Fellowship Application Process Research Articles

Gender Differences in Letters of Recommendations and Personal Statements for Neurotology Fellowship over 10 Years: A Deep Learning Linguistic Analysis.

Personal statements (PSs) and letters of recommendation (LORs) are critical components of the neurotology fellowship application process but can be subject to implicit biases. This study evaluated general and deep learning linguistic differences between the applicant genders over a 10-year span. Retrospective cohort. Two institutions. PSs and LORs were collected from 2014 to 2023 from two institutions. The Valence Aware Dictionary and Sentiment Reasoner (VADER) natural language processing (NLP) package was used to compare the positive or negative sentiment in LORs and PSs. Next, the deep learning tool, Empath, categorized the text into scores, and Wilcoxon rank sum tests were performed for comparisons between applicant gender. Among 177 applicants over 10 years, 120 were males and 57 were females. There were no differences in word count or VADER sentiment scores between genders for both LORs and PSs. However, among Empath sentiment categories, male applicants had more words of trust (p = 0.03) and leadership (p = 0.002) in LORs. Temporally, the trends show a consistently higher VADER sentiment and Empath "trust" and "leader" in male LORs from 2014 to 2019, after which there was no statistical significance in sentiment scores between genders, and females even have higher scores of trust and leadership in 2023. Linguistic content overall favored male applicants because they were more frequently described as trustworthy and leaders. However, the temporal analysis of linguistic differences between male and female applicants found an encouraging trend suggesting a reduction of gender bias in recent years, mirroring an increased composition of women in neurotology over time.

Evolution of the transplant hepatology fellowship application process and its impact on the future of the hepatology workforce.

Evolution of the transplant hepatology fellowship application process and its impact on the future of the hepatology workforce.

Behavioral analysis of social media and email usage among hematology-oncology fellowship applicants: A national survey.

e21003 Background: The advent of digital communication has transformed the landscape of fellowship programs, with social media(SoMe) emerging as pivotal platforms for information dissemination and engagement between applicants and programs. Despite its proven influence in surgical and urological specialty, the role of SoMe in Hematology-Oncology (HO) fellowships remains to be elucidated. This pioneering survey evaluates the utility and impact of SoMe alongside traditional email among Internal Medicine residents applying the fellowship application process in the era of virtual interviews. Methods: An anonymous, cross-sectional survey was administered via SurveyMonkey to residents applying to U.S. HO fellowships in the 2023-2024 cycle. Outreach methods included emails to all internal medicine program directors, SoMe, and online forums. The questionnaire probed the frequency of SoMe and email usage, types of content accessed, and the influence of these platforms on applicants' strategic choices and program preferences. Results: Analysis from 33 respondents revealed a demographic predominance of individuals aged 26-35 years, with an equal gender distribution and significant representation from the Middle Atlantic region. The majority were non-U.S. graduates (51.5%), predominantly identifying as Asian (54.5%). While 67% of respondents used Twitter/X, but only 13.6% used it for direct program contact, resulting in a minimal 4.5% receiving interview offers. Twitter/X was acknowledged as a useful information source by 55% of respondents, and 20% felt it influenced their program ranking decisions. Conversely, 70% and 45% used Instagram and LinkedIn respectively, but usage for fellowship applicants was minimal, with no respondents utilizing it for program outreach or reporting any increase in interview offers because of its use. Notably, 25% felt pressured to use SoMe to boost their application prospects. In contrast, 74% approached program directors through personalized emails, attributing a 34% increase in interview offers to this method. Conclusions: Our findings emphasize the enduring prominence of email in fellowship applications while illuminating the evolving but significant presence of SoMe. This divergence highlights a potential big change where SoMe particularly Twitter/X, begins to complement traditional methods. Such insights suggest that fellowship programs should strategically integrate digital tools into their application processes and actively improve their online engagement to align with applicant behaviors.

Trends in the National Resident Matching Program (NRMP) Headache Medicine Match Data and the Evolution of the Headache Fellowship Application Process: A Retrospective Observational Study (P3-7.004)

Trends in the National Resident Matching Program (NRMP) Headache Medicine Match Data and the Evolution of the Headache Fellowship Application Process: A Retrospective Observational Study (P3-7.004)

Racial and ethnic bias in letters of recommendation in academic medicine: a systematic review.

