Matching Program Research Articles

Analysis of National Resident Matching Program for Radiology Fellowships: Factors Affecting Program Fill Rates

PurposeThe National Resident Matching Program (NRMP) is used by an increasing number of diagnostic radiology (DR) residents applying to subspecialty fellowships. Data characterizing match outcomes on the basis of program characteristics are limited. The aim of this study was to determine if fellowship or residency size, location, or perceived reputation was related with a program filling its quota. MethodsUsing public NRMP data from 2004 to 2022, DR residency, breast imaging (BI), musculoskeletal imaging (MSK), interventional radiology (IR), and neuroradiology (NR) fellowship programs were characterized by geography, DR and fellowship quota, applicants per position (A/P), and reputation as determined by being an Aunt Minnie best DR program semifinalist, Doximity 2021-2022 top 25 program, or U.S. News & World Report top 20 hospital. The DR program’s reputation was substituted for fellowships at the same institution. A program was considered filled if it met its quota. ResultsThe 2022 A/P ratios were 1.02 for IR, 0.83 for BI, 0.75 for MSK, and 0.88 for NR. IR was excluded from additional analysis because its A/P was >1. The combined BI, MSK, and NR fellowships filled 78% of positions (529 of 679) and 56% of programs (132 of 234). Factors associated with higher program filling included Doximity top 25 program, Aunt Minnie semifinalist, and U.S. News & World Report top 20 hospital affiliation (P < .001 for all); DR residency quota greater than 9, and fellowship quota of three or more (P < .01). The Ohio Valley (Ohio, western Pennsylvania, West Virginia, and Kentucky) filled the lowest, at 39% of programs (P = .06). ConclusionsLarger fellowship programs with higher perceived reputations and larger underlying DR residency programs were significantly more likely to fill their NRMP quota.

Meta-analysis of residency program application and acceptance according to sex, race and ethnicity.

We aimed to investigate trends in residency program application and acceptance rates according to sex and race and ethnicity. We collected data from the Journal of the American Medical Association Graduation Medical Education Reports. We extracted the data for 25 residency programs in the United States from 2005 to 2021 and conducted statistical analyses. Men were most matched for orthopedics (84.7%, 95% confidence interval [CI] 84.2%-85.1%), and women for oncology (78.7%, 95% CI 78.2%-79.2%). The most matched program was orthopedics for the White subgroup (43.5%, 95% CI 43.2%-43.9%), radiology for the Black subgroup (20%, 95% CI 18.9%-20.9%), general surgery for the Hispanic subgroup (11%, 95% CI 10.7%-11.2%), and internal medicine for the Asian subgroup (35.3%, 95% CI 34.9%-35.6%). Match rates for women were lower than those for men in all programs except psychiatry, pediatrics, obstetrics and gynecology, and dermatology. Match rates were significantly lower for Black, Hispanic, and Asian subgroups than the White subgroup in all programs except for internal medicine, with the Asian subgroup being higher. We observed a significant increase in both application and acceptance rates for women and racial and ethnic minorities over the past 40 years.

Geographic Location and Corporate Ownership of Hospitals in Relation to Unfilled Positions in the 2023 Emergency Medicine Match.

In the 2023 National Resident Matching Program (NRMP) match, there were 554 unfilled emergency medicine (EM) positions before the Supplemental Offer and Acceptance Program (SOAP). We sought to describe features of EM programs that participated in the match and the association between select program characteristics and unfilled positions. The primary outcome measures included the proportion of positions filled in relation to state and population density, hospital ownership type, and physician employment model. Secondary outcome measures included comparing program-specific attributes between filled and unfilled programs, including original accreditation type, year of original accreditation, the total number of approved training positions, length of training, urban-rural designation, hospital size by number of beds, resident-to-bed ratio, and the percentage of disproportionate share patients seen. The NRMP Match had 276 unique participating EM programs with 554 unfilled positions. Six states offered 52% of the total NRMP positions available. Five states were associated with two-thirds of the unfilled positions. Public hospitals had a statistically significant higher match rate (88%) when compared to non-profit and for-profit hospitals, which had match rates of 80% and 75%, respectively (P < 0.001). Programs with faculty employed by a health system had the highest match rate of 87%, followed by clinician partnerships at 79% and private equity groups at 68% (P < 0.001 overall and between all subgroups). The 2023 match in EM saw increased rates in the number of residency positions and programs that did not fill before the SOAP. Public hospitals had higher match rates than for-profit or non-profit hospitals. Residency programs that employed academic faculty through the hospital or health system were associated with higher match rates.

