Fellowship Applicants Research Articles

Examining Implicit Bias Differences in Pediatric Surgical Fellowship Letters of Recommendation Using Natural Language Processing

We analyzed the prevalence and type of bias in letters of recommendation (LOR) for pediatric surgical fellowship applications from 2016-2021 using natural language processing (NLP) at a quaternary care academic hospital. Demographics were extracted from submitted applications. The Valence Aware Dictionary for sEntiment Reasoning (VADER) model was used to calculate polarity scores. The National Research Council dataset was used for emotion and intensity analysis. The Kruskal-Wallis H-test was used to determine statistical significance. SETTING: This study took place at a single, academic, free standing quaternary care children's hospital with an ACGME accredited pediatric surgery fellowship. Applicants to a single pediatric surgery fellowship were selected for this study from 2016 to 2021. A total of 182 individual applicants were included and 701 letters of recommendation were analyzed. Black applicants had the highest mean polarity (most positive), while Hispanic applicants had the lowest. Overall differences between polarity distributions were not statistically significant. The intensity of emotions showed that differences in "anger" were statistically significant (p=0.03). Mean polarity was higher for applicants that successfully matched in pediatric surgery. This study identified differences in LORs based on racial and gender demographics submitted as part of pediatric surgical fellowship applications to a single training program. The presence of bias in letters of recommendation can lead to inequities in demographics to a given program. While difficult to detect for humans, natural language processing is able to detect bias as well as differences in polarity and emotional intensity. While the types of emotions identified in this study are highly similar among race and gender groups, the intensity of these emotions revealed differences, with "anger" being most significant. From this work, it can be concluded that bias in LORs, as reflected as differences in polarity, which is likely a result of the intensity of the emotions being used and not the types of emotions being expressed. Natural language processing shows promise in identification of subtle areas of bias that may influence an individual's likelihood of successful matching.

Program and Faculty Reputation Are Valued Most by Applicants to Orthopaedic Sports Medicine Fellowships

To determine the top orthopaedic surgery sports medicine fellowship programs in the United States and the most important aspects of fellowship programs as perceived by applicants. An anonymous survey was distributed via e-mail and text message to all current/former orthopaedic surgery residents who applied to one particular orthopaedic sports medicine fellowship program during the 2017-2018 through 2021-2022 application cycles. The survey asked applicants to rank what they considered to be the top-10 orthopaedic sports medicine fellowship programs in the United States before and after completion of their application cycle, based on operative and nonoperative experience, faculty, game coverage, research, and work-life balance. Final rank was calculated by awarding 10 points for a first-place vote, 9 points for a second-place vote, etc., with total number of points used to determine final ranking for each program. Secondary outcomes included rates of applying to perceived top-10 programs, relative importance of different fellowship program aspects, and preferred type of practice. Seven-hundred sixty-one surveys were distributed with 107 applicants responding (14% response rate). Applicants voted the top orthopaedic sports medicine fellowships programs to be: (1) Steadman Philippon Research Institute, (2) Rush University Medical Center, and (3) Hospital for Special Surgery, both before and following the application cycle. When ranking fellowship program aspects, faculty members and fellowship reputation were most likely to be ranked highest in importance. This study demonstrates that most orthopaedic sports medicine fellowship applicants highly valued program reputation and faculty members when choosing a fellowship program and that the application/interview process did not have a substantial effect on how individuals perceived the top programs. The findings of this study are important for residents applying to orthopaedic sports medicine fellowships and may have implications on fellowship programs and future application cycles.

Impact of Virtual Interviewing on Geographic Placement for Cardiology Fellowship Recruitment

