Unmatched Applicants Research Articles

Analysis of Reapplications to Integrated and Independent Plastic Surgery Residency.

Background:Plastic surgery is one of the most competitive specialties to match, with integrated plastic surgery having the highest rate of unmatched applicants in all categorical specialties. Unmatched applicants face difficult challenges, especially because there is a lack of data to help inform and guide both reapplicants and their advisors.Method:A national survey targeting plastic surgery applicants to both integrated and independent tracks from 2014 to 2020 was conducted in August 2020 to identify reapplicants, their application characteristics, and their outcomes.Results:Eighteen of the 54 (33.3%) integrated reapplicants responded to the survey, as well as 7 of the 42 (16.7%) independent reapplicants. Fifty percent of integrated reapplicants and 43% of independent reapplicants successfully eventually matched. For integrated reapplicants, the mean (SD) number of first cycle invites was the greatest predictor of eventual match success, 9.00 (5.93) invites for reapplicants that eventually successfully matched compared with 2.89 (2.89) for those that remained unmatched, P = 0.025. Integrated reapplicants obtained on average 2.47 less invites during the reapplicant cycle compared with the initial cycle, P = 0.046. A Fisher exact test revealed no differences in match outcomes of those integrated reapplicants who spent time in between cycles pursuing research compared with a preliminary surgical year, P = 0.99.Conclusions:Reapplication to both integrated and independent plastic surgery may result in worse matching outcomes compared with the initial match. Applicants should attempt to preemptively address potential initial application weaknesses as reapplication after a failed initial attempt may carry disadvantages.

Predictors of otolaryngology applicant success using the Texas STAR database.

ObjectivesTo examine applicant characteristics and behaviors associated with a successful match into otolaryngology residency.MethodsSelf‐reported survey data from applicants to otolaryngology residency between 2018 and 2020 were obtained from the Texas STAR database. Characteristics and predictors associated with a successful match were examined using Chi‐square tests, two‐sided t‐tests, and logistic regression models.ResultsA total of 315 otolaryngology residency applicants responded to the survey of whom 274 matched (87%) and 41 did not match (13%). Matched applicants had a significantly higher mean USMLE Step 1 score (P = .016) and Step 2 CK score (P = .007). There were no significant differences in AOA status (45% vs 36%; P = .207), mean number of applications submitted (70 vs 69; P = .544), and mean number of away rotations (2.1 vs 2.0; P = .687) between matched and unmatched applicants. Significant predictors of a successful match included receiving honors in 5 or more clerkships (OR 2.0, 95% CI 1.0‐4.0; P = .040), receiving honors in an ENT clerkship (OR 3.7, 95% CI 1.0‐12.9; P = .044), and having 3 or more peer‐reviewed publications (OR 2.3, 95% CI 1.1‐4.5; P = .020). The majority of applicants (79.9%) matched at a program where they either did an away rotation, had a personal geographic connection, or attended medical school in the same geographic region.ConclusionsBoard scores, excelling on clinical rotations, and having productive research experience appear to be strong predictors of a successful match in otolaryngology. The majority of applicants report a personal or geographic connection to the program at which they match.Level of evidence4.

Trends in the Physical Medicine and Rehabilitation Match: Analysis of NRMP Data from 2007 to 2018.

We provide an updated analysis of data about U.S. Physical Medicine and Rehabilitation (PM&R) residency program applicants collected by the National Resident Matching Program (NRMP). Analyze trends within NRMP data for PM&R residency match rates, compare matched to unmatched applicants, and compare PM&R applicants to other medical specialties. Secondary analysis of NRMP data. NRMP data set. Residency program applicants who participated in the NRMP Match, 2007 to 2018. Not applicable. Number of applicants, match rates, difference in characteristics including rank order list (ROL), U.S. Medical Licensing Examination (USMLE) Step 1 and Step 2 Clinical Knowledge (CK) scores, publications, Alpha Omega Alpha (AOA) status, PhD degree, and experiences in research, volunteer, and work. Number of applicants and residency positions increased from 2007 to 2018. Length of ROL increased and was longer for matched compared to unmatched applicants, with maximum mean difference of 7.4 in 2016 (95% confidence interval [CI] 5.6-9.2). Matched U.S. Allopathic Seniors had higher USMLE scores compared to unmatched, with a mean difference of 12.7 for Step 1 (95% CI 8.3-17.0) and 12.6 (95% CI 8.6-16.6) for Step 2 CK (P< .001). Number of publications and volunteer experiences were higher for matched U.S. Allopathic Seniors (0.64, 95% CI 0.09-1.2 and 1.5, 95% CI 0.65-2.3, respectively). PM&R USMLE Step 1 and 2 CK scores increased at a significantly faster rate than for all other specialties, with estimated rate differences of 0.46 (95% CI 0.21-0.71) and 0.69 (95% CI 0.45-0.93) points per year, respectively. PM&R residency has become more competitive. USMLE Step 1 and 2 CK scores have outpaced the inflation of scores in other specialties. ROL length has increased, suggesting more ranked programs to successfully match. These analyses update our knowledge about PM&R residency applicants and suggest surrogate markers for a successful match.

