Increasing lengths of rank order lists of applicants and programs of US medical residencies

Background To match medical students into residency training programs, both the program and student create rank order lists (ROLs). We aim to investigate temporal trends in ROL lengths across 7 match cycles between 2014 and 2021 for both matched and unmatched residency applicants and programs. Methods retrospective study of ROLs of 7 match cycles, 2014-2021. Residency match and ROL data were extracted from the NRMP database to assess the number of programs filled and unfilled, length of ROLs, position matched, and average ranks per position for osteopathic (DO) and allopathic (MD) medical programs. Results For filled residency programs, the average ROL length consistently increased from 70.72 in 2015 to 88.73 in 2021 ( P = .003), with ROL lengths consistently longer for filled vs unfilled residency programs ( P < .001). The average ROL length for matched applicants increased consistently from 10.41 in 2015 to 12.35 in 2021 ( P = .002), with matched applicants having consistently longer ROLs than unmatched applicants ( P < .001). From 2015 to 2021, in both MD and DO applicants, progressively lower proportions of applicants matched their first and second choices. Conclusion Trends across the past 7 residency match cycles suggest that ROL lengths for both programs and applicants have been increasing with matched programs and applicants submitting significantly longer ROLs than unmatched applicants. Additionally, fewer applicants are matching at their preferred programs over time. Our findings support the mounting evidence that the Match has become increasingly congested and we discuss the possible factors that may be contributing to the current state of the Match as well as potential solutions.

Shifting the Surgical Residency Match to a 100% Virtual Interview Format During the COVID-19 Pandemic, How has It Affected Placement Into Surgical Training Programs?

Introduction The AAMC transitioned to virtual interview formats for the 2020-2021 residency match. This study aims to examine the impact of the 100% virtual interview format for the 2020-2021 residency match on both application and match changes for multiple surgical specialties, including neurosurgery (NS), orthopedic surgery (OS), plastic surgery (PS), general surgery (GS), thoracic surgery (TS), and vascular surgery (VS). Methods Cross-sectional study comparing application and match changes between the in-person 2019-2020 and virtual 2020-2021 residency match cycles for different surgical specialties. Results There was an overall increase in the number of applicants for 5 of the surgery specialties but not VS, and an overall increase in the number of applications per residency program across all specialties. The average number of applications per applicant also increased, except in TS. There were no major match changes except in TS, which saw an increase in number of spots filled by MDs to nearly 100% from 84.2% in the previous cycle. Conclusion The switch to the 100% virtual 2020-2021 residency match interview format was associated with an overall increase in the number of applications per program and number of applications per applicant across multiple surgical specialties. There was a decrease in the number of applicants to VS and an increase in the number of applications per applicant. The switch to a virtual interview format in 2020-2021 was also associated with an increase in TS spots filled by MDs to almost 98%, increasing the already concerning TS match disparity for DO and IMG applicants.

15 2020 CaRMS Residency Match Confirms Popularity of Pediatrics

Primary Subject area Medical Education Background Longitudinal data about the interest in, and competitiveness of, pediatric postgraduate training in Canada has not been reported. Objectives 1. To describe the results of the 2020 CaRMS pediatric residency match with respect to application rates, first-choice discipline choices, and succesful match rates by gender. 2. To examine the trend of these indices over the past decade. Design/Methods Data from the 2020 Canadian Residency Matching Service (CaRMS) pediatric residency match was evaluated and compared over the past decade. Residency match data from other programs was also used for some comparison reporting. Results Of a total pool of 2998 Canadian medical graduate (CMG) applicants in 2020, 305 (10.2%) applied to pediatrics, and 17 of these latter applicants (5.6%) applied solely to pediatrics. In the first iteration CaRMS match, pediatrics was the first-choice discipline for 177 CMG applicants (6.0% of all first choices). Pediatrics has been consistent as a first-choice discipline over the years: 5.9% (2017), 5.5% (2015), and 6.1% (2013). Of the 155 first-year positions offered in pediatrics this year, all were filled. Of those CMGs who matched to pediatrics in 2020, the specialty was the first-choice discipline for 128 applicants (92.8%) and the second-choice discipline for 9 applicants (6.5%). There were clear gender differences noted. Pediatrics accounted for 8.3% of female and 3.2% of male first-choice disciplines. Of the 135 females whose first-choice discipline was pediatrics, 101 matched to that first choice (74.8%). Of the 41 males whose first-choice discipline was pediatrics, 26 matched to that first choice (63.4%). Since 1995 (at CaRMS’ inception), the rates of first-choice discipline choice by gender have been quite stable (Table 1), with females consistently higher than males, while the first-choice discipline matching rate by gender have varied (Figure 1). Forty CMG applicants whose first-choice discipline was pediatrics matched to an alternate discipline choice and nine went unmatched, suggesting that pediatrics continues to be a competitive discipline. The pediatric rate of first-choice discipline matching to another alternate choice of 22.6% (40/177) is comparable to Anesthesia (22.1%; 34/154), Ophthalmology (26.7%; 20/75), and Otolaryngology (20.9%; 9/43). Conclusion Pediatrics continues to be a top specialty choice for graduates of Canadian medical schools, according to data from the 2020 CaRMS match. There are gender differences noted in the choice of pediatrics as a first-choice discipline, and in the successful match rate to pediatrics programs. The rate of successful first-choice discipline matching by gender have varied over time, with the past two years showing significantly greater matching success for females. These trends in the CaRMS pediatric data have implications on discipline recruitment and the pediatric workforce in Canada, and merit further exploration.