Although the field of otolaryngology has experienced a decline in the number of applicants to our residency programs, otolaryngology remains a highly competitive field with an extremely strong applicant pool. Many highly qualified candidates cannot obtain a position in our field each year, and many of these candidates choose to reapply the next year. Data are lacking regarding reapplicants' success rate and the best gap year employment and training options for these reapplicants. Reapplicants were studied prospectively via a two-stage survey during the 2014-2015 and 2015-2016 application cycles. Success rates for the overall group were compared to those from published data, and success rates between subgroups were also compared. First-time reapplicants in the study performed extremely well. Their match rate (19/22) was not significantly different from that of traditional otolaryngology applicants (551/619, p = 0.73) and was significantly higher than that of nontraditional applicants not in our cohort (23/62, p < 0.001). No significant difference was found between applicants by employment/training activities, with both researchers (11/12) and surgical interns (8/10, p = 0.57) performing well. Predictors of reapplicant success could not be assessed because only 3 reapplicants in the cohort were unsuccessful. First-time otolaryngology reapplicants remain a highly competitive group of applicants to our field, regardless of employment/training activities undertaken after graduating medical school.
By any measure, the field of otolaryngology-head and neck surgery is one of the most competitive specialties in the United States. For example, in 2016, the average United States Medical Licensing Exam (USMLE) Step 1 score for matched applicants to otolaryngology programs was 248, higher than every field except dermatology (249) and integrated plastic surgery (250). (1) In years past, high levels of competition have led to many highly qualified applicants going "unmatched" but still desiring to pursue a career in the specialty.
The first difficult decision these applicants face is whether it is worthwhile to reapply to the specialty. Unfortunately, data are lacking regarding their odds of a successful match as a "reapplicant." In addition to their yearly report of applicant totals and match rates, the National Resident Matching Program (NRMP) publishes additional competitiveness data for matched and unmatched applicants in most specialties, including USMLE scores, Alpha Omega Alpha Honor Medical Society (AOA) standing, number of publications, and other measures, in their "Charting Outcomes in the Match" publication every 2 to 3 years.
Before 2016, the data were reported for both United States allopathic senior medical students (traditional applicants) and the heterogeneous group "independent applicants," which includes reapplicants, foreign medical graduates, osteopathic medical students, those applying to specialties for a second residency, and others. For 2016, even the independent applicant data were not available. The otolaryngology match rate for reapplicant U.S. allopathic graduates is unknown and/or unreported but may be higher or lower than for the entire independent group.
During the "gap year" between application cycles, motivated reapplicants will have several months to improve their applications, and they are offered several options that may help them to do so. They may enter a...