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

Background: Given the safety concerns during the COVID-19 (coronavirus disease 2019) pandemic, residency programs suspended away rotations in 2021, and the interview process was transitioned to a virtual video format. In the present study, we assessed the extent to which these changes had affected match outcomes and whether medical school ranking, international graduate status, or affiliation with a home neurosurgery program had affected these outcomes. Methods: A cross-sectional analysis of neurosurgery match data from 2016 to 2021 was performed, and the match outcomes were assessed by matched program geography and program research ranking. χ² tests were performed to identify significant differences between the 2021 and 2016–2020 match results. Results: A total of 1324 confirmed matched neurosurgery residents were identified from 2016 to 2021 (2016–2020, n = 1113; 2021, n = 211). No statistically significant differences were found in the rates of matching at a home program, within state, or within region between 2021 and 2016–2020 in the overall cohort. The proportions of international graduates and students without home programs among the matched applicants were unchanged in 2021. In 2021, students from the top 25 medical schools were less likely to match within their state or region (P < 0.05). Conclusions: Our findings might reflect enhanced weighting given by programs to applicants from top medical schools in the absence of data from in-person rotations and interviews. These findings, coupled with the potential benefits of an increasingly virtual application process in improving equity and diversity among candidates from underrepresented communities, should be considered when determining permanent modifications to future residency application cycles.