Researchers from Mass General and the University of Vermont surveyed 2884 fourth-year students from 20 US medical schools in 2014; 1367 (47.4%) responded—52% of them were female.
Just over half of the students applied to internal medicine, pediatrics, or surgery residencies.
While the average number of programs applied to was 36.4, those seeking surgery applied to a mean of 58.2 programs, significantly more (p < 0.001) than those applying to any other specialty.
Except for radiology, for which applicants averaged 16.9 interviews, all other specialties including surgery had a mean of about 12 interviews per applicant.
Of those who answered the survey, only 71 (5.2%) did not match in the specialty they wanted.
The cost of interviewing was between $1000 and $5000 for about two thirds of the respondents with 14% spending less than $1000 and about 20% spending more than $5000.
The study produced some interesting data about fourth-year electives outside of the students’ medical schools, also known as “audition electives,” which were done by 56% of those surveyed. The mean number of audition electives was 1.8, with surgery and emergency medicine applicants significantly more likely to have done them, p < 0.001.
Audition electives influenced the ranking of programs for 89% of the students, but only 34% of them matched to programs where they had done an away elective.
Contrast that 34% match rate with this—81.8% of the survey respondents who did an audition elective felt that it would increase their chances of matching at that residency program. Apparently many of them were wrong.
Was the 34% match rate due to the students not finding the audition elective programs to their liking? Or were the programs not impressed with two-thirds of the students who did audition electives? Unfortunately, the paper was not able to investigate those questions.
The cost of doing an audition elective ranged from under $1000 for 42.1% of the applicants, $1000 to $3000 for 39.6%, and more than $3000 for 18.3%.
Another recent study found 71% of students applying to all specialties who auditioned “matched at one of their top three choices compared with 84% of non-auditioners who matched to one of their top three choices (p < 0.01).” Of 33 who did audition electives in general surgery, 1 (3%) matched at the hospital where the elective was done.
I receive many emails from medical students asking how they can improve their chances of matching in a surgical residency. They often mention audition electives. My standard answer has always been that I never put much stock in them because I feel it is easy for someone to be a superstar for a month or six weeks, but that doesn’t always translate into an excellent performance over one year or five years. I always told students who wanted to do audition electives with me that they should not have any misconceptions about the experience.
A post I wrote in 2014 about how surgery program directors choose applicants to interview cited a paper which found that a previous rotation at the PD’s institution ranked near the bottom of the selection criteria.
So do an away elective if you want to see how others do things or to learn something different, but don’t waste a lot of money and don’t expect it to guarantee you will match there.