Assessing the Finances of Applying to Surgical Residency in 2019-2020: A US Nationwide Surgical Specialties Comparison
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ABSTRACT:
SUBMITTER: Gordon A
PROVIDER: S-EPMC10539139 | biostudies-literature | 2023 Oct
REPOSITORIES: biostudies-literature
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Project description:BackgroundDespite unprecedented changes to undergraduate medical education and the residency selection process during the COVID-19 pandemic, there is little objective evidence on how the pandemic affected match outcomes such as matched applicant characteristics, interview distribution, geographic clustering, and associated costs. We investigated COVID-19's impact on the residency match by comparing surgery applicants' characteristics, interview distribution, and related costs from 2018 to 2020 to 2021.MethodsData from the Texas Seeking Transparency in Applications to Residency initiative were analyzed. Descriptive statistics, bivariate testing, and sensitivity analysis were performed to compare matched applicants in surgical specialties from 2018-2020 to 2021.ResultsThis study included 5,258 applicants who matched into 10 surgical specialties from 2018 to 2021. In 2021, there was a decrease in proportion of students who reported a geographic connection to their matched program (38.4% vs 42.1%; P = .021) and no significant difference in number of interviews attended (mean [SD], 13.1 [6.2] vs 13.3 [4.7]; P = .136) compared to prior years. Applicants in 2021 had more research experiences and fewer honored clerkships (both P < .001), and these associations persisted in sensitivity analysis. Matched applicants in 2021 reported significantly lower total costs associated with the residency application process compared to 2018 to 2020 (mean [SD] $1,959 [1,275] vs $6,756 [4,081]; P < .001).ConclusionAlthough COVID-19 appeared to result in a reduction in number of honored clerkships, it may have provided more opportunities for students to engage in research. Overall, the adoption of virtual interviews and away rotations may have successfully mitigated some of the adverse consequences of the pandemic on the residency match for surgical specialties.
| S-EPMC8648584 | biostudies-literature
Project description:ObjectiveThis study aims to assess trends in applicant-reported costs of the otolaryngology residency application process between 2019 and 2021 and evaluate the impact of application costs on number of interview offers.Study designCross-sectional study.SettingUS allopathic and osteopathic medical schools.MethodsSurvey data from applicants were obtained from the Texas STAR database (Seeking Transparency in Application to Residency) for the years 2019 to 2021. Outcomes included total cost, interview cost, other costs, application fees, and number of interview offers. Simple and multivariable linear regression was used to identify novel predictors of cost and assess the correlation between cost and interview offers.ResultsAmong 363 otolaryngology applicants, there was a 74% reduction in total costs and a 97% reduction in interview costs in the 2021 cycle vs the 2020 cycle. Significant predictors of total cost among otolaryngology applicants included the number of away rotations (P < .01), the number of research experiences (P = .04), and couples matching (P < .01). During the 2019 and 2020 application cycles, there was a significant association between applicant-reported total spending and number of otolaryngology interview offers (P < .01), which was not present during the 2021 cycle (P = .35).ConclusionNumber of otolaryngology interview offers appears to be directly correlated with applicant-reported total costs regardless of number of applications or interviews attended, which may be a source of inequality in the application process. There was a drastic reduction in total costs, interview costs, and other costs during the COVID-19 pandemic, which was likely driven by virtual interviewing and the absence of away rotations.
| S-EPMC9382083 | biostudies-literature
Project description:ImportanceDisparities in representation between sexes have been shown at multiple career stages in medicine despite increasing representation in the overall physician workforce.ObjectiveTo assess sex representation of applicants to the Canadian R-1 entry match for postgraduate training programs from 1995 to 2019, comparing distribution between different specialties as well as applied vs matched applicants.Design, setting, and participantsThis cross-sectional analysis of aggregate data provided by the Canadian Resident Matching Service between 1995 and 2019 analyzed aggregate data for the Canadian R-1 residency match from 1995 through 2019.ExposuresApplicant sex as reported in the Canadian Resident Matching Service database.Main outcomes and measuresThe sex representation of applicants was compared and the longitudinal trends in sex representation were analyzed by specialty between 1995 and 2019. The sex representation of overall applicants to the Canadian R-1 entry match were compared with matched applicants, and both were stratified by specialty.ResultsA total of 48 424 applicants were identified (26 407 [54.5%] female applicants), of which 41 037 were matched applicants. Using specialty groupings, female applicants were most highly represented in obstetrics and gynecology (1776 of 2090 [85.0%]) and least represented in radiology (658 of 2055 [32.0%]). Within individual subspecialties, female applicants had the lowest representation in neurosurgery (90 of 394 [22.8%]). While female applicants represented an increasing proportion of the overall applicant population between 1995 and 2019 (z = 2.71; P = .007), significant increases were seen in some, but not all, individual specialties. Differences by sex were found among Canadian medical graduate match rates to their top-ranked specialty: female applicants had a lower likelihood of being rejected for family medicine (rejection of male applicants: OR, 0.46; 95% CI, 0.39-0.54; P < .001) and psychiatry (OR, 0.59; 95% CI, 0.46-0.76; P < .001) and were more likely to be rejected for all-encompassing surgery (acceptance of male applicants: OR, 1.19; 95% CI, 1.10-1.28; P < .001).Conclusions and relevanceIncreasing representation of female residency applicants over time was seen in some, but not all, medical specialties in Canada, and sex-based differences in successful match rates were observed in some specialties. The reasons for these disparities require further investigation for corrective strategies to be identified.
