Geographic diversity in the OBGYN residency match – longitudinal comparison during virtual interview and signaling cycles

Abstract

It is not well known how recent changes to the residency match process have impacted geographic diversity among residency matches. This study uses the Obstetrics and Gynecology match to evaluate how the recent changes, such as starting virtual interviews and the implementation of program signaling, impacted geographic diversity of residency matches by assessing the rates at which students remained at their home medical schools or in their school’s state for training. Residency programs on “Fellowship and Residency Electronic Interactive Database Access” with a corresponding medical school were included. Medical schools of matched residents in 2020–2025 were identified and used to calculate concordance rates for residency. Program-level analysis allowed for structural evaluation of institutional patterns. Paired sample t-tests and repeated measures analysis assessed concordance changes over time. Cluster Analysis was used to identify subgroups by concordance patterns. Across 126 programs, concordance rates – percent of each OBGYN residency class that matched from the residency program’s home medical school and from a medical school in the program’s same state – remained relatively stable over the six match cycles. There was a significant drop and subsequent rebound in concordance observed between the 2022–2023 and 2023–2024 cycles (p 2022−23 =0.03, p 2023−24 =0.003). Cluster analysis revealed two distinct subgroups, one with high and one with low concordance. Southern programs were more likely to have higher institution concordance rates while programs with more fellowships had lower state concordance rates. Although patterns of geographic concordance remained largely stable despite application reforms, program characteristics, such as region and fellowship offerings, were associated with concordance groups. Overall, findings suggest innovations in the application process may not significantly alter geographic diversity and equity outcomes.