Gender-Based Differences in Urology Residency Applicant Personal Statements

ObjectiveTo gain insight into the perceptions of urology held by medical students as they enter the field, we analyzed the linguistic characteristics and gender differences in personal statements written by urology residency program applicants.MethodsPersonal statements were abstracted from residency applications to a urology residency program. Linguistic Inquiry and Word Count, a validated text analysis software, characterized the linguistic content of the statements. Analyzed statements were compared according to gender of the applicant using multivariate analysis, examining the association of applicant gender and statement characteristics. Multivariate analysis was also performed to determine the association of personal statement characteristics with matching into urology residency.ResultsOf 342 analyzed personal statements, no significant difference was found in statement characteristics between matched and unmatched applicants. Male and female applicants wrote with the same degree of overall analytical thinking, authenticity, and emotional tone. Clout, a measure of portrayed confidence, was low for both genders. Female applicants used more social and affective process words. Male applicants used more words indicating a sense of community and acceptance. Female applicants had more references to women within their statements.ConclusionSignificant linguistic differences exist among personal statements written by men and women applying to urology residency. Word usage differences follow societal gender norms. Statement content demonstrates a difference between genders in perceived sense of belonging, highlighting the importance of gender concordant mentorship within the field.

PubMed-Indexed Research Productivity of Students Matching at Top Urology Programs: 2017-2020

To evaluate the number of PubMed-indexed research projects of medical students matching at top-ranked urology programs as compared to the average publications reported in the Electronic Residency Applicant Service (ERAS). Doximity Residency Navigator was used to generate the top 50 residency programs when sorted by reputation. Residents were then found using program websites. PubMed was queried for peer-reviewed publications of incoming interns through post graduate year 3 residents as of February 2020. All PubMed-indexed research was recorded before September 15th of the residents' fourth year of medical school. We recorded the number of publications, first/last author publications, and urology-specific publications. The average number of publications across all 4 years was 2.38 ± 4.19. The average for urology-specific publications was 1.05 ± 3.19 and for first/last author publications was 0.80 ± 1.77. Most matched applicants had at least one PubMed-indexed publication (61.2%) and having over 3 placed them in the 75th percentile. It is uncommon for students to have urology specific or first/last author publications (34.0%, 36.5%). Top 10 programs matched applicants with significantly more research in each of the aforementioned categories and as program reputation declined, so did the publications of the applicants they matched. Most research that matched urology applicant's report in ERAS is not PubMed Indexed. Most had at least one PubMed-indexed publication by the time they submitted ERAS and those at top programs had more. It would be helpful to students and faculty advisors if ERAS published research metrics for matched and unmatched applicants separating PubMed-indexed work from posters and presentations.

The pediatric surgery match by the numbers: Defining the successful application

BackgroundPediatric surgery remains the most competitive general surgery subspecialty. The authors suspected significant inflation in academic metrics since the last published paper. This study aimed to identify factors associated with applicant success in the match. MethodsAfter IRB approval, all applications to a single accredited pediatric surgery fellowship program were reviewed for match years 2014–2018. Matched and unmatched applicants were compared in an unadjusted and adjusted analysis. ResultsThis training program received 414 of 425 total applications (97%). Match results were available for 388 (94%). Matched applicants were more likely to train in programs with pediatric surgery fellowships (64% vs. 28%) and to have dedicated research time (55% vs. 21%; all p < 0.01). Matched applicants had more total publications (median: 12 vs. 7, p < 0.01) and higher ABSITE scores (median: 64th vs. 59th percentile, p < 0.01). Training in multiple programs negatively impacted the chance to match (p < 0.01). The median number of publications per applicant increased over the study time period from 7 to 11 (p < 0.01). ConclusionsThe likelihood of matching into a pediatric surgery fellowship was related to the type of residency attended, dedicated research time, ABSITE scores, and number of publications. Overall, the total number of publications reported by all applicants increased. Type of StudyRetrospective Comparative Study. Level of EvidenceLevel III.

