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Introduction: Despite the importance of linguistic analysis, no systematic research has been explored in the form of linguistic analysis on personal statements for military orthopedic surgery residency programs. This study was conducted to analyze U.S. Navy (USN) orthopedic surgery applicants' personal statements using an automated textual analysis program to assess personal statements for linguistic styles., Methods: A retrospective analysis of USN orthopedic applicant personal statements from application years 2016 to 2019 was performed utilizing the Linguistic Inquiry and Word Count (LIWC) software. LIWC analyzed the text for summary variables: analytical thinking, clout, authenticity, and emotional tone. We compared this analysis with Step 1 and Step 2 scores and determined whether an applicant matched., Results: A total of 94 personal statements (60,230 words) were analyzed using LIWC. The average word count was 640.7, with an average of 23 words per sentence. The average-matched applicant USMLE Step 1 and Step 2 scores were 240 and 250, respectively. When examining summary traits utilizing multiple logistic regression analysis, only analytical thinking demonstrated a statistically significant difference in matched versus unmatched applicants with a P = .011 (OR = 1.10)., Conclusion: As the USMLE Step 1 exam transitions from a scoring system to Pass/Fail grading, programs will look at other characteristics to determine who would likely succeed in residency. From a linguistic analysis standpoint, matched applicants' personal statements demonstrated higher analytical thinking, clout, affiliation, power, and risk focus than unmatched applicants. Unmatched applicants demonstrated higher authenticity than matched applicants., (© The Association of Military Surgeons of the United States 2024. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site–for further information please contact journals.permissions@oup.com.)

Background: Disparities exist in underrepresented in medicine (URiM) resident representation. This review examines recent trends in resident diversity, URiM recruitment strategies, and identifies research gaps in equity, diversity, and inclusion (EDI) for URiM residents., Methods: MEDLINE, EMBASE, Web of Science, and ERIC databases were searched for studies published from 2017 to 2022 on URiM resident prevalence and recruitment initiatives., Results: 3634 abstracts were reviewed, and 52 articles were included. 35 (67 ​%) studies reported on prevalence of URiM residents, demonstrating URiM resident composition is lower than residency applicant demographics, particularly in surgery. Seventeen (33 ​%) studies reported on URiM recruitment interventions, such as visiting clerkship programs, holistic review, and targeted outreach, and demonstrated success in increasing recruitment of URiM candidates to programs., Conclusions: URiM residents remain disproportionately underrepresented, and markedly so among surgical residency programs. Further research should focus on implementing EDI interventions in surgery and assess URiM resident attrition post-matriculation., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Objectives: To compare otolaryngology interview and match outcomes between applicants with and without home residency programs., Methods: Otolaryngology applicants from US allopathic medical schools during the 2019-2023 cycles who responded to the Texas Seeking Transparency in Application to Residency (STAR) survey were identified. Students were stratified based upon whether their medical school had an affiliated otolaryngology residency program. The primary outcomes were number of interviews and match rate. Wilcoxon-rank sum and χ 2 testing was used to assess associations between home program status and interview and match outcomes., Results: Of the 633 fourth-year medical students applying to otolaryngology during the 2019-2023 application cycles, 89 had no home program (NHP) and 544 had a home program (HP). Applicants with NHP completed significantly more away rotations than applicants with a HP (2.2 vs. 1.5; p < 0.01). There was no difference in mean number of applications submitted between applicants with NHP and applicants with a HP. However, applicants with a HP received a significantly greater number of interviews (14.7 vs. 11.8; p < 0.01), attended more interviews (12.4 vs. 11.3; p = 0.02), attended a lower percentage of their offered interviews (84.4% vs. 95.8%), and had a higher match rate (81.8% vs. 70.8%; p = 0.02) than applicants with NHP. Applicants with NHP interviewed at (1.9 vs. 1.3; p < 0.01) and matched at (33.7% vs. 23.9%; p = 0.048) significantly more away rotation institutions than applicants with a HP., Conclusion: Applicants with NHP received fewer interviews and had lower match rates. Away rotations may be especially important for applicants with NHP., Level of Evidence: NA Laryngoscope, 134:4494-4500, 2024., (© 2024 The American Laryngological, Rhinological and Otological Society, Inc.)

