J. Kessel1, K. Landrum2,3, C.B. Agala3, L. Pascarella4 1University Of North Carolina At Chapel Hill, School Of Medicine, Chapel Hill, NC, USA 2University Of North Carolina At Chapel Hill, Department Of Epidemiology, Chapel Hill, NC, USA 3University Of North Carolina At Chapel Hill, Department Of Surgery, Chapel Hill, NC, USA 4University Of North Carolina At Chapel Hill, Department Of Vascular Surgery, Chapel Hill, NC, USA
Introduction: Matching into general surgery residency involves guidance by mentors and applicant’s qualifications, but the impact of away rotations on odds of matching is unclear, especially with the COVID-19 related changes.
Methods: We analyzed self-reported data from general surgery resident applicants from the Texas STAR database to assess if away rotations correlate with successfully matching. Secondarily, we aimed to evaluate the impact of the COVID-19 pandemic on matching into general surgery. Descriptive and associational statistics were used to evaluate predictors of matching and the influence of away rotations.
Results: We reviewed 2,223 general surgery applicants from 2017-2023. Overall, applicants were more likely to complete an away rotation than not in the 2023 cycle and 20% of matched applicants earned spots at places they completed an away rotation. Applicants, on average, applied to 54 programs (median: 50) with a median number of interviews offered being 15 (SD: 9; min: 0; max: 59). The median number of attended interviews was 14 (mean 13, 6 SD; min: 0; max: 37). Overall, 48% of candidates completed at least one away rotation and had a higher match rate compared to those who did not do an away (89% vs 80%; p<0.0001). Participants completing at least one away rotation applied to more programs (median: 56 vs 61; p<0.0001) yet they received and attended the same number of interviews (median: 14 vs 13; p=0.2692) compared to those not completing an away. There was a statistically significant difference in the number of publications by those that completed away rotations vs not (away median: 1; no away median: 2, p=0.0014); however, there was no difference in number of volunteer, leadership, or research experiences, nor academic performance other than step 1 and 2 scores. 53% of respondents applied during pandemic years (2020-2022). Those applicants applied to more programs (p=0.0306), attended more interviews (p=0.0405), and had lower odds of completing an away rotation (OR: 0.57; 95: CI: 0.48, 0.67); however, still matched at higher odds if an away rotation was completed (OR 1.91 pandemic; OR 2.32 non-pandemic). Overall, participants completing at least 1 away rotation had 2.1 times the odds (OR 2.10; 95% CI: 1.64, 2.69; p<0.0001) of matching compared to participants completing no away rotations, after adjusting for step 1 and 2 scores, number of research experiences, and honors in general surgery clerkship.
Conclusion: Overall, applicants that complete away rotations are more likely to match despite receiving comparable interview invitations and academic profiles. The COVID-19 pandemic impacted the likelihood of completing an away rotation, but applicants were more likely to attend more interviews and still matched at higher rates if an away rotation was completed. The matching process remains complex as applicants and programs evolve highlighting the need for further studies on this relationship.