2019 musculoskeletal radiology fellowship match process: initial experiences and lessons learned.

To present the 2019 Musculoskeletal (MSK) fellowship Match information most useful to MSK fellowship programs and sections in hopes of optimizing the fellowship application and selection process for MSK fellowship applicants and training programs. We performed a mixed method analysis to gain a better understanding of the 2019 MSK Fellowship Match process. First, we distributed a ten-question survey to the fellowship leadership from the 78 US fellowship programs registered with the Society of Skeletal Radiology. Second, we collected and reviewed NRMP Match data that were distributed on Match Day. We received completed surveys from 37 (45.7%) programs. Thirty-three (89.2%) of the responding programs identified themselves as academic, 3 (8.1%) as hybrid, and 1 (2.7%) as private practice. On average, programs interviewed 15.4 applicants over the interview session, with a range between 2 and 40. There was an average of 2.7 (range 1-8) open positions per fellowship and 1.2 (range 0-4) internal candidates per program. Each program interviewed 5.8 applicants per open position (range 1-24). There were a total of 81 certified MSK fellowship programs and 204 available positions in these programs. Twenty-four programs (29.6%) did not fill all positions resulting in a total of 36 unfilled positions (17.6%). The percentage of MSK unfilled programs, unfilled positions, and unmatched applicants were comparable to the Breast Imaging and Neuroradiology subspecialty matches. The MSK Fellowship Match was a success with high match rates for applicants and programs. Most importantly, the Match allowed programs to make more informed decisions on their fellowship training opportunities.

How the Reputation of Orthopaedic Residency Programs Is Associated with Orthopaedic Fellowship Match Results.

The primary goal of the present study was to determine if applicants from higher-ranking U.S. orthopaedic surgery residency programs match at a more desired position on their fellowship match-rank list compared with those applicants from lower-ranked residency programs. San Francisco Match provided results regarding applicant data and match results from 2014 to 2018 for all orthopaedic subspecialties except the hand and the shoulder and elbow. Unmatched applicants and international medical graduates were excluded. Residency programs were divided into 5 tiers (with tier 1 being the highest-ranked residency programs and tier 5 being the lowest-ranked programs) on the basis of 2018 Doximity rankings of orthopaedic residency programs. Statistical analysis consisted of descriptive statistics, chi-square tests, and analysis of variance. Two thousand eight hundred and eleven applicants met inclusion criteria. Applicants from residency programs in tiers 1 and 2 applied to significantly fewer programs than those from tiers 3, 4, or 5 (p < 0.0001). Applicants from each tier were significantly more likely to attain interviews than applicants from all tiers below them (p < 0.01). Applicants from tier-1 residency programs matched at a significantly higher position on their rank list (p < 0.001) and were more desirably ranked by fellowship programs (p = 0.003) compared with all other tiers. Applicants from the highest-ranking residency programs apply to fewer programs, interview at a greater percentage of these programs, and are more likely to match to 1 of their top-ranking programs than applicants from lower-ranking programs. However, the association of the applicant match position with the program ranking appears to be most pronounced when it comes to fellowships selecting which applicants to interview. These findings may help future applicants when determining which programs to apply to during the match.

The Fate of Unmatched Orthopaedic Applicants: Risk Factors and Outcomes.