Female and underrepresented minority representation in radiology

Rational and objectiveDiversity, equity, inclusion, and representation in various sectors have garnered increasing attention in the past two decades, including healthcare. In this report we investigate representation of females and underrepresented minorities (URM) in the field of radiology and asses for significant growth trends in representation in residency training programs in the United States. Materials and methodsDe-identified trainee demographic information for active radiology trainees from 2016 to 2021 was queried using the Accreditation Council for Graduate Medical Education (ACGME), and new radiology trainees using the National Resident Matching Program (NRMP)’s Main Residency Match Data and Reports databooks. ResultsIn 2021 females represented 26.7% of DR residency trainees and 22% of IR integrated trainees. In the same year URM trainees represented 11.3% of trainees and 8.7% of IR integrated trainees. From 2017 to 2021, diagnostic radiology had a compound average growth rate (CAGR) 1% (p <0.01) of female representation and 1.12% (p<0.01) of URM representation. ConclusionThis study quantifies female and underrepresented minority representation among radiology trainees for diagnostic radiology and radiology subspecialities, identifying modest uptrends in representation within both demographics.

Optimization of Bilateral Cooperation at the Local Level: Vocational Schooling Program and Firm Productivity in Central Java

In 2011 the Indonesian and the German government initiated the Sustainable Economic Development through Technical and Vocational Education and Training Program (SED-TVET). Within the diplomacy realm, this kind of bilateral strategy has often been utilized to strengthen a country's specific needs. Following the program, Provincial Government in Central Java responds distinctively to the initiative by emphasizing link and match program to promote skilled-labor employment. This paper aims to investigate the effect of these national and local policies on firms’ productivity. Our identification of treatment year is critical as this precedes wider implementation of TVET program at the national level in 2016. To capture the precise treatment effect of the program, we deploy difference-in-difference strategy using the province’s neighbors as the control group. We find that firms in Central Java employed nearly 20% higher share of skilled labor relative to its controls. This correlates with significantly higher productivity and export performance. The results highlight the benefit of well-coordinated bilateral cooperation while also stressing the important role of local leadership in optimizing the impact of the program.

HPV Vaccination Practices Among Medical Trainees in Pediatrics, Obstetrics and Gynecology, and Family Medicine.

The human papillomavirus (HPV) vaccine has been proven effective in preventing HPV-related cancer. However, vaccination uptake in the United States remains unacceptably low. The aim of this study is to determine whether residents' HPV vaccination status, demographics, or residency training setting are predictive of vaccination prescribing practices. This was an anonymous, IRB-approved, opt-in survey of OBGYN, Family Medicine, and Pediatric residents. Using the National Residency Match Program Web site, surveys were sent to program directors requesting their residents' participation. Demographics, practice settings, HPV vaccination status, reasons for being inappropriately vaccinated, and resident vaccination-prescribing practices were analyzed. A total of 853 residents participated. A total of 56.7% of respondents were fully vaccinated against HPV. The most common reasons for being unvaccinated were as follows: age (51.7%, n = 122), monogamous (30.9%, n = 73), do not believe it works (22.5%, n = 53), and affordability/insurance did not cover (14.4%, n = 34). Residents working in an urban setting were more likely to be vaccinated than those in suburban (odds ratio [OR] = 1.93, 95% confidence interval [CI], 1.364-3.229, p < .001) or rural (OR = 2.08, 95% CI 1.461-3.359, p 0.01) settings. Males were less likely than females (OR = 0.90, 95% CI 0.702-0.997, p < .001) to be vaccinated. Single residents were more likely to be vaccinated than married (OR = 2.56, 95% CI 2.444-2.704, p < .001) or divorced (OR = 2.15, 95% CI 1.822-3.264, p 0.21) residents. Vaccinated residents were more likely to recommend HPV vaccination to their patients than those who were unvaccinated (OR = 1.83, 95% CI 1.321-2.548, p .004). A significant portion of Family Medicine, Pediatrics, and OBGYN residents have not received appropriate vaccination against HPV. Vaccination is highest among residents who identify as female, single, or working in urban settings. Vaccinated residents were also found to be almost 2 times as likely to recommend vaccination to their patients. As such, our data suggest that targeted provider education is needed to increase vaccination rates for both trainees and their patients.

