OBJECTIVE: Traditional options for unmatched applicants in urology include pursuing a research fellowship or completing a preliminary general surgery training year. We aimed to create a novel urology-focused preliminary curriculum.
METHODS: The general surgery program commits three preliminary positions for urology-focused interns. These interns complete six months of urology rotations and six months of general surgery rotations. Additionally, they are paired with a urology faculty member to participate in a longitudinal coaching and mentorship program.
METHODS: The curriculum is situated within a Department of Surgery, which includes the Division of Urology, at one academic institution.
METHODS: Eight residents have completed the urology-focused preliminary curriculum in three academic years (2022-2023).
RESULTS: Six residents have obtained categorical urology positions. Four matched via the American Urological Association Urology Match into a post-graduate year 1 (PGY1) position, and two matched outside of a formal matching process into a PGY2 position.
CONCLUSIONS: This urology-focused preliminary curriculum presents a novel strategy to address the growing number of unmatched applicants in competitive surgical subspecialties such as urology.

OBJECTIVE: Following the transition to virtual interviews in 2021, interviewees began receiving gifts as a recruitment strategy in lieu of the preinterview dinner. This study characterizes quantity, type, and frequency of gift receipt in relation to program perception and ranking.
METHODS: An anonymous survey study was conducted. Variables included demographics, interview modality, gift type, frequency of gift receipt, monetary value, and changes in program perception and ranking. Descriptive analyses and Pearson\'s chi-square testing were performed.
METHODS: Single institution with a medium to large general surgery program size.
METHODS: All general surgery residents at the single institution without exclusion.
RESULTS: About 25 residents responded (60% response). Two respondents (8%) participated in both in-person (IPIs) and virtual interviews (VIs). About 72% (n = 18) participated in VIs, 36% (n = 9) IPIs. About 68% matched in 2021 or later. Overall, 76% received a gift during interviews. 100% of IPIs received a gift, while 67% of VIs received a gift. 88.9% of IPIs received a meal. VIs received: meal shared (28.6%), meal not shared (14.3%), food-specific gift card (28.6%), other food items (21.4%), or other (7.1%). About 66.7% of IPIs (n = 6) reported 76% to100% of programs offered a meal, whereas no VIs reported 76% to 100% of programs offering (p = 0.0002). VIs were less likely to have a shared meal experience (p = 0.017). About 55.5% of IPIs and VIs received nonfood gifts. Residents\' perception of a program\'s interest, resources, and ranking of the program were not significantly different based on gifting.
CONCLUSIONS: Virtual interviews introduced heterogeneity in the receipt of gifts. The impact of a variable gifting experience is uncertain but raises concern for a potential new source of bias in the recruitment process.

The residency match process can be overwhelming. We are the Collaboration of Surgical Education Fellows (CoSEF), a multi-institutional group of surgical residents. Our perspectives represent our current experiences as residents at academic programs, but all authors recently underwent the general surgery resident interview and match process, during which they interviewed at programs of all kinds. Based on our collective experiences, we aim to highlight program attributes that applicants should consider to find their perfect match.

UNASSIGNED: The COVID-19 pandemic brought unprecedented changes to the medical field, including the gastroenterology (GI) fellowship application process. This study aimed to assess the impact of the pandemic on GI fellowship applications, with a focus on applicants\' gender and medical school training type.
UNASSIGNED: Data from the GI match results for 2018-2022 were collected, including the number and percentage of matched applicants per year, categorized by gender, US medical graduates, international medical graduates (IMGs), and Doctors of Osteopathic Medicine (DOs). Statistical analyses were performed to evaluate trends and changes in matching rates, both before and during the pandemic.
UNASSIGNED: There was a significant increase in the number of females matching into GI fellowships over the 5-year period. DOs also witnessed a significant increase in matching rates during the COVID-19-impacted years (2021-2022). However, no significant changes were observed for US medical graduates and IMGs.
UNASSIGNED: The study highlights positive trends in gender and DO representation in GI fellowships. Despite these improvements, gender disparities persist, necessitating continued efforts to promote diversity and equity in the field. Additionally, challenges for IMGs remain, requiring attention to structural barriers. The long-term effects of the pandemic on fellowship matching and diversity warrant further investigation to inform future policies and practices in GI training programs.

