The role of medical school prestige and location in neurosurgery residency placement: An analysis of data from 2016 to 2020

Objective: There remains a gap in the literature analyzing how categorical variables may affect the highly competitive neurosurgery residency application process for MD Seniors in the United States. We aimed to improve understanding of the impact of medical school prestige and geographic location on candidacy for neurosurgery residency. Methods: Schools were stratified into high and low prestige cohorts based on the U.S. News and World Report Rankings and by geographic location. Publicly available match data displayed by websites of included medical schools from 2016 to 2020 were examined, and neurosurgery residency placement rates were then compared. Analysis was performed using Fisher's exact test and chi-square analysis, with a p-value of 0.05. Results: There were 6685 total matches in the high-prestige cohort and 12,997 total matches in the low-prestige cohort, with 115 (1.72%) and 113 (0.87%) neurosurgery matches, respectively (OR = 2.00, p < 0.0001). Considering geographic location, there were 5244 total matches in the Midwest, 3456 total matches in the West, 4994 total matches in the South, and 6053 total matches in the Northeast, with 51 (0.97%), 24 (0.69%), 83 (1.66%), and 114 (1.88%) being neurosurgery residency placements, respectively (p < 0.0001). Conclusions: Neurosurgery residency placement may be correlated with attending more prestigious medical schools and those located in the Northeast or South United States. Further elucidation of similar variables may prove to be important as neurosurgery residency becomes more competitive and the evaluation process changes.