DO seniors and IMGs have lower match probabilities than MD seniors after adjusting for specialty choice and USMLE Step 1 score.

It is unknown if US residency applicants of different educational backgrounds (US allopathic [MD], Doctor of Osteopathic Medicine [DO], and international medical graduates [IMG]) but comparable academic performance have similar match success. Our objective was to compare match probabilities between applicant types after adjusting for specialty choice and United States Medical Licensing Examination (USMLE) Step 1 scores. We performed a secondary analysis of published data in National Resident Matching Program (NRMP) reports from 2016, 2018, 2020, and 2022 for US MD seniors, DO seniors, and IMGs (US citizens and non-US citizens). We examined the 10 specialties with the most available spots in 2022. Average marginal effects from a multiple variable logistic regression model were utilized to estimate each non-MD senior applicant type's probability of matching into their preferred specialty compared to MD seniors adjusting for specialty choice, Step 1 score, and match year. Each non-MD applicant type had a lower adjusted percent difference in matching to their preferred specialty than MD seniors,-7.1 % (95 % confidence interval [CI],-11.3 to-2.9) for DO seniors,-45.6 % (-50.6 to-40.5) for US IMGs, and-56.6 % (-61.5 to-51.6) for non-US IMGs. Similarly, each non-MD applicant type had a lower adjusted percent difference in matching than MD seniors across almost all Step 1 score ranges, except for DO seniors with Step 1 scores <200 (-2.0 % [-9.5 to 5.5]). After adjusting for specialty choice, Step 1 score, and match year, non-US MD applicants had lower probabilities of matching into their preferred specialties than their US MD colleagues.

A 10-year analysis of application and match rates for pain medicine training in the United States.

We analyzed application and match rates for pain medicine training in the United States and hypothesized that there would be (1) greater growth in the number of training positions than applicants, (2) higher match rates among US allopathic graduates relative to non-US allopathic graduates, and (3) greater number of unfilled training positions over time. Retrospective, cross-sectional study of all applicants for pain medicine training in the United States. National Resident Matching Program data were obtained over a ten-year period (2014-2023). Match rates and applicant-to-position ratios were calculated and compared over time with linear regression. Comparisons were made with chi-square tests. Growth in the number of annual training positions (261-377, 44% increase) exceeded growth in the number of interested applicants (398-415, 4% increase) (P < .001). Annual applicant-to-training position ratios decreased (1.5-1.1, P < .001). The representation of US allopathic graduates among incoming pain medicine fellows decreased over the study period (73%-58%, P < .001) while US osteopathic graduates increased (9%-28%, P < .001).Match rates increased for both US allopathic graduates (71%-91%, P < .001) and non-US allopathic graduates (51%-81%, P < .001). From 2018 to 2023, US allopathic graduates (79%) had higher match rates than US osteopathic graduates (60%, P < .001) and international medical graduates (57%, P < .001). More available annual training positions went unfilled over the study period (2%-5%, P = .006). Stagnant annual applicant volume and increasing number of available training positions have led to increasing match rates for pain medicine fellowship training. Fewer US allopathic graduates are pursuing pain medicine training. The increasing percentage of unfilled training positions warrants ongoing surveillance.