Introduction: Between 1994 and 2014, despite an increase in applicants, successful matches into general surgery (GS) decreased by 13%. We aim to (1) understand the trends in competitiveness for a GS residency, and ascertain the associations between (2) geographical distribution and (3) research experiences on matching., Methods: National Resident Matching Program data (2013-2022) were analyzed for (1) annual positions and matches, (2) United States Medical Licensing Examination scores, and (3) research experiences. Geographical locations of general surgery residency programs (GSRPs) for matched US seniors were obtained from medical school websites and through contacting institutions. Distances between medical schools and respective matches were assessed for the proportion of students matching within 100 miles, in the same state or same region, or in a different geographical region than their medical school., Results: Of 28,690 applicants, 15,242 (53.12%) matched into a GS residency. Matched GS applicants had higher United States Medical Licensing Examination scores compared to applicants who matched in Emergency Medicine and Family Medicine (P < 0.001). US Medical Doctor (MD) match rates into GS were lower compared to Neurosurgery (P < 0.01), possibly due to competition from non-US MD applicants within GS. More applicants matched into GSRPs in the same region as their medical school, with 14% matching into home programs or within the same state as their medical school., Conclusions: Higher board examination scores and research participation are associated with successful matches. GS competition from non-US MDs may be driving the match rates for US MDs lower. More than half of students matched into GSRPs in the same region as their medical school., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Importance: The lack of underrepresented in medicine physicians in academic plastic surgery has been a topic of interest for many years, and accordingly outreach has been undertaken to address the pipeline from medical school to residency and beyond., Objective: This study aims to assess and identify the characteristics associated with plastic surgery match success for underrepresented in medicine applicants., Design: Residency application data for first time, US allopathic medical school seniors from the 2017-2018 to 2021-2022 applicant cycles were abstracted from Electronic Residency Application Service applications, and match results were determined using the National Residency Matching Program database and online public sources. Data included self-reported race, and multiple application characteristics. Multivariable logistic regression of application characteristics were used to assess the relationship between underrepresented in medicine status and successfully matching. Binary logistic regression was used in subgroup analyses of each application characteristic, and interactions regression was used to evaluate the relative weight of each characteristic on successfully matching., Results: Underrepresented in medicine applicants were 57% less likely to match than non-underrepresented in medicine applicants (OR 0.43, p = 0.001), though they were 60% less likely to match (OR adj 0.4, p = 0.216) when adjusted. Subgroup analysis revealed that odds of matching as an underrepresented in medicine applicant were significantly increased if the applicant had a home program, took a research year, and had an increased number of published research and presentations (ORs 0.43-0.48, all p < 0.05). Odds of matching as an underrepresented in medicine applicant were significantly decreased if the applicant went to a medical school ranked in the highest or lowest third (ORs 0.41-0.42, all p < 0.01); however, on interaction regression the odds of matching from a highly ranked medical school was increased (OR 3.5, 95% CI 0.98-12.55, p = 0.05)., Conclusions: The likelihood of matching as an underrepresented in medicine applicant is lower than the rest of the applicant population, and there are no individual applicant characteristics that can increase these odds to equal that of the general applicant population., (Copyright © 2024 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

Differences in employee evaluations due to gender bias may be small in any given rating cycle, but they may accumulate to produce large disparities in the number of women and men promoted to the top of an organization. A highly cited simulation by Martell et al. (1996) demonstrates this cumulative advantage process in a multilevel organization. We replicated this simulation to uncover important details about its operating assumptions, and we extended the simulation to examine a range of variables that may impact the cumulative effects of gender bias. The replication revealed that the male cumulative advantage in the Martell et al. simulation requires (a) decades of typical promotion cycles to produce, (b) constant mean differences in the performance ratings of women and men but equal within-group variances, and (c) attrition that occurs randomly at a low and constant rate. Our extended simulation demonstrates that (a) cumulative effects of gender bias are higher when the attrition rate is lower, (b) gender biases are mitigated when attrition is more strongly associated with good or poor performance, and (c) the cumulative effects of mean gender differences in performance ratings can often be smaller than the cumulative effects of variance differences between gender subgroups. Results suggest that talent development and recognition of high performers might have a greater positive impact on female representation at top levels of a firm than programs aimed at reducing bias in employee evaluations. We encourage additional simulation work that further explores the dynamics of cumulative advantage in employment settings. