Is the Completion of a Research Gap Year or Summer Research Program Associated With Increased Odds of Matching Into...

In 2024, 73% of United States doctor of medicine (MD) seniors who applied to orthopaedic surgery residency matched. This competitiveness encourages applicants to seek strategies to improve their chances of matching, particularly with the US Medical Licensing Examination (USMLE) Step 1 transition to pass/fail. Despite growing usage of structured research programs by applicants (so-called "research gap years"), studies report mixed results on whether they improve match outcomes. A systematic review is needed to synthesize these findings and provide clarity for applicants and programs.

In this systematic review, we asked: (1) What associations have been reported between completing a research gap year and match outcomes for first-time orthopaedic residency applicants? (2) What associations have been reported between completing a research gap year and match outcomes for previously unmatched applicants? (3) What associations have been reported between participation in a summer research program and subsequent residency match outcomes?

In October 2024, we queried PubMed, Google Scholar, and EBSCOhost to identify studies published through October 2024 that evaluated the impact of research gap years and summer research programs on orthopaedic residency competitiveness. Included studies had to assess the frequency, research productivity, or percentage of students who matched after completing a research gap year or summer research program. Case reports, reviews, and non-English publications were excluded. A total of 10 studies were included, consisting of five cross-sectional surveys, three retrospective comparative studies, and two prospective comparative studies. These studies evaluated program directors and applicants (first-time, unmatched re-applicants, and matched residents), with sample sizes ranging from 17 to 558 participants and study periods spanning from 2000 to 2023. Risk of bias was assessed using the Joanna Briggs Institute tool for cross-sectional studies (range 0 to 8), with higher scores indicating better quality; the included studies had a mean score of 6.3, reflecting moderate quality overall. Because of study heterogeneity, a qualitative synthesis was performed rather than a meta-analysis.

First-time applicants who completed a research gap year consistently had higher match percentages (73% to 91%) than applicants who did not complete a gap year. Unmatched applicants who completed a research gap year showed improved match percentages, with 29% matching at the same institution. Participating in summer research programs was associated with increased research productivity, development of mentor-mentee relationships, and higher odds of matching into orthopaedic surgery, particularly when participants had first-author publications and continued to collaborate with their research team after the program ended.

Research gap years and summer research programs are associated with increased research productivity and development of mentor-student relationships, with higher match success most consistently reported among research gap year applicants with substantial research output, although outcomes are variable and do not guarantee match success.

Research gap years appear most beneficial for first-time applicants with limited prior research experience, particularly when they yield substantial productivity, while summer research programs may be especially valuable for students at schools without a home orthopaedic program by providing mentorship and specialty-specific research opportunities.