Trends in Surgical Specialty Fellowship Applications in the Era of COVID-19 and Virtual Interviewing

The COVID-19 pandemic disrupted surgical training by decreasing operative volume and changing resident exposure to various specialties. Simultaneously, fellowship interviewing transitioned from in-person to virtual formats. The effect of the pandemic on surgical fellowship application trends has not been assessed. This study characterizes surgical fellowship application trends surrounding the COVID-19 pandemic.

Cross-sectional study using publicly available fellowship application and match data.

Data from the National Resident Matching Program (NRMP) and Electronic Residency Application Service (ERAS).

Applicants to colon and rectal surgery (CRS), surgical oncology, pediatric surgery, surgical critical care (SCC), thoracic surgery, and vascular surgery fellowships from 2017 to 2024.

The total number of surgical fellowship applicants increased by 19%, from 748 in 2017 to 890 in 2024. The largest increase in applicants occurred in 2020 after the start of virtual interviews, particularly for SCC (+27.0%). The number of submitted applications across all specialties increased by an average of 37.4% during the study period, with notable growth after the pandemic began. However, in the 2023 to 2024 cycle when virtual interviews were no longer mandated, overall application numbers decreased (-3.0%) and the number of total applicants to subspecialty fellowships decreased (-4.4%). Match percentages increased that cycle for all specialties except CRS and surgical oncology.

While the number of surgical fellowship applications and applicants increased overall throughout the study period, stark increases occurred both immediately after the pandemic's onset and when virtual interviews began. Early declines in both the number of applicants and applications submitted after the return of in-person interviews suggests that interview format may influence recruitment patterns, which has important implications for both fellowship programs and applicants.