Introduction:Orthopaedic surgery residency has become increasingly competitive for medical school applicants with at least one in five applicants not matching annually. For unmatched applicants, the new application cycle is a perplexing and disconcerting period, where unique decisions must be addressed by the applicant. We aimed to investigate the risk factors and outcomes of unmatched orthopaedic applicants.Methods:This was a retrospective study using a survey-based questionnaire administered electronically to medical students annually from 2016 to 2019 immediately after match day. Applicant responses totaled 934 completed surveys, of which 81 identified themselves as unmatched from the previous year and reapplied for a subsequent cycle. Variables collected through the survey included demographics, United States Medical Licensing Examination scores, Electronic Residency Application Service application characteristics, and interim year pursuits. A univariate analysis was performed with an alpha level of 0.05 denoting statistical significance.Results:Overall, 58.0% of unmatched applicants subsequently matched into an orthopaedic residency. Applicants who pursued a research year or surgical internship after initially not matching had a subsequent match rate of 52.1% and 64.0%, respectively (p = 0.46). Of those who matched, 19.1% were Alpha Omega Alpha (AOA) compared with 2.9% in the unmatched group (p = 0.04). When stratified by gender, 83.3% of women matched subsequently compared with 50.8% of men (p = 0.02). There were no differences in Step 1 scores (242.5 vs. 240.7, p = 0.60), Step 2 clinical knowledge (CK) scores (248.3 vs. 244.5, p = 0.60), or the number of publications (15.6 vs. 10.9, p = 0.25) between applicants who matched or did not match, respectively.Discussion:Our findings demonstrate that most orthopaedic applicants matched during their subsequent attempt. Women and those with AOA status had a significantly higher match rate than their counterparts. There was no difference in outcomes between those who pursued a research year or surgical internship, Step 1 or 2CK scores, or the number of publications. Further study is warranted to properly analyze risk factors for not matching on a subsequent attempt.Level of Evidence:Prognostic Level IV.

Evaluating the Influence of Research on Match Success for Osteopathic and Allopathic Applicants to Residency Programs.

Analyzing factors that may enhance osteopathic applicants' likelihood of matching is warranted given that United States osteopathic and allopathic residency programs will have a single accreditation system in 2020. To determine the impact of research accomplishments and experiences on osteopathic and allopathic residency matching. Analysis of variance, t test, and odds ratios were used to examine data from the National Resident Matching Program Charting Outcomes from 2016 and 2018. Relationships between match status and medical degree, specialty matching, and mean numbers of research accomplishments and experiences in the Main Residency Match were analyzed. Matched osteopathic and allopathic applicants had significantly greater numbers of research accomplishments (mean [SD], 5.18 [4.34]) than unmatched applicants (3.66 [2.87]) (P=.006). Applicants who matched (mean [SD], 2.81 [1.64]) had similar numbers of research experiences to those who did not match (2.43 [1.26]) (P=.068). Matched and unmatched allopathic applicants' research accomplishments (5.91 [3.72]) were significantly greater than that of osteopathic applicants (2.60 [2.90]) (P<.001). Significant differences also were found between the means of research experiences of matched and unmatched osteopathic (mean [SD], 1.73 [1.21]) and allopathic applicants (3.36 [1.25], P<.001). Matched and unmatched osteopathic applicants' had similar means for research accomplishments (mean [SD], 3.00 [3.64] and 2.20 [1.84], respectively; P=.242) and experiences (1.79 [1.31] and 1.66 [1.12], respectively; P=.664). By contrast, significant differences were found between the numbers of research accomplishments for matched (mean [SD], 6.97 [4.07]) vs unmatched (4.86 [3.02]) allopathic applicants (P=.007). The only subspecialty for which research experiences of osteopathic applicants correlated with matching was physical medicine and rehabilitation (OR, 2.75; 95% CI, 1.30-5.84). Research seems to have a greater influence on matching for allopathic than osteopathic applicants. Although both osteopathic and allopathic programs have standards pertaining to scholarly activity, allopathic medical schools may place a greater emphasis on research. Increasing osteopathic medical students' exposure to research is predicted to enhance their competitiveness for matching and help develop skills relevant to the practice of evidence-based medicine.

EP match

The recent National Residency Matching Program (referred to as “the Match”’) for clinical cardiac electrophysiology (CCEP) fellowship did not end as many had hoped, with more than half of all programs having slots left unfilled. Around 1 of 10 applicants who participated in the Match was not matched with one of their selected programs. We do not know the results of the “scramble” that occurred among those 8 unmatched applicants, but we assume that they were able to secure an unfilled position. There are several reasons for the Match findings that are important to reflect on.

Is Psychiatry’s Popularity Rising Among U.S. Med School Seniors?

Is Psychiatry’s Popularity Rising Among U.S. Med School Seniors?

