Abstract
INTRODUCTION: Despite significant changes over the past 5 years, the otolaryngology head and neck surgery (OHNS) residency application process remains highly competitive. This study assessed how applicant and medical school characteristics predict success in entering OHNS residency programs. METHODS: 1,363 application files submitted to a single academic OHNS residency program during the 2019-2020, 2020-2021, and 2023-2024 cycles were reviewed. Applicant characteristics, Step scores, medical school rankings, geographic locations, and research productivity were analyzed. T-tests and chi-square tests were used for comparative analyses, while linear modeling identified match success predictors. RESULTS: Applications declined in the 2023-2024 cycle compared to earlier cycles. Although mean Step 1 scores predicted success previously, they lost significance in 2023‒2024. Step 2 scores remained reliable predictors across cycles (p = 0.021), with matched applicants consistently scoring higher (e.g., 2023-2024 mean: 255.8 ± 11.4 vs. 249.1 ± 14.3, p < 0.001). Research productivity increased throughout cycles, with matched applicants demonstrating higher output (e.g., 2023-2024 mean publications: 5.4 ± 6.3 vs. 4.4 ± 7.3, p < 0.001). Research fellowships increased (26.6% in 2023-2024) and were notably linked to higher productivity, especially for applicants from lower ranked schools. Modeling indicated that Step 2 scores, medical school rankings, and research output significantly predict match success. CONCLUSION: Fewer applications were received in the 2023-2024 cycle, and Step 1 scores lost their predictive value, reflecting recent evaluation changes. Still, Step 2 scores and research productivity remain crucial for match success, suggesting their increasing relevance for applicants seeking OHNS residencies.