at each stage to compare representation among the trainees or physicians to age-matched segments of the US population. Results: RQ decreases from undergraduate to active cardiologist for African Americans (0.719 to 0.314), Hispanics (0.660 to 0.359), American Indians (0.551 to 0.221), and Native Hawaiians (1.121 to 0.512). The lowest RQs of 0.133 and 0.137 were observed for American Indian active internal medicine residents and cardiology fellows, respectively. Racial disparities in medical education declined between 2012 and 2022, with RQs increasing from 0.541 to 0.735 for African American medical school matriculants and from 0.444 to 0.578 for Hispanic medical school matriculants. Similar increases were seen in the active cardiologist population for African Americans (2013 RQ: 0.227, 2022 RQ: 0.342) and Hispanics (2013 RQ: 0.283, 2022 RQ: 0.375). Conclusion: While racial diversity in the cardiology training pipeline has increased over the last decade, significant disparities persist for under-represented minorities. Addressing these barriers will help achieve a cardiology workforce reflective of the diverse population it serves.

Increased accessibility of computer-based testing for residency application to a hospital in Brazil with item characteristics comparable to paper-based testing: a psychometric study

With the coronavirus disease 2019 pandemic, online high-stakes exams have become a viable alternative. This study evaluated the feasibility of computer-based testing (CBT) for medical residency applications in Brazil and its impacts on item quality and applicants’ access compared to paper-based testing. In 2020, an online CBT was conducted in a Ribeirao Preto Clinical Hospital in Brazil. In total, 120 multiple-choice question items were constructed. Two years later, the exam was performed as paper-based testing. Item construction processes were similar for both exams. Difficulty and discrimination indexes, point-biserial coefficient, difficulty, discrimination, guessing parameters, and Cronbach’s α coefficient were measured based on the item response and classical test theories. Internet stability for applicants was monitored. In 2020, 4,846 individuals (57.1% female, mean age of 26.64±3.37 years) applied to the residency program, versus 2,196 individuals (55.2% female, mean age of 26.47±3.20 years) in 2022. For CBT, there was an increase of 2,650 applicants (120.7%), albeit with significant differences in demographic characteristics. There was a significant increase in applicants from more distant and lower-income Brazilian regions, such as the North (5.6% vs. 2.7%) and Northeast (16.9% vs. 9.0%). No significant differences were found in difficulty and discrimination indexes, point-biserial coefficients, and Cronbach’s α coefficients between the 2 exams. Online CBT with multiple-choice questions was a viable format for a residency application exam, improving accessibility without compromising exam integrity and quality.

Predictive Value of Neurosurgery Applicant Metrics on Resident Academic Productivity.

Scholarship has been critical to neurosurgery. As grades and board examinations become pass-fail, finding metrics to distinguish applicants coupled with an emphasis on research has led to growth of reported academic output among neurosurgery applicants. We aimed to evaluate applicant factors that associate with an academically productive neurosurgery resident. Applicant characteristics were extracted from Electronic Residency Application Service archives from 2 geographically distinct neurosurgical programs for the 2014 to 2015 match cycle. Publications during residency were quantified, and residency careers were examined. Factors associated with residency publications were examined using univariate and multivariate regressions. A total of 228 United States (US) applicants to neurosurgery were assessed (89% of US neurosurgery applicants), with 173 matching across 93 programs. The average publication number of matched applicants was higher at 6.6 (median: 4, range: 0-43) that of than unmatched applicants (mean: 2.9, median: 1, range: 0-51). A total of 93.1% of publications were substantiated on PubMed review. Matched candidates published 19.3 manuscripts (median: 13, range: 0-120) on average during residency. On univariate analysis, factors associated with higher residency publications included taking a non-degree-granting extra year for research in medical school, consistently high clerkship grades, depth of preresidency research involvement, number of coresidents, program R25 status, and academic output of neurosurgery department leadership. After multivariate correction, the training environment played an outsized role in predicting resident academic output, with program R25 status significantly associated with resident academic output (odds ratio: 1.25, P = .012). Taking an extra research year in medical school approached but was not significant (odds ratio: 1.19, P = .099). Twelve matched international medical school graduates (IMGs) were also assessed (75% of matched IMG neurosurgery applicants). IMGs exhibited higher total publications and conference abstracts than US matched applicants and also published more during residency. Cultivating an environment that promotes research endeavors is critical for neurosurgical resident academic growth. Preresidency publication number does not predict publication potential during residency.