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)

816 Comparing Match Data for Neurological and Orthopaedic Surgery Applicants From 2016-2022: Is There a Point of Diminishing Return for Research Experiences and Publications?

INTRODUCTION: The application process for neurological surgery (NSGY) and orthopaedic surgery (Ortho) residency positions is highly competitive. Prior work has characterized variables associated with improved match rates; however, limited analyses have been published in recent years. METHODS: Data on the characteristics of NSGY and Ortho applicants was obtained from the National Residency Matching Program Interactive Charting Outcomes in the Match tool from 2016 to 2022. The POM was computed for each subgroup classification available for applicant characteristics. RESULTS: Applicant characteristics that correlated with an improved POM into both NSGY and Ortho included increasing USMLE Step 1 and Step 2 scores, being a US MD Senior, number (#) of contiguous ranks (a proxy for # of interviews), # of volunteer experiences, and being a member of AOA. An increasing # of publications correlated with an increased POM until 25+ were reported for NSGY applicants but only until more than 11-15 were reported for Ortho applicants. A PhD correlated positively with the POM for NSGY applicants but negatively for Ortho applicants. Non-PhD graduate degrees correlated negatively with the POM for both NSGY and Ortho applicants. An increasing # of work experiences correlated negatively with the POM for NSGY applicants at all levels, and correlated negatively with the POM for Ortho applicants after 3-5 were reported. CONCLUSIONS: There appeared to be a point of diminishing return where an increasing number of publications no longer increased the probability of matching for both NSGY and Ortho applicants. Non-PhD graduate degrees did not improve the POM. Ranking more programs was associated with a higher POM for both NSGY and Ortho applicants, suggesting an incentive to take as many interviews as possible if not otherwise restricted.

Osteopathic Students Have Decreased Match Rates in Orthopaedic Surgery Compared with Allopathic Students.

Orthopaedic surgery continues to be one of the most competitive specialties to match into as a medical student, particularly for osteopathic medical students. Therefore, in this study, we sought to examine the prevalence of osteopathic students (DO) matching into orthopaedic surgery at traditional Accreditation Council for Graduate Medical Education (ACGME) accredited programs (former allopathic residency programs) in recent years. A retrospective review of National Residency Match Program annual reports and Association of American Medical Colleges's Electronic Residency Application Service Statistic reports were performed to determine the number of applications and match rates among osteopathic (DO) and allopathic (MD) medical students into orthopaedic surgery from 2019 to 2023. Data on the degree type of current residents at all ACGME-accredited residency programs were identified. During the analyzed study period of 2019 to 2023, there were 3,473 (74.5%) allopathic students and 571 (59.9%) osteopathic students who successfully matched into orthopaedic surgery. This match rate for allopathic students was 74.5% compared with 59.9% for osteopathic students. Of the 3,506 medical students who hold postgraduate orthopaedic surgery positions at former allopathic programs over the past 5 years, only 58 (1.7%) hold an osteopathic degree. Of the 560 medical students who hold postgraduate orthopaedic surgery positions at former osteopathic programs over the past 5 years, 47 (8.4%) hold an allopathic degree. The match rate of allopathic students at former osteopathic programs is significantly higher than the match rate of osteopathic students at former allopathic programs. Osteopathic students continue to match into orthopaedic surgery at lower rates than their allopathic counterparts. In addition, there remains a consistent and low number of osteopathic students matching into former allopathic programs. Allopathic students also have a higher likelihood of matching into former osteopathic programs when compared with osteopathic students matching into previous allopathic orthopaedic surgery programs.

Relationship Between National Residency Matching Program (NRMP) Rank Order and Otolaryngology Residency Performance.

