Applying to Integrated Thoracic Surgery Residency: A Survey-Based Cost Analysis

Application costs are known for other competitive surgical subspecialties but not for integrated thoracic surgery residency (I6). We sought to quantify I6 application costs, assess the value of away rotations and geographic connections, and identify characteristics of matched applicants.

We retrospectively reviewed the Texas Seeking Transparency in Application to Residency survey-based database for I6 applicants (2019-2022). Away rotation analyses excluded the 2021 application cycle (n = 30) because of limitations imposed by the COVID-19 pandemic.

Eighty I6 applicant responses were included with a response rate of 8.8% (80/909); 47 (58%) matched into an I6 program. Average total application costs ranged from $1554 to $9173, with interviews as the largest contributor in 2019 and 2020. Away rotations were the second largest contributor in 2019 and 2020 and the largest contributor in 2022. Of those who matched, 7 (24%) had completed an away rotation at their matched program and 9 (19%) had a geographic connection to their matched program. Thirty-three (33/50 [66%]) applicants completed an away rotation, and 83% of rotations resulted in an interview. Similar proportions of matched and unmatched applicants completed away rotations (P = .933), with no difference in the mean number of away rotations completed per applicant (P = .435). Matched applicants had a higher mean number of published abstracts and presentations (7.61 ± 3.58 vs 5.64 ± 3.70; P = .020), more frequently completed a research year (23.4% [n = 11] vs 6.1% [n = 2]; P = .038), and more frequently scored >250 on USMLE Step 2 (85.1% [n = 40] vs 60.6% [n = 20]; P = .012).

I6 match rates are low (31.7%), and away rotations account for the greatest cost to applicants. Matched applicants excel in research and on standardized examinations.