Letters of recommendations (LORs) are key components of academic medicine applications. Given that bias against students and trainees underrepresented in medicine (UIM) has been demonstrated across assessment, achievement, and advancement domains, the authors reviewed studies on LORs to assess racial, ethnic, and UIM differences in LORs. Standardized LORs (SLORs), an increasingly common form of LORs, were also assessed for racial and ethnic differences. A systematic review was conducted for English-language studies that assessed racial or ethnic differences in LORs in academic medicine published from database inception to July 16, 2023. Studies evaluating SLORs underwent data abstraction to evaluate their impact on the given race or ethnicity comparison and outcome variables. Twenty-three studies describing 19,012 applicants and 41,925 LORs were included. Nineteen studies (82.6%) assessed LORs for residency, 4 (17.4%) assessed LORs for fellowship, and none evaluated employment or promotion. Fifteen of 17 studies (88.2%) assessing linguistic differences reported a significant difference in a particular race or ethnicity comparison. Of the 7 studies assessing agentic language (e.g., "strong," "confident"), 1 study found fewer agentic terms used for Black and Latinx applicants, and 1 study reported higher agency scores for Asian applicants and applicants of races other than White. There were mixed results for the use of communal and grindstone language in UIM and non-UIM comparisons. Among 6 studies, 4 (66.7%) reported that standout language (e.g., "exceptional," "outstanding") was less likely to be ascribed to UIM applicants. Doubt-raising language was more frequently used for UIM trainees. When SLORs and unstructured LORs were compared, fewer linguistic differences were found in SLORs. There is a moderate bias against UIM candidates in the domains of linguistic differences, doubt-raising language, and topics discussed in LORs, which has implications for perceptions of competence and ability in the high-stakes residency and fellowship application process.

Applicant-Fellow Virtual Sessions in Recruitment for Gastroenterology Fellowship.

Since the COVID-19 pandemic in 2020, virtual interviews have become a norm for gastroenterology (GI) fellowship recruitment. Most interviews hold a session for applicant and current fellow interaction. There is wide variability of the sessions across programs. There are a paucity of data on the influence of these sessions on applicants' ranking of programs. We aim to describe applicants' experiences and perceptions of virtual happy hours (i.e., applicant-fellow sessions) during the GI fellowship application process. We surveyed applicants participating in the 2022 GI fellowship match cycle to understand their experience with virtual fellow-only happy hours. Mixed methods analyses were performed. The survey was completed by 68 (13.91%) applicants, of which, 75% reported that at least half of the interviews they attended had conducted a virtual, fellow-only happy hour. Most respondents preferred that the virtual happy hours should be conducted prior to the interview day (58%) and that breakout rooms with a smaller ratio of applicants to fellows are helpful (78%). The majority (87%) of respondents reported attending these sessions at least 75% of the time. Nearly half (44%) of respondents reported that these sessions influenced/altered their ranking decisions with respect to programs. Given the advantages associated with virtual interviews and their ongoing support by professional societies, the virtual platform is likely here to stay in future. Virtual fellow-only happy hours help provide a representation of the program's mission and when successfully implemented, can be leveraged to optimize recruitment and attract qualified, diverse candidates.

