A 3-Year Analysis of Characteristics That Predict Interview Offer to a Vascular Surgery Residency Program

Vascular surgery (VS) program directors consider letters of recommendation (LOR) to be among the most essential parts of the residency application. This study aims to characterize applicant and LOR factors associated with an interview offer to a VS integrated residency (VSIR) program over three consecutive application cycles.

Applicant characteristics (all applicants; n = 388) and LORs were abstracted from residency applications to a VSIR program from 2021 to 2024. Applicant demographic data and letter writer characteristics were abstracted. The Linguistic Inquiry and Word Count (LIWC-22) software, a validated text analysis program, was used to characterize LOR body content. Analyzed letters were compared according to interview offer and application year using multivariable analysis, examining the association between interview offer and applicant, letter writer, and LOR linguistic characteristics.

Applicants offered an interview (n = 129; 33% of all applicants) were more likely to hold alpha omega alpha membership, obtain honors on a surgery rotation, and have a higher Step 2 score. A higher proportion of LORs written by VS was associated with interview offer (89.5% vs 66.3%, p < 0.001), while fewer letters from general surgeons was associated with an interview offer in all years. The presence of at least one chair, chief, program directors, or away rotation letter was associated with an interview offer. Presence of an away letter increased each year, with 66% of applicants having an away letter in 2023 compared to 42% in 2021 (p < 0.001). Letters written for applicants offered an interview were 18% more likely to reference teaching (p < 0.001), 14.7% more likely to reference research (p = 0.004), and 7.3% more likely to reference curiosity (p = 0.03) with no variations by applicant year. Letters for interviewed applicants were less likely to reference ability (p = 0.02) and grindstone (p = 0.006).

Applicants offered a VSIR interview were more likely to demonstrate academic excellence and have letters written by VS and away institution faculty; these associations have strengthened in the absence of United States Medical Licensing Exam Step 1 scores after 2021. Linguistic characteristics of LORs remain relatively unchanged across application cycles, with an emphasis on teaching and research remaining associated with an interview offer.