The process of resident recruitment is costly, and our surgical residency program expends significant time on the resident selection process while balancing general duties and responsibilities. The aim of our study was to explore the relationship between otolaryngology-head and surgery (OHNS) residents' National Residency Matching Program (NRMP) rank-list position at our institution and their subsequent residency performance. Retrospective cohort study. Single site institution. We retrospectively reviewed 7 consecutive resident classes (2011-2017) at a single tertiary OHNS residency program. We reviewed each resident's absolute rank order in the NRMP matches. Measures of residency performance included overall faculty evaluation during postgraduate year 5 (PGY5), annual in-service examination scores (scaled score), and the number of manuscripts published in peer-reviewed journals. Correlations between NRMP rank order and subsequent residency performance were assessed using Spearman's rho correlation coefficients (ρ). Twenty-eight residents entered residency training between 2011 and 2017. The average rank position of the trainees during this study was 9.7 (range: 1-22). We found no significant correlation between rank order and faculty evaluation during PGY5 (ρ = 0.097, P = .625) or number of publications (ρ = -0.256, P = .189). Additionally, when assessing the association between rank order and annual Otolaryngology Training Examination-scaled scores, no statistically significant relationship was found between the 2 (P > .05). Our results showed that there were no significant correlations between OHNS rank order and various measures of success in residency training, which aligns with existing literature. Further investigation of this relationship should be conducted to ensure the applicability of our findings.

The Evolving Plastic Surgery Applicant: How Far Have We Come in 30 Years?

Plastic surgery training has undergone tremendous change and transitioned through many models over the years, including independent, combined, and integrated. This study evaluates how these changes and others have affected plastic surgery applicants' demographics and academic qualifications over the last 30 years. Data on applicant demographics and academic qualifications were extracted from multiple sources including the National Resident Matching Program, the American Association of Medical Colleges, and cross-sectional surveys of plastic surgery applicants for the years 1992, 2005, 2011, and 2022. Data were compared using pairwise χ2 goodness of fit tests. The sex distribution of plastic surgery applicants changed significantly over the last 30 years: whereas men predominated in 1992 (86% male vs 14% female), by 2011, the distribution was nearly equal (54% male vs 46% female in both 2011 and 2022, P < 0.001).The racial makeup of applicants also changed over time (P < 0.05). White applicants decreased from 73% in 1992 to 55% in 2011, and 53% in 2022. While there was an increase in Asian (7% to > 17% to > 20%) and other (13% to > 14% to > 21%) applicants over time, whereas the proportion of Black applicants remained stagnant (5% to > 6% to > 8%).Applicants with prior general surgery experience declined precipitously over the years: 96% in 1992, 64% in 2005, 37% in 2011, and 26% in 2022 (P < 0.001). When compared with 1992, Alpha Omega Alpha status increased significantly in 2011 (36% vs 12%, P < 0.05) but did not change considerably in 2005 (22%) and 2022 (23%). Research experience increased dramatically over the years, with the proportion of applicants with at least one publication going from 43% in 1992, to 75% in 2005, to 89% in 2011, and to 99% in 2022 (P < 0.001). Applicant interest in academic plastic surgery did not change considerably over the years at roughly ranging from 30% to 50% of applicants (P = ns). There has been a shift in the demographics and academic qualifications of plastic surgery applicants over the last 3 decades. Understanding this evolution is critical for reviewing and evaluating the makeup of our specialty, and enacting changes to increase representation where necessary.

Mapping of Aquifer Characteristics and Reservoir Protective Capacity Variation in Obafemi-Owode Local Government Area, Ogun State South-West Nigeria