Outcomes in the Orthopaedic Sports Medicine Fellowship Match, 2010-2017.

Background:Sports medicine is one of the most competitive fellowships in orthopaedic surgery. Despite its popularity, fellowship applicants have limited understanding of the orthopaedic sports medicine fellowship match process.Purpose:To define key outcomes in the orthopaedic sports medicine fellowship match, including the overall match rate, number of programs filled, and number of applicants ranked by programs that filled between 2010 and 2017.Study Design:Cross-sectional study.Methods:This study utilized data regarding the orthopaedic sports medicine fellowship match collected by the American Orthopaedic Society for Sports Medicine (AOSSM) from 2010 through 2017. Applicant data included number of applicants, number of matched and unmatched applicants, and percentage of applicants matching into their top choices. Fellowship program data included number of programs participating in the match and number of applicants ranked by filled and unfilled programs.Results:Between 2010 and 2017, the mean number of orthopaedic sports medicine fellowship applicants was 244.8. On average, 92.0% of applicants matched into a fellowship program. The mean number of programs participating in the fellowship match was 92.9, with a mean of 219.9 accredited positions and 5.4 nonaccredited positions. Over the time period studied, a mean of 75.8% of programs matched all available positions. Programs that matched fully ranked 9.0 applicants per position, on average, compared with a mean of 6.5 applicants ranked per position among programs that did not fully match (P = .0016).Conclusion:From 2010 to 2017, the number of applicants, positions available, overall match rate, and number of programs participating in the orthopaedic sports medicine fellowship match have remained consistent. The mean number of applicants per position ranked by fully matched fellowship programs was 9.0 compared with a mean of 6.5 applicants per position ranked by programs that did not fully match. These data may be helpful as we look to the future of orthopaedic sports medicine fellowship positions and the match process. In addition, this study reveals characteristics that divide sports medicine fellowship programs that fully match from those that do not. Applicants and/or fellowship program directors may utilize this information to modify their approach to the match process going forward.

Unmatched Integrated Cardiothoracic Surgery Program Applicants: Where Do They End Up?

With the recent introduction of Integrated Cardiothoracic Surgery Residency Programs (IPs), limited data exist on unmatched applicants. We aimed to determine the dropout rate in individuals who applied for IP but did not match. An online Institutional Review Board-approved survey was sent to current residents (n= 409), provided by the Thoracic Surgery Directors Association, toevaluate preferences and pathway to cardiothoracic surgery (CTS). Descriptive analysis was performed on quantitative data. Main Residency Match Data from 2008 to 2017 were collected. Of 250 respondents, 89 (36%) were in IPs. In the cohort, 110 (44%) applied for at least one IP, whereas only 10 of the remaining 140 CTS residents had contemplated applying. From written comments of those 140 residents, the most common reasons against applying for IP programs were (1) uncertainty of IP training/belief that general surgery offered more well-rounded training and (2) uncommitted to CTS as a medical student. Interestingly, 96% of IP residents were set on a cardiac career, whereas a larger proportion of 4/3 and traditional residents were interested in general thoracic (36%). According to the National Resident Matching Program, 147 individuals applied to IP programs from 2008 to 2011 and were unmatched. Only 20 of those individuals (14%), from our results, ended up in a CTS residency program. Only a small percentage of applicants that did not match to an IP from 2008 to 2011 have ended up in CTS. As IPs continue to develop and improve, the concerns brought about by current CTS residents must be addressed to attract the next generation of exceptional surgeons.

Key Word Use in Letters of Recommendation for Ophthalmology Residency Applicants According to Race, Gender, and Achievements

