OBJECTIVE: Limitations to medical student clinical rotation opportunities brought on by the pandemic has the potential to exacerbate differences in access to clinical experience between medical schools, and thus impact the distribution of graduates matching into neurosurgical programs nationwide. The utilization of virtual interviews that started after the pandemic are likely here to stay. In this study we seek to evaluate match rates for American (AMGs) and international medical graduates (IMGs) across the 6 most recent academic years, examining specifically the rate of home-institution matching before, during, and after the COVID-19 pandemic.
METHODS: All neurological surgery residents for the years 2018-2024 were included in this analysis, with basic information about each resident being collected using publicly available online resources. For any remaining programs where information was not publicly available, program directors were contacted. Statistical analysis was performed using SPSS version 26.0 with a level of significance p<0.05.
RESULTS: Of the total of 1271 AMGs, 1005 (79.1 %) matched away from their home institution. When dividing the 6 academic years into 3 subgroups (pre, intra, and post COVID-19), there was no significant variation between the rates of home institution matching (pre=21.0 %, during=20.4 %, post=21.3 %, p=0.740). Similar results were found while assessing IMGs (pre=28.6 %, during=30.8 %, post=32.3 %, p=0.777). Our analysis found no variation in match rates when isolating for gender across the 6 years studied either for AMGs or IMGs. However, overall institute-specific variations were found where some programs showed increased likelihood of home program match (p<0.001).
CONCLUSIONS: Preliminary data analysis suggests that contrary to the broader trends seen in other specialties, neurosurgery applicants do not exhibit a significant shift towards matching in closer proximity to their home institutions post COVID-19 pandemic and during the virtual interviews era.

UNASSIGNED: Surgical residency training is prominently demanding and stressful. This can affect the residents\' wellbeing, work-life balance and increase the rates of burnout. We aimed to assess rates of satisfaction and burn-out among GS residents in the national training programs and provide a subsequent in-depth analysis of the potential reasons.
UNASSIGNED: A sequential explanatory mixed-methods study was conducted using an online survey and virtual interviews. The validated abbreviated Maslach Burnout Inventory (aMBI) was used to assess burnout while satisfaction was assessed via 5-points Likert scale.
UNASSIGNED: After excluding incomplete responses from the total 74 received, 53 were analyzed. The average participant age was 27.4 ± 2 years, with females comprising 52 % of the sample. Junior residents made up 58.5 %, and nearly half -45 %- considered quitting GS training. Moderate to high burnout rates were noted on each aMBI subscale, ranging from 41.7 % to 62.5 %. The majority of residents expressed dissatisfaction with the level of research engagement (81.1 %), supervision, and mentorship. However, operative exposure was a source of satisfaction. Dissatisfaction rates with intra-operative learning, academia, teaching, and clinical exposure were 62.3 %, 52.8 %, 50.9 %, and 35.8 %, respectively. Interviews revealed surgical case flow and a friendly work environment as major satisfaction sources. Conversely, lack of academic supervision and suboptimal hands-on training were major dissatisfaction sources.
UNASSIGNED: Dissatisfaction and burn-out is prevalent among national GS training programs. Sub-optimal educational delivery and low-quality hands-on operative exposure -rather than lack of exposure to cases- seem to be the culprit.

Objectives:The study aimed to address the shortage of pediatric surgery specialists globally by investigating the discrepancies in training programs and population metrics across different countries and regions. Methods: An international survey of pediatric surgeons gathered data on training duration, examination procedures, certification, and population metrics like mortality rate and surgeon-to-population ratio. Results: The study included 44 countries. The average length of pediatric surgery training was 5.7 years, with no significant difference between different regions. The pediatric mortality rate and surgeons count per 100 000 people were inversely correlated, while training duration was associated with GDP and life expectancy, but not pediatric mortality rate or surgeons\' count. Conclusion: Many countries\' pediatric surgery training programs do not align with their actual need for pediatric surgeons. Nations with limited economic resources may opt to shorten residency programs or offer pediatric surgery as a direct specialty after medical school to mitigate the shortage effectively.

