Applicant Characteristics Associated With Being Ranked by US Surgical Specialty Programs in 2022-2025

Area of Science:

• Medical Education
• Surgical Residency Matching
• Applicant Ranking Dynamics

Background:

• Understanding surgical specialty program ranking patterns is crucial for informed decision-making by both residency applicants and programs.
• Applicant characteristics significantly influence how programs rank candidates.

Purpose of the Study:

• To analyze the characteristics of applicants on program rank order lists (ROLs) for five surgical specialties: general surgery, neurological surgery, orthopaedic surgery, otolaryngology, and plastic surgery.
• To determine if applicant characteristics differ between competitive and less competitive segments of the ROLs.

Main Methods:

• Analysis of 2899 certified program ROLs from the 2022-2025 NRMP Main Residency Matches for five surgical specialties.
• Inclusion of USMLE data and applicant demographic information, examining variables such as medical school type, location/citizenship, sex, URiM status, and USMLE Step 1/Step 2 CK scores.
• Utilized descriptive statistics and boxplots to identify ranking patterns.

Main Results:

• General surgery programs demonstrated higher rates of ranking US DOs (79.1%) and US IMGs (48.6%) compared to other specialties.
• Other surgical specialties ranked US DOs (18.0-49.7%), US IMGs (<20%), and non-US IMGs (20.4-54.8%) with varying frequencies.
• Fewer than 15% of non-general surgery specialties ranked applicants with prior USMLE Step 1 or Step 2 CK failures.

Conclusions:

• Significant differences in ranking patterns were observed across the five surgical specialties based on applicant type and USMLE performance.
• Applicant sex and underrepresented in medicine (URiM) status also showed differential ranking patterns, though to a lesser extent.