key: cord-0852157-61q0rd9z
authors: Dowdle, Travis S.; Ryan, Michael P.; Tarbox, Michelle B.; Wagner, Richard F.
title: An Analysis of Internal and Regional Dermatology Matches During the Second Year of the COVID-19 Pandemic: a Cross Sectional Study
date: 2022-04-28
journal: J Am Acad Dermatol
DOI: 10.1016/j.jaad.2022.04.036
sha: 3700bf16aaba0f63c06da5c440f35de18509a585
doc_id: 852157
cord_uid: 61q0rd9z

nan

The COVID-19 pandemic has significantly impacted the dermatology residency 38 application process over the past two cycles. Our previous analysis of the 2020-2021 match, in 39 which most applicants could not complete away rotations and interviews were virtual, revealed a 40 significant increase in internal matches (40.3%) compared to pre-pandemic levels (26.7%) 41 (P<0.001). 1 Updated guidelines released by the 'Coalition for Physician Accountability' and 42 confirmed by dermatology program directors limited away rotations to one per student with a 43 home dermatology program for the 2021-2022 cycle. 2 This investigation examined changes in 44 internal and regional matches during this second pandemic match. 45

Publicly available match lists produced directly from the institution itself were gathered 46 from allopathic medical schools with associated dermatology residency training programs. The 47 total possible number of programs that met these criteria was 115. A three-year control was 48 established from 2017-2020 (70 schools) to establish baseline internal and regional match 49

percentages. This was compared to the 2021-2022 first pandemic match (66 schools) and the 50 2020-2021 second pandemic match (63 schools). Regions were established via the AAMC 51

Residency explorer tool. 3 Statistical analysis was performed using Chi square in Excel. 52

During pre-pandemic match cycles (2017-2020), 26.7% of dermatology applicants 53 matched to their home institution. There were statistically significant increases in internal 54 matches of 40.3% during the first pandemic match (2020-2021) and 33.5% during the second 55 pandemic match (2021-2022). There were no significant differences in the overall proportion of 56 regional matches across the pre-pandemic (61.6%), first pandemic (67.5%), or second pandemic 57

The cause of this increase in internal matches is likely multifactorial with two large 59 contributors potentially being the lack of in-person interviews and the limited away rotation 60 opportunities. The average number of self-reported dermatology away rotations undertaken by 61 matched applicants was as high as 2.82 between the pre-pandemic match years of 2016-2018. 4 62

Analyses have established the perceived importance of these experiences and how influential 63 they can be regarding rank list decisions for both applicants and programs. 5 64

Although not statistically significant, the decrease in internal matches from 40.3% in the J o u r n a l P r e -p r o o f Table 2 . Comparison of internal and regional matches among the first pandemic match cycle 111 (2020-2021), and the second pandemic match cycle (2021-2022). There was no significant 112 difference between internal matches in the first and second pandemic matches (p=0.116). There 113 was also a significant decrease in the South subgroup (p=0.021). J o u r n a l P r e -p r o o f *Highlighted Changes* 120

The COVID-19 pandemic has significantly impacted the dermatology residency 121 application process over the past two cycles. Our previous analysis of the 2020-2021 match, in 122 which most applicants could not complete away rotations and interviews were virtual, revealed a 123 significant increase in internal matches (40.3%) compared to pre-pandemic levels (26.7%) 124 (P<0.001). 1 Updated guidelines released by the 'Coalition for Physician Accountability' and 125 confirmed by dermatology program directors limited away rotations to one per student with a 126 home dermatology program for the 2021-2022 cycle. 2 This investigation examined changes in 127 internal and regional matches during this second pandemic match. 128 Table 1 . Comparison of internal and regional matches among the baseline pre-pandemic match 183 cycle (2017-2020) and the second pandemic match cycle (2021-2022). There was a significant 184 increase between the baseline internal match percentage of 26.7% and the second pandemic 185 match cycle 33.5% (p=0.039). There was also a significant increase in the West subgroup 186 J o u r n a l P r e -p r o o f Table 2 . Comparison of internal and regional matches among the first pandemic match cycle 194 (2020-2021), and the second pandemic match cycle (2021-2022). There was no significant 195 difference between internal matches in the first and second pandemic matches (p=0.116). There 196 was also a significant decrease in the South subgroup (p=0.021). 197 198 

Internal and geographic dermatology match trends in the 164 age of COVID-19

Recommendations on away dermatology electives for the 2021-2022 academic year

Explorer TM Tool: Dashboard. Accessed

Does it match? Analyzing self-reported online 172 dermatology match data to Charting Outcomes in the Match

The dermatology residency application process

The cause of this increase in internal matches is likely multifactorial with two large 142 contributors potentially being the lack of in-person interviews and the limited away rotation 143 opportunities. The average number of self-reported dermatology away rotations undertaken by 144 matched applicants was as high as 2.82 between the pre-pandemic match years of 2016-2018. 4 145Analyses have established the perceived importance of these experiences and how influential 146 they can be regarding rank list decisions for both applicants and programs. 5 147Although not statistically significant, the decrease in internal matches from 40.3% in the 148 2020-2021 cycle to 33.5% in the 2021-2022 cycle could be a result of applicants having the 149 ability to perform one away rotation. If analysis of the upcoming 2022-2023 match cycle, with 150normal away rotation opportunities, shows the internal match rate reverting to baseline then this 151 would support the notion that away rotations are having the largest impact, while a persistently 152 high internal match rate would support that other factors, such as virtual interviews, are still 153 contributing. Persistently high levels of internal matches also create an even greater barrier to 154 matching for medical students without a home dermatology residency program. These trends are 155 very important to track as this data will help leaders in dermatology better understand which 156 factors related to the pandemic are influencing match patterns. Limitations of this study include 157 that the data set only captures about 57% of medical school match lists and the inability to 158 determine how many students match to programs they completed away rotations at.