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

An understanding of surgical specialty program ranking patterns related to residency applicant characteristics could help inform applicant and program decision-making.

To assess characteristics of applicants on program rank order lists (ROLs) for general surgery, neurological surgery, orthopaedic surgery, otolaryngology, and plastic surgery and whether applicant characteristics differ on the competitive vs less competitive ROL segments.

Certified program ROL data (N=2899) from the 2022-2025 National Resident Matching Program (NRMP) Main Residency Matches for 5 surgical specialties, United States Medical Licensing Examination (USMLE) data from the National Board of Medical Examiners, and applicant self-reported demographic information from NRMP were analyzed. Included programs submitted a certified ROL ≥30 and had less than 25% missing data in the competitive and less competitive ROL segments for the variable of interest. Descriptive statistics and boxplots were used to examine ranking patterns for applicant type (medical school type and location/citizenship status), sex, underrepresented in medicine (URiM) status, and USMLE Step 1/Step 2 Clinical Knowledge (CK) performance.

General surgery programs were more likely to rank various applicant types, with 79.1% ranking US DOs and 48.6% ranking US international medical graduates (IMGs). Among the other surgical specialties, 18.0-49.7% ranked US DOs, less than 20% ranked US IMGs, and 20.4-54.8% ranked non-US IMGs. Besides general surgery, 15% or less of the remaining surgical specialties included any applicants who had ever failed Step 1 or Step 2 CK.

In all 5 surgical specialties, overall and competitive ranking patterns differed by applicant type and USMLE performance. Differential patterns were also seen to a lesser extent for sex and URiM status.