Objectives To identify differences in letters of recommendation (LORs) of applicants to a single ophthalmology residency program by gender, race, academic performance, and match outcome. Design This was a retrospective analysis of LORS for 2,523 applicants (7,569 letters) to the University of California, Irvine ophthalmology residency program from 2011 to 2018. Methods Programming scripts were employed to determine the number of times 22 key words from four thematic categories (standout words, ability, grindstone, and compassion) appeared in LORs for each applicant. A chi-square test was performed to assess for possible differences in the presence of each key word by the following characteristics: gender, underrepresented minority (URM) status, Alpha Omega Alpha (AOA) membership, the United States Medical Licensing Exam (USMLE) Step 1 score, and match outcome. Linear regressions were created to determine the frequency at which words in each thematic category appeared according to the same baseline characteristics. Results In the LORs, females were more likely to be described as “empathetic” (p = 0.002), URMs were more likely to be described as “caring” (p = 0.002), high Step 1 scorers (≥240) were more likely to be described as “outstanding” (p = 0.002), and matched students were more likely to be described as “exceptional” (p = 0.001), “outstanding” (p &lt; 0.001), and “superb” (p = 0.001). Standout words appeared more often in the LORs of AOA members, matched candidates, and high Step 1 scorers (p &lt; 0.001 for all comparisons). “Competent” appeared more commonly in LORs for low Step 1 scorers (p &lt; 0.001) and unmatched applicants (p = 0.001). Conclusion This study identifies differences in LORs by gender, URM status, and achievement including successful ophthalmology residency match. Females and URMs were more likely to be described as “empathetic” and “caring,” respectively; otherwise, we detected no gender or racial disparities in key word use in LORs. Candidates with high USMLE Step 1 scores or AOA membership had a higher frequency of standout words in their LORs. Whether they were truly more qualified in various dimensions or if they benefited from a halo effect bias warrants further investigation. There was a significant difference in the number of standout words in LORs between matched and unmatched applicants, suggesting that key word frequency may be a relevant metric for LOR appraisal.

Laparoscopic skills assessment: an additional modality for pediatric surgery fellowship selection

AimThe Pediatric Surgery fellow selection is a multi-layered process which has not included assessment of surgical dexterity. Materials and methodsData was collected prospectively as part of the 2016 Pediatric Surgery Match interview process. Applicants completed a questionnaire to document laparoscopic experience and fine motor skills activities. Actual laparoscopic skills were assessed using a simulator. Time to complete an intracorporeal knot was tabulated. An initial rank list was formulated based only on the ERAS application and interview scores. The rank list was re-formulated following the laparoscopic assessment. Un-paired T-test and regression were utilized to analyze the data. ResultsForty applicants were interviewed with 18 matched (45%). The mean knot tying time was 201.31s for matched and 202.35s for unmatched applicants. Playing a musical instrument correlated with faster knot tying (p=0.03). No correlation was identified between knot tying time and either video game experience (p=0.4) or passing the FLS exam (p=0.78). Laparoscopic skills assessment lead to significant reordering of rank list (p=0.01). ConclusionsLaparoscopic skills performance significantly impacted ranking. Playing a musical instrument correlated with faster knot tying. No correlation was identified between laparoscopic performance and passing the FLS exam or other activities traditionally believed to improve technical ability. Type of studyProspective study. Level of evidenceLevel II.

Personality traits within a pediatric surgery fellowship applicant pool

BackgroundThe Big Five framework examines five factors that represent a description of human personality. These factors correlate with success measures and job satisfaction. The Big Five Inventory is a 44-item instrument designed to measure the Big Five framework. Our aim was to document the distribution of Big Five personality traits among Pediatric Surgery fellowship applicants, compare with community norms, surgical residents, between genders, and correlate to the fellowship match results. Materials and methodsForty Pediatric Surgery fellowship applicants at a university hospital completed the Big Five Inventory during the interview process. It was analyzed and compared with general surgery residents' results and community norms. The data were compared regarding gender and match results. Continuous variables were compared by unpaired t-tests and Mann–Whitney tests. A P value <0.05 was considered significant. ResultsThe 40 applicants were equally divided between male and female. When compared with general surgery residents and community norms, applicants of both genders scored higher on agreeableness (P < 0.01), conscientiousness (P < 0.01), and emotional stability (P < 0.01). Applicants scored higher on openness when compared with surgical residents (P < 0.01). Male applicants scored higher on emotional stability than females (P = 0.026). Matched applicants scored higher for conscientiousness than unmatched applicants (P = 0.016). ConclusionsPediatric Surgery fellowship applicants expressed higher levels of desirable professional traits compared with general surgery residents and community norms. Male applicants demonstrated higher emotional stability than females. Conscientiousness was higher in matching applicants. This first reported experience with personality testing in Pediatric Surgery fellow selection demonstrated potential utility in applicant matching.