Background Virtual interviewing for cardiology fellowship was instituted in the 2021 fellowship application cycle because of the COVID-19 pandemic and restricted travel. The impact on geographic patterns of fellow-training program matching is unknown. This study sought to determine if there was a difference in geographic placement of matched fellows for cardiology fellowship match after initiation of virtual interviews compared with in-person interviewing. Methods and Results All US-based accredited cardiovascular disease fellowship programs that participated in the 2019 to 2021 fellowship match cycles and had publicly available data with fellowship and residency training locations and training year were included. Each fellow was categorized based on whether their fellowship and residency programs were in the same institution, same state, same US census region, or different census region. Categories were mutually exclusive. Of 236 eligible programs, 118 (50%) programs were identified, composed of 1787 matched fellows. Compared with the previrtual cohort (n=1178 matched fellows), there was no difference in the geographic placement during the 2021 virtual cycle (n=609 matched fellows) (P=0.19), including the proportion matched at the same program (30.6% versus 31.5%), same state but different program (13% versus 13.8%), same region but different state (24.2% versus 19.7%), or different region (35% versus 33.1%). There was also no difference when stratified by program size or geographic region. Conclusions The use of virtual interviewing in the 2021 cardiology fellowship application cycle showed no significant difference in the geographic placement of matched fellows compared with in-person interviewing. Further study is needed to evaluate the impact of virtual interviewing and optimize its use in fellowship recruitment.

Predictors of matching into an ophthalmology fellowship for international medical graduates: a San Francisco match analysis.

To describe the characteristics and outcomes of international medical graduates (IMGs) applying for ophthalmology fellowship match. Design Case control study. Setting San Francisco Fellowship Match data between 2010 and 2017. Participants IMGs applying for ophthalmology fellowships. Main outcome(s) and measure(s) Applicant characteristics for IMGs were stratified by their match outcome and compared using Chi-Square and Mann-Whitney U test. A multivariable logistic regression model was used to assess the effect of applicant characteristics on their match outcomes. 22.62% (785/3471) of the fellowship match applicants were IMGs of which 35.92% (n = 282) matched. This rate was 58% lower than the 86.4% match rate for US-MG (p < 0.001). Factors associated with higher odds of matching among IMGs were graduating from a US residency (Odds Ratio (OR):2.330; 95% Confidence Interval (CI):1.433-3.789), higher USMLE Step 3 score (OR:1.019;95% CI: 1.006-1.032), applying to more programs (OR:1.035;95%CI: 1.017-1.053), ranking more programs (OR:1.200; 95% CI:1.096-1.313) and having a higher percentage of programs ranked (OR:1.021;95% CI: 1.014-1.028). Fellowship match rates for IMGs were significantly lower than for US-MGs. IMGs graduating from an ophthalmology residency in the US, scoring higher Step 3 scores, distributing more applications, and ranking more programs had increased odds of matching. This information may assist IMG fellowship applicants and their mentors when they consider pursuing an ophthalmology fellowship program in the US.

Predictors of Interest in Radiation Oncology: The Effect of Race, Ethnicity, Gender, and Other Diversity Measures

The presence of women and people underrepresented in medicine (URiM) continues to be lower in radiation oncology (RO) than within the United States population, medical school graduates, and oncology fellowship applicants. The objective of this study was to identify demographics of matriculating medical students who are inclined to consider pursuing a residency in RO and identify barriers to entry that students may perceive before medical school training. A survey of incoming medical students at New York Medical College was distributed via e-mail and assessed demographic background information, interest in and awareness of oncologic subspecialties, and perceived barriers to RO. Students of the incoming class of 2026 had a complete response rate of 72% (155 complete responses and 8 incomplete responses of 214 class members). Two-thirds of participants had prior awareness of RO, and half have considered pursuing an oncologic subspecialty, but less than one-fourth have ever previously considered a career in RO. Students responded that they need more education, clinical exposure, and mentorship to increase their chance of choosing RO. Male participants had 3.4 times the odds of having an acquaintance in the community tell them about the specialty and also had significantly greater interest in using advanced technologies. There were no URiM participants who had personal relationships with an RO physician compared with 6 (4.5%) non-URiM participants. The average response to "What is the likelihood that you will pursue a career in RO?" showed no significant difference between genders. All races and ethnicities scored a similar likelihood of pursuing a career in RO, which differs greatly from the current RO workforce. Responses emphasized the importance of education, mentorship, and exposure to RO. This study demonstrates the need for support of female and URiM students during medical school.

Academic Productivity of Successful Micrographic Surgery & Dermatologic Oncology Fellowship Applicants.