Can't Buy Me Love? The Use of Gifts in the Residency Application Process.

To set themselves apart, some programs use gifts or promotional items to highlight the residency program or unique local culture. The distinction between advertisement and persuasion may be blurry in this case. We sought to quantify the prevalence of gifts to applicants and how frequently the US federal threshold for "nominal gifts" was exceeded. We reviewed a publicly accessible, Internet resource called the "ERAS Megathread." This is a Google spreadsheet found on Reddit where applicants participating in The Match can anonymously contribute information about their experience. The incidence of "gifts" was quantified for surgical residency programs, along with the nominal value if indicated. The spreadsheets were reviewed for 2021, 2022, and 2023. Over the past 3 application cycles, 15.1% [11.1%-18.2%] of general surgery residency programs provided a gift to applicants. Of these programs, the majority (70.2%) are university-based programs. In 2023, 57.9% of these gifts exceeded US$20. Given the anonymous nature of the data set, and the lack of transparency in the match process, it was not possible to correlate gift giving with its effect on recruitment. Students are courted by residency programs, and a significant minority of programs provide a gift to applicants. The impact of a substantial gift on a financially vulnerable student is difficult to quantify. It behooves us as a specialty to determine what should be a universal standard and to consider outlining explicit guidelines for The Match.

Artificial Intelligence-Generated Writing in the ERAS Personal Statement: An Emerging Quandary for Post-graduate Medical Education.

This study was designed to investigate if artificial intelligence (AI) detection software can determine the use of AI in personal statements for residency applications. Previously written personal statements were collected from physicians who had already matched to residency through the Electronic Residency Application System. Physicians were recruited for the study through collegial relationships and were given study information via email. The study team constructed five parallel statements from the shared personal statements to prompt AI to create a personal statement of similar content. An online AI detection tool, GPTZero, was used to assess all the personal statements. Statistical analyses were conducted using R. Descriptive statistics, t-tests, and Pearson correlations were used to assess the data. Eight physicians' statements were compared to eight AI-generated statements. GPTZero was able to correctly identify AI-generated writing, assigning them significantly higher AI probability scores compared to human-authored essays. Human-generated statements were considered more readable, used shorter words with fewer syllables, and had more sentences compared to AI-generated essays. Longer average sentence length, low readability scores, and high SAT word percentages were strongly associated with AI-generated essays. This study shows the capacity of GPTZero to distinguish human-created versus AI-generated writing. Use of AI can pose significant ethical challenges and carries a risk of inadvertent harm to certain applicants and erosion of trust in the application process. Authors suggest standardization of protocol regarding the use of AI prior to its integration in post-graduate medical education.

Elevating equity: advancing diversity and inclusivity through trialing bias reduction tools in the general internal medicine program resident application process.

Decades of medical data show worse patient outcomes among racial and gender minorities due to implicit, explicit, and structural biases. Increasing representation of marginalized groups among care providers is imperative to help address this. Limited literature exists on bias awareness strategies for interviewers during the selection of applicants to General Internal Medicine (GIM) programs in Canada. This study examines the trial of bias reduction tools to increase interviewers' awareness of implicit biases. The Model of Improvement framework guided the trail of an instructional video, the adapted implicit association test (IAT), and a paper awareness tool (PAT) to increase interviewers' awareness of implicit biases during the University of Alberta's GIM applicant selection. An anonymous online survey was disseminated to physician interviewers. Descriptive statistics (percentages) and a modified sentiment analysis was completed. 10 of 14 interviewers completed the survey. Respondents reported an increased awareness of using bias reduction tools (IAT, 25%; video, 71%; PAT, 67%) to inform them on their implicit biases. The future use of IAT, video, and PAT was supported by 50%, 71%, and 67% of interviewers, respectively. Interviewers prefer the instructional video and PAT over the IAT. Textual responses suggest existing concerns for biases inherent to the interview process yet 70% (7/10) of respondents believe that interviews should have a weighting of 50% towards final ranking of candidates. As many institutions continue to rely on interviews to evaluate candidates, our findings indicate the need for a national study to develop a framework to mitigate inherent biases during interviewing of candidates.

Welcome to the operating theatre! Introductory bootcamp in operating theatre specialities for medical students.

