Factors affecting admission to anesthesiology residency in the United States: choosing the future of our specialty.

BACKGROUND: Admission to an anesthesiology residency in the United States is competitive, and the odds associated with a successful match based on the applicants' characteristics have not been determined. The objective of this study was to examine factors associated with admission to anesthesiology residency in the United States. METHODS: The study was a retrospective cohort evaluation of the 2010 to 2011 residency applicants. Applicants' characteristics and objective factors used to select trainees were extracted. The primary outcome was a successful match to an anesthesiology residency. Data were analyzed using conditional inference tree analysis and propensity score matching. RESULTS: Data available from 1,976 applications were examined corresponding to 58% of the national sample. The odds (99% CI) for successful match were 3.6 (3.1-4.2) for U.S. medical school graduates, 2.6 (2.3 to 3.0) for applicants with United States Medical Licensing Examination Step 2 scores more than 210, and 1.2 (1.1 to 1.3) for female applicants. The odds (99% CI) for a successful match for international and U.S. graduate applicants younger than 29 yr was 3.3 (2.0-5.4) and (1.9 to 4.2), respectively, even after propensity matching for medical school, exam scores, and gender. The average applicant had no peer-reviewed scholarly productivity. CONCLUSION: Although anesthesiology residency acceptance was primarily associated with U.S. medical school attendance and United States Medical Licensing Examination Step 2 scores, our study suggest an influence of age and gender bias in the selection process. Peer-reviewed scholarly production among applicants and prior graduate education did not appear to influence candidate selection.