Elias, Marcus L. MD*; Burshtein, Joshua G. MD*; Barilla, Steven MD*; Sharon, Victoria R. MD, DTMH* Author Information

Abstract 10670: Impact of Virtual Interviewing on Geographic Placement in the Cardiology Fellowship Match

Introduction: Virtual interviewing for cardiology fellowship was instituted in the 2021 fellowship application cycle due to the COVID-19 pandemic and restricted travel. It is unknown what impact this has had on geographic patterns of fellow-training program matching. Our aim was to determine if there was a significant difference in the geographic placement in the cardiology fellowship match based on virtual interviews compared to prior years with in-person interviewing. Methods: All U.S. based accredited cardiovascular disease fellowship programs that participated in the 2019-2021 fellowship match cycles were identified. Those that had publicly available data regarding fellow residency training and training year were included. Each fellow was categorized based on their fellowship program and residency training as from the same program, from the same state, from the same region or from a different region. These were mutually exclusive categories. Results: Of the 236 eligible programs, 118 programs (50%) had available data for the 2019-2021 application cycles. Cumulatively n=1787 total fellows were identified. Compared to the pre-virtual cohort (n=1178 matched fellows) there was no difference in the geographic placement during the 2021 virtual cycle (n=609 matched fellows) including the proportion that matched at the same program (30.6% vs 31.5%, p=0.738), in the same state (13% vs 13.8%, p=0.719), same region (24.2% vs 19.7%, p=0.164), or different region (35% vs 33.1%, p=0.274). There was also no difference when stratified by small, medium, or large program size or geographic region. Conclusions: The use of virtual interviewing in the 2021 cardiology fellowship application cycle did not result in a significant difference in the geographic placement of fellows. Further study is needed to evaluate the impact of virtual interviewing and optimize its use in fellowship recruitment.

Abstract 14462: Diversity of Cardiology Fellowship Candidates in the Era of Virtual Interviews

Introduction: The goal of cardiovascular training programs is to increase recruitment of women and underrepresented in medicine (UIM) trainees. Due to the COVID-19 pandemic, virtual interviewing replaced in-person interviewing for cardiology fellowship applications in the United States. However, there is little data on the influence of these changes on fellowship candidate diversity. Methods: In a single-center retrospective study, we identified demographic changes in the profiles of trainees who interviewed for the Stanford University Cardiovascular Fellowship Program before and after the transition to virtual interviewing (2019 and 2020 vs 2021 and 2022 cycles). UIM applicants were defined as those who self-identified Black or Hispanic. Test of proportions and t-test were used for categorical and numeric variables respectively. Results: Over four years, 2250 trainees applied, 212 candidates interviewed, and 24 were accepted to the fellowship. Of those interviewed, 42.0% were women, 9.9% were Black, and 9.4% were Hispanic. The proportion of UIM trainees interviewed increased from 10.5% during the in-person years to 30.2% during the virtual years (p &lt; 0.001; Figure 1A). The increase among women was not statistically significant (40% in-person vs. 44% virtual, p = 0.58). The geographic distribution shifted over time to include lower representation from closer Western programs (40% in-person to 29% virtual) and higher representation from Northeast programs (35% in-person to 44% virtual; Figure 1B). The weighted mean distance of represented residency programs nominally increased from 1730 miles to 2067 miles away (p = 0.06). Conclusions: Virtual interviews were associated with a three-fold increase in UIM interviewed applicants for cardiology fellowship positions at a single center. Further research is warranted to assess the full impact of virtual interviews, as well as to understand and mitigate potential bias in the evolving selection process.

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.

VIRTUAL INTERVIEWS beyond COVID-19: Applicant and Program directors’ Perspectives

The 2020-21 interview cycle for Reproductive Endocrinology and Infertility (REI) fellowship was transitioned to a virtual format due to COVID-19. A previous study established that both fellowship applicants and program directors (PDs) had favorable experiences and perceptions of virtual interviews (VIs) and endorse its continued use.1

Factors Influencing Sports Medicine as a Career Choice Among Orthopaedic Trainees in Saudi Arabia.

