Neurosurgery Residency Program Directors' Perspectives: A Scoping Review of Program Director Survey Responses

Area of Science:

• Medical Education and Training
• Surgical Residency Admissions
• Neurosurgery Program Evaluation

Background:

• Neurosurgery residency is highly competitive, with increasing applicant numbers and limited positions.
• Program director (PD) surveys offer crucial insights into selection criteria and residency expectations.
• Understanding PD perspectives is vital for prospective neurosurgery residents.

Purpose of the Study:

• To systematically review and synthesize findings from Program Director (PD) surveys on neurosurgery residency admissions over the past 20 years.
• To identify key applicant evaluation criteria, residency training factors, and the impact of COVID-19.
• To provide guidance for aspiring neurosurgery residents navigating the competitive application process.

Main Methods:

• Conducted a three-database scoping review of PD survey studies published within the last 20 years, excluding official National Resident Matching Program (NRMP) data.
• Screened and selected studies based on predefined inclusion and exclusion criteria.
• Evaluated selected articles for survey characteristics and summarized response data, focusing on PD perspectives.

Main Results:

• Nineteen PD survey studies were included, showing diversity in structure and topics, with an average response rate of 54%.
• Key selection factors include interviews, United States Medical Licensing Exam (USMLE) Step 2 scores, and letters of recommendation.
• Concerns exist regarding the transition of USMLE Step 1 to pass/fail, the need for research opportunities, and the impact of COVID-19 on virtual interviews and applicant experiences.

Conclusions:

• Neurosurgery residency selection remains heavily influenced by traditional metrics like USMLE scores, recommendations, and interviews.
• The shift to pass/fail USMLE Step 1 scoring presents challenges in candidate evaluation.
• Enhancing research opportunities, mentorship, and addressing training challenges are crucial for the future of neurosurgery residency.