| S-EPMC7686870 | biostudies-literature
Project description:Lack of ergonomic training and poor ergonomic habits during the operation leads to musculoskeletal pain and affects the surgeon's life outside of work. The objective of the study was to evaluate the severity of ergonomic hazards in the surgical profession across a wide range of surgical subspecialties. We conducted intraoperative observations using Rapid Entire Body Assessment (REBA) score system to identify ergonomic hazards. Additionally, each of the ten surgical subspecialty departments were sent an optional 14 question survey which evaluated ergonomic practice, environmental infrastructure, and prior ergonomic training or education. A total of 91 surgeons received intraoperative observation and were evaluated on the REBA scale with a minimum score of 0 (low ergonomic risk <3) and a maximum score of 10 (high ergonomic risk 8-10). And a total of 389 surgeons received the survey and 167 (43%) surgeons responded. Of the respondents, 69.7% reported suffering from musculoskeletal pain. Furthermore, 54.9% of the surgeons reported suffering from the highest level of pain when standing during surgery, while only 14.4% experienced pain when sitting. Importantly, 47.7% stated the pain impacted their work, while 59.5% reported pain affecting quality of life outside of work. Only 23.8% of surgeons had any prior ergonomic education. Both our subjective and objective data suggest that pain and disability induced by poor ergonomics are widespread among the surgical community and confirm that surgeons rarely receive ergonomic training. Intraoperative observational findings identified that the majority of observed surgeons displayed poor posture, particularly a poor cervical angle and use of ergonomic setups, both of which increase ergonomic risk hazards. This data supports the need for a comprehensive ergonomic interventional program for the surgical team and offers potential targets for future intervention.
| S-EPMC7872272 | biostudies-literature
Project description:Background Program signaling is an innovation that allows applicants to express interest in specific programs while providing programs the opportunity to review genuinely interested applicants during the interview selection process. Objective To examine the influence of program signaling on "selected to interview" status across specialties in the 2022 Electronic Residency Application Service (ERAS) application cycle. Methods Dermatology, general surgery-categorical (GS), and internal medicine-categorical (IM-C) programs that participated in the signaling section of the 2022 supplemental ERAS application (SuppApp) were included. Applicant signal data was collected from SuppApp, applicant self-reported characteristics collected from the MyERAS Application for Residency Applicants, and 2020 program characteristics collected from the 2020 GME Track Survey. Applicant probability of being selected for interview was analyzed using logistic regression, determined by the selected to interview status in the ERAS Program Director's WorkStation. Results Dermatology had a 62% participation rate (73 of 117 programs), GS a 75% participation rate (174 of 232 programs), and IM-C an 86% participation rate (309 of 361 programs). In all 3 specialties examined, on average, signaling increased the likelihood of being selected to interview compared to applicants who did not signal. This finding held across gender and underrepresented in medicine (UIM) groups in all 3 specialties, across applicant types (MDs, DOs, international medical graduates) for GS and IM-C, and after controlling for United States Medical Licensing Examination Step 1 scores. Conclusions Although there was variability by program, signaling increased likelihood of being selected for interview without negatively affecting any specific gender or UIM group.
| S-EPMC10686664 | biostudies-literature
Project description: Not available
| S-EPMC9652751 | biostudies-literature
Project description:Integrated plastic surgery remains one of the most competitive specialties within the National Resident Matching Program. Although the burden of applying to surgical residencies has been studied, the literature lacks data specific to integrated plastic surgery applicants. This study reports the current total cost, along with the outcomes of applying to and interviewing for integrated plastic surgery residency.MethodsA survey was sent to applicants in the 2018-2020 integrated plastic surgery application cycles. Survey questions focused on applicant demographics and home medical school characteristics, application processes, interview attendance, interview cost, and applicant financing. Comparative and regression analyses were performed on survey responses.ResultsThe survey was distributed to 493 applicants. An estimated 245 (49.7%) applicants responded. On average, applicants applied to 68.3 ± 16.4 (mean ± SD) programs, received 17.6 ± 11.4 interview invites, and attended 12.6 ± 5.7 of the interviews they received. On average, each applicant spent a total of $6690 ± $4045 during the interview season, with individual interviews costing $531. Residency programs providing financial assistance supplemented $73 ± $64 per interviewee, corresponding to 13.7% of per-interview cost. To cover costs, 33.8% of applicants sought additional funding, and 30.7% of applicants stated that they had supplemental income, with an average monthly supplemental income of $1971 ± $1558.ConclusionsThis study quantifies the recent total and per-interview cost of applying to integrated plastic surgery residency. It also identifies the importance of cost to applicants and how the cost burden of residency applications is supported.
