The 2021 Neurosurgery Match: An Analysis of the Impact of Virtual Interviewing and Other COVID-19–Related Changes

Mulligan, Kathleen; Pan, Xuankang; Gerges, Christina; Rabah, Nicholas M.; Selden, Nathan R.; Wolfe, Stacey Quintero; Wright, Christina Huang; Wright, James

doi:10.1016/j.wneu.2021.11.109

Cited by 11 publications

(3 citation statements)

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“…They could help to avoid a paradoxical effect of remote interviewing for neurosurgical residency and pass/fail USMLE examinations: diminished specific information about applicants leading to an increased emphasis on medical school association. 13 Similarly, milestones forms would more globally promote objectivity and potentially mitigate unconscious bias in candidate evaluation. Secondarily, this form yields specific feedback on a defining medical school experience, the sub-internship.…”

Section: Fig 4 Box-and-whisker Plot Showing Cms Distributions and Num...mentioning

confidence: 99%

Milestones for neurosurgery sub-interns: a novel evaluation tool to quantitatively differentiate residency applicants

Bowden

Tan

Rothbaum

et al. 2023

Journal of Neurosurgery

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OBJECTIVE The study objective was to create a novel milestones evaluation form for neurosurgery sub-interns and assess its potential as a quantitative and standardized performance assessment to compare potential residency applicants. In this pilot study, the authors aimed to determine the form’s interrater reliability, relationship to percentile assignments in the neurosurgery standardized letter of recommendation (SLOR), ability to quantitatively differentiate tiers of students, and ease of use. METHODS Medical student milestones were either adapted from the resident Neurological Surgery Milestones or created de novo to evaluate a student’s medical knowledge, procedural aptitude, professionalism, interpersonal and communication skills, and evidence-based practice and improvement. Four milestone levels were defined, corresponding to estimated 3rd-year medical student through 2nd-year resident levels. Faculty and resident evaluations as well as student self-evaluations were completed for 35 sub-interns across 8 programs. A cumulative milestone score (CMS) was computed for each student. Student CMSs were compared both within and between programs. Interrater reliability was determined with Kendall’s coefficient of concordance (Kendall’s W). Student CMSs were compared against their percentile assignments in the SLOR using analysis of variance with post hoc testing. CMS-derived percentile rankings were assigned to quantitatively distinguish tiers of students. Students and faculty were surveyed on the form’s usefulness. RESULTS The average faculty rating overall was 3.20, similar to the estimated competency level of an intern. Student and faculty ratings were similar, whereas resident ratings were lower (p < 0.001). Students were rated most highly in coachability and feedback (3.49 and 3.67, respectively) and lowest in bedside procedural aptitude (2.90 and 2.85, respectively) in both faculty and self-evaluations. The median CMS was 26.5 (IQR 21.75–29.75, range 14–32) with only 2 students (5.7%) achieving the highest rating of 32. Programs that evaluated the most students differentiated the highest-performing students from the lowest by at least 13 points. A program with 3 faculty raters demonstrated scoring agreement across 5 students (p = 0.024). The CMS differed significantly between SLOR percentile assignments, despite 25% of students being assigned to the top fifth percentile. CMS-driven percentile assignment significantly differentiated the bottom, middle, and top third of students (p < 0.001). Faculty and students strongly endorsed the milestones form. CONCLUSIONS The medical student milestones form was well received and differentiated neurosurgery sub-interns both within and across programs. This form has potential as a replacement for numerical Step 1 scoring as a standardized, quantitative performance assessment for neurosurgery residency applicants.