Recent trends in hand surgery fellowship applicants and programs

BackgroundHand surgery is a competitive fellowship that draws applicants from orthopedic, plastic, and general surgery. In 2010, recommendations from the American Academy of Orthopaedic Surgeons (AAOS) Board of Specialty Societies Match Oversight Committee and the American Society of Plastic Surgeons (ASPS) Plastic Surgery Workforce Task Force led to significant reforms to their respective workforces and training. This study characterizes trends in hand fellowship applicants and programs since these recommendations (2010–2023). Materials and methodsWe queried hand fellowship applicant and program data from the American Society for Surgery of the Hand (ASSH), the National Resident Matching Program (NRMP), and the Accreditation Council for Graduate Medical Education (ACGME). Results, discussion and conclusionsFrom 2010 to 2023, the number of ACGME-accredited hand fellowship programs increased across specialties (orthopedic surgery, 58 to 74 (27.6 % increase, R = 0.97, p < 0.001); plastic surgery, 14 to 19 (35.7 % increase, R = 0.91, p < 0.001); general surgery, 1 to 2 (50 % increase, R = 0.71, p = 0.004). The number of available fellowship positions commensurately increased by 38.8 % over the same time period. The number of applicants did not significantly change between 2010 (155 applicants) and 2023 (198 applicants) (R = 0.32, p = 0.27). The ratio of applicants-to-positions significantly decreased from 2010 (1.12 applicants per position) to 2023 (1.04 applicants per position) (R = -0.74, p = 0.003). Yet, applicants ranked nearly twice as many programs in 2023 (14.9 programs per applicant) compared to in 2010 (7.5 programs per applicant) (R = 0.98, p < 0.001). In light of the American Orthopaedic Association endorsing signal preferencing in the 2022–2023 residency Match, strategies to optimize rank lists in the fellowship application process should be further explored.

Underemphasis of histopathology training in the micrographic fellowship application process.

Underemphasis of histopathology training in the micrographic fellowship application process.

The Neonatal-Perinatal Medicine fellowship application webinar series: a novel approach to helping applicants succeed

BackgroundIn 2022, 13,586 candidates applied to subspecialty fellowships. Formal resources to inform candidates on subspecialty-specific fellowship application are limited. Candidates rely on residency application experience, informal advice, and online research for navigating the application process. Thus, a need exists for formal subspecialty-specific fellowship application guidance. The American Academy of Pediatrics Organization of Neonatal-Perinatal Medicine Training Program Directors (ONTPD) and Trainees and Early Career Neonatologists (TECaN) created a webinar-based curriculum to help educate trainees about the application process and recruit diverse fellowship applicants.MethodsIn 2022, ONTPD and TECaN co-hosted and implemented a four-part national webinar series focused on different aspects of the Neonatal-Perinatal Medicine (NPM) fellowship application and interview processes. Webinars were advertised through list-servs and social media, conducted in two time zones, and recorded for asynchronous viewing. Registration, demographic data, and questions for webinar panelists were collected via electronic survey. Program evaluation data was collected after each webinar and following the fellowship match.ResultsIn the 2022 appointment year, 310 candidates participated in the NPM fellowship match and 250 individuals registered for the webinar series. A quarter (26%) of registrants identified as underrepresented in medicine. Most registrants reported minimal or no knowledge of the fellowship application (64%, 158/248) and interview (81%, 201/248) processes. The majority of registrants (70%, 173/248) were planning on applying to fellowship in 2022, and 91% of post-webinar respondents (43/47) felt the webinars were moderately or extremely helpful, a finding that was sustained beyond the match (37/42). Almost all respondents rated the quality of the webinars as good or higher and were likely or very likely to recommend them to peers (39/42). There was considerable variability amongst respondents in the number of fellowship programs applied to, interviewed at, and ranked, and factors influencing rank list.ConclusionWe describe a virtual curriculum to prepare trainees for the NPM fellowship application and interview process. This webinar series provides needed education to fellowship candidates, bridges the gap between candidate knowledge and program director expectations, is generalizable to other specialties, and can be replicated with minimal resources.

The Neuromuscular Portal and Match

Prior to 2021, the neuromuscular medicine fellowship application process suffered from non-standardized timelines and substantial variability. To rectify this, the American Association of Neuromuscular &amp; Electrodiagnostic Medicine (AANEM) established a standardized application timeline and an online application portal in 2020-2021, followed by the introduction of a partial match process. In 2021-2022, AANEM launched a traditional, binding, two-way match system for fellowship positions allocation based on the Gale-Shapley stable matching algorithm. Surveys assessing perceptions of fairness in the application portal and match process were dispatched to applicants and program directors following the 2021 and 2022 recruitment cycles. In the 2020-21 cycle, 90% of program directors and 95% of applicants affirmed the standardized timeline benefited applicants. However, 57% of applicants deemed the process as unfair. All programs and most applicants (58%) favored a transition to a two-way match. The implementation of the two-way match in 2021-22 attracted participation from 97% of programs, with 80% of applicants and 95% of programs viewing the process as fair to applicants. A significant majority of both applicants (86%) and programs (94%) supported maintaining the standardized timeline and two-way match. We advocate for the universal adoption of the AANEM Match for neuromuscular fellowship recruitment and a standardized fellowship application timeline across all neurologic specialties to promote transparency, fairness, and equity for applicants.

