J. A. Keeley1, C. DeVirgilio1, A. Moazzez1, S. Lee1, B. Jarmin2, A. L. Neville1 1Harbor-UCLA Medical Center,General Surgery,Torrance, CA, USA 2Gunderson Medical Foundation,General Surgery,La Crosse, WI, USA
Introduction: Over the past decade, it appears that the number of General Surgery residency applicants has increased. We hypothesized that implementation of the 80-hour workweek in 2003 may have influenced this trend. The purpose of this study was to evaluate national and local trends in applications to surgical residency after implementation of the 80-hour workweek.
Methods: NRMP Results and Data from the Main Residency Match between 1999 and 2014 were interrogated for the number of applicants, available general surgery positions, and ranks per available positions. Data from an academic program (California) and an independent program (Wisconsin) was also collected for available years, 2007 to 2014. Data was statistically analyzed using linear regression (SPSS V22).
Results: Nationally, the number of unfilled residency positions decreased from an average of 44.7 prior to 2003 to 4.1 after 2003, (p= 0.04). Since 2003, the percentage of total US applicants applying to surgery, the percentage of general surgery positions available, and the number of positions per US applicant have been stable (Figure 1). However, the number of ranks submitted per available position increased from 9.6 in 2004 to 11.0 in 2014 (p=0.007).
The number of applications submitted to the two individual programs increased over the last eight years, both in total number and in percentage of the US surgical applicants who applied to each program. Total US applicants (percentage of surgical applicants) increased from 237 (22.7%) and 72 (6.9%) to 377 (29.6%) and 187 (14.7%) respectively for the two programs studied.
Conclusion: Since the introduction of the 80-hour workweek in 2003, there has been an increase in the number of applications to individual programs and the number of ranks per position. This may reflect a perceived increase in the competitiveness of the specialty, particularly given the decreased number of unfilled positions since 2003. However, nationwide, the total number of applicants and number of positions available per applicant has remained stable. The increased number of applications to individual programs increases the difficulty of the interview selection process and suggests the need for a refined approach to selecting candidates.