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Background: Educational debt is commonly observed among applicants to orthopaedic surgery residency programs; however, an understanding of the debt burden among minority and nonminority applicants is not well established. Thus, this study aimed to fill these knowledge gaps by examining the extent of and factors shaping educational debt among orthopaedic surgery applicants., Questions/purposes: (1) What is the educational debt burden among orthopaedic surgery residency applicants? (2) After controlling for relevant confounding variables, what factors are independently associated with increasing levels of educational debt? (3) After controlling for relevant confounding variables, are individuals classified as an underrepresented minority or those with educational debt and socioeconomic disadvantage less likely to match in orthopaedic surgery?, Methods: A retrospective evaluation of orthopaedic surgery residency application data from the American Association of Medical Colleges was analyzed from 2011 to 2021. The American Association of Medical Colleges database was selected because every residency applicant must register and apply through the American Association of Medical Colleges. Therefore, these data exist for every residency applicant, and the sample was comprehensive. Self-reported data including premedical, medical, and total educational debt burden as well as classification as socioeconomically disadvantaged and application fee waiver use were collected. Applicants were dichotomously categorized as an underrepresented minority or a not underrepresented minority based upon self-identified race and ethnicity. Monetary values were reported in USD and inflation-adjusted to 2021 using the Consumer Price Index. We performed t-tests and chi-square tests for continuous and categorical variables, respectively. Significance was considered at p < 0.05. In all, 12,112 applicants were available in the initial cohort, and 67% (8170 of 12,112) of applicants with complete data were included from 2011 to 2021 in the final study cohort. Of these, 18% (1510 of 8170) were women, 14% (1114 of 8170) were classified as underrepresented minorities, and 8% (643 of 8170) were classified as socioeconomically disadvantaged. Sixty-one percent (4969 of 8170) of applicants reported receiving at least one scholarship, 34% (2746 of 8170) had premedical school debt, and 72% (5909 of 8170) had any educational debt including medical school. Among all applicants, the median (IQR) educational debt was USD 197,000 (25,000 to 288,000). Among those with scholarships, the median amount was USD 25,000 (9000 to 86,000)., Results: After controlling for the potentially confounding variables of gender and socioeconomic disadvantage, classification as an underrepresented minority applicant was independently associated with higher scholarship amounts than applicants characterized as not underrepresented minorities (β = USD 20,908 [95% confidence interval (CI) 15,395 to 26,422]; p < 0.001), whereas underrepresented minority classification was not independently associated with a difference in total educational debt (β = USD 3719 [95% CI -6458 to 13,895]; p = 0.47). After controlling for the potentially confounding variables of gender and classification as an underrepresented minority, socioeconomic disadvantage was independently associated with higher scholarship amounts (β = USD 20,341 [95% CI 13,300 to 27,382]; p < 0.001) and higher total educational debt (β = USD 66,162 [95% CI 53,318 to 79,006]; p < 0.001) than applicants not classified as socioeconomically disadvantaged. After controlling for the potentially confounding variables of gender and classification as an underrepresented minority, socioeconomic disadvantage was independently associated with decreased match rates (OR 0.62 [95% CI 0.52 to 0.74]; p < 0.001)., Conclusion: These findings underscore the need for comprehensive scholarship initiatives to ensure equitable financial accessibility for applicants from all backgrounds., Clinical Relevance: In the future, orthopaedic surgery may benefit from research comparing the effectiveness of various initiatives aiming to improve fairness in the burden of debt among applicants to orthopaedic surgery residency programs., Competing Interests: Each author certifies that there are no funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article related to the author or any immediate family members. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research ® editors and board members are on file with the publication and can be viewed on request., (Copyright © 2024 by the Association of Bone and Joint Surgeons.)

