To the Editor,
Dermatology is one of the most competitive residencies for matching among medical school applicants. A strong connection with a residency program through research or clinical rotations may distinguish between similarly qualified applicants. Our previous study of research-mentor relationships among matched dermatology applicants corroborated the importance of program connections.1 However, the 2020-2021 residency match cycle was uniquely affected by the COVID-19 pandemic, which prevented applicants from fostering connections with faculty at outside institutions. Our study objectives were to evaluate research-mentor relationships among matched dermatology applicants in the 2020-2021 pandemic match cycle with comparisons to pre-pandemic match cycles.
We searched for publicly available 2021 residency match lists from all U.S. allopathic medical schools. We found the names of 118 matched dermatology applicants from 34 medical school match lists (Table 1). The senior authors of applicants' PubMed-indexed articles published before September 15, 2020 were also identified. The senior author who published with an applicant most often was considered the research-mentor. Mentor and home program connections appeared to play a significant role, with 31.3% of successful dermatology applicants matching at their mentors' institutions, and 30.5% matching at their home programs where their mentors also practiced (Table 2).
We previously evaluated research-mentor relationships among matched dermatology applicants in the top 25 dermatology residencies from 2016-2018 ranked by Doximity Residency Navigator, which combines physician feedback with objective data.2 We found that 26.2% of successful applicants matched at their mentors' institutions, and 10.3% matched at their home programs where their mentors also practiced.1 While the subset of matched applicants in our current study differs from that of our previous study, mentor and home program connections appeared to be equally or more important for matching in the 2020-2021 pandemic cycle compared to pre-pandemic match cycles. In a survey-based study of 44 applicants to a dermatology residency program from 2013-2015, all under-represented minorities (URMs) and the majority of matched non-URMs reported having a mentor. Therefore, mentorship likely confers a strong benefit for matching, as faculty provide networking opportunities that build on applicants' social capital while sharing knowledge and experience.3
Similarly, Abdelwahab et al. investigated the impact of the COVID-19 pandemic on the proportion of dermatology residency applicants matching into their home programs during the 2021 match.4 The authors reported that there were statistically significantly greater odds of matching at least 1 home applicant in the 2021 vs 2017-2019 cycles (odds ratio=2.3; P=0.02). Home matching occurred more frequently with programs having more spots than the national median (4) and less often with programs having <4 spots (P=0.00001). The authors hypothesized that during the pandemic, with virtual rotations and interviews the norm, programs and outside applicants had difficulty connecting, resulting in applicants and their home programs ranking each other relatively higher.
Abdelwahab et al's findings may be at least partially explained by our study demonstrating that a significant proportion of matched applicants worked with mentors at their home programs. Together, these studies demonstrate that limited exposure of programs to outside applicants and mentor relationships at home programs likely impacted match outcomes during the pandemic. Dermatology applicants without home programs, who have limited mentorship opportunities, are significantly disadvantaged. Novel solutions, such as formal mentorship programs and their promotion through social media,5 can help make the residency application process more equitable for applicants.
