Trends and Predictors of Cost in the Obstetrics and Gynecology Residency Application Process [ID 2683644]

INTRODUCTION: Travel restrictions from the COVID-19 pandemic required residency programs to transition from an in-person to virtual interview process. Obtaining an obstetrics and gynecology residency position is known to be competitive and places a considerable financial burden on applicants. This study aims to quantify the total costs in the application process before and after virtual interviews were implemented. METHODS: The Texas STAR database was queried to identify obstetrics and gynecology residency applicants from 2019 to 2023. The primary outcome was applicant-reported spending on the residency application process. Descriptive statistics and linear regression models were used to evaluate for associations with sociodemographic, temporal, and geographic factors. RESULTS: A total of 2,315 obstetrics and gynecology applicants were included. Applicants reported significantly less average total spending on the residency application process after the start of the COVID-19 pandemic compared to the years prior ($2,515 [SD 2,055] versus $4,909 [SD 2,869]; P<.001). Applicants who identified as underrepresented in medicine (P=.022), had a DO degree (P<.001), completed a research year (P=.030), participated in the couples match (P<.001), or were from the Western region (P<.001) reported significantly more total spending. There was a significant positive correlation between total non-interview-related spending and the number of interviews received (P<.001). CONCLUSION: There was a significant reduction in applicant spending after the start of the COVID-19 pandemic, likely related to transition to virtual interviews and limitations on in-person away rotations. The association of applicant spending with the number of interview offers raises concern for possible equity implications.