Emerging Subspecialties in Neurology: Interventional Neurology: A Starter Guide for Neurology Residents.

Interventional neurology is a subspecialty at the cross-section of neurology, neurosurgery, and neuroradiology that uses image-guided endovascular catheter techniques to diagnose and treat neurovascular disorders. Although interventional neurology techniques have existed for decades, recent landmark trials in stroke thrombectomy have catalyzed dramatic changes to the interventional neurology field, and there is rising neurology interest and representation. Unlike other neurology subspecialties, however, interventional neurology training and fellowship applications are not standardized. Thus, it can be difficult for neurology trainees to navigate this rapidly changing and multidisciplinary field. This article seeks to provide neurology residents and residency program directors with a brief overview of the modern interventional neurology field, the current fellowship application process, and tips on how neurologists can best prepare for a career in interventional neurology. To this end, we conducted a nationwide survey of interventional neurology fellowship program directors regarding training neurologists. We distill survey responses into concrete, actionable items for neurology trainees.

Letters of recommendation for gynecologic oncology fellowship differ by gender and race

IntroductionLetters of recommendation (LOR) play a significant role in applicant selection for gynecologic oncology (GO) fellowship. LORs can be agentic, associated with competence, independence and strength, or communal, associated with being accommodating, cooperative and empathetic. Agentic LORs have been shown to reflect favorably on applicants, making them more likely to be selected for interview. The primary goal of this study was to determine linguistic differences in LORs for applicants applying to GO fellowship based on applicant gender and race. MethodsAll applications to a single academic institution from the years 2018–2020 were analyzed. LORs were extracted from all applicants who self-reported their gender and race/ethnicity. Analysis was performed using Linguistic Inquiry Word Count (LIWC) in terms of agentic and communal language. All analysis was done using SAS version 9.4. ResultsFrom 2018 to 2020, there were 239 GO fellowship applications to a single academic institution. There were 186 (78.1%) applicants who identified as female and 52 (21.8%) who identified as male. Female applicants were more likely to have more research (p = 0.047) and volunteer activities (p = 0.02) than male applicants. There were no differences between female and male applicants in terms of age, geographic location of residency, USMLE scores, AOA status, number of publications or attending a Doximitiy-rated top 20 residency program. There were 139 (60.7%) applicants who identified as White, 46 (20.1%) as Asian, 16 (7.0%) as Black, 19 (8.3%) as Latinx and 9 (3.9%) as other. On multivariable analysis, LORs written for male applicants had higher agentic scores compared to females (p < 0.05), and LORs of female applicants received higher communal scores (p < 0.05). LORs for applicants who identified as Black or Latinx were found to have lower agentic scores compared to individuals who identified as White(p < 0.05 for both). ConclusionThere were demonstrated linguistic differences in LOR for GO fellowship based on applicant gender and race/ethnicity. LORs written for white, male applicants were more likely to have higher agentic scores compared to minority, female applicants. LORs written for female applicants were more likely to have higher communal scores. As LORs have been shown to be instrumental in GO fellowship interview selection and linguistic differences exist based on applicant gender and race/ethnicity, this study highlights the need for a more objective GO fellowship application process. DisclosuresPortion of this paper was presented at the Society for Gynecologic Oncology as part of a focus plenary.

