Improving Transparency in the Residency Application Process: Survey Study.

BACKGROUND: Increasing numbers of residency applications create challenges for applicants and residency programs to assess if they are a good fit during the residency application and match process. Applicants face limited or conflicting information as they assess programs, leading to overapplying. A holistic review of residency applications is considered a gold standard for programs, but the current volumes and associated time constraints leave programs relying on numerical filters, which do not predict success in residency. Applicants could benefit from increased transparency in the residency application process. OBJECTIVE: This study aims to determine the information applicants find most beneficial from residency programs when deciding where to apply, by type of medical school education background. METHODS: Match 2023 applicants voluntarily completed an anonymous survey through the Twitter and Instagram social media platforms. We asked the respondents to select 3 top factors from a multiple-choice list of what information they would like from residency programs to help determine if the characteristics of their application align with program values. We examined differences in helpful factors selected by medical school backgrounds using ANOVA. RESULTS: There were 4649 survey respondents. When responses were analyzed by United States-allopathic (US-MD), doctor of osteopathic medicine (DO), and international medical graduate (IMG) educational backgrounds, respondents chose different factors as most helpful: minimum United States Medical Licensing Examination (USMLE) or Comprehensive Osteopathic Medical Licensing Examination (COMLEX) Step 2 scores (565/3042, 18.57% US-MD; 485/3042, 15.9% DO; and 1992/3042, 65.48% IMG; P<.001), resident hometown region (281/1132, 24.82% US-MD; 189/1132, 16.7% DO; and 662/1132, 58.48% IMG; P=.02), resident medical school region (476/2179, 22% US-MD; 250/2179, 11.5% DO; and 1453/2179, 66.7% IMG; P=.002), and percent of residents or attendings underrepresented in medicine (417/1815, 22.98% US-MD; 158/1815, 8.71% DO; and 1240/1815, 68.32% IMG; P<.001). CONCLUSIONS: When applying to residency programs, this study found that the factors that respondents consider most helpful from programs in deciding where to apply differ by educational background. Across all educational groups, respondents want transparency around standardized exam scores, geography, and the racial or ethnic backgrounds of residents and attendings.

Sniffin' Sticks to Measure Olfactory Function and Recovery Following Bilateral Superior Turbinate Resection as Part of Endoscopic Transsphenoidal Approach.

BACKGROUND: Extended endoscopic transsphenoidal (EET) approaches can include complete resection of both superior turbinate (ST) for wider exposure. Moreover, ST resection has been associated with postoperative olfactory impairment. OBJECTIVE: We sought to determine the impact of bilateral ST resection on olfaction during a transsphenoidal approach. METHOD: A prospective observational study was conducted on 29 patients undergoing endoscopic skull base surgery sparing the olfactory tracts at a tertiary academic center. Olfactory function was measured with Sniffin' Sticks at the preoperative visit, 2-weeks and 6 to 8 weeks postoperatively. All components: odor threshold (OT), odor discrimination (OD), odor identification (OI) and composite scores (TDI = OT+OD+OI) were evaluated. RESULT: Study was completed in 15 patients with 14 excluded due to a variety of reasons. At 2 weeks, a significant decrease was noted in composite scores (32.3 ± 5.4 vs. 23.8 ± 5.8, P < .05) and OT (7.7 vs. 3.2, P < .05). There was a significant increase in olfactory scores between post-op weeks 2 and 6 to 8 weeks in TDI (23.8 vs. 31.4, P < .05) as well as in OT (3.2 vs. 7.6, P < .05), OD (9.4 vs. 11.1, P < .05), and OI (11.1 vs. 12.7, P < .05). No significant difference was found between TDI (32.3 ± 5.4 vs. 31.4 ± 5.1), OT (7.7 vs. 7.6), OD (11.4 vs. 11.1) and OI (13.2 vs. 12.7) from preoperative and 6-8 weeks postoperative visits. CONCLUSION: Patients undergoing bilateral ST resection during EET procedures experience transient hyposmia postoperatively. However, the olfactory function normalizes to preoperative levels at 6 to 8 weeks. The resection of the bilateral superior turbinate does not appear to decrease olfactory function.

Elective egg freezing: what is the vision of women around the globe?

AIM: The interest in oocyte cryopreservation (OC) for nonmedically indicated reasons is increasing. Knowing women's beliefs and knowledge from various geographic regions could help providers to understand the similarities and differences that could facilitate proper counseling. MATERIALS & METHODS: Articles about social egg freezing published over the past 18 years were extracted from the literature. RESULTS: We demonstrated that there are common rationales toward OC among women in the USA and other countries. The ultimate goal was to prolong fertility. The most commonly reported reasons were aging, lack of partner, career and financial status. CONCLUSION: The beliefs and rationales toward elective OC among women in the USA and other countries are consistent.

Adherence to the American Urological Association Choosing Wisely® Recommendations.

INTRODUCTION: The AUA (American Urological Association) initially published 5 Choosing Wisely® recommendations in 2013 to highlight best practices in urology. In this study we evaluated the impact and adherence to the Choosing Wisely recommendations among AUA members. METHODS: A survey of the AUA membership was conducted in 2014, 1 year after publication of the Choosing Wisely statements, to determine familiarity with the initiative, influence on practice and potential methods of preferred communication about such efforts. To better understand the desired method of information distribution, questions about AUA guideline communication were used as a standard for comparison. RESULTS: There were 605 respondents, representing an 8.1% response rate from all AUA members. The majority were 55 to 64 years old (34.3%), in a urology group practice (41.4%) and in practice for more than 20 years (48.9%). Overall 43.0% of respondents claimed to know of the existence of Choosing Wisely recommendations and 75.8% found the Choosing Wisely recommendations helpful to their practice. Respondents cited lack of publicity (45.0%) as the most common barrier to wider adoption. CONCLUSIONS: This study highlights the need for improved communication regarding the Choosing Wisely initiative and future updates. Our results show that physicians specifically would be willing to use Choosing Wisely recommendations more in their clinical practice if they were adapted into their electronic medical record. Ongoing work is needed to develop a tool to promote and evaluate adherence to the Choosing Wisely recommendations that could be integrated into an electronic medical record.