A retrospective longitudinal study of students' residency choices at the French medical ranking exam

The evolution of medical students' population and their choices of medical residency is poorly documented in France. The objective of this study was to perform a retrospective analysis of medical student's residency choices at their national ranking exam (NRE) once they have completed six years of theoretical and practical medical training.

Published choices after the French NRE were processed from 2011 to 2023. A longitudinal follow-up of the median rank of affected students for each medical speciality and each training university hospitals is presented. Demographics and gender statistics are also presented. Violin plots, heatmaps and bump charts were used for a better analysis. Mann-Kendall test was used for trend analysis.

We analyzed choices of more than 100,000 students and show that men were more likely to have a better ranking, though with a non homo-geneous distribution compared to women who were more homogeneously distributed. We also proved that younger students better performed at the exam. We observed an unprecedented increased attractiveness of medical gynecology (+ 14 places, p = 0.007) as well as anesthesiology and resucitation (+ 13 places, p = 0.008).Vascular medicine (+ 4 places, p = 0.014), otorhino-laryngology (+ 2 places, p = 0.041) and dermatology (+ 5 places, p = 0.019) also significantly gained attractivity over the study period contrary to neurosurgery (-23 places, p = 0.023) and infectious diseases (-8 places, p = 0.048). Medical schools of Rennes (+ 7 places, p = 0.005) and Caen (+ 3 places, p = 0.048) have been gaining interest over the whole period while Grenoble (-5 places, p = 0.013), Paris (-5 places, p = 0.0083) and Limoges (-4 places, p = 0.006) have been significantly loosing attractivity.

This work provides an overview of choices trends at the French medical NRE and illustrates for the first time the evolution of medical students' demography and residency choices over a thirteen-year period.