A Visiting Rotation for Underrepresented in Medicine Pediatric Residents Is Valuable for Recruitment Into Pediatric Fellowships

To truly build an equitable health care system, we need a diverse physician workforce that reflects the demographics of the general population. Diversity improves clinical care outcomes, improves patient satisfaction, and is associated with improved treatment adherence when patients are treated by race-concordant physicians. Additionally, Black, Indigenous, and Hispanic/Latinx physicians are more likely to focus their care efforts on the most vulnerable patient populations in the United States.1 A sense of urgency has developed as recent trends show a decreasing proportion of underrepresented in medicine (UIM) pediatric subspecialty fellows.2,3 The drivers causing this workforce issue have not been fully identified, with limited exposure to subspecialty experiences as a potential contributor. Increasing the numbers of UIM physicians requires deliberate action by academic institutions to recruit and support UIM applicants across various medical subspecialties.The Promoting Resident Experiences in the Subspecialties at Stanford (PRESS) program is a 4-week funded and mentored pediatric subspecialty rotation for UIM residents who will be applying for subspecialty fellowship in the next year. PRESS was created with the following goals: (1) to increase recruitment of UIM trainees into pediatric subspecialty fellowships and academic medicine; (2) to improve inclusion, belonging, and career development of the next generation of UIM subspecialists through coaching and mentoring; and (3) to enhance our learning community by increasing the diversity among our trainees and institution, both during the rotation and afterward. Visiting residents self-select a subspecialty experience, are assigned a faculty mentor and a fellow mentor within the division, and are invited to events within the division, the department, and the larger graduate medical education community. They receive individualized mentorship and coaching on creating a CV and personal statement as well as strategies to increase success in the fellowship application process. Each resident receives funding to cover travel and living expenses during the rotation.Our inaugural cohort consisted of 5 residents. Our residents identified as African American/Black, Hispanic/Latinx, Asian, and North African, and hailed from 4 different states. Our second cohort will include 7 residents (37% acceptance rate), identifying as African American/Black, Hispanic/Latinx, and Southeast Asian, coming from 4 different states.A survey of the first cohort determined that all residents (100%) found the program to be valuable, offering a unique experience and a network of colleagues in and out of their chosen subspecialty. All residents stated that participation in the PRESS program encouraged them to apply to our institution when they would not have otherwise. All residents found the mentorship and individualized coaching helpful. One resident remarked: “It was an absolutely invaluable experience and nothing I probably would have gotten to experience on my own. The support and mentorship was great and I loved the desire for change. I would love for other UIM to experience medicine at an elite center…and I've already recommended that several people I know apply for next year.”Program leadership and residents cited the program as an effective recruiting tool, and leaders felt the PRESS program allowed them to consider applicants that they might not have otherwise. As one fellowship leader highlighted, there is the benefit of “participating in developing opportunities for exposure/recruitment of UIM trainees, [and the] ability to gain new perspectives.” Excitedly, one resident from our inaugural cohort matched into the pediatric cardiology fellowship at our institution. All other residents matched into their desired specialties.The PRESS program represents a feasible and effective program to expose and recruit UIM trainees into programs they would not have otherwise considered and to help them develop a sense of belonging in their subspecialty. It may also help fellowship programs and institutions expand their recruitment base, encouraging a more diverse applicant pool.

Diagnostic Radiology Fellowship Applicant Selection Criteria: A Survey of Program Directors

Introduction In this study, we aimed to investigate the importance of various characteristics used by diagnostic radiology subspecialty fellowship programs when selecting candidates for their fellowship programs. Methods An online survey was sent to program directors from multiple radiology fellowship programs in the United States. Multiple questions were asked, including applicant gender, personal statement, interview performance, research experience, United States Medical Licensing Exam (USMLE) performance, and residency program attended. Survey recipients were asked to rank these characteristics from least to most important. Results A total of 119 responses were collected (response rate of 26.2%), with a relatively balanced representation of the different subspecialties. An aggregate analysis of all the subspecialties showed interview performance, letters of recommendation, and residency program attended as the three most important factors considered by the program directors when selecting a candidate for their fellowship program. In contrast, the three least important factors were gender, prior subspecialty training, and minority status. The applicant's visa status, personal statement, and USMLE Step 3 performance were the only statistically significant (p<0.05) differences between the subspecialties. The women's and body imaging subspecialties rated the personal statement more important than musculoskeletal imaging and neuroradiology. Cardiothoracic and musculoskeletal imaging rated the applicant's visa status more important than neuroradiology. Women's and cardiothoracic imaging rated USMLE Step 3 performance as more important than musculoskeletal imaging. Conclusion Selecting the ideal candidate for a fellowship in radiology can be difficult. Our findings outline which applicant characteristics program directors believe are the most and least important when selecting an ideal candidate. For instance, personal characteristics such as interview performance and letters of recommendation are more valued than extracurricular activities such as research experience. Identifying these characteristics provides a better understanding of the fellowship application process and may guide future applicants.

