The influence of gender and virtual interviews on applicants’ evaluation of surgical residency programs: a changing landscape

While previous research has acknowledged a range of influential factors in selecting residency programs, it has not provided a clear ranking of their relative significance. The primary aim of this study is to evaluate the relative influence of 21 selection factors on the creation of a rank list among applicants to surgical training programs, assessing for gender-based differences and the influence of interview format (in-person or virtual).

A cross-institutional survey of surgical residents and applicants from January to November 2023 was conducted. By answering Best–Worst Scaling (BWS) questions, respondents prioritized 21 factors previously identified as influential to residency program selection. BWS required respondents to select the most and least influential factors from different item combinations. Using a simple count analysis, the relative prioritization of factors was determined. Data were then segmented and compared between self-identifying cisgender men and women. A secondary analysis compared factor ranking between in-person and virtual interviewees.

Eighty-eight surgical residents and applicants were surveyed. Of the respondents, 57 (65%) identified as cisgender women. “Program Reputation” ranked as the second most influential factor for men, while women ranked it sixth (p =  < 0.001). “Program Atmosphere,” “Interview Experience,” “Post-Residency Opportunities,” and “Personal Experience with House Staff” were equally important for all applicants, regardless of gender. Notably, men ranked “Family Factors” higher than women (8th vs 11th, p =  < 0.001). Data stratified by interview format revealed that 55 (63%) respondents participated in virtual interviews, while 33 (37%) were in-person. “Family Factors” ranked higher for virtual than in-person interviewees (8th vs. 15th, p =  < 0.001).

Our results reveal distinct differences in how men and women assess training programs, even among their highest priorities. While women were prioritized their personal evaluations, men were significantly more influenced by external factors. Additionally, applicants interviewing virtually assess training programs differently than those interviewing in-person. In the virtual interview era, family considerations were prioritized more often in the decision-making process, suggesting a growing need for initiatives that foster interpersonal support systems.