How Did Coronavirus-19 Impact the Expenses for Medical Students Applying to an Orthopaedic Surgery Residency in 2020 to 2021?

Abstract

Background Orthopaedic surgery is one of the most competitive specialties for residency applicants. For the 2021 residency match, the coronavirus-19 pandemic introduced complexity for programs and applicants because away rotations were limited and in-person interviews were cancelled. This may have changed the landscape in terms of expenses for candidates in important ways, but this topic has been insufficiently studied. Questions/purposes Given that in 2021, students did not attend away rotations and all interviews were held virtually, we asked (1) What were the financial savings associated with this change? (2) Was medical school geographic region associated with differences in expenses when applying to residency? Methods A retrospective, cross-sectional analysis of the 2020 and 2021 Texas Seeking Transparency in Application to Residency Dashboard database was performed. The data were derived from an online survey of a nationwide pool of applicants from 87% (123 of 141) of US allopathic medical schools upon conclusion of the match. The response percentage was 29% (521 of 1794). We believe this nationwide dataset represents the largest and most current data for this applicant group. Responses from applicants applying to orthopaedic surgery residency in the year before the COVID-19 pandemic application changes (2020) and during COVID-19 (2021) were queried and compared. After the orthopaedic surgery match, the database was evaluated for individual (application costs, away rotation expenses, and interview expenses) and total expenses for medical school seniors applying to orthopaedic surgery residency. Applicant characteristics were compared between application cycles. The 2020 to 2021 Texas Seeking Transparency in Application to Residency Dashboard database had 521 responses (n = 263 in 2020 and n = 258 in 2021) from applicants applying to orthopaedic surgery residency. Demographic and applicant characteristics were comparable between application cycles. Median expenses are reported with percentile distributions and geographic comparisons. A Mann-Whitney U test or Kruskal-Wallis H test was used to determine whether there were statistically significant differences in expenses between years and between medical school regions at a p value threshold of < 0.05.Each author certifies that there are no funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article related to the author or any immediate family members. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research® editors and board members are on file with the publication and can be viewed on request. Ethical approval for this study was waived by the institutional review board from Maimonides Medical Center,

Orthopaedic Surgery Residency Application, and Selection Criteria Adaptations, in Times of COVID-19

“…Although this rise can be partially attributed to the ongoing growth for several years, the growth during the 2019 to 2020 application cycle was significantly higher than that reported between previous cycles (p < 0.05). In our opinion, this significant rise in the annual growth in the number of applications can be attributed to the virtual nature of interviews that cycle that has slashed a huge financial burden 20 . In addition, we theorize the ease of scheduling and stacking virtual interviews from coast to coast has also contributed to this growth.…”

Cost of the Otolaryngology Residency Application Process: Comparison With Other Specialties and Equity Implications

“…These findings highlight the significant savings that applicants experienced due to the implementation of virtual interviews and the cancellation of away rotations, which is consistent with previous findings from otolaryngology 12 , 13 and other surgical subspecialties. 14 , 15 …”

Impact of COVID-19 Pandemic on Expenses of Medical Students Applying to Otolaryngology Residency Programs

“…Previous studies of otolaryngology applicants have used the National Residency Match Program data to show a significant increase in the number of applicants matching at or close to home during the years of the COVID-19 pandemic, likely due to the limitations of away rotations and in-person interviews [ 11 - 12 ]. Studies were performed with dermatology and orthopedics applicants looking more specifically at the change in costs related to the COVID-19 pandemic [ 9 , 13 ]. These studies both found that virtual interviews and a limited number of away rotations significantly reduced the cost of the application process, with applicants from the Western United States medical schools potentially saving the most [ 9 , 13 ].…”

“…Studies were performed with dermatology and orthopedics applicants looking more specifically at the change in costs related to the COVID-19 pandemic [ 9 , 13 ]. These studies both found that virtual interviews and a limited number of away rotations significantly reduced the cost of the application process, with applicants from the Western United States medical schools potentially saving the most [ 9 , 13 ]. To our knowledge, this is the first comparative cost analysis study conducted to evaluate the effect of the pandemic on otolaryngology applicants.…”

“…To our knowledge, no studies have evaluated the financial savings associated with the implemented changes specifically in relation to otolaryngology residencies. The implications of these changes are important to evaluate despite decreased opportunities for applicants because the decreased cost of applications may have enabled lower income students to be more competitive in the pursuit of otolaryngology residency positions [ 9 ]. The purpose of this study is to compare the cost of the residency application process including interviews, applications, away rotations, and total costs before and during the COVID-19 pandemic.…”