The Effect of Single Accreditation on Medical Student Match Rates in Surgical Specialties

Abstract

Introduction The year 2020 marked the first year in which a match under single accreditation took place. Both osteopathic (DO) and allopathic (MD) students would participate in the first match cycle without a dedicated DO match system. Our primary objective was to investigate how single accreditation has impacted the DO applicants attempting to match into surgical specialties. Our secondary objective was to investigate the impact of single accreditation at the program director (PD) level and whether or not this process would see a change in DO PD distribution in previously American Osteopathic Association (AOA)-approved programs. Method Information on number of applicants and post-match positions was gathered from AOA and National Residency Match Program (NRMP) websites. Credentials of PDs were obtained from the Accreditation Council on Graduate Medical Education website. Based on the available data, the following surgical specialties were compared for the years 2020, 2018, and 2016: General Surgery, Neurological Surgery (NSGY), Orthopedic Surgery, Otolaryngology/ENT (ENT), Plastic Surgery, and Thoracic Surgery. Data from 2016 were not included in the results as the AOA match results analysis was insufficient and unable to be directly compared to the NRMP data. Results of matched DO and MD applicants were compared using bivariate analysis. A p-value of <0.05 was considered significant. Results From the year 2018 to 2020, the DO applicants saw a decrease of 3% in the total number of matched postgraduate year 1 spots in surgical specialties. NRMP results from 2020 saw that 51.7% of DO applicants matched and 67.7% (p < 0.001) of MD applicants matched for the specialties examined. Percent of matched:applied for DO applicants was lower than MD applicants in the fields of NSGY (p < 0.001), ENT (p < 0.001), Plastic Surgery (p < 0.001), General Surgery (p < 0.001), and Thoracic Surgery (p = 0.011). After evaluating 60 former AOA General Surgery programs, 56% were found to have MD as PD. Another 26 former AOA surgical programs were investigated, and 58% were found to have MD PD. Conclusion Single accreditation has impacted the match process now that a large number of both MD and DO applicants are using the NRMP match system for postgraduate placement. Based on the available data, our results indicate that in the examined surgical specialties, there is a statistically significant difference in the number of MD and DO residents.

Routes to Residency: A National Survey Demonstrating the Pathways to Become a Plastic Surgeon

“…For DO candidates, there have been historically low successful match rates in PRS, which have been further compounded by the recent elimination of the American Osteopathic Association match. 14,15 In our study, one DO matched into an integrated position as a PGY1, and the other initially matched into categorical GS, then left their program and rematched as a PGY1 in integrated PRS. These findings emphasize the difficulty of directly matching integrated as an IMG or DO, but they also demonstrate the multiple other options available to achieve a training position.…”

Identifying Attitudes Toward and Acceptance of Osteopathic Graduates in Surgical Residency Programs in the Era of Single Accreditation: Results of the American College of Osteopathic Surgeons Medical Student Section Questionnaire of Program Directors

“…These results suggest that other residency programs may have similar demographics in their applicants that would only be discovered with in-depth analysis of those who apply. However, despite these similarities, osteopathic applicants continue to have difficulties matching to certain residency programs and specialties [ 3 ]. Additionally, Etheart et al discovered that 27 of the 48 general surgery residency programs previously accredited by the AOA were under the direction of MD program directors [ 3 ].…”

“…However, despite these similarities, osteopathic applicants continue to have difficulties matching to certain residency programs and specialties [ 3 ]. Additionally, Etheart et al discovered that 27 of the 48 general surgery residency programs previously accredited by the AOA were under the direction of MD program directors [ 3 ]. It is unclear if this finding has an impact on osteopathic applicants' matching into surgical residency programs, but it should be considered as a potential factor.…”

“…As osteopathic medical schools have expanded, osteopathic medical students now make up greater than twenty-five percent of all matriculating medical students, naturally leading to an increase in osteopathic applicants to competitive residency programs [ 1 ]. Despite the increase in applicant numbers, osteopathic medical students do not match into surgical specialties at the same rate as their allopathic counterparts, most recently evidenced in the 2021 National Residency Match Program (NRMP) match results [ 2 , 3 ]. Additionally, Beckman and Speicher noted in a 2020 article that surgical specialties are the least likely to train osteopathic physicians [ 4 ].…”

Are We There Yet? Doctor of Osteopathic Medicine Students and the Urology Match

“…The trend has been that osteopathic students match into these specialties at lower rates than their allopathic counterparts. 1,3 The surgical subspecialties with the lowest percentage of DO residents are otolaryngology, plastic surgery, urology and neurosurgery. 4…”