Nasser Jacob S, Artino Anthony R, Kind Terry, Duan Xuejing, Mihalic Angela P, Chretien Katherine
School of Medicine and Health Sciences, George Washington University, Washington, DC, USA.
School of Public Health, Milken Institute, George Washington University, Washington, DC, USA.
Med Educ Online. 2023 Dec;28(1):2189558. doi: 10.1080/10872981.2023.2189558.
Evidence-informed data may help students matching into competitive residency programs guide curricular activities, extracurricular activities, and residency career choices. We aimed to examine the characteristics of students applying to competitive surgical residencies and identify predictors of matching success. We identified the five lowest match rates for the surgical subspecialities listed in the 2020 National Resident Matching Program report to define a surgical residency as competitive. We analyzed a database from 115 United States medical schools regarding application data from 2017 to 2020. Multilevel logistic regression was used to determine predictors of matching. Statistical significance was set at < 0.05.A total of 1,448 medical students submitted 25,549 applications. The five most competitive specialties included were plastic surgery ( = 172), otolaryngology ( = 342), neurological surgery ( = 163), vascular surgery ( = 52), orthopedic surgery ( = 679), and thoracic surgery ( = 40). We found that medical students with a geographical connection (adjusted OR, 1.65 [95% CI, 1.41 to 1.93]), and students who did an away rotation at the applied program (adjusted OR, 3.22 [95% CI, 2.75 to 3.78]) had statistically significantly increased odds of matching into a competitive surgical specialty. Furthermore, we found that students with a United States Medical Licensing Examination (USMLE) Step 1 score below 230 and Step 2 Clinical Knowledge (CK) score below 240 had increased odds of matching if they completed an away rotation at the applied program. Completing an away rotation and geographical connection to the institution may contribute more than academic criteria for selection into a competitive surgical residency after an interview. This finding may be due to less variation in academic criteria among this pool of high-performing medical students. Students with limited resources who apply to a competitive surgical specialty may be at a disadvantage given the financial burden of an away rotation.
基于证据的数据可能有助于申请竞争激烈的住院医师培训项目的学生指导课程活动、课外活动和住院医师职业选择。我们旨在研究申请竞争激烈的外科住院医师培训项目的学生的特征，并确定匹配成功的预测因素。我们根据2020年全国住院医师匹配计划报告中列出的外科亚专业的五个最低匹配率，将外科住院医师培训项目定义为竞争激烈的项目。我们分析了来自115所美国医学院校的2017年至2020年申请数据的数据库。采用多水平逻辑回归来确定匹配的预测因素。统计学显著性设定为<0.05。共有1448名医学生提交了25549份申请。竞争最激烈的五个专业包括整形外科（=172）、耳鼻喉科（=342）、神经外科（=163）、血管外科（=52）、骨科（=679）和胸外科（=40）。我们发现，与申请项目所在地区有联系的医学生（调整后的比值比，1.65[95%置信区间，1.41至1.93]），以及在申请项目中进行过外地轮转的学生（调整后的比值比，3.22[95%置信区间，2.75至3.78]），匹配到竞争激烈的外科专业的几率在统计学上显著增加。此外，我们发现，美国医学执照考试（USMLE）第一步成绩低于230分且第二步临床知识（CK）成绩低于240分的学生，如果他们在申请项目中完成了外地轮转，匹配的几率会增加。在面试后，完成外地轮转以及与机构的地域联系对外科住院医师培训项目的选拔可能比学术标准贡献更大。这一发现可能是由于在这批成绩优异的医学生中，学术标准的差异较小。鉴于外地轮转的经济负担，申请竞争激烈的外科专业但资源有限的学生可能处于劣势。
