Small urology programs saw increase in at-home, in-section matches during COVID-19 pandemic

A recent study found that small urology programs had a significant increase in at-home and in-section residency matches in 2021, the first full year of the pandemic, compared with the 5 years prior.¹

“Our results suggest that small residencies likely experienced greater difficulty locating ideal candidates during the pandemic given virtual interviews and no away rotations," the authors wrote.

The investigators compared residency match outcomes in 2021 and 2022 (pandemic years) with the 5 previous cycles, ranging from 2016 to 2020 (pre-pandemic). Included variables for analysis were residency program class size, program and resident American Urological Association (AUA) section, and program and resident medical school. AUA sections were stratified into Mid-Atlantic, New England, New York, North Central, Northeastern, South Central, Southeastern, and Western sections.

Data showed that 87.7% of positions were filled between 2016 and 2020, which rose to 99.7% in 2021 and 99.5% in 2022. Of total matches in 2021, 21.3% of positions were filled by applicants in their home institution, compared with 17.4% of positions between 2016 and 2020 and 19.01% in 2022. Further, 44.8% of positions were filled by students within their AUA section in 2021, compared with 41.2% between 2016 and 2020 and 46.0% in 2022. These differences were not found to be statistically significant.

However, when programs were stratified by size, findings showed that small programs (having 1-2 residents per class) saw a statistically significant increase in at-home and in-section matches in 2021. In 2021, small programs had 28.1% (P = .011) spots filled by applicants at their home program, compared with 16.2% between 2016 and 2020. This number went back down in 2022, with only 19.5% of applicants at small programs matching with their home program. When combining the 2021 and 2022 into 1 analysis, the pandemic years showed that 23.9% of applicants at small institutions were matched at their home program (P = .030) compared with 16.2% pre-pandemic.

The same trend was seen in small urology programs when comparing matches with applicants’ AUA section. In 2021, the number of students matching with a small urology program in their AUA section was 57.1% (P = 0.0034), compared with 41.7% between 2016 and 2020. This number again went down in 2022, with only 50.5% of applicants matching in their AUA section. When combining 2021 and 2022 into 1 analysis, the pandemic years showed that 53.9% of applicants at small institutions were matched at programs within their AUA section (P = .0024) compared with 41.7% pre-pandemic.

The authors explained these trends, writing, “Our results suggest that small residencies likely experienced greater difficulty locating ideal candidates during the pandemic given virtual interviews and no away rotations. This trend may have been diluted in larger programs which can better afford to take some students of less familiarity.”

Further, when looking at specific AUA sections, the investigators found that the Southeastern section had a significant increase in matching home and in-section applicants in 2021 compared with other AUA sections. The Southeastern section matched 30.2% of applications with their home institution, compared with 15.9% for other sections (P = .012). By AUA region, the Southeastern section matched 62.0% of applicants in-section in 2021 compared with 45.0% of other AUA regions (P = .012).

References

1. Wang KR, Shah YB, Simhal RK, et al. The impact of COVID-19 on the urology resident match and geographic proximity of applicants. Urology. Published online March 23, 2023. Accessed March 24, 2023. doi:10.1016/j.urology.2023.01.050