Ryan S Chung, David J Cote, Robert G Briggs, Ishan Shah, Michelle Lin, Keiko M Kang, Angela Tang-Tan, David Gomez, Jonathon Cavaleri, Angela P Mihalic, John C Liu, Steven L Giannotta, William J Mack, Gabriel Zada
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引用次数: 0
Abstract
Objective: Applications to neurosurgical residency programs have progressively increased, both in applicant numbers and programs applied to per applicant. The adoption of signaling, beginning with 8 signals in the 2022-2023 cycle and increasing to 25 in the 2023-2024 cycle, has the potential to improve the match process and reduce applicant costs. This study analyzed trends in the neurosurgery residency match from 2017 to 2024 to evaluate the impact of signaling.
Methods: The Texas STAR (Seeking Transparency in Application to Residency) is a survey administered annually to US applicants following the match. Data included neurosurgery applicants from 2017 to 2024 and were categorized into pre-COVID-19 (2017-2020), COVID-19 (2021-2022), and signaling (2023-2024) cohorts. Applicant-reported characteristics associated with matching were assessed. For the 2023 and 2024 cycles, signal yield (interviews at signaled programs divided by total signals), signal-to-interview ratio (percentage of interviews at signaled programs), and nonsignal yield (interviews at nonsignaled programs divided by nonsignaled applications) were calculated. Comparative statistics and regression models were applied.
Results: Among 418 applicants (127 from 2023-2024 with signaling data), those in recent cycles submitted fewer applications (73.9 pre-COVID-19 vs 74.7 COVID-19 vs 64.3 signaling, p = 0.01) and received fewer interview offers (24.7 vs 23.0 vs 18.9, p < 0.001). In the 2023-2024 cycles, matched applicants had more abstracts, posters, presentations (8.65 vs 9.58 vs 10.47, p < 0.001) and publications (5.78 vs 7.71 vs 7.91, p < 0.001), with fewer total applications (72.62 vs 75.03 vs 62.26, p < 0.001) and interviews offered (25.85 vs 23.40 vs 21.02, p = 0.004), compared with matched applicants from previous cycles. A multivariable model showed that fewer applications was associated with greater match likelihood for 2023-2024 applicants (OR 0.87, 95% CI 0.77-0.99). Signal yield (54.0% vs 19.1%, p < 0.001), signal-to-interview ratio (71.5% vs 38.0%, p < 0.001), and nonsignal yield (22.4% vs 8.6%, p = 0.02) were higher among matched applicants versus unmatched applicants in 2024. The signal-to-interview ratio increased for matched applicants from 2023 to 2024 (18.2% vs 71.5%, p < 0.001), while the nonsignal yield decreased (33.7% vs 22.4%, p = 0.005), in line with increases in number of signals.
Conclusions: Signaling has changed the landscape of the neurosurgery residency match process, with fewer applications submitted and fewer interviews offered per applicant. Signals seemingly result in increased interview likelihood and may hone the selection process to more efficiently align applicant and program preferences.
目的：申请神经外科住院医师项目的人数和每个申请人申请的项目都在逐步增加。从2022-2023周期的8个信号开始，到2023-2024周期增加到25个信号，采用信号有可能改善匹配过程并降低申请人成本。本研究分析了2017年至2024年神经外科住院医师匹配的趋势，以评估信号的影响。方法：德克萨斯州STAR（寻求居住申请透明度）是一项每年对美国申请人进行的调查。数据包括2017年至2024年的神经外科申请人，并分为COVID-19前期（2017-2020），COVID-19（2021-2022）和信号（2023-2024）队列。评估申请人报告的与匹配相关的特征。对于2023年和2024年的周期，我们计算了信号产量（有信号程序的面试数除以总信号数）、信号面试比（有信号程序的面试数的百分比）和非信号产量（无信号程序的面试数除以无信号程序）。采用比较统计和回归模型。结果：在418名申请人中（127名来自2023-2024年，具有信号数据），最近周期的申请人提交的申请较少（73.9对74.7对64.3信号，p = 0.01），获得的面试机会较少（24.7对23.0对18.9,p < 0.001）。在2023-2024周期中，匹配的申请人有更多的摘要、海报、演讲（8.65 vs 9.58 vs 10.47, p < 0.001）和出版物（5.78 vs 7.71 vs 7.91, p < 0.001），总申请（72.62 vs 75.03 vs 62.26, p < 0.001）和面试（25.85 vs 23.40 vs 21.02, p = 0.004），与前几个周期的匹配申请人相比。多变量模型显示，2023-2024年申请者的申请数量越少，匹配可能性越大（OR 0.87, 95% CI 0.77-0.99）。2024年，匹配申请人的信号率（54.0%对19.1%,p < 0.001）、信号与面试比率（71.5%对38.0%,p < 0.001）和非信号率（22.4%对8.6%,p = 0.02）高于未匹配申请人。从2023年到2024年，匹配申请人的信号与面试比率增加了（18.2%对71.5%,p < 0.001），而非信号率下降了（33.7%对22.4%,p = 0.005），这与信号数量的增加一致。结论：信号已经改变了神经外科住院医师匹配过程的景观，提交的申请越来越少，每个申请人的面试机会也越来越少。信号似乎会增加面试的可能性，并可能磨练选择过程，更有效地协调申请人和项目的偏好。
期刊介绍：
The Journal of Neurosurgery, Journal of Neurosurgery: Spine, Journal of Neurosurgery: Pediatrics, and Neurosurgical Focus are devoted to the publication of original works relating primarily to neurosurgery, including studies in clinical neurophysiology, organic neurology, ophthalmology, radiology, pathology, and molecular biology. The Editors and Editorial Boards encourage submission of clinical and laboratory studies. Other manuscripts accepted for review include technical notes on instruments or equipment that are innovative or useful to clinicians and researchers in the field of neuroscience; papers describing unusual cases; manuscripts on historical persons or events related to neurosurgery; and in Neurosurgical Focus, occasional reviews. Letters to the Editor commenting on articles recently published in the Journal of Neurosurgery, Journal of Neurosurgery: Spine, and Journal of Neurosurgery: Pediatrics are welcome.
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