Residency programs in anesthesiology and intensive care (AIC), and emergency medicine (EM) continually evolve to ensure well-prepared trainees for these critical fields of healthcare. The objective of this study was to collect comprehensive feed-back from AIC and EM residents, comprising opinions and attitudes on: curriculum and structure of the residency program; scope of training environment, opportunities and complexity; training guidance and mentorship; teaching approach. An anonymous online cross-sectional survey was conducted among AIC and EM trainees during December 2023-January 2024 and June 2023-July 2023, respectively. Two hundred and thirty-five answers were collected: 137 (73/64 female/male) and 98 (55/43 female/male) respondents from the AIC and EM programs, respectively. Overall feed-back was equivalent for both residency programs, with differences related to the distinct characteristics of each medical specialty. The main issues identified across the programs were the need to improve and diversify the teaching approaches, with trainees\' strong desire for more professional guidance, mentoring, and constant feed-back. The findings would inform decision-making beyond current residency programs in these critical care specialties, highlighting the need to design solutions for interactive and highly immersive educational experiences, such as simulation, augmented reality or virtual reality.

OBJECTIVE: We aimed to investigate trends in residency program application and acceptance rates according to sex and race and ethnicity.
METHODS: We collected data from the Journal of the American Medical Association Graduation Medical Education Reports. We extracted the data for 25 residency programs in the United States from 2005 to 2021 and conducted statistical analyses.
RESULTS: Men were most matched for orthopedics (84.7%, 95% confidence interval [CI] 84.2%-85.1%), and women for oncology (78.7%, 95% CI 78.2%-79.2%). The most matched program was orthopedics for the White subgroup (43.5%, 95% CI 43.2%-43.9%), radiology for the Black subgroup (20%, 95% CI 18.9%-20.9%), general surgery for the Hispanic subgroup (11%, 95% CI 10.7%-11.2%), and internal medicine for the Asian subgroup (35.3%, 95% CI 34.9%-35.6%).
CONCLUSIONS: Match rates for women were lower than those for men in all programs except psychiatry, pediatrics, obstetrics and gynecology, and dermatology. Match rates were significantly lower for Black, Hispanic, and Asian subgroups than the White subgroup in all programs except for internal medicine, with the Asian subgroup being higher. We observed a significant increase in both application and acceptance rates for women and racial and ethnic minorities over the past 40 years.

Purpose  Microscopic ophthalmic surgery requires an understanding of three-dimensional (3D) spaces within the eye. Recently, there has been an increase in 3D video training tools in health care. Studies have evaluated the efficacy of 3D tutorials in general surgery, but little has been published within ophthalmology. We present a randomized study evaluating differences in surgically naïve trainees after watching either a 2D or 3D phacoemulsification tutorial. Design  This was a double-blind, randomized study. A group of third and fourth year medical students at our institution were randomized with stratified randomization based on prior surgical courses to control for differences in baseline surgical skill. The two study arms were watching 2D or 3D instructional videos on phacoemulsification (Richard Mackool). Methods  Participants received a preliminary survey and participated in an hour-long microscopic surgery session. During the session, participants performed tasks evaluating baseline microscopic spatial awareness and surgical skill. The students were then instructed to watch either a 2D or 3D video on phacoemulsification based on their randomized study arm. During the postintervention session, participants performed the biplanar incision and capsulorhexis steps of cataract surgery discussed in the video on model eyes. Students were evaluated on speed and overall capsulorhexis quality. Results  Thirty-one students qualified for the study and completed the microscopic surgery session. Students in both groups had similar baseline speed and quality of preintervention microscopic tasks ( p  > 0.05 for all tasks). Postintervention, students randomized to the 3D video performed significantly faster than the 2D group for biplanar incision (11.1 ± 5.5 s vs. 20.7 ± 10.5 s, p  = 0.001). There were no statistically significant differences found between the groups in capsulorhexis timing ( p  = 0.12) or quality score ( p  = 0.60). Conclusions  3D video surgical training tutorials may improve speed of certain steps of cataract surgery for surgically naïve ophthalmology trainees. Given the limited sample size of this study, further investigation of their effectiveness is warranted.