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Section: Fig 4 Box-and-whisker Plot Showing Cms Distributions and Num...mentioning

confidence: 99%

Milestones for neurosurgery sub-interns: a novel evaluation tool to quantitatively differentiate residency applicants

Bowden

Tan

Rothbaum

et al. 2023

Journal of Neurosurgery

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“…In 2021, 74.3% of applicants successfully matched into neurosurgery residency programs, while the average match rate was 89.8% in other specialties. 14 Among the 74.3% who successfully matched into neurosurgery in 2021, 32.2% were graduates of a top 25 US allopathic medical school. 14 The successful neurosurgical applicant often has a breadth of research experience, clinical exposure, and leadership, while also scoring among the top percentiles on United States Medical Licensing Examination (USMLE) Step examinations and in their respective medical school curricula.…”

Section: Applying To Neurosurgery Residency Training Programsmentioning

confidence: 99%

“…18 In 2021, only 18.8% of those who matched came from an institution that did not have a home neurosurgery residency training program. 14 The majority of Black/African American medical school students are not concentrated at institutions that have historically sent many students to neurosurgery residency programs or have home neurosurgery programs. This could be a point of hindrance for Black/African American medical students hoping to achieve a neurosurgical residency position.…”

Section: Applying To Neurosurgery Residency Training Programsmentioning

confidence: 99%

The role of limited access to students from more diverse nonfeeder medical schools in creating diversity inequities in neurosurgical residency

Klein,

Sowah,

Levi

2023

Neurosurgical Focus

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OBJECTIVE Improving racial/ethnic diversity in neurosurgery is a long-standing issue that needs to be addressed. The positive correlation between medical students with home neurosurgery programs and successful matriculation into neurosurgical residency is well documented. In this article, the authors explored the relationship between decreased racial/ethnic diversity in neurosurgery residency programs and racial/ethnic diversity in feeder medical schools. METHODS The authors conducted a standardized review of the literature to evaluate potential causes for decreased racial/ethnic diversity within neurosurgery. Additionally, they calculated the average enrollment of Black/African American medical students at the top 5 neurosurgery feeder medical schools (determined by Antar et al. following the 2014–2020 match cycles) during the 2021–2022 school year and compared that with the enrollment at US allopathic medical schools with the highest enrollment of Black/African American students. They also compared these two groups in terms of how many students they sent into neurosurgery residency programs from 2014 to 2020. For each of these comparisons, the authors conducted a two-sample t-test to evaluate correlation between these two variables. RESULTS There was significantly lower average enrollment of Black/African American students at the top 5 feeder medical programs into neurosurgery residency (80.6 ± 8.32) compared with the top 5 medical schools with Black/African American enrollment in the 2021–2022 school year (279 ± 122.00, p < 0.05). The authors also found a significant increase in the number of students entering neurosurgery residency programs between the top 5 feeder medical programs into neurosurgery residency (30.8 ± 6.06) and the top 5 medical programs for Black/African American enrollment (6 ± 6.16, p < 0.0001). CONCLUSIONS In this paper, the authors examined, through a Black/African American lens, the role of racial/ethnic diversity in medical schools that historically send many students to neurosurgery residency. This study sought to provide insight into this problem and examine how Black/African American students from nonfeeder medical schools are disproportionately affected. The authors’ findings suggest that the lack of Black/African American representation in neurosurgery is strongly correlated with the diversity efforts of medical schools. Lastly, the authors highlight the University of Miami’s Summer Research Scholarship in Neurosurgery for Medical Students and other programs as potential solutions to combat the lack of racial/ethnic diversity in neurosurgery.

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Virtual Radiology Fellowship Recruitment: Benefits, Limitations, and Future Directions

Lakhani¹,

Deng²,

Chung³

et al. 2023

Academic Radiology

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The 2021 Neurosurgery Match: An Analysis of the Impact of Virtual Interviewing and Other COVID-19–Related Changes

Cited by 11 publications

References 9 publications

Milestones for neurosurgery sub-interns: a novel evaluation tool to quantitatively differentiate residency applicants

Milestones for neurosurgery sub-interns: a novel evaluation tool to quantitatively differentiate residency applicants

The role of limited access to students from more diverse nonfeeder medical schools in creating diversity inequities in neurosurgical residency

Virtual Radiology Fellowship Recruitment: Benefits, Limitations, and Future Directions

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