Since the early 2000's, the appeal of certain operating room specialties has decreasedamong medical school graduate students. The recent reform of the second and third cycles of medical studies in France provides an opportunity to set up teaching programs around operating room specialties. We have organised a teaching unit which is part of the final year of medical studies. The main objectives are: (1) to examine whether a boot camp can modify students' opinions and preconceived assumptions about a surgical and/or anaesthetist career (2) to determine whether these changes in perception, have an impact on students' interest in pursuing a surgical/anaesthetic career compared with the current situation. The "working in the operating theatre" boot camp (UETB) took place after the written exams of the sixth year of medical school, before students choose their future specialty for residency. This program included practical workshops, readings and time for exchanges surgeons and anaesthetists. At the beginning and at the end of the UETB, feedback forms were collected. The cohort included 59 students from the Toulouse medical school, academic year 2023-2024. After attending the UETB, there was a significant qualitative improvement in interest in a surgical and intensive care-anaesthesia career. Feedback on how the UETB influenced the choice of a future specialty was very positive, with statistically significant qualitive improvement., Additionally, the students' perception of a work-life quality as a surgeon and/or anaesthetist improved significantly. The outcome of this study makes a strong case for integrating additional exposure to the various surgical subspecialties into the graduate medical curriculum in France. By helping to dispel misperceptions of "a surgical/anaesthetist career" early on, opportunities such as the UETB program may enable addressing the attrition rate observed among surgical and anaesthetic residency applications.

Diversity, Equity, and Inclusion in US Anesthesiology Residency Matching.

Patient outcomes are improved with physician-patient gender, racial, and ethnic concordance. However, female, Black, Hispanic or Latino, Native Hawaiian-Pacific Islander (NH-PI), and American Indian-Native Alaskan (AI-AN) physicians are underrepresented in anesthesiology. The American Association of Medical Colleges 2018 Diversity in Medicine Report revealed that women comprise only 35% of anesthesiologists yet nearly half of medical school graduates are women. More than 77% of anesthesiologists are White or Asian. Anesthesiology applicant and match trends may provide insights needed to address underrepresentation within anesthesiology. We hypothesized that proportionally fewer women and racially and ethnically minoritized applicants apply and match into anesthesiology. This retrospective observational study identified 47,117 anesthesiology applicants among the 546,298 residency applicants in the Electronic Residency Application Service (ERAS) system between 2011 and 2022 and stratified applicants by self-reported gender, race, and ethnicity. The demographics of anesthesiology trainees reported in the 2014 to 2015, 2018 to 2019, and 2022 to 2023 Accreditation Counsel of Graduate Medical Education (ACGME) Data Resource Books were used as surrogates for matched applicants as demographics are not reported by the National Residency Match Program. To facilitate comparisons, ERAS applicants were grouped into 4-year epochs to align with consolidated ACGME reports corresponding to the application years. Odds ratios (OR); 95% confidence interval of applying to and matching into anesthesiology were analyzed. Women had lower odds of applying to anesthesiology compared to men overall (OR, 0.55; 95% CI, 0.54-0.56, P < .0001) and maintained significantly lowered odds of applying within each epoch. Women had similar odds of matching into anesthesiology residency compared to men (OR, 1.10; 95% CI, 1.06-1.14, P < .0001). Black, Hispanic or Latino, Asian and NH-PI, and AI-AN applicants had similar odds to White applicants of applying to anesthesiology but odds of matching were significantly lower overall ( P < .0001) for Asian and NH-PI (OR, 0.66; 95% CI, 0.63-0.70), Black (OR, 0.49; 95% CI, 0.45-0.53), Hispanic or Latino (OR, 0.50; 95% CI, 0.46-0.54), and AI-AN (OR, 0.20; 95% CI, 0.15-0.28) applicants. The odds of matching among some minoritized applicants increased in the ACGME 2022 to 2023 report year. From 2011 to 2022, women had lower odds of applying to anesthesiology residency than men yet had similar odds of matching. Racial and ethnic minoritized groups had significantly lower odds of matching compared to White applicants despite similar odds of applying. These findings highlight disparities in the anesthesiology match and may help identify opportunities to promote workforce diversity within the field. More detailed reporting of gender, race, and ethnicity in annual match data may better define barriers to entry and identify opportunities for improvement.