Introduction: Recruit training is designed to transform civilians into physically fit military service members, who embody their service's core values and possess military discipline and skills. At the time this research began, the U.S. Marine Corps (USMC) remained the only service that segregated recruits by gender at the lowest unit level (e.g., platoon) and employed gender-segregated drill instructor teams. USMC's Marine Corps Recruit Depots (MCRD) must comply with a 2020 Congressional Mandate to not segregate training by gender in Parris Island by 2025 and San Diego by 2028. In turn, USMC requested an independent scientific study to analyze current approaches to gender integration at recruit training to propose alternate models and other policy recommendations that increase gender integration while maintaining current USMC standards. The Marine Corps is currently evaluating alternate models and recommendations to optimize entry-level training. This article outlines considerations for choosing the optimal research study design, research methods, and types of data collected in a study intended to provide policy recommendations on gender-integrated recruit training for the USMC., Materials and Methods: Research data were collected during visits to the MCRDs and selected recruit training locations for the Army, Air Force, Navy, and Coast Guard. Data collection on USMC recruits from three cohorts involved social science assessments (focus groups and surveys) and human performance testing (countermovement jumps and isometric mid-thigh pulls, sleep and activity wearables, and cortisol data) at multiple points in the training cycle. Data on recruits from the sister services were limited to social science assessments. Approximately 600 recruits between the two MCRDs and 160 recruits from the sister services participated in the study during a 7-month timeframe in 2021. The research team conducted extensive ethnographic observations of recruit training at all selected research sites and interviewed training cadre, drill instructors, and service leadership responsible for recruit training (∼90 interviews). Additionally, the research team interviewed 20 experts on gender integration or recruit training who possessed alternate viewpoints from the current USMC practice., Results: The mixed methods study was designed to assess the current gender integration practices at recruit training across the services to generate alternative models of gender integration for USMC. The research team developed a set of multidisciplinary objectives and research questions serving as the foundation of the research study design and data collection process. The study was designed to collect qualitative, quantitative, and administrative data informed by social science and human performance disciplines. To ensure that all aspects and implications relevant to gender integration were considered, select data were collected across services and with stakeholders at all levels., Conclusions: This multidisciplinary research approach provided a comprehensive picture of the current USMC recruit training models. The research team captured multiple perspectives and data points for analysis through an expansive view on gender integration across all services, by interacting with participants at all levels of the institutions in varied ways. The information and data gathered enabled the research team to establish objective, data-driven alternate models, and recommendations for enhancing gender integration at recruit training for the USMC., (© The Association of Military Surgeons of the United States 2024. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Introduction: Drill instructors (DIs) are responsible for executing their Services' recruit training programs and for training recruits. DIs assume a variety of roles, including teaching and developing practical skills and knowledge, mentoring, modeling appropriate behavior and attitudes, motivating recruits for success during and after recruit training, applying and instilling discipline, and ensuring the safety and welfare of recruits. This article examines two major research questions at the intersection of gender, gender-integrated training, and the DI role: (1) What differences exist in how DIs experience their role by gender? and (2) how does gender-integrated recruit training affect DIs' approach to training?, Materials and Methods: This article draws from 87 semistructured interviews conducted with Service leaders, training cadre, and DIs in service of a broader Marine Corps interdisciplinary study on gender integration at recruit training. Interviews were conducted virtually and in-person with Marine Corps, Army, Navy, Air Force, and Coast Guard personnel from June to November 2021. Each interview was coded with initial and secondary codes developed through a flexible coding approach. Data were analyzed across and within relevant categories such as gender and Service to identify themes and patterns., Results: Although the DI role was universally described as demanding and difficult, unique challenges for women consistently emerged from the data. The top reported challenges faced by female DIs were personnel shortages, work and family conflict, culture-driven