| S-EPMC7859384 | biostudies-literature
Project description:Background Residency selection in the United States relied on in-person interviews for many decades. The COVID-19 pandemic and recommendations from the Coalition for Physician Accountability (COPA) required programs to implement virtual interviews for the 2020–2021 residency selection cycle. Although virtual interviews may become the norm in the future, there is scant data at the institutional level to inform how to best approach this process. Objective To describe the perceptions of applicants to several residency programs at one institution on the importance of virtual recruitment features and assess the impact on their overall ranking decisions. Methods Applicants who interviewed for 12 medical and surgical residency programs during the 2020–2021 cycle at the University of California San Francisco were invited to participate in an anonymous survey in March 2021, after all interviews were completed. A survey consisting of 26 questions was administered to applicants on features that are important during interviews and the impact on their ranking decisions scored on a 5-point Likert scale. Results Of the 1422 participating applicants, 303 (21%) completed the survey. The most important feature for applicants during the interview day was getting a feel of the program (92%). Conversations with residents (91%) and faculty (79%) were also highly rated. Respondents reported morale and happiness of residents (71%) as an extremely important factor in their overall ranking decision . Conclusion Programs should consider prioritizing features that aid in alignment with getting to know residents and faculty and provide a sense of morale over emphasis on the institutional and location features. Supplementary Information The online version contains supplementary material available at 10.1007/s44186-022-00004-5.
| S-EPMC8906359 | biostudies-literature
Project description:ObjectivesTo compare gender diversity between UK surgical specialties, assess trends over time, and estimate when gender parity might be achieved.DesignObservational study.SettingNational Health Service, UK.ParticipantsNHS Hospital & Community Health Service workforce statistics for 2011 to 2020 MAIN OUTCOME MEASURES: Logistic regression was used to compare female representation in 2020 between surgical specialties, and to examine for any significant trends between 2011 and 2020. The method of least squares was used to estimate when female representation of specialty registrars would reach 50% ('gender parity') for specialties with <40% female representation.ResultsIn 2020, female consultant and specialty registrar representation was significantly different between surgical specialties (both p<0.001). Female representation for each specialty were as follows (from highest to lowest): Specialty Registrars-Ophthalmology 49.7%, Otolaryngology 48.2%, Paediatric Surgery 45.5%, Plastic Surgery 42.2%, General Surgery 39.8%, Urology 31.6%, Vascular Surgery 25.0%, Neurosurgery 24.7%, Cardiothoracic Surgery 21.3%, and Trauma and Orthopaedics 20.6%; Consultants-Ophthalmology 32.4%, Paediatric Surgery 31.7%, Plastic Surgery 20.9%, General Surgery 17.5%, Otolaryngology 17%, Vascular Surgery 13.7%, Urology 11.7%, Cardiothoracic Surgery 10.8%, Neurosurgery 8.2%, and Trauma and Orthopaedics 7.3%. There was a significant positive trend in female representation of specialty registrars between 2011 and 2020 for all specialties except for Paediatric Surgery (representation consistently >45%) and Vascular Surgery (representation consistently <30%). General Surgery was estimated to achieve gender parity of their specialty registrars by 2028, Urology by 2033, Neurosurgery by 2064, Trauma and Orthopaedics by 2070, and Cardiothoracic Surgery by 2082.ConclusionsDespite improvements over the last decade, gender disparity persists in the UK surgical workforce and there are significant differences between surgical specialties. Further work is necessary to establish the reasons for these observed differences with a specific focus on Vascular Surgery, Cardiothoracic Surgery, Neurosurgery, and Trauma and Orthopaedics.
| S-EPMC8968535 | biostudies-literature
Project description:Background: The coronavirus disease 2019 (COVID-19) pandemic was an unprecedented shock to the healthcare systems, and its consequences on managing rare cancers are unknown. We investigated COVID-19’s impact on the activity of sarcoma-labeled networks by comparing key indicators in 2019–2020 (before and during the pandemic, respectively). Methods: We compared the incidence of limb and trunk soft tissue sarcomas, surgery rate, surgery center, surgery quality, and surgery delays nationally and in various regions, focusing on the three most severely affected regions. Findings: In this study, sarcoma incidence did not decrease, and the tumor and patient characteristics were similar in both years. The number of patients who underwent surgery in the labeled centers increased significantly (63% versus 57%, p = 0.015), the rate of R0 resection increased (55% versus 47%, p = 0.004), and the rate of re-excision decreased (12% versus 21%, p < 0.0001). In the univariate analysis, the time to surgery was similar in both years. Cox regression analysis revealed that the factors associated with a longer time to surgery were age > 70 years (p = 0.003), retroperitoneal location (p > 0.001), tumor size (p < 0.001), deep tumors (p < 0.001), and regions (p < 0.001). However, we have observed an increase in the time before surgery in the regions most stroked by the COVID-19 pandemic. Interpretation: The model of the labeled center network for managing rare tumors was resilient. Paradoxically, the quality indicators improved during the pandemic due to the direct referral of patients with sarcomas to the labeled centers. Summary: This study shows that a nationwide network organization has made it possible to maintain care for these rare tumors during the pandemic.
| S-EPMC10472827 | biostudies-literature