Impact of Away Rotations on Urogynecology Fellowship Match

Objectives: Urogynecology/Female Pelvic Medicine and Reconstructive Surgery (FPMRS) fellowship match success may be influenced by numerous factors, including an applicant’s residency program, research experience, exam scores, and letters of recommendation. Away rotations broaden the applicant’s FPMRS experience and potentially increase the competitiveness of their application. However, such rotations can be costly and impact their home residency program. The purpose of this study is to determine if participating in an away rotation increases the likelihood of FPMRS match success.

Methods: This was a retrospective analysis of 246 applications to Indiana University FPMRS fellowship over six cycles, 2015-2019. Variables collected included match success into any FPMRS program, whether an away rotation was performed, age, race/ethnicity, gender, medical school location (US or foreign), residency program descriptors (university or community, whether associated with an FPMRS fellowship), medical degree (allopathic, osteopathic, or foreign), residency in-service exam scores, United States Medical Licensing Examination (USMLE) and/or Comprehensive Osteopathic Medical Licensing Examination (COMLEX) scores, FPMRS research, non-FPMRS research, and quality of the personal statement and letters of recommendation.

The FPMRS match rate between 2010 and 2019 was 73.2%. Assuming an alpha of 0.05 and power of 0.8, 62 applicants who performed an away rotation would be needed to detect a 20% increase in rate of match success.

Data was summarized for the overall cohort and by FPMRS match (Yes/No) for all the demographic and independent variables. T-test was used to compare continuous variables with normal distributions. Wilcoxon rank sum test was used for non-normal distributions. Chi-square test was used to compare categorical variables. Univariate logistic regression was performed to test the association of each variable collected with FRMRS match (Yes/No). Backward selection was used to determine the variables that were included in the multivariable logistic regression. All variables with a P-value of < 0.05 at the univariate level were included in the multivariable analysis. All tests were conducted at 95% significance level. SAS 9.4 (Cary, NC) was used for all analyses.

Results: Of the 245 applicants for whom match success data was available, 80 performed an FPMRS away rotation and 171 (69.8%) successfully matched into an FPMRS fellowship. Comparing the group that matched to that which did not, 33.9% of matched applicants performed an FPMRS away rotation vs 30.1% (P-value 0.57). The groups also did not significantly differ in terms of race/ethnicity, gender, US vs foreign medical school, medical degree, and university- vs community-based residency. Applicants who matched were more likely to be younger, have research presented at an FPMRS-related scientific meeting, and have higher-rated personal statements.

Conclusions: Our findings indicate performing an FPMRS away rotation does not increase an applicant’s likelihood of match success. Time spent doing month-long away rotations may be more productively focused on conducting FPMRS-related research projects.