sexism in the training environment from male peers and recruits, and pressure to excel above and beyond their male peers. In recruit training, DIs are responsible for executing gender-integrated practices. Service leaders, training cadre, and DIs described how gender integration practices affect their approach to the role and implementation of training, including addressing and dismantling sexism, shutting down recruit romantic relationships, training all recruits in an equal manner, knowing gender-specific grooming standards, increasing communication among DIs, and working with mixed-gender DI teams., Conclusions: Female DIs face additional challenges in and outside the role compared with their male peers, and some of these challenges are preventable. Staffing and personnel issues plague the female DI population and are a persistent and pervasive challenge to gender integration efforts. Women are a necessary and highly desirable population to fill the DI role, particularly as Services aim to expose recruits to leaders of both genders during their critical first training experience. DIs play an important role in ensuring the successful completion of recruit training, ultimately helping to build the future leaders of the military. The success of gender integration efforts depends on DIs' intentional approach to the process. Future research can build on this work by expanding the scope to other military training environments (beyond recruit training) and examining how DIs' own sociodemographic positions (e.g., gender, race, ethnicity, and sexual orientation) inform their perspective on and approach to equity in the training environment., (© The Association of Military Surgeons of the United States 2024. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Introduction: This article uses recent survey data from a study on gender integration at recruit training across the U.S. Armed Forces to examine service, gender, and training differences in recruit's gender attitudes, beliefs, and cohesion metrics. In addition to providing a descriptive understanding of our recruit sample, this article examines factors germane to gender integration at recruit training such as gender attitudes, sexist beliefs, and unit cohesion., Materials and Methods: This article uses data from a survey of U.S. Marine Corps (USMC), U.S. Army, U.S. Air Force, U.S. Navy, and U.S. Coast Guard recruits as part of a USMC-commissioned study to develop alternate models and recommendations for increasing gender integration in USMC recruit training. At all sites but the USMC, recruits completed the survey 1 to 2 weeks before graduation. At the Marine Corps Recruit Depots, recruits participated in the survey at the beginning (week 2) and end (week 11) of their 13-week training cycle. A 19-question survey captured sociodemographic information, perspectives and experiences during recruit training, and gender attitudes and beliefs. Analyses were conducted on the sample with complete data on the measures reported, including those USMC recruits observed at both week 2 and week 11 (n = 629). Descriptive statistics (percentage) were calculated for all categorical outcome variables. Outcome variables (cohesion, gender, and sexism attitudes) were compared between groups using chi-squared tests or Fisher's exact tests, as appropriate., Results: Recruits differed significantly across services in perceptions of unit cohesion on 3 of the 4 indicators: Platoon members are cooperative, know they can depend on each other, and really respect each other (P < .05). These differences appear to be driven by female recruit difference across service. They reported significant differences in gender role attitudes across the services, with USMC recruits being most likely to endorse traditional gender roles compared to other service recruits. Male USMC recruits were significantly more likely than their female peers to agree that men should achieve outside the home and women should take care of the home and family (21.3% versus 6.3%, P < .05). The only statistical differences in attitudes about equality of treatment and opportunity among recruits were between male and female USMC recruits. All items capturing sexist attitudes elicited statistically significant differences between male USMC recruits and male recruits in other services (P < .05). There were significant differences in all sexism measures between male and female USMC recruits (P < .05). There is a significant decline in some sexist attitudes between weeks 2 and 11 of training among male USMC recruits (P < .05). Nearly one-half to three-fourths of male USMC recruits hold sexist attitudes, even near the end of recruit training., Conclusions: The disparate gender and sexism attitudes of male USMC recruits compared with their peers in other services, and their fellow female USMC recruits suggest efforts to increase gender integration at entry-level training are needed, but also may be challenging since male USMC recruits report the highest levels of sexist attitudes among all recruits., (© The Association of Military Surgeons of the United States 2024. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site–for further information please contact journals.permissions