The Neurosurgery Match: COVID Comparison and Bibliometric Analysis.

INTRODUCTION: Because of the effect of COVID on academic opportunities, as well as limitations on travel, away rotations and in-person interviews, COVID-related changes could impact the neurosurgical resident demographics. Our aim was to retrospectively review the demographics of the previous four years of neurosurgery residents, provide bibliometric analysis of successful applicants, and analyze for the effects of COVID on the match cycle. METHODS: All AANS residency program websites were examined for a list of demographic characteristics for current post-graduate year (PGY) 1 to 4. Gathered information included gender, undergraduate and medical institution and state, medical degree status, and prior graduate programs. RESULTS: A total of 114 institutions and 946 residents were included in the final review. 676 (71.5%) of the residents included in the analysis were male. Of the 783 who studied within the United States, 221 (28.2%) residents stayed within the same state of his or her medical school. 104 of 555 (18.7%) residents stayed within the same state of his or her undergraduate school. Demographic information as well as geographic switching relative to medical school, undergraduate school, and hometown showed no significant changes between pre-COVID and COVID-matched cohorts overall. The median number of publications per resident significantly increased for the COVID-matched cohort (median, 1; interquartile range (IQR), 0-4.75) when compared to the non-COVID-matched cohort (median, 1; IQR, 0-3, p = 0.004) as did first author publications (median, 1; IQR, 0-1 vs median, 1; IQR, 0-1; p = 0.015), respectively. The number of residents matching into the same region in the Northeast relative to undergraduate degree was significantly greater after COVID (56 (58%) vs 36 (42%), p = 0.026). The West demonstrated a significant increase in the mean number of total publications (4.0 ± 8.5 vs 2.3 ± 4.2, p = 0.02) and first author publications (1.24 ± 2.33 vs 0.68 ± 1.47, p = 0.02) after COVID, with the increase in first author publications being significant in a test of medians. CONCLUSION: Herein we characterized the most recently matched neurosurgery applicants, paying particular attention to changes over time in relation to the onset of the pandemic. Apart from publication volume, characteristics of residents and geographical preferences did not change with the influence of COVID-induced changes in the application process.

Reducing Health Disparities in Radiology Through Social Determinants of Health: Lessons From the COVID-19 Pandemic.

During the COVID-19 pandemic, the disproportionate morbidity and mortality borne by racial minorities, patients of lower socioeconomic status, and patients lacking health insurance reflect the critical role of social determinants of health, which are manifestations of entrenched structural inequities. In radiology, social determinants of health lead to disparate use of imaging services through multiple intersecting contributors, on both the provider and patient side, affecting diagnosis and treatment. Disparities on the provider side include ordering of initial or follow-up imaging studies and providing standard-of-care interventional procedures, while patient factors include differences in awareness of screening exams and confidence in the healthcare system. Disparate utilization of mammography and lung cancer screening lead to delayed diagnosis, while differential provision of minimally invasive interventional procedures contributes to differential outcomes related to treatment. Interventions designed to mitigate social determinants of health could help to equalize the healthcare system. Here we review disparities in access and health outcomes in radiology. We investigate underlying contributing factors in order to identify potential policy changes that could promote more equitable health in radiology.

The Roots of Structural Racism in the United States and their Manifestations During the COVID-19 Pandemic.

During the COVID-19 pandemic, the disproportionate morbidity and mortality borne by racial minorities, patients of lower socioeconomic status, and patients lacking health insurance reflect pre-existing structural inequities. Structural racism is racial discrimination rooted in history, perpetuated through policies, and manifested in disparities in healthcare, housing, education, employment, and wealth. Although these disparities exert greater impacts on health outcomes than do genetics or behavior, scientists, and policy makers are only beginning to name structural racism as a key determinant of population health and take the necessary steps to dismantle it. In radiology, structural racism impacts how imaging services are utilized. Here we review the history and policies that contribute to structural racism and predispose minority and disadvantaged communities to inferior outcomes during the COVID-19 pandemic in order to identify policy changes that could promote more equitable access to radiologic services.