Spouses of thoracic surgery applicants: changing demographics and motivations in a new generation

Recent Changes in Characteristics of Applicants and Matriculants to Thoracic Surgery Fellowships

The match rate for traditional thoracic surgery fellowships decreased from 97.5% in 2012 to 59.1% in 2021, reflecting an increase in applications. We queried whether characteristics of applicants and matriculants to traditional thoracic surgery fellowships changed during this time period. Applicant data from the 2008 through 2018 application cycles were extracted from the Electronic Residency Application System (ERAS) and Graduate Medical Education (GME) Track Resident Survey and stratified by period of application (2008-2014 vs 2015-2018). Characteristics of applicants and matriculants were analyzed. There were 697 applicant records in the early period and 530 in the recent period (application rate 99.6/year vs 132.5/year; P = 0.0005), and 607 matriculant records in the early period and 383 in the recent period (matriculation rate 87% vs 72%; P < 0.0001). There was no difference in representation of university-affiliated versus community-based general surgery residency programs among applicants comparing the periods. Higher proportions of applicants and matriculants in the early period trained in general surgery programs affiliated with a comprehensive cancer center or a thoracic surgery fellowship. Applicants and matriculants of the recent period had higher median numbers of journal publications and had higher impact factor journal publications. The increase in applicants for thoracic surgery training is primarily from general surgery trainees in residency programs not affiliated with a comprehensive cancer center or a thoracic surgery fellowship. The increased interest in thoracic surgery training was accompanied by overall enhanced scholarship production among the applicants and matriculants regardless of their residency characteristics.

Characteristics of Matriculants to Thoracic Surgery Residency Training Programs

BACKGROUND

Thoracic surgery (TS) residency positions are in high demand. There is no study describing the nationwide attributes of successful matriculants in this specialty. We examined the characteristics of TS resident applicants and identified factors associated with acceptance.

METHODS

Applicant data from 2014 to 2017 application cycles was extracted from the Electronic Residency Application System and stratified by matriculation status. Medical education, type of general surgery residency, and research achievements were analyzed. The number of peer-reviewed publications and the corresponding impact factor for the journals where they were published were quantified.

RESULTS

There were 492 applicants and 358 matriculants. The overall population was primarily male (79.5%), white (55.1%), educated at United States allopathic medical schools (66.5%), and trained at university-based general surgery residencies (59.6%). Education at United States allopathic schools (odds ratio [OR], 2.54; P < .0001), being a member of the American Osteopathic Association (OR, 3.27; P = .021), general surgery residency affiliation with a TS residency (OR, 2.41; P = .0003) or National Cancer Institute designated Comprehensive Cancer Center (OR, 1.76; P = .0172), and being a first-time applicant (OR, 4.71, P < .0001) were independently associated with matriculation. Matriculants published a higher number of manuscripts than nonmatriculants (median of 3 vs 2, P < .0001) and more frequently published in higher impact journals (P < .0001).

CONCLUSIONS

Our study includes objective and quantifiable data from recent application cycles and represents an in-depth examination of applicants to TS residency. The type of medical school and residency, as well as academic productivity, correlate with successful matriculation.

Medical specialty selection criteria of Israeli medical students early in their clinical experience: subgroups

BACKGROUND

Israeli medical school classes include a number of student subgroups. Therefore, interventions aimed at recruiting medical students to the various specialties should to be tailored to each subgroup.

METHODS

Questionnaires, distributed to 6 consecutive 5th-year classes of the Hebrew University - Hadassah School of Medicine, elicited information on criteria for choosing a career specialty, criteria for choosing a residency program and the importance of finding a specialty interesting and challenging when choosing a residency.

RESULTS

Completed questionnaires were returned by 540 of 769 (70%) students. The decision processes for choosing a medical specialty and choosing a residency program were different. Family and colleagues had minimal influence on choosing a specialty, while family and their residential locality had much influence on choosing a residency, especially among women. Older age, marriage, and spousal influence were positively associated with choice of a specialty. Two-thirds of the students had completed military service, 20% were attending medical school prior to military service, 5% had completed national service and 9% had entered medical school without serving. Despite the pre-military subgroup being younger and having another 7 years of medical school, internship and military service before residency, they had begun thinking about which specialty to choose, just like the post-military students. When choosing a residency program, post-military women were more influenced by their families and family residential locality than their pre-military counterparts; differences ascribed to the older and often married post-military women having or wanting to begin families. This difference was reinforced by fewer post- than pre-military women willing to wait 2-3 years for a residency in the specialty that interested them most and were willing to begin residency immediately after internship in a specialty that interested them less.

CONCLUSIONS

Medical school classes are composed of various subgroups, each with its own characteristics. It is important to differentiate between choosing a specialty and a residency program. Choosing a specialty is a uniquely personal decision with some spousal influence among married students. It is of central importance even among pre-military students not slated to begin residency for many years. In contrast, choosing a residency program is influenced by family, where one grew up and other family-related considerations.

The Role of the Away Rotation in Otolaryngology Residency

Objective

To determine the availability and purpose of away rotations during otolaryngology residency.

Study Design

Cross-sectional survey.

Setting

Otolaryngology residency programs.

Subjects and Methods

An anonymous web-based survey was sent to 98 allopathic otolaryngology training program directors, of which 38 programs responded. Fisher exact tests and nonparametric correlations were used to determine statistically significant differences among various strata of programs. A P value of <.05 was considered statistically significant.

Results

Thirty-nine percent (n = 38) of queried programs responded. Mandatory away rotations and elective away rotations were both present in 6 of 38 programs (16%). Neither number of faculty ( P = .119) nor residents ( P = .88) was predictive of away rotation. Away rotations were typically >151 miles from the home institution and typically used to address deficiencies in clinical exposure (67%) or case volume (50%). Participants of mandatory away rotations were universally provided housing, with other consideration such as stipend (33%), relocation allowance (33%), or food allowance (16%) sometimes offered. In contrast to mandatory rotations, half of elective rotations were to obtain a unique international mission trip experience. Nearly one-third of surveyed program directors (29%) would consider adding an away rotation to their curriculum in the next 3 years.

Conclusions

Mandatory and elective away rotations play a role in a small, but not insignificant, number of training programs. The rationale for these rotations is variable. Given that nearly one-third of program directors would consider adding an away rotation in the near future, further research into components of a meaningful away rotation and how to optimize the away rotation experience is warranted.