Matching into competitive surgical residencies: predictors of success

Figures & data

Table 1. Student Characteristics.

N (%)
Academic Predictors
USMLE Step 1 Score
190–209	7 (0.5)
210–219	18 (1.2)
220–229	68 (4.7)
230–239	191 (13.2)
240–249	437 (30.2)
250–259	523 (36.1)
≥260	204 (14.1)
USMLE Step 2 CK Score
210–219	8 (0.6)
220–229	22 (1.5)
230–239	86 (5.9)
240–249	252 (17.4)
250–259	531 (36.7)
≥260	543 (37.5)
Unknown	6 (0.4)
Honored Clerkships (Mean ± SD)	4.44 (2.31)
AOA Status
Yes	620 (42.8)
No	763 (52.7)
Absent School Chapter	65 (4.5)
Other Degrees
PhD	29 (2.0)
MS	131 (9.0)
MPH	38 (2.6)
Other	75 (5.2)
None	1,175 (81.1)
Honored Specialty Applying For
Yes	1,042 (72.0)
No	85 (5.9)
Unknown	321 (22.2)
Research Predictors
Research Experiences (Mean ± SD)	5.5 (2.9)
No Research Experiences	0 (0)
Peer-Reviewed Publications (Mean ± SD)	4.0 (3.5)
No Peer-Reviewed Publications	69 (4.8)
Abstracts/Posters/Presentations (Mean ± SD)	6.7 (3.7)
No Abstracts/Posters/Presentations	6 (0.4)
Research Year
Yes	196 (13.5)
No	1,184 (81.8)
Unknown	68 (4.7)
Geographic Predictors
Geographic Connection
Yes	249 (17.2)
No	1,199 (82.8)
Other Predictors
Number of Leadership Roles (Mean ± SD)	4.3 (±2.8)
No Leadership Roles	95 (6.6)
Away Rotation Status
Yes	66 (4.6)
No	1,382 (95.4)
Couples Match Status
Yes	100 (6.9)
No	931 (64.3)
Unknown	417 (28.8)

Table 2. Predictors of matching into top surgical residency specialties^π.

	OR (95% CI)	P-Value
Academic Predictors
USMLE Step 1 Score
190–209	Reference
210–219	0.90 (0.17, 4.73)	0.900
220–229	0.73 (0.16, 3.45)	0.694
230–239	0.87 (0.19, 4.01)	0.857
240–249	0.83 (0.18, 3.82)	0.814
250–259	0.86 (0.19, 3.93)	0.843
≥260	0.83 (0.18, 3.87)	0.816
USMLE Step 2 CK Score
210–219	Reference	—
220–229	0.99 (0.23, 4.27)	0.990
230–239	0.94 (0.25, 3.59)	0.931
240–249	0.98 (0.27, 3.57)	0.975
250–259	0.96 (0.26, 3.49)	0.951
≥260	0.94 (0.26, 3.40)	0.920
Honored Clerkships (Mean ± SD)	1.00 (0.96, 1.04)	0.908
AOA Status
No	Reference	—
Absent School Chapter	0.98 (0.67, 1.43)	0.900
Yes	0.88 (0.74, 1.05)	0.154
Other Degrees
None	Reference	—
PhD	1.20 (0.76, 1.89)	0.443
MS	0.93 (0.73, 1.20)	0.589
MPH	0.83 (0.53, 1.30)	0.419
Other	1.03 (0.72, 1.48)	0.853
Honored Specialty Applying For
No	Reference	—
Yes	1.01 (0.73, 1.38)	0.967
Research Predictors
Research Experiences	1.00 (0.97, 1.02)	0.798
Peer-Reviewed Publications	0.99 (0.97, 1.02)	0.477
Abstracts/Posters/Presentations	1.00 (0.97, 1.02)	0.851
Research Year
No	Reference	—
Yes	1.03 (0.82, 1.29)	0.796
Geographic Predictors
Geographic Connection
No	Reference	—
Yes	1.65 (1.41, 1.93)	<0.001
Other Predictors
Number of Leadership Roles	1.00 (0.98, 1.03)	0.902
Away Rotation Status
No	Reference	—
Yes	3.22 (2.75, 3.78)	<0.001
Couples Match Status
No	Reference	—
Yes	1.00 (0.80, 1.25)	0.988

Notes: ^π Variables in this multivariable include Step 1 and Step 2 USMLE scores, number of honored clerkships, AOA status, degree type, honored specialty applying for, research experiences, presence of a geographical connection, number of leadership roles, and away rotation status.

Table 3. Influence of away rotation and geographical connection on matching given USMLE step score.

	Unadjusted OR (95% CI)	P-Value
USMLE Step 1 < 230 and USMLE Step 2 CK < 240
Away Rotation
No	Reference	—
Yes	5.61 (3.17, 9.92)	<0.001
Geographical Connection
No	Reference	—
Yes	1.30 (0.72, 2.36)	0.383
USMLE Step 1 ≥ 230 and USMLE Step 2 CK ≥ 240
Away Rotation
No	Reference	—
Yes	4.71 (4.24, 5.24)	<0.001
Geographical Connection
No	Reference	—
Yes	2.02 (1.83, 2.22)	<0.001

Figure 1. Match rate after interview stratified by Specialty^α,χ.

Table 4. Match rate by year and specialty.

	2017				2018				2019				2020
	N	Matched	Unmatched	% Matched	N	Matched	Unmatched	% Matched	N	Matched	Unmatched	% Matched	N	Matched	Unmatched	% Matched
Neurological Surgery	4	4	0	100	38	37	1	97	54	48	6	89	67	55	12	82
Orthopedic Surgery	30	20	10	67	176	144	32	82	210	179	31	85	263	233	30	89
Otolaryngology	13	13	0	100	81	75	6	93	105	86	19	82	143	124	19	87
Plastic Surgery	14	12	2	86	41	38	3	93	42	37	5	88	75	61	14	81
Thoracic Surgery					6	4	2	67	20	11	9	56	14	7	7	50
Vascular Surgery	3	3	0	100	11	9	2	82	15	12	3	80	23	16	7	70

Table

Academic Predictors
USMLE Step 1 Score	Please select the range in which your USMLE Step 1 score falls.
USMLE Step 2 CK Score	Please select the range in which your USMLE Step 2 CK score falls.
Honored Clerkships	On how many core clerkships did you receive a final grade of A/Honors?
AOA Status	Are you a member of Alpha Omega Alpha Honor Medical Society?
Other Degrees	Please indicate any additional degree you will have completed at the time of your graduation from medical school.
Honored Specialty Applying For	Did you receive a final grade of A/Honors on your home rotation in this specialty?
Research Predictors
Research Experiences	Please indicate the number of research experiences listed on your residency application.
Peer-Reviewed Publications	Please indicate the number of peer-reviewed publications listed on your residency application that have been submitted, accepted, or published.
Abstracts/Posters/Presentations	Please indicate the number of abstracts, posters, and presentations listed on your residency application.
Research Year	Please indicate if you took an additional year (or more) for the purpose of research.
Geographic Predictors
Geographic Connection	Indicate if you had a geographic connection to the area.
Other Predictors
Number of Leadership Roles	Please indicate the number of leadership positions listed on your residency application.
Away Rotation Completed at Institution	Indicate if you completed an away rotation at the program.
Couples Match Status	Did you participate in the Couples Match?

*Adapted from the Texas STAR Database Survey.