Contributions of Surgical Critical Care Program Directors Society to the training of surgeons.

In 1986, Surgical Critical Care (SCC) was formally recognized as a specialty by the American Board of Surgery (ABS), however it took another two decades to develop a formal national training structure in SCC. In 2003, the program directors of SCC fellowships began to meet and the Surgical Critical Care Program Directors Society (SCCPDS) was officially formed in 2004, with recognition of the SCCPDS as a non-profit organization in 2008. Over the next several years, and in conjunction with other interested groups, such as the American Association for the Surgery of Trauma (AAST) and the Society of Critical Care Medicine (SCCM), SCCPDS created a formal curriculum, developed a unified system for the fellowship application process, and increased recruitment and match such that now approximately 1 in 6 general surgery graduates are pursuing training in SCC. In discussion with past and present leadership of SCCPDS, there are several ongoing initiatives to further improve the educational opportunities of the fellows and increase inclusion of other organizations and other specialties interested in SCC. The purpose of this article is to discuss the role of SCCPDS in the development and evolution of SCC and Acute Care Surgery (ACS) training. Expert Opinion; Level V.

Recommendations to improve recruitment and retention of underrepresented in medicine trainees in neonatal-perinatal medicine.

Physicians who identify as Black, Latinx, American Indian, Pacific Islander, and certain Asian subgroups represent racial and ethnic populations that are underrepresented in medicine (URM). While the proportion of URM pediatric trainees has remained unchanged, that of Neonatal-Perinatal Medicine (NPM) fellows has decreased. Informed by the medical literature and our lived experiences, we compiled and developed a list of recommendations to support NPM fellowship programs in the recruitment, retention, and promotion of URM trainees. We describe ten recommendations that address 1) creating a culture of inclusivity and psychological safety, 2) the critical appraisal of recruitment practices and climate, and 3) an inclusive and holistic fellowship application process. The first two themes lay the foundation, while the final theme spotlights our recommendations for URM recruitment. Each recommendation is a step towards improvement in recruitment and inclusion at a program.

INFORMATION WANTED: REI FELLOWSHIP WEBSITES DO NOT DELIVER

Reproductive Endocrinology and Infertility (REI) fellowship websites are often the primary information source for prospective fellows throughout their fellowship research and application process. We evaluated REI program websites for the comprehensiveness of their information as well as accessibility.

The Committee on Advanced Subspecialty Training-accredited postgraduate neurosurgery fellowship application experience: a national survey.

The neurosurgery fellowship application process is heterogenous. Therefore, the authors conducted a survey of individuals graduating from Committee on Advanced Subspecialty Training (CAST)-accredited fellowships in the past 5 years to examine 1) experiences with the fellowship application process, 2) perspectives on the process, 3) reasons for pursuing a given subspecialty and fellowship, and 4) post-fellowship practices. A survey querying demographics, experiences with and perspectives on the fellowship application process, and factors contributing to the pursuit of a given fellowship was distributed to individuals who had graduated from CAST-accredited fellowships in the past 5 years. The survey response period was May 22, 2021-June 22, 2021. Of 273 unique individuals who had graduated from CAST-accredited fellowships in the past 5 years, 65 (29.7%) were included in this analysis. The most common postgraduate year (PGY) during which respondents applied for fellowship positions was PGY5 (43.8%), whereas the most common training level at which respondents accepted a fellowship position was PGY6 (46.9%), with a large degree of variability for both (range PGY4-PGY7). Only 43.1% respondents reported an application deadline for their fellowship. A total of 77.4% respondents received 1-2 fellowship position offers, and 13.4% indicated that there was a match process. In total, 64.5% respondents indicated that the fellowship offer timeline was mostly or very asynchronous. The time frame for applicants to decline or accept a fellowship offer was heterogeneous and mismatched among institutions. Respondents agreed that a more standardized application timeline would be beneficial (median response "agree"), and 83.1% of respondents indicated that PGY5 or PGY6 was the appropriate time to interview for a fellowship. Respondents reported heterogeneous experiences in applying for a fellowship, indicated that a standardized application timeline including interviews at PGY5 or PGY6 would be beneficial, and preferred streamlining the fellowship application process.