Sports medicine is one of the most popular orthopaedic specialties, with more fellowship applicants than in any other subspecialty of orthopaedics. To investigate the factors influencing orthopaedic trainees to complete their fellowships and subsequently subspecialize in sports medicine in Saudi Arabia, as well as to compare the motivational factors of trainees planning to pursue sports medicine versus other orthopaedic specialties. Cross-sectional study. An online anonymous questionnaire was distributed to 400 orthopaedic surgical trainees from 44 training centers (residency and fellowship training programs) across Saudi Arabia. The questionnaire identified trainees planning to select sports medicine as their career and the most influential factors affecting their choice; items exploring the influential factors were answered on a 5-point Likert-type scale. A comparison of responses was performed with candidates aiming to pursue other orthopaedic specialties. The chi-square or Fisher exact test was used to compare demographic parameters and the percentage of "agree" and "strongly agree" responses between trainees opting for sports medicine fellowships and those choosing other fellowships. Of the 400 potential participants, 250 orthopaedic trainees (response rate, 63%) completed the survey (201 [80%] male and 49 [20%] female). Sports medicine was the most coveted specialty among trainees, with 70 (28%) participants opting for it as their career choice. The most prominent factors for the decision included disease prognosis and surgical outcomes (90%), personal interest (87%), experience during residency training (83%), type of surgical skills (81%), disease pathology and patient population (77%), expected workload and lifestyle (73%), role model or mentor (70%), and patient volume and variety of cases (67%). Significant differences compared with trainees who preferred other orthopaedic specialties included role model/mentor impact (70% vs 54%), expected rate of income (60% vs 47%), and private sector job opportunities (64% vs 45%) (P = .025, .034, and .020, respectively). Study findings indicated that a significant percentage of orthopaedic trainees in Saudi Arabia choose to specialize in sports medicine. Role model/mentorship, private sector job opportunities, and expected rate of income were the most influential when compared with the motivations of trainees not choosing sports medicine.

Expectations versus reality: Understanding the accuracy of impressions made during virtual interviews of pediatric pulmonary fellowship programs.

As a result of the SARS-CoV-2 pandemic, all pediatric pulmonary fellowship programs conducted virtual interviews for the first time in the Fall of 2020. This study aimed to understand the accuracy of virtual-interview derived-impressions of fellowship programs, as well as applicant preference for future fellowship interview cycles. A group of pediatric pulmonary fellows and Program Directors designed a REDCap survey. The survey was distributed to all first-year pediatric pulmonary fellows who participated in the 2020-2021 virtual interview season. 23/52 (44%) of first-year pediatric pulmonary fellows completed the survey. 96% were able to form general impressions about fellowship programs during their virtual interviews. 96% reported that generally their fellowship experience matched their virtual-interview derived-impressions. 17 of the 19 factors applicants use to rank programs had no statistically significant change (p > 0.05) in impression from virtual interview to fellowship experience. The two factors with a statistically significant (p < 0.05) change in impression were patient care related-volume of "bread and butter" pediatric pulmonary patients and volume of tertiary care pediatric pulmonary patients. 87% prefer some form of in-person interview option in future application cycles. A tiered interview format in which applicants are first invited to a virtual interview day followed by an optional in-person second look day was the most popular preference for future interview cycles (48%). Virtual interviews may provide accurate representations of pediatric pulmonary fellowship programs and applicants prefer some type of in-person interview option in future application cycles.

Allergy and immunology interest and exposure among US medical students and residents.

Despite the immense burden of allergic disease, the allergy and immunology (AI) workforce in the United States continues to shrink. Fellowship applications for AI have declined sharply in contrast to those in more popular specialties. Here we have sought to evaluate the current level of AI interest and exposure among early trainees in the United States, as well as their perspective on how to improve interest in the field. An 18-item questionnaire was sent via e-mail list-serve to 2 groups: (1) mostly residents in the American Academy of Allergy, Asthma & Immunology (AAAAI) with interest in AI and (2) medical students in the American Medical Student Association (AMSA) whose specialty interests were not known. In the AAAAI group, 412 members were surveyed and 70 responses were received. In the AMSA group, 4778 members were surveyed and 47 responses were received. More individuals in the AAAAI group interacted with their AI division than in the AMSA group (73% vs 19% [P< .001]). On average, the AAAAI group would "probably" pursue AI whereas the AMSA group who would "definitely not" do so (P<.001). Almost all of the AMSA group (94%) had heard of AI before, but only 19% of them interacted with AI at their program. Regarding ways to increase interest in AI, the top responses for both groups were clinical exposure via electives and shadowing (a score of 4.69 on a 5-point scale) and didactic exposure via lectures and presentations (a score of 4.29). Our study suggests that increasing AI opportunities for didactics and clinical exposure may lead medical students to develop more interest in pursuing the field. Some strategies are also discussed.