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BACKGROUND: Between 1994 and 2014, despite an increase in applicants, successful matches into general surgery (GS) decreased by 13%. We aim to (1) understand the trends in competitiveness for a GS residency, and ascertain the associations between (2) geographical distribution and (3) research experiences on matching.
METHODS: National Resident Matching Program data (2013-2022) were analyzed for (1) annual positions and matches, (2) United States Medical Licensing Examination scores, and (3) research experiences. Geographical locations of general surgery residency programs (GSRPs) for matched US seniors were obtained from medical school websites and through contacting institutions. Distances between medical schools and respective matches were assessed for the proportion of students matching within 100 miles, in the same state or same region, or in a different geographical region than their medical school.
RESULTS: Of 28,690 applicants, 15,242 (53.12%) matched into a GS residency. Matched GS applicants had higher United States Medical Licensing Examination scores compared to applicants who matched in Emergency Medicine and Family Medicine (P < 0.001). US Medical Doctor (MD) match rates into GS were lower compared to Neurosurgery (P < 0.01), possibly due to competition from non-US MD applicants within GS. More applicants matched into GSRPs in the same region as their medical school, with 14% matching into home programs or within the same state as their medical school.
CONCLUSIONS: Higher board examination scores and research participation are associated with successful matches. GS competition from non-US MDs may be driving the match rates for US MDs lower. More than half of students matched into GSRPs in the same region as their medical school.

The National Resident Matching Program (NRMP), known as \"The Match (TM),\" facilitates the placement of medical graduates into residency and fellowship programs in the United States. Programs may opt out of TM for various reasons. The selective and intermittent withdrawal of programs from TM raises ethical concerns surrounding fairness, transparency, beneficence, autonomy, and justice for applicants. We discuss these issues, present the history behind TM, and offer suggestions to promote fairness.

BACKGROUND: Letters of recommendation (LOR) are considered by program directors (PDs) to be an integral part of the residency application. With the conversion of United States Medical Licensing Examination (USMLE) Step 1 to a binary pass/fail outcome, LORs will likely have higher important in the application process moving forward. However, their utility in securing an interview for a particular applicant remains undetermined. This study aims to identify the applicant and LOR characteristics associated with an interview invitation.
METHODS: Letter writer (n = 977) characteristics were abstracted from applications (n = 264) to an individual integrated vascular surgery residency program over 2 application cycles. A validated text analysis program, Linguistic Inquiry and Word Count, was used to characterize LOR content. Applicant, letter writer, and LOR characteristics associated with an interview invitation were determined using multivariable analysis.
RESULTS: Letter writers were 70.9% vascular surgeons (VS), 23.7% PDs, and 45.4% professors. Applicants offered an interview were more likely to come from a top 50 medical school (35.2% vs 25.8%, P = 0.013) and an institution with a home vascular program (45.5% vs 34.1%, P = 0.006). Alpha Omega Alpha membership was significantly associated with interview offer (28.4%, P < 0.001). A greater proportion of letters from VS was associated with an interview offer (P < 0.001) compared with letter writers of other specialties. One or more PD letters were significantly associated with an interview offer (79.55% vs 20.45%, P = 0.008), whereas number of letters from APDs was not significantly associated with interview offer. Letters written by away institution faculty were significantly associated with interview offer (75%, P < 0.001), whereas nonclinical letters were not. Presence of one or more letters from a chair (57.95% vs 42.05%, P = 0.015) or chief (67.05% vs 32.95%, P = 0.028) was significantly associated with interview offer. Letters for applicants offered an interview had more references to research and teaching, which were more common in letters written by versus Letters written by PDs were more likely to use assertive, advertising language in favor of applicants. There were no significant applicant, letter writer, or LOR characteristics associated with a top 20 rank.
CONCLUSIONS: Successful applicants were more likely to have LORs written by VS, PDs, and those of higher academic rank with references to research and teaching.

As competitiveness to obtain a residency position in the field of Otolaryngology-Head and Neck Surgery (Oto-HNS) has continued to rise, applicants have endeavored to set themselves apart. One increasingly popular strategy is maximizing research output. Over the past 6 years, applicant metrics such as board scores and volunteer and work experiences have risen incrementally, while research production has more than doubled, from 8.4 mean number of abstracts, presentations, and publications in 2016 to 17.2 in 2022. This coincides with the exponential surge of new research fellowships among Oto-HNS departments over a similar period, which is now up to at least 68 advertised positions. With a significant difference between the research production of matched and unmatched applicants, programs may be signaling a positive bias towards research-heavy applicants. Whether this is intended and/or preferable should be examined more closely.

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