Patterns and Predictors of Cross-Applications Among Otolaryngology Residency Applicants

To evaluate the applicant characteristics associated with cross-applying to otolaryngology-head and neck surgery (OHNS) and at least one additional specialty.

We analyzed all Association of American Medical Colleges Electronic Residency Application Service applications submitted to OHNS residency programs between 2020 and 2023. Cross-applicants applied to OHNS and at least one other specialty. Chi-square tests and t-tests compared the characteristics of OHNS-only applicants and cross-applicants. Multivariable logistic regression identified independent predictors of cross-application.

Among 2440 applicants to OHNS, 53.0% (N = 1293) cross-applied, most commonly to General Surgery (N = 894, 36.6%) and Internal Medicine (N = 508, 20.8%). Cross-applicants comprised the majority of international medical graduates (IMG, 88.4%), osteopathic applicants (DO, 86.0%), and applicants 30 years of age or older (70.6%). Compared to those who applied to only OHNS, cross-applicants had significantly fewer research experiences (difference [Δ] = -1.50 ± 0.11 [mean ± standard error]; p < 0.001) and publication entries (Δ = -3.70 ± 0.54; p < 0.001). Independent predictors of cross-applying included IMG (odds ratio [OR]: 7.15; 95% CI: 3.78-13.96; p < 0.001) or DO status (OR = 7.04; 95% CI: 4.37-11.63; p < 0.001), age ≥ 30 (OR = 1.76; 95% CI: 1.32-2.36; p < 0.001), being a reapplicant (OR = 5.35; 95% CI: 3.25-9.08; p < 0.001), and having fewer research experiences (OR = 0.89; 95% CI: 0.86-0.92; p < 0.001).

Cross-applying to other specialties is common for OHNS applicants. These findings illustrate the complexity of the residency application process and the importance of tailored advising for applicants.

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