Factors Influencing Fellowship Training Among Ophthalmology Residents: A Pilot Study.

There has been an increase in ophthalmology fellowship training programs and applicants. The current ophthalmology literature lacks any recent study examining factors influencing residents' decisions to pursue subspecialty fellowship training. An anonymous, 16-item survey was distributed to residents from a convenience sample of ophthalmology residency programs by their program directors or administrators. A total of 72 residents and 9 interns from 9 distinct programs completed the survey. Eighty-two percent of respondents reported they have either applied or will apply for a fellowship position. Gender and race showed no significant association with fellowship application. Respondents perceived that obtaining a fellowship position would be easier (61%) than obtaining an ophthalmology residency. The desire for additional clinical and surgical training were the 2 primary factors for the pursuit of fellowship training. Half of those pursuing fellowship training (49%) indicated they still desired to practice comprehensive ophthalmology. None of the respondents indicated they wished to practice in a rural area. The data collected in this pilot study elicited factors and variable associations that provide a sound basis for informing revisions and improvements to the data collection tool for a follow-up prospective, longitudinal study involving all ACGME ophthalmology training programs. The results indicate some of the essential factors associated with the pursuit of fellowship training by the current generation of residents. The results also highlight potential trends related to residents' views of their training and desired practice patterns.

Ten Steps for Writing an Exceptional Personal Statement.

Ten Steps for Writing an Exceptional Personal Statement.

S1494 Gastroenterology Fellowship Virtual Interviews: Applicant and Faculty Perceptions on Virtual Interview Advantages and Barriers

Introduction: During the COVID-19 pandemic, virtual interviews for resident and fellowship applicants became the standard. However, studies evaluating the experience of virtual interviews format are lacking. Accordingly, we sought to survey both gastroenterology fellowship applicants and interviewing faculty members about their experiences with the virtual interview process. Methods: Interviewees and faculty at 13 different gastroenterology fellowship programs at academic medical centers across the United States completed a post-interview survey. The online survey was conducted during the 2020 ERAS fellowship interview season via Google Forms. The survey responses were anonymously collected and reported. Results: A total of 177 gastroenterology fellowship applicants and 83 faculty members completed the electronic surveys. Most participants reported a positive experience with 91% and 84% of applicants and faculty respectively, scoring at least 4 points on a 5-point scale. Eighty-8 percent and 85% of applicants and faculty respectively, reported that they had enough insight about the applicant or the fellowship program during the interview. Over 67% of applicants reported cost-savings of greater than $1,000 per interview. Thirty-6 percent of applicants reported that they missed the personal interaction with the current gastroenterology fellows in the respective programs and the experience of physically touring the facility. Twenty-7 percent and 25% of applicants and faculty experienced technical difficulties during the interview process, respectively. Thirty-one percent and 22% of applicants and faculty would like for the virtual interviews to be the standard of future fellowship interviews, while 35% and 42% of applicants and faculty would consider it in the future, respectively. Figure 1 shows the ranking process for both applicants and faculty. Conclusion: Virtual interviews were perceived as effective and cost-saving by both gastroenterology fellowship applicants and faculty members. The virtual experience was widely accepted by most applicants and faculty, with high potential to become the standard of fellowship interview process in the future. However, a substantial portion experienced technical difficulty. Further improvements in technology are needed to optimize the process and increase the acceptance of the virtual interview experience.Figure 1.: Applicants and faculty perspectives on the ranking process. LOR, letters of recommendation.

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.

Breast Surgical Oncology Fellowship applicant selection and ranking: A survey of Society of Surgical Oncology programs.

