(1120) Otolaryngology Away Rotations: Analysis of Applicant Preferences and Influence on Match Outcomes

Introduction: Otolaryngology (OTO) residency applicants participate in visiting subinternships (VSIs) as part of the application process. The factors OTO applicants consider when applying to away rotations and correlation to match outcomes have not been rigorously studied.

Methods: A survey was distributed to all (472) signaling OTO residency applicants in the 2023 Match. The survey assessed demographics, residency application and match data, VSI application/invitation data, and 16 factors when applying to VSIs. An ad hoc cluster analysis was used to differentiate preference patterns. Multivariable-adjusted models were created to examine associations.

Results: Complete response rate was 41.5%. Nearly all respondents (97%) applied for and were invited to least one VSI, with mean 5 applied to and 3 invited. Compared to “US MD Seniors,” “US DO Seniors” applied to and were invited to more VSIs (mean dif. 10.7 [95% CI: 7-14.3], 3.6 [2.4-4.9]). Similarly, “those without a home program” applied to and were invited to more (mean dif. 3.4 [1.5-5.3], 1.5 [0.9-2.1]). More VSI invitations was associated with matching at an away rotation as opposed to non-home programs (IRR per away: 1.24 [1.02-1.49]). However, number of invitations were not associated with overall match success (IRR 1.08 [0.84-1.4]).
Three VSI preference patterns were identified: 1) group 1 (n = 73) prioritized external program/applicant factors (geographic location, proximity to family, city size – large); 2) group 2 (n = 50) prioritized factors focused on the professional characteristics of the program and applicant (perceived training experience, interview chance, prior connections), 3) and mixed cluster (n = 73). Compared to group 2, group 1 had a lower likelihood of matching at a VSI (RRR 0.32 [0.13, 0.81]) and trended towards a higher likelihood of having a home program (RRR 1.53 [0.62, 3.84]).

Conclusions: Applicants nearly universally participate in VSIs. Those seeking to match to specific programs are advantaged by participating in VSIs regardless of strategic focus. Differing VSI application strategies may influence likelihood of matching at a VSI.