The effect of COVID-19-related changes on geographical outcomes in the 2021 dermatology residency match.
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ABSTRACT:
SUBMITTER: Mulligan KM
PROVIDER: S-EPMC8653266 | biostudies-literature |
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:PurposeThe COVID-19 pandemic modified the Residency Match process for fourth-year medical students. In-person away rotations were discouraged, interviews were virtual, and traditional factors used to rank programs were absent. Here, we compare survey results administered to both the 2020 and 2021 Match applicants to assess the influence of the pandemic on the radiation oncology (RO) Match process.MethodsAn institutional review board-approved prospective cross-sectional study was conducted. The 2020 and 2021 RO Match applicants at a large RO program were invited to participate. Descriptive summary statistics were assessed.ResultsThe 2020 and 2021 Matches each had 76 applicants complete the survey with response rates of 54% and 57%, respectively. The 2 groups were predominantly white, cisgender male, single, and without children. Whereas 11% of 2020 applicants did not complete away rotations, 45% of 2021 applicants did not. For 2021 Match applicants, 65% of away rotations were performed virtually, whereas 51% were not for medical school credit. Of the applicants, 84% were satisfied with virtual interviews and 72% felt cost savings were worth not having in-person interviews. Whereas 49% of Match 2020 applicants spent >$5000 in interview costs, 0% of the Match 2021 applicants did so, with 45% spending <$100. Postinterview communications from programs increased during the pandemic from 36% to 42% in 2020 Match and 2021 Match, respectively. Although program culture was the most common factor influencing 2021 Match applicants program rankings, half of applicants did not gain a sense of program culture during virtual interviews.ConclusionsWe found 2021 Match applicants completed fewer away rotations, were satisfied with virtual interviews/reduced costs, and did not gain a sense of program culture through virtual rotations/interviews despite it being the most important ranking factor reported. This study supports further exploration of virtual away rotations and virtual interviews moving forward beyond the pandemic.
| S-EPMC8555343 | biostudies-literature
Project description:BackgroundThe cancellation of clinical rotations (CRs) and implementation of virtual interviews (VIs) profoundly affected the residency selection process leading up to the 2021 NRMP Match. The authors investigated how these changes influenced the caliber of applicants taken by general surgery (GS) residency programs from the perspectives of program directors (PDs).MethodsA 14 question, web-based electronic survey was emailed to PDs of ACGME-accredited GS residency programs. Questions sought program characteristics and PDs' perspectives regarding potential differences in subjective characteristics and clinical skills demonstrated by their 2021 Match class relative to previous resident classes.ResultsA total of 75 PDs (27.2%) responded to our survey. Most respondents observed no changes in residents' fit with their program (72.0%), communication skills (68.0%), responsiveness to clinical instruction and feedback (73.3%), work ethic (73.3%), and rotation evaluations (68.0%). Only 21.3% of PDs believed that VIs negatively impacted their ability to accurately assess applicant intangibles. Conversely, 56.0% of PDs reported that the cancellation of CRs in 2020 negatively affected residents' clinical competency at the start of residency. At 1-year following the 2021 NRMP Match, 30.7% of PDs reported that the clinical skills exhibited by their 2021 Match class were poorer than previous resident classes.DiscussionOur findings suggest that VIs limited selection committees' ability to accurately assess applicant's subjective characteristics to a lesser degree than previously described in the literature. Canceled CRs adversely affected the 2021 Match Class's clinical skills at the start of residency and at 1 year following the 2021 NRMP Match.
| S-EPMC9720422 | biostudies-literature
Project description:Background An Early Result Acceptance Program (ERAP) has been proposed for obstetrics and gynecology (OB/GYN) to address challenges in the transition to residency. However, there are no available data-driven analyses on the effects of ERAP on the residency transition. Objective We used National Resident Matching Program (NRMP) data to simulate the outcomes of ERAP and compare those to what occurred in the Match historically. Methods We simulated ERAP outcomes in OB/GYN, using the de-identified applicant and program rank order lists from 2014 to 2021, and compared them to the actual NRMP Match outcomes. We report outcomes and sensitivity analyses and consider likely behavioral adaptations. Results Fourteen percent of applicants receive a less preferred match under ERAP, while only 8% of applicants receive a more preferred match. Less preferred matches disproportionately affect DOs and international medical graduates (IMGs) compared to US MD seniors. Forty-one percent of programs fill with more preferred sets of applicants, while 24% fill with less preferred sets of applicants. Twelve percent of applicants and 52% of programs are in mutually dissatisfied applicant-program pairs (a pair in which both prefer each other to the match each received). Seventy percent of applicants who receive less preferred matches are part of a mutually dissatisfied pair. In 75% of programs with more preferred outcomes, at least one assigned applicant is part of a mutually dissatisfied pair. Conclusions In this simulation, ERAP fills most OB/GYN positions, but many applicants and programs receive less preferred matches, and disparities increase for DOs and IMGs. ERAP creates mutually dissatisfied applicant-program pairs and problems for mixed-specialty couples, which provides incentives for gamesmanship.
