• Karl J Habashy, Tatiana Abou-Mrad, Mateo Gomez, Victor A Arrieta, Victor Gabriel El-Hajj, Abdul Karim Ghaith, Adam M Sonabend, Najib E El Tecle, Matthew B Potts, and Nader S Dahdaleh.
• Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Northwestern Medicine Lou & Jean Malnati Brain Tumor Institute of the Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
• World Neurosurg. 2024 Sep 1; 189: e476e484e476-e484.

ObjectiveNeurosurgery is one of the most competitive specialties, and navigating the match process is often challenging for aspiring applicants. Here, we analyze insights from the National Resident Matching Program Director Surveys, illustrating evolving trends in applicant selection for interviews and for the ranking process, and providing a comparison with other specialties.MethodsWe evaluated 7 surveys administered from 2012 to 2022. Six biennial surveys reported on factors influencing interview and ranking processes, while all 7 surveys included data about the program director (PD)'s attitude toward United States Medical Licensing Examination (USMLE) test scores.ResultsThe response rate of PDs decreased over the years. The most cited factor for interviews included specialty-specific recommendation letters (95%), USMLE Step 1 scores (91%), and interest in research (78%). A recent decline in emphasis on USMLE Step 1 scores coincided with a growing reliance on USMLE Step 2 scores. Award in basic science held significant esteem to a subset of programs. Personal characteristics dominated for ranking, with faculty interaction (89%), interpersonal skills (89%), and house staff interaction (85%) being the most important. Yet, PDs reported a difficulty in assessing interpersonal skills through virtual interviews.ConclusionsOur analysis revealed the pervasive importance of specialized endorsements and academic achievements when screening applicants for the interview process. A shift in emphasis toward the USMLE Step 2 became apparent. Personal characteristics, on the other hand, seemed crucial to make a match and rank high among the pool of interviewed applicants. We uncovered difficulties in assessing these characteristics through virtual interviews.Copyright © 2024. Published by Elsevier Inc.

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