OBJECTIVE: To determine the characteristics of current US Otolaryngology-Head and Neck Surgery (Oto-HNS) residents and their medical school.
METHODS: Data were manually collected between Dec 2022 and Jan 2023 for 1649 residents attending 163 US-based ACGME accredited Oto-HNS residency programs, reflecting the 2018-2022 cohort. All data were collected from publicly available sources including residency and medical school program websites, web of science, and professional networking sites (ex: LinkedIn, Doximity). Data were analyzed to determine the \"feeder\" schools which contributed the greatest number and percent of residents. Using univariable linear regression models, we characterized factors which were associated with feeder school status.
RESULTS: Of 1649 residents analyzed, 364 (22 %) matched to their home program and 918 (56 %) stayed in the region of their medical school. The median [IQR] number of published papers and abstracts was 5 [3, 9] with an h-index of 2 [1,4]. Factors associated with producing a greater percent of Oto-HNS residents include presence of an interest group, presence of a home program, USNWR research rank of the medical school, Doximity reputation rank of the home residency program, average pre-residency h-index of the school\'s graduates, and total NIH research funding (each p < 0.001).
CONCLUSIONS: In the changing landscape of residency applications after the USMLE Step 1 exam\'s transition in January 2022 to pass/fail scoring, it is important to objectively characterize current Oto-HNS residents. Findings from this study will inform prospective residents and residency programs seeking to improve access to Oto-HNS. Future small-scale studies may help further identify driving factors within medical school curricula.

Background Orthopedic surgery residency programs are some of the least gender-diverse specialty programs in medicine. Despite strong representation at the undergraduate and medical school levels and increased applications to orthopedic surgery residency programs by women, there is still a substantial gender gap at the resident level. This study explores the relationship between the gender diversity of orthopedic surgery residency programs and program rankings. Methodology Program rank, program director gender identity, and gender diversity data were collected for the top 100 programs by reputation in Doximity. Gender diversity was measured as the proportion of female residents in the program and alumni. Results The greatest percentage of women in a program was 33% and the smallest was 3%. After linear regression analysis, we found that there was a statistically significant positive correlation between program rank and the proportion of women. The higher ranked a program was, the greater the proportion of women. There was no significant correlation between program director gender, appointment year, and program rank. Conclusions These results suggest that, although there is still a long way to go before closing the gender gap in orthopedic surgery residency programs, higher-ranked programs are associated with greater gender diversity than their lower-ranked counterparts.

This article was migrated. The article was marked as recommended. Social media use across the health professions has significantly expanded in recent years. Specific attention has been paid to both the value of social media use in graduate medical education with residency program twitter accounts. More recently, social media has been examined for its role in supporting the rapid expansion of information exchange and connection across digital and virtual platforms during the COVID-19 pandemic. With the ongoing response to the pandemic, the 2020-2021 residency application cycle is anticipated to be a completely virtual interview process. Here, we draw from our collective experiences managing, maturing, and maximizing social media accounts for residency programs and GME to provide practical tips for using social media for the upcoming virtual interview season.

BACKGROUND: In Japan, postgraduate clinical training encompasses a 2-year residency program, including at least 24 weeks of internal medicine (IM) rotations. However, the fragmented structure of these rotations can compromise the training\'s quality and depth. For example, a resident might spend only a few weeks in cardiology before moving to endocrinology, without sufficient time to deepen their understanding or have clinical experience. This study examined current patterns and lengths of IM rotations within the Japanese postgraduate medical system. It scrutinized the piecemeal approach-whereby residents may engage in multiple short-term stints across various subspecialties without an overarching, integrated experience-and explored potential consequences for their clinical education.
METHODS: This nationwide, multicenter, cross-sectional study used data from self-reported questionnaires completed by participants in the 2022 General Medicine In-Training Examination (GM-ITE). Data of 1,393 postgraduate year (PGY) one and two resident physicians who participated in the GM-ITE were included. We examined the IM rotation duration and number of IM subspecialties chosen by resident physicians during a 2-year rotation.
RESULTS: Approximately half of the participants chose IM rotation periods of 32-40 weeks. A significant proportion of participants rotated in 5-7 internal medicine departments throughout the observation period. Notable variations in the distribution of rotations were observed, characterized by a common pattern where resident physicians typically spend 4 weeks in each department before moving to the next. This 4-week rotation is incrementally repeated across different subspecialties without a longer, continuous period in any single area. Notably, 39.7% of participants did not undertake general internal medicine rotations. These results suggest a narrowed exposure to medical conditions and patient care practices.
CONCLUSIONS: Our study highlights the need to address the fragmented structure of IM rotations in Japan. We suggest that short, specialized learning periods may limit the opportunity to gain broad in-depth knowledge and practical experience. To improve the efficacy of postgraduate clinical education, we recommend fostering more sustained and comprehensive learning experiences.