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“MATCH.COM” - HOW VIRTUAL APPLICATIONS IMPACT RESIDENCY MATCH GEOGRAPHY
Journal of General Internal Medicine ; 37:S663, 2022.
Article in English | EMBASE | ID: covidwho-1995579
ABSTRACT
SETTING AND

PARTICIPANTS:

Design:

Cross-sectional. Setting/

participants:

US graduating medical students. Inclusion US allopathic medical schools with publicly available match data of individual students, 2018-2021. Exclusions Students matching into preliminary, transitional, combined, or non-residency positions. DESCRIPTION The COVID-19 pandemic disrupted the 2021 residency match with potential for significant geographic impact as students were unable to attend away rotations or in-person interviews. EVALUATION Data sources Association of American Medical Colleges (AAMC;2020), US News and World Report (USWNR) rankings (2020), and official university websites (2018-2021). The unit of analysis was each medical student.

Analysis:

We used the US Census Region and Division of medical schools and residency programs to calculate the match distance from medical school to residency. 'Match space' was defined by whether an applicant matched at their home school, home state, adjacent state, same census division, adjacent census division, or skipped 1 or more census division. We defined competitive specialty with a composite variable comprising of US senior fill rate, number of positions, and salary. Ordinal logistic regression examined match distance (dependent outcome) with school, specialty characteristics, and pre/post COVID.

Results:

34,672 students representing 66 medical schools from 28 states matched into 26 specialties in 50 states and Canada. 59% of students were from public institutions, and 27% of schools ranked in the top 40 for research. The mean percentage of in-state students by school was 60.3% (range 3- 100%). Match space was lower after the pandemic (adjusted odds ratio [OR] 0.94, 95% CI 0.90 - 0.98;p=0.006), from schools with higher percentage of in-state matriculants (OR 0.74, 95% CI 0.72-0.76), from top NIH-funded institutions (OR 0.88, 95% CI 0.85-0.92), from the Northeast (OR 0.71, 95% CI 0.67-0.75;Midwest reference), and the West (OR 0.67, 95% 0.60-0.74). Match space was higher for students graduating from private schools (OR 1.11, 95% CI 1.05- 1.19) or matching into more competitive specialties (OR 1.08, 95% CI 1.02-1.14). DISCUSSION / REFLECTION / LESSONS LEARNED After the COVID-19 pandemic, students graduating from US allopathic schools matched closer to their home institution. Students attending public schools and schools with more in-state matriculants also matched closer. School reputation, with research rank as a surrogate, showed a higher match distance relative to those outside of the top 40 ranking. Our study adds insight into how geographic match patterns were influenced by school, specialty choice, and the pandemic.
Keywords

Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Experimental Studies Language: English Journal: Journal of General Internal Medicine Year: 2022 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Experimental Studies Language: English Journal: Journal of General Internal Medicine Year: 2022 Document Type: Article