| S-EPMC10150816 | biostudies-literature
Project description:BackgroundGeriatric patients account for a growing proportion of dermatology clinic visits. Although their biopsychosocial needs differ from those of younger adults, there are no geriatrics training requirements for dermatology residency programs.ObjectiveThis study explored the state of geriatrics education in dermatology programs in 2016.MethodsThis constructivist study employed cross-sectional, mixed-methods analysis with triangulation of semistructured interviews, surveys, and commonly used curricular materials. We used purposive sampling of 5 US academic allopathic dermatology programs of different sizes, geographic locations, and institutional resources. Participants were interviewed about informal curricula, barriers, and suggestions for improving geriatrics education, and they also completed a survey about the geriatrics topics that should be taught. The constant comparative method with grounded theory was used for qualitative analysis. We identified formal geriatrics curricular content by electronically searching and counting relevant key texts.ResultsFourteen of 17 participants (82%) agreed to be interviewed, and 10 of 14 (71%) responded to the survey. Themes of what should be taught included diagnosing and managing skin diseases common in older adults, holistic treatment, cosmetic dermatology, benign skin aging, and the basic science of aging. Topics currently covered that could be expanded included communication, systems-based challenges, ethical issues, safe prescribing, quality improvement, and elder abuse. Cosmetic dermatology was the most commonly taught formal geriatrics curricular topic.ConclusionsThere were discrepancies among topics participants felt were important to teach about geriatric dermatology and curricular coverage of these areas. We identified challenges for expanding geriatrics curricula and potential solutions.
| S-EPMC6314366 | biostudies-literature
Project description:The transition from internship to residency is a critical period for trainees. This study investigated factors that influence the transition of residents from postgraduate year 1 (PGY-1) to dermatology residency. In June 2019, a program director-specific survey and a resident-oriented survey were administered via Survey Monkey. An email containing survey hyperlinks was sent via the Association of Professors of Dermatology Listserv to program directors, who were asked to forward the email to their current trainees. A total of 44 dermatology residents and 33 program directors responded. More than 58% of program directors identified a preliminary year in internal medicine as most beneficial. Both residents and program directors indicated rheumatology, infectious disease, and allergy and immunology as the most relevant PGY-1 electives. Eighty-two percent of program directors expected <1 h/week or no independent preparation for dermatology residency during PGY-1. The stress of incoming residents as perceived by program directors was significantly less than the self-reported stress of residents during their transition to dermatology residency (Mann-Whitney U, two-sided, P = 0.011).
| S-EPMC7785141 | biostudies-literature
Project description:BackgroundThe number of residency applications submitted by medical students rises annually, resulting in increased work and costs for residency programs and applicants, particularly in emergency medicine. We propose a solution to this problem: an optional, two-stage Match with a "summer match" stage, in which applicants can submit a limited number of applications early. This would be conducted similarly to the early decision process for college admissions. The study objectives were to explore stakeholder opinions on the feasibility of a summer match and to identify the ideal logistic parameters to operationalize this proposal.MethodsWe used exploratory qualitative methodology following a constructivist paradigm to develop an understanding of the potential impact of a summer match. We interviewed 34 key stakeholders in the U.S. residency application process identified through purposive sampling including educational administrators (program directors, designated institutional officials, medical school deans) and trainees (students, residents). We coded and thematically analyzed interview data in two stages using an inductive approach.ResultsWe identified six themes from the participant interviews that broadly reflected issues of the residency application process, value, and equity. These themes included disrupting the status quo, logistic concerns, match strategy, differential benefits, unintended consequences, and return on investment. Most study participants supported the summer match concept, with medical students and residents most in favor. We developed a theoretical summer match protocol based on these findings.ConclusionsA summer match may reduce the burdens of increasing residency applications and associated costs. Pilot testing is necessary to confirm this hypothesis and determine the impact of the proposed summer match protocol. Unintended consequences must be considered carefully during implementation.