Virtual Pediatric Orthopaedic Fellowship Interviews During the Pandemic: What Did the Applicants and Programs Think?

The COVID-19 pandemic precluded in-person interviews for the 2020-2021 fellowship application cycle and may impact future interview cycles. No information is available detailing the implications of a virtual format on either the interviewee or the fellowship program. Two surveys regarding the 2020-2021 virtual interview season were developed and distributed by the Pediatric Orthopaedic Society of North America (POSNA) Fellowship Training and Practice Qualifications Committee: one survey for fellowship applicants and one survey for fellowship program directors. Surveys were completed by 45 pediatric orthopaedic fellowship applicants and 34 fellowship program directors. Nineteen (42.2%) applicants applied to more programs because of the virtual format and 30 (66.7%) applicants accepted more interviews because of the virtual format. Thirty-one (67%) applicants did not feel the virtual interview format negatively affected their match process. Thirty-eight (84.4%) applicants indicated that they saved >$2000 with the virtual format. Approximately half (22/45, 48.5%) of the applicants would keep the fellowship-interview process virtual-even if in-person interviews were possible-whereas 8 (17.8%) applicants would transition back toward in-person interviews.Most program directors utilized online interviews for the first time (n=28, 82.3%) during the 2020-2021 application cycle. Programs interviewed more applicants for the 2020-2021 cycle than in the prior 5 years (19.3 vs. 15.7 applicants, P <0.01), with programs interviewing 10.1 applicants per fellowship position. The majority (n=22, 64.7%) of programs utilized Zoom for the interview platform. Program directors indicated that the applicants were either more accomplished (n=14, 41.2%) or similar in accomplishment (n=20, 58.8%) when compared with the applicants from prior years. Half of the program directors (n=17, 50%) surveyed would utilize virtual interviews next year, even if in-person interviews are possible. During the 2020-2021 fellowship application process, interviewees applied to and were interviewed at more programs because of the virtual format, while saving >$2000. In a similar manner, fellowship programs were able to interview a greater number of applicants without adversely impacting the applicant quality. Approximately half of the interviewees and program directors would continue to perform virtual interviews, even if in-person interviews are possible. Level V.

The Neurology Fellowship Application Conundrum: Finding Common Ground.

For many neurologic subspecialties, the fellowship application process begins early in the first half of the second year of neurology-specific training (PGY3 for adult neurology residents and PGY4 for child neurology residents). In 2019, the American Academy of Neurology (AAN) published a position statement recommending communication between fellowship candidates and training programs begin no sooner than March 1 of the penultimate year of training and that programs offer fellowship positions no sooner than August 1 of the final year of training. A few pilot subspecialties adopted this timeline for 2021 recruitment for positions beginning in 2022. All United States-based AAN-affiliated neurology and child neurology residents who recently completed the fellowship application process received a survey about their fellowship application experience. Of the 291 residents who responded to the survey, 96% agree that applications should not be submitted before March 1 of the penultimate year of training and 72% believe that August 1 of the final year is a reasonable time to begin offering positions. Nearly half (49%) of residents believe that there is too little time for subspecialty/clinical exposure before applying for fellowship and 88% feel the current process and timeline are stressful. Residents who applied to programs in pilot subspecialties report more time to choose, less stress, and a lower number of time-pressured offers. A large majority of residents (89%) prefer to submit a single application through a centralized system. The survey results suggest that residents who just completed the fellowship application process agree with the AAN recommended timeline for all subspecialties and that all neurology subspecialties should consider adopting a fellowship match. Programs can help facilitate a better fellowship application experience by providing earlier exposure to a broad range of neurologic subspecialties and ensure that residents are given opportunities to attend national meetings and participate in appropriately scoped scholarly endeavors.