Patterns of Residency Transitions into and out of Otolaryngology

Introduction: Residency transitions into/out of specialties represent inefficiencies in the training system that are stressful for both individual trainees as well as their programs. This study examines patterns among residents switching into/out of otolaryngology-head and neck surgery (OHNS), focusing on demographic and application characteristics.

Methods: We analyzed the 2019-2023 Association of American Medical Colleges (AAMC) Electronic Residency Application Service (ERAS) applicant dataset and GME Track®. Characteristics of residents transitioning into/out of OHNS were examined using descriptive statistics, chi-square tests, t-tests, and logistic regression.

Results: Among 103 residents switching into OHNS, the majority originally matched into general surgery (88.3%), followed by transitional year (6.8%) and internal medicine (2.9%). All had applied to OHNS, most commonly cross-applying to general surgery (47%). In contrast, the 14 residents who left OHNS transitioned primarily to anesthesiology (28.6%), internal medicine (28.6%), and family medicine (21.4%). Half of those who switched out had originally applied exclusively to OHNS, while others had also applied to internal medicine (14.3%) or other non-surgical fields (35.7%). Cross-application was significantly more common among those who switched in compared to those who switched out (90.3% vs. 50%, p=0.0003), with cross-applicants having 9.30 times higher odds (95% CI: 2.70-33.00) of switching into OHNS than those who did not originally cross-apply.

Conclusions: Understanding residency transition patterns reveals that residents switching into OHNS predominantly come from general surgery and typically have previously cross-applied to OHNS, while those switching out tended to transition to non-surgical specialties and either did not originally cross-apply, or cross-applied to non-surgical fields.