Variation of Aquifer potential characteristics and its impacts on the groundwater subsurface protection of the aquiferous zone using electrical resistivity method was carried out at Obafemi-Owode Local Government Area, Ogun State South-West Nigeria with the principal purpose of assessing and rating aquifer protective capacity of the overburden units in the area. Twenty seven (27) vertical electrical sounding (VES) were conducted using Schlumberger configuration with the maximum electrode spacing of 100m at each point using Allied OMHEGA Resistivity meter. The data were interpreted using partial curve matching techniques and computer iteration program using WINRESIST. Parameters such as aquifer resistivity, aquifer thickness, overburden thickness, bedrock resistivity, reflection coefficient and longitudinal unit conductance were calculated and used for evaluating the groundwater yields and vulnerability of the aquiferous zone to contaminant seepages. The range of reflection coefficient is found to be between 0.02 and 0.98 while that of the protective capacity is between 0.00135 and 0.510. Groundwater potentials of the area were categorized as being high (overburden thickness 13m and reflection coefficient less than 0.8); medium (overburden thickness 13m and with reflection coefficient 0.8) and low (overburden thickness &lt; 13m and reflection coefficient. Also, the study area shows a very poor, poor, and moderate protective capacity rating. Seven (7) VES stations have very poor protective capacity, eighteen (18) VES stations shows poor protective capacity and only two (2) VES stations shows a moderate protective capacity rating. Since the illustration the longitudinal conductance revealed the impermeability of the confining layers which is generally ˂ 1.0 Siemens; values ˃1.0 Siemens which indicates zones in which the confined aquifer is subject to protection by the overlying formation materials; these revelations in the study area were possible indications that the groundwater quality status may have been impaired which necessitated the urgent need for the groundwater to be randomly...

Vascular In-person for Students In the match Trial: An investigation of postinterview site visits to address the limitations of virtual interviews

PurposeThe graduate medical education community implemented virtual residency interviews in response to travel restrictions during the COVID-19 pandemic, and this approach has persisted. Although many residency applicants wish to visit in-person prospective training sites, such opportunities could bias programs toward those who are able to meet this financial burden, exacerbating equity concerns. One proposed solution is to offer applicants the opportunity to visit only after a program’s rank list is “locked,” avoiding favoritism to applicants who visit, but allowing applicants to experience some of the camaraderie, geography, and local effects of an in-person visit. As debate about the optimal format of residency interviews continues, it is important to investigate whether in-person program visits, completed after program rank list certification, provide meaningful benefits to applicants in the residency match process. MethodsAll vascular programs entering the 2023 integrated vascular surgery residency match were invited to participate. Programs agreed to certify their National Resident Matching Program rank lists by February 1, 2023. Applicants then had the opportunity to visit the programs at which they interviewed. The particulars of the visit were determined by the individual programs. Applicants completed their standard rank list and locked on the standard date: March 1, 2023. Applicants then completed a survey regarding the impact of the visits on their rank order list decision-making. Program directors (PDs) completed a survey regarding their experiences as well. Data were collected using REDCap. ResultsTwenty-one of the 74 (28%) programs participated. Nineteen PDs completed the postinterview site visit survey (response rate 90%). Applicants interviewing at the participating programs (n = 112) were informed of the study, offered the opportunity to attend postinterview site visits, and received the survey. Forty-seven applicants responded (response rate 42%). Eighty-six percent of applicants stated that the visit impacted their rank list. Most important factors were esprit de corps of the program (86%), the faculty/trainees/staff (81%), and the physical setting (62%). Seventy-one percent of those participating spent ≤$800 on their visit. Eighty-one percent were satisfied with the process. Twenty-one percent of PDs would have changed their rank list if they could have based on the applicants’ in-person visit. Sixty-three percent of the visit sessions cost the programs ≤$500, and 63% were satisfied with the process. ConclusionsThis study is the first to document the impact of in-person site visits by applicants on a graduate medical education match process in one specialty. Our results suggest that this process provides meaningful data to applicants that helped them with their decision-making evidenced by most altering their rank lists, while avoiding some of the critical equity issues that accompany traditional in-person interviews. This may provide a model for future interview processes for residency programs.

Examining differences in trends in the orthopedic surgery match for osteopathic and allopathic medical graduates after the transition to single accreditation.

