Impact of Virtual Interviews on Neurological Surgery Match Outcomes for US Allopathic Senior Medical Students: An Analysis of Home Program Influence

Introduction: In response to the COVID-19 pandemic, the Accreditation Council for Graduate Medical Education shifted to virtual residency interviews from 2020 to 2021, impacting specialties, including neurological surgery (NS). Subsequent interviews (2021-2023) were conducted virtually, raising questions about their impact on matching outcomes for senior US allopathic medical students pursuing NS. We focused on discerning whether students without a home neurosurgical program face decreased odds of successfully matching into NS.

Methods: We analyzed data from the National Resident Matching Program from 2019 to 2023. Match statistics, proximity of residency programs to medical schools with or without home programs (HPs), and rankings of medical schools as top 40 NIH-funded institutions were examined, stratified by interview format. Location data was assessed using Google Mountain View.

Results: Our study included 741 senior US allopathic NS applicants (612 with HPs, 129 without) over five years. The average match ratio (MR) of MD students accepted into NS over the total number of matched students across all specialties was 1.55%. During virtual interviews (VIs), it was 1.60% for schools with HPs and 1.42% without, while in-person interviews yielded 1.63% and 1.28%, respectively. Students from schools with HPs had 1.3 times higher odds of matching into NS during in-person interviews (p = 0.033) and 1.1 times higher odds during VIs (p = 0.011). The average distance between matched NS programs and students' medical schools did not significantly differ by attendance at an HP school. Attendance at a top 40 institution showed no significance in MR.

Conclusion : This study is the first to explore match outcomes for schools without HPs, stratifying them by interview format in NS. Limitations include the lack of data for applicants not matched into NS; however, an MR was calculated to circumvent this issue. Students from institutions with home NS programs exhibited a higher MR. Notably, the transition to VIs improved outcomes for schools without HPs. Disparities persist in the percentage of students accepted into NS from schools without HPs, warranting further action by residency programs.