Impact of Interview Modality on Gender Disparities in Plastic and Reconstructive Surgery Residency Match Success

The transition from in-person to virtual visits during the COVID-19 pandemic transformed the residency application process. Recognizing the gradual return to in-person interviews and the historical presence of gender disparities within medical fields, the present study sought to evaluate how interview modality influences the success rates of applicants to Plastic and Reconstructive Surgery (PRS) residency programs, with a focus on gender and applicant characteristics.

Data on PRS residency applicants to a single integrated Plastic and Reconstructive Surgery program from 2017 to 2021 (4 application cycles) were obtained from the Electronic Residency Application Service (ERAS), National Residency Matching Program databases, and public online sources. The dataset included demographics (gender, race, orphan status), academic and professional qualifications (research year participation, Alpha Omega Alpha [AOA] and Gold Humanism Honor Society [GHHS] memberships, USMLE Step 1 and 2 scores, reapplicant status, type of medical graduate, additional degrees), interview modality (virtual or in-person), and match results. Specifically, interviews in the 2017/18, 2018/19, and 2019/20 cycles were in-person and those that took place in the 2020/21 application cycle were virtual. Data analysis included univariate regression with chi-squared test and multivariate logistic regression to assess the impact of virtual interviews on match success across genders and other factors.

A total of 1298 applicants (573 females, 724 males, 1 uncategorized) were included in the analysis; 985 (75.9%) underwent in-person interviews, and 313 (24.1%) had virtual interviews. There was a predominance of males with in-person interviews (58.2%) and females with virtual interviews (51.4%) (p = 0.002). The overall match success rate was 63.5%, with virtual interviews having a lower match rate (56.9%) compared to in-person (65.5%) (p = 0.004). Gender analysis revealed that female applicants had a higher overall match rate (67.2%) than males (60.5%) (p = 0.008). Notably, females had 37.9% higher odds of matching compared to males (p = 0.006). Specifically, the majority of applicants who successfully matched with in-person interviews were male (56.3%), and the majority of those who matched with virtual interviews were female (57.9%) (p = 0.001). Gender was not a significant determinant in match rates when considering other characteristics (p = 0.213). Race played a crucial role (p = 0.011), with Asian, Hispanic, and other race categories associated with overall lower match success (p = 0.004, p = 0.049, p = 0.045). Participation in a research year was positively correlated with match success (p < 0.001). Being a previous graduate at the time of application (as opposed to being a senior medical student at the time of application) had a negative correlation (p < 0.001). Reapplicant status had no significant impact (p = 0.213, p = 0.650).

Virtual interviews for PRS residencies led to lower overall match rates compared to in-person interviews, with varying outcomes based on gender and race. Applicant success was additionally influenced by personal and career-related factors, such as race and research activity. These findings underscore the complexity of residency selection processes.