| S-EPMC8237086 | biostudies-literature
Project description:ImportanceThe ophthalmology residency application process is critical for applicants and residency programs, and knowledge about the preferences of applicants would assist both groups in improving the process.ObjectiveTo evaluate the experiences and preferences of ophthalmology residency applicants.Design, setting, and participantsThis cross-sectional, nonvalidated survey was conducted online. All applicants to the Bascom Palmer Eye Institute ophthalmology residency program during the 2018-2019 application cycle were invited to complete the survey. Data collection occurred from April 1, 2019, to April 30, 2019.Main outcomes and measuresApplicant demographics, application submissions, interview experiences, financial considerations, match results, and suggestions for improvement of the application process.ResultsResponses were received from 185 applicants (36.4%), including 77 women (41.6%). A successful match into an ophthalmology residency was achieved by 172 respondents (93.0%). There was a mean (SD) US Medical Licensing Examination Step 1 score of 245.8 (13.3) points. Respondents applied to a mean (SD) of 76.4 (23.5) ophthalmology residency programs, received 14.0 (9.0) invitations to interview, and attended 10.3 (4.4) interviews. Choices regarding applications and interviews were based mostly on program reputation, location, and advisor recommendation. A usual lead time of at least 3 weeks between the invitation and interview was reported by 126 respondents (69.2%), which was reduced to 14 respondents (15.1%) when a wait-list was involved. The ophthalmology residency application process cost a mean (SD) of $5704 ($2831) per applicant. Respondents reported that they were most able to reduce costs through housing choices (hotel stays or similar arrangements) and least able to reduce costs by limiting the number of programs to which they applied or at which they interviewed.Conclusions and relevanceThe ophthalmology residency application process is complex and poses substantial challenges to applicants and residency programs. These findings suggest that many current applicants have difficulty selecting programs to apply to, and most respondents desired changes to the current system of interview invitations and scheduling.
| S-EPMC7068667 | biostudies-literature
Project description:BackgroundResidency program location may be an important factor for orthopedic surgery residency applicants. More than half of residents locate their practice near the site of their training, and surgical specialties (eg, otolaryngology, plastic surgery, and general surgery) have shown geographic patterns in their residency matches.ObjectiveWe analyzed geographic trends in the orthopedic surgery Match.MethodsHometown, undergraduate institution, and medical school "preresidency locations" of all allopathic, nonmilitary, orthopedic surgery residents were recorded from program websites for the 2015-2016 academic year. Program and preresidency locations were coded according to state and US census division. Statistical analysis was used to investigate associations between residency program locations and preresidency locations.ResultsOf 2662 residents in the study, 1220 of 2614 (47%), 536 of 1329 (40%), and 308 of 744 (41%) matched into the same division as their medical school, undergraduate institution, and hometown, respectively. There were significant differences among divisions (P < .001). Also, 817 of 2662 (31%), 319 of 1329 (24%), and 200 of 770 (26%) residents matched in the same state as their medical school, undergraduate institution, and hometown, respectively, with significant differences between states for medical school (P < .0001) and undergraduate institution (P < .0001), but not hometown (P = .22). Overall, 21% of residents (538 of 2612) matched at the program affiliated with their medical school.ConclusionsThere is an association among hometown, undergraduate institution, and medical school for the training program location in which orthopedic surgery residents match, with variability in locations matched at state and census division levels.
| S-EPMC6108356 | biostudies-literature
Project description:The development and deployment of matching procedures that incentivize truthful preference reporting is considered one of the major successes of market design research. In this study, we test the degree to which these procedures succeed in eliminating preference misrepresentation. We administered an online experiment to 1,714 medical students immediately after their participation in the medical residency match-a leading field application of strategy-proof market design. When placed in an analogous, incentivized matching task, we find that 23% of participants misrepresent their preferences. We explore the factors that predict preference misrepresentation, including cognitive ability, strategic positioning, overconfidence, expectations, advice, and trust. We discuss the implications of this behavior for the design of allocation mechanisms and the social welfare in markets that use them.
| S-EPMC6233132 | biostudies-literature