Introduction: Urology remains a competitive surgical sub-specialty with a match process independent of the National Resident Matching Program. Each year a cohort of competitive applicants go unmatched and are faced with the decision to reapply the following cycle while doing a research fellowship or a preliminary internship in the interim or choose a different specialty altogether. We sought to investigate the outcomes and eventual career paths for unmatched applicants in Urology by evaluating a cohort of unmatched applicants.
Methods: Data was obtained from the 2008-2013 American Urological Association urology match lists. Reapplication status was evaluated by comparing urology match lists. Additional information regarding eventual specialty choice, fellowship training, and academic or private practice setting were obtained from publicly available sources. Comparative analysis with univariate and multivariate analysis was performed between unmatched applicants who eventually matched into urology and applicants who chose alternative career paths.
Results: 441 unique applicants were identified with at least one unmatched result between 2008-2013. Amongst these applicants, 40.6% (n=179) were reapplicants from another cycle, 69.2% (n=305) were male, 85.3% (n=377) were MDs and 33.9% (n=148) became urologists. Eventual urologists were more likely to be male (73.3%, p=.123) and more likely to be from a Doctor of Osteopathy (DO) degree granting school (p= <0.0001). For eventual urologists, the most common pathway was a preliminary surgery year (43.2% n=64), followed by obtaining a position through the DO match (18.2%, n=27) and research fellowship (12.1%, n=18). Of the 292 applicants who went into other specialties, 9.9% (n= 29) reapplied to Urology before choosing an alternate specialty, such as anesthesiology (18.2%), Internal Medicine (18.8%), General Surgery (18.5%), Radiology (8.9%), Family Medicine (8.6%), Emergency Medicine (5.8%), and OB/GYN (5.8%).
Conclusions: Approximately 1 in 3 unmatched urology applicants will eventually obtain a urology residency position (33.6%, 148/441). DO students were more successful at eventually obtaining a urology position although this may be reflective of separate DO urology residency positions during this study time period. The most common specialty choices for unmatched urology applicants were internal medicine (18.8%), general surgery (18.5%) and anesthesiology (18.2%). Applicants who applied in multiple cycles were likely (83.6%, n=148/177) to be successful in the urology match.
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