Addressing the neurosurgery match gap in medical schools without home residency programs: a curricular proof of...

Students at medical schools without home residency programs face barriers such as limited research opportunities, lack of faculty mentorship, and minimal specialty exposure that result in lower match rates in competitive fields like neurosurgery and reduce workforce diversity.

We sought to design and implement a structured, year-long research curriculum as a proof-of-concept model to explore whether such programming may improve specialty match outcomes for students from underresourced institutions.

Following Kern's six-step curriculum development process, we developed a research elective to be completed between the third and fourth years of medical school beginning in 2021. To minimize financial and logistical barriers, participants retained part-time enrollment, preserving financial aid, insurance, and malpractice coverage. Students engaged in immersive research and clinical experiences at sponsoring institutions with neurosurgery residency programs. To assess the broader perceived need for similar programs, a survey was distributed to the American College of Osteopathic Surgeons Medical Student Section (ACOS-MSS), with over 140 responses, inquiring about research year participation and interest.

In this initial proof-of-concept cohort, all four students who have utilized this curriculum successfully matched into neurosurgery programs. Given the small sample size, these results should be interpreted with caution, because students may have benefited from additional factors supportive of matching independent of the curriculum. Of 146 ACOS-MSS survey respondents, 5 (3.4 %) were currently completing a research year, whereas 49 (33.6 %) indicated that they would be interested in or would consider embarking on a research gap year if available - most commonly in surgical specialties such as neurosurgery, plastic surgery, and cardiothoracic surgery.

This proof-of-concept suggests that a dedicated research year may offers a pathway for those without home residency programs to enhance competitiveness during the match process, although larger prospective studies are needed to establish efficacy. The high level of interest identified among osteopathic medical students highlights a widespread need for standardized, accessible specialty-development curricula. Broader adoption could promote diversity in medical education by expanding access to competitive specialties and fostering partnerships between osteopathic and allopathic institutions.