The landscape of medical education in the United States has undergone significant changes, particularly with the rise of osteopathic medical students, constituting a substantial portion of medical school entrants. The merger of the Accreditation Council for Graduate Medical Education (ACGME) and the American Osteopathic Association (AOA) in 2020 opened residency slots to allopathic graduates that were previously historically allocated to osteopathic (Doctor of Osteopathic Medicine [DO]) physicians. This has impacted various medical specialties, notably orthopedic surgery. Despite an increase in orthopedic surgery applicants, the match rates for DO candidates have faced challenges, raising concerns about the impact of this merger on the future of orthopedic training for DO students. This research aims to analyze the trends in orthopedic surgery match rates for DO vs MD applicants since the single accreditation merger, which began in 2015 with a 5-year transition period that was finalized by 2020. By examining factors such as application numbers, research output, standardized test scores, and program director preferences, the study seeks to identify disparities and challenges faced by DO applicants in securing orthopedic surgery residencies. This study utilized publicly available data from the National Residency Match Program (NRMP) 2018, 2020, and 2022 reports. Data encompassed applicant characteristics, including standardized test scores, research experiences, and match outcomes. The study also incorporated insights from NRMP program director surveys, focusing on interview and ranking practices. The analysis involved comparisons of application numbers, match rates, research productivity, and test scores between DO and MD applicants. Statistical analysis was employed to identify any statistically significant differences among the examined variables for the 3 years included in the study. The research revealed a consistent increase in orthopedic surgery applicants from both DO and MD backgrounds. However, MD applicants consistently had higher match rates compared to their DO counterparts, with the gap narrowing over the years. Notably, disparities persisted in research output, with MD applicants demonstrating a significant advantage in publications and presentations. Standardized test scores, although slightly higher for MD applicants, did not significantly impact the differences in match rates. MD applicants had statistically significantly higher numbers of applicants (P = .0010), number of publications (P = .0091), and number of research experiences (P = .0216) over the years examined. However, there was no statistically significant difference in the scores on Step 1 (P = .5038) or Step 2 (P = .4714) between MD and DO candidates. Despite progress in the acceptance and ranking of DO applicants by program directors, the study highlights enduring challenges in orthopedic surgery match rates between DO and MD candidates. The lack of research opportunities for DO students stands out as a crucial area for improvement, necessitating systemic changes within medical education. Addressing this disparity and ensuring equal access to research experiences could mitigate the gap in match rates, promoting a more equitable environment for all aspiring orthopedic surgeons, regardless of their medical background. Such efforts are vital to fostering inclusivity and enhancing opportunities for osteopathic medical students pursuing competitive specialties like orthopedic surgery.

Post-COVID Analysis of Which U.S. Medical Schools Produce the Most Neurosurgery Residents: 2021–2023 in Review

ObjectiveThe process surrounding application to the national residency matching program changed drastically because of COVID. Virtual interviews, pre-interview zoom socials, and limitations on sub-internships are major changes that applicants worldwide have had to overcome. The available literature does not reflect the impact of major changes to the interview process. Here, we examine the neurosurgery resident cohort from 2021-2023 to investigate differences between United States medical schools pre- and post-COVID. MethodsA database was constructed reporting the number of students matched to neurosurgery for U.S. medical schools (MD and DO) from 2021-2023. Percentage of total graduates matched to neurosurgery was calculated and institutions were ranked by this metric. This rank was compared to the rank reported by Antar et al in 2021. Variables were compared across the pre- and post-COVID cohorts. ResultsCase Western, Johns Hopkins, Mayo Clinic, Vanderbilt, University of Illinois and University of California San Francisco produced the most neurosurgical residents as a percentage of total graduates. There was a statistically significant difference in the post-COVID cohort between medical schools with a home program vs those without. For the top 20 ranked U.S. News medical schools, there was a statistically insignificant increase in the number of graduates matched to neurosurgery ConclusionsWith the data provided, there have not been many significant changes in which medical schools produce the most neurosurgery residents since COVID changes were implemented. The playing field has remained relatively the same in the setting of major changes that were made.

"Cold feet": A qualitative study of medical students who seriously considered emergency medicine but chose another specialty.

