Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA.
Department of Neurosurgery, University of California San Diego, La Jolla, California, USA.
World Neurosurg. 2020 May;137:e584-e596. doi: 10.1016/j.wneu.2020.02.069. Epub 2020 Feb 19.
The increasing competitiveness of the neurosurgical residency match has made it progressively difficult for foreign medical graduates (FMGs) to match in neurosurgery. We compared FMG to U.S. medical graduate (USMG) match rates in neurosurgery and identified factors associated with match outcomes for FMGs in neurosurgery.
Retrospective review of American Association of Neurological Surgeons membership data and Association of American Medical Colleges Charting the Outcomes match reports (2007-2017).
Across 1857 neurosurgical residents (USMG: 91.1%, FMG: 8.9%), average FMG match rates were 24% (range, 15%-35%) versus 83% (range, 75%-94%; P < 0.001) for USMG. FMGs were more male (89.5% vs. 82.0%, P = 0.016), older (33.9 vs. 31.8 years, P = 0.008), and more likely to take research year(s) before matching (95.8% vs. 78.5%, P < 0.001). FMGs had greater publications (5 vs. 2, P < 0.001) and H-indices (3 vs. 1, P < 0.001). The number of matched USMGs increased by 3.3 annually, whereas that of matched FMGs remained unchanged (β = 0.07). Compared with USMGs, FMGs were less likely to match to National Institutes of Health (NIH) Top 40 (32.7% vs. 47.5%, P < 0.001) and Doximity Top 20 (20.0% vs. 29.0%, P = 0.014) programs. FMGs with prior U.S. neurosurgery program affiliation were more likely to match at NIH and Doximity Top 20 programs (P < 0.05). For NIH programs, FMGs were older (35.3 vs. 32.0, P = 0.011), had higher H-indices (5 vs. 2, P < 0.001), publications (7 vs. 2, P < 0.001), and were more likely to take research year(s) (94.4% vs. 76.0%, P = 0.002) than USMGs. FMGs had similar patterns for matching into Doximity Top 20 programs.
Although FMGs have lower match rates into U.S. neurosurgery residencies than USMGs, several demographic, professional, and academic factors could increase the chances of successful FMG neurosurgical match.
神经外科住院医师匹配的竞争日益激烈，使得外国医学毕业生（FMG）越来越难以在神经外科匹配。我们比较了 FMG 和美国医学毕业生（USMG）在神经外科的匹配率，并确定了与 FMG 在神经外科匹配结果相关的因素。
回顾性分析美国神经外科学会会员数据和美国医学院协会图表结果匹配报告（2007-2017 年）。
在 1857 名神经外科住院医师中（USMG：91.1%，FMG：8.9%），FMG 的平均匹配率为 24%（范围 15%-35%），而 USMG 的匹配率为 83%（范围 75%-94%；P<0.001）。FMG 更男性（89.5% vs. 82.0%，P=0.016），年龄更大（33.9 岁 vs. 31.8 岁，P=0.008），并且更有可能在匹配前参加研究年（95.8% vs. 78.5%，P<0.001）。FMG 的出版物数量更多（5 篇 vs. 2 篇，P<0.001）和 H 指数更高（3 篇 vs. 1 篇，P<0.001）。匹配的 USMG 数量每年增加 3.3 人，而匹配的 FMG 数量保持不变（β=0.07）。与 USMG 相比，FMG 更不可能匹配到 NIH 前 40 名（32.7% vs. 47.5%，P<0.001）和 Doximity 前 20 名（20.0% vs. 29.0%，P=0.014）项目。有美国神经外科项目背景的 FMG 更有可能匹配到 NIH 和 Doximity 前 20 名项目（P<0.05）。对于 NIH 项目，FMG 年龄更大（35.3 岁 vs. 32.0 岁，P=0.011），H 指数更高（5 篇 vs. 2 篇，P<0.001），出版物更多（7 篇 vs. 2 篇，P<0.001），并且更有可能参加研究年（94.4% vs. 76.0%，P=0.002）比 USMG。FMG 进入 Doximity 前 20 名项目的模式也类似。
尽管 FMG 在美国神经外科住院医师培训中的匹配率低于 USMG，但一些人口统计学、专业和学术因素可以增加 FMG 神经外科成功匹配的机会。