SU‐F‐P‐16: Improving the MedPhys Match and Interview Process: Results From An Independent Survey of Applicants and Programs

Purpose:To provide recommendations from applicants and program directors on improving the Medical Physics Residency Matching Program (the “MedPhys” Match) and the associated interview process.Methods:A survey gauging interview and match experience was emailed to all applicants and program directors registered for the inaugural 2014/15 MedPhys Match. Detailed questions included satisfaction with the match experience, logistics and cost of interviewing for applicants, and specific suggestions to improve the match.Results:109 out of 402 applicants and 42 out of 77 programs completed the surveys. Of these applicants, 92 submitted rankings and 52 matched. 77% of matched applicants and only 7% of unmatched applicants were satisfied with the experience. Generally, 15% of applicants stated that the match needs no improvement, while 79% stated that it could use minor or major improvement. Primary suggestions from applicants included coordination of interviews into geographic regions and a fixed date by which interview invitations/dates are announced. 98% of programs were satisfied with the experience, with 75% stating that no improvements are needed, and 25% stating that the match could use minor improvement. Suggestions from programs included coordination of interviews in geographic locations, an earlier match date, and quicker turnaround on offer acceptances.Conclusion:Overall, matched applicants were satisfied and programs were very satisfied with the match experience. It is unclear whether the dissatisfaction among unmatched applicants is largely attributable to the process itself or to the fact that they may be shut out of the board certification process. Since a majority (79%) of applicants but only a minority (25%) of programs felt that the current match requires minor or major improvement, our applicants should be considered a valuable source of suggestions for improvement. Addressing these concerns early on may lead to more transparency and an improved experience for applicants and programs.

Analysis of Unmatched Orthopaedic Residency Applicants: Options After the Match.

Orthopaedic surgery is one of the most competitive specialties, resulting in many applicants going unmatched. Many unmatched applicants pursue a preliminary internship or research fellowship, but whether these activities make them more successful in subsequent match cycles has not been studied. To determine the effectiveness of activities during the intervening period on match success in a subsequent cycle. After reviewing rank order lists for our program and National Resident Matching Program correspondence from 1994 to 2013, we identified 198 of 1216 ranked applicants (16.3%) who did not initially match. Of these, 57 applicants who matched through the Supplemental Offer and Acceptance Program did not reapply to orthopaedics or trained overseas. Of 141 reapplicants, 56 matched into orthopaedic surgery, with 87.5% (P < .001) matching at a program in the same region where they had either completed their medical degree or postgraduate year, and 37.5% matching at their home institution (P < .001). Successful reapplicants after a research fellowship had a significantly higher number of publications than unsuccessful reapplicants (P < .05). There was no significant difference in success after research or internship (P = .80) and no significant difference in success rates for US versus international reapplicants (P = .43). Success of reapplication into orthopaedic surgery may be less dependent on the route taken during the interim period, and more dependent on developing relationships with faculty at a local or regional institution.

Understanding the Interview and Ranking Behaviors of Unmatched International Medical Students and Graduates in the 2013 Main Residency Match.

Over the past decade, the number of unfilled positions in the National Resident Matching Program (NRMP) Main Residency Match has declined by one-third, while the number of unmatched applicants has grown by more than 50%, largely due to a rise in the number of international medical school students and graduates (IMGs). Although only half of IMG participants historically have matched to a first-year position, the Match experiences of unmatched IMGs have not been studied. We examined differences in interview and ranking behaviors between matched and unmatched IMGs participating in the 2013 Match and explored strategic errors made by unmatched IMGs when creating rank order lists. Rank order lists of IMGs who failed to match were analyzed in conjunction with their United States Medical Licensing Examination (USMLE) Step 1 scores and responses on the 2013 NRMP Applicant Survey. IMGs were categorized as "strong," "solid," "marginal," or "weak" based on the perceived competitiveness of their USMLE Step 1 scores compared to other IMG applicants who matched in the same specialty. We examined ranking preferences and strategies by Match outcome. Most unmatched IMGs were categorized as "marginal" or "weak". However, unmatched IMGs who were non-US citizens presented more competitive USMLE Step 1 scores compared to unmatched IMGs who were US citizens. Unmatched IMGs were more likely than matched IMGs to rank programs at which they did not interview and to rank programs based on their perceived likelihood of matching. The interview and ranking behaviors of IMGs can have far-reaching consequences on their Match experience and outcomes.