Emergency medicine (EM) has historically been among the most competitive specialties in the United States. However, in 2022 and 2023, 219 of 2921 and 554 of 3010 respective National Resident Matching Program positions were initially unfilled. Medical students' selection of a medical specialty is a complex process. To better understand recent trends in the EM residency match, this qualitative study explored through one-on-one interviews the rationale of senior medical students who seriously considered EM but ultimately pursued another specialty. A convenience sample of senior medical students from across the United States was recruited via multiple mechanisms after the 2023 match. Participant characteristics were collected via an online survey. Qualitative data were generated through a series of one-on-one semistructured interviews and thematic analysis of the data was performed using a constant comparative approach. Sixteen senior medical students from 12 different institutions participated in the study. Thematic saturation was reached after 12 interviews but data from all 16 interviews were included for qualitative analyses. Five major themes emerged as important in students' consideration but ultimate rejection of EM as a career: (1) innate features of EM attracted or dissuaded students, (2) widespread awareness of a recent workforce report, (3) burnout in EM, (4) their perception of EM's standing in the health care landscape, and (5) early EM experience and exposure. This qualitative study identified five major themes in the career decisions of senior medical students who seriously considered EM but chose another specialty. These findings may help inform the perceptions of students and guide future EM recruitment efforts.

"Home Field Advantage": The Presence of a "Home" Neurosurgical Residency Training Program is Associated With Improved Match Outcomes.

Competition for neurosurgical residency training positions remains fierce. The support provided by applicants' home neurosurgery residency training programs (NRTP) is suspected to play a key role in the National Resident Matching Program (NRMP) process. We sought to evaluate the impact of the presence of an Accreditation Council for Graduate Medical Education-accredited NRTP at medical students' home institutions has on NRMP match outcomes. Our cross-sectional observational study examined all US allopathic senior student Electronic Residency Application Service applications to a single NRTP from 2016 to 2022. We analyzed a total of 1650 Electronic Residency Application Service applications to a single NRTP, of which 1432 (86.8%) were from schools with an Accreditation Council for Graduate Medical Education-accredited NRTP (NRTP+) and 218 (13.2%) were from schools without a residency (NRTP-). NRTP+ applicants matched a higher rate on both pooled analysis (80.8% vs 71.6%, P = .002) and paired analysis ( P = .02) over the seven-cycle study period. This difference was present before (82.4% vs 73.9%, P = .01) and after (77.2% vs 65.6%, P = .046) the COVID-19 pandemic. Cohorts were overall similar; however, NRTP+ applicants had more publication experiences (19.6 ± 19.0 vs 13.1 ± 10.2, P < .001) and were more likely to complete a research gap year (RGY) (25.8% vs 17.0%, P = .004). Completing a RGY was associated with an increased likelihood of matching for NRTP+ applicants but not for NRTP- applicants: NRTP+: 84.9% vs 78.1% ( P = .0056); NRTP-: 70.3% vs 70.9% ( P = .94). The presence of a NRTP at a medical student's home institution is associated with improved NRMP match outcomes. This held true both before and after the COVID-19 pandemic. Applicants from schools with a NRTP had more publication experiences and were more likely to complete a RGY. Completion of a RGY is associated with an increased likelihood of matching only for students with an affiliated NRTP.

SPARKing New Insight Into Autism Across the Lifespan.

Autism is heterogeneous at many levels, including clinical symptoms and etiology. A key strategy in studying heterogeneous conditions is having large enough sample sizes to stratify into smaller groups that are more homogeneous. SPARK and Simons Searchlight are large and growing research cohorts of individuals with autism in the United States and individuals with genetically defined neurodevelopmental conditions around the world, respectively. They both provide freely available phenotypic and genotypic data with the ability to re-contact participants through the research match program. Deep dives into each gene in Searchlight provide comprehensive natural history data to understand the differing clinical courses to inform proper clinical care, and work toward treatment for each condition. Moreover, pilots of genetically based newborn screening programs for neurogenetic disorders can provide opportunities for equitable and early diagnosis to try to improve outcomes with earlier interventions.