In 2003, the Society of Surgical Oncology (SSO) initiated a breast surgical oncology fellowship, which has now grown to 60 SSO accredited programs as of 2021. Limited knowledge exists on the traits of successful applicants and the factors influencing the rank list. A web-based, anonymous survey was sent to all SSO Breast Surgical Oncology Fellowship program directors. The survey consisted of 26 questions. Descriptive statistics were used to analyze survey responses and evaluate impact on applicant interview and rank list. Thirty-four programs (57% response rate) completed the survey. Programs received an average of 70 applications and granted 24 interviews. Most programs reported a minimum ABSITE cut-off score (n = 28, 82%) and a defined publication requirement (n = 22, 65%), including a first-author requirement (n = 18, 53%) to extend an invitation to interview. For postinterview rank, applicant interpersonal skills were highly valued. The interview was the most important aspect for the rank list. Many programs have ABSITE and publication thresholds before offering an interview. Upon receiving interview invitation, the applicant's interview performance, interpersonal skills, and letters of recommendation were the most important aspect in rank list decision making.

Analyzing trends in obstetrics and gynecology fellowship training over the last decade using the normalized competitive index

BACKGROUNDThe objective and relative competitiveness of obstetrical and gynecologic subspecialty training programs remain understudied. Traditional metrics, such as match rate or program fill rate, fail to standardize the application environment. This limits their applicability when examining demographic trends or when comparing data between different fellowship matches. The normalized competitive index was introduced to serve as a comprehensive metric of competitiveness by incorporating disparate indicators and normalizing to enable more detailed analyses.OBJECTIVEThis study aimed to analyze trends in the competitiveness across obstetrical and gynecologic subspecialty fellowship matches during the last decade.STUDY DESIGNThe results and data reports from the National Resident Match Program fellowship for 2010 to 2019 were used to collect data on multiple metrics of competitiveness for 6 obstetrical and gynecologic subspecialties. These data were used to determine the normalized competitive index. Subanalyses were conducted to identify trends over the last decade.RESULTSAmong fellowship programs in obstetrics and gynecology, the overall specialty match rate was 67.6%. The overall specialty program fill rate was 95.7%. According to the normalized competitive index metric, minimally invasive gynecologic surgery was the most competitive fellowship match (normalized competitive index=1.31; P=.002). Maternal-fetal medicine was the least competitive (normalized competitive index=0.94; P≤.005). When comparing the first and second half of the decade, no specialty experienced a significant decrease in match rate. The only significant increase in match rates occurred for female pelvic medicine and reconstructive surgery (P=.035). Subanalyses of the normalized competitive index metric and other indicators of competitiveness demonstrated a strong negative correlation between the normalized competitive index and the subspecialty match rate (r=−0.9444) and a moderately positive correlation between the normalized competitive index and the program fill rate (r=0.4047).CONCLUSIONThe normalized competitive index offers trainees a more quantitative understanding of the fellowship application environment. By incorporating multiple metrics and normalizing the result, it uniquely enables comparison between the subspecialty matches and the match process over time. The same standardization offers the potential for future comparisons of competitiveness within a single subspecialty match based on geographic region, applicant demographics, and other important determinants of a diverse and vibrant training environment.

No difference in subsequent trainee satisfaction associated with in-person exposure prior to remote interviews

ABSTRACT Background In 2020–2021, residency and fellowship applicants participated in virtual interviews. There was concern that trainees who had not been to the area before would potentially have different satisfaction with their new workplace and community. Objective To compare satisfaction and likelihood to recommend work and community among new trainees with or without prior exposure to a single academic center or its environs. Methods We conducted an IRB-approved cross-sectional survey of new trainees. An electronic survey included demographic items, self-report of prior exposure to the area, satisfaction with the program and area, and likelihood to recommend the program and area. Descriptive statistics were used for responses and Chi square tests for comparisons. Results In September 2021 and May 2022 electronic surveys were sent to all 173 trainees who started residency or fellowship in July 2021, which had 87 responses (50.3% response rate) and 31 (18.0% response rate) responses, respectively. At both times, most respondents were interns. The majority of the September group (55.6%), while 38.7% of the May group had prior exposure to the area. Overall, the majority were satisfied with Penn State Health and would recommend their workplace. The majority also agreed they were satisfied with their new community and would recommend it to others. There were no significant differences in the proportions of satisfied trainees for any of the four outcomes at either timepoint. Conclusions Satisfaction with training and the community were not significantly different for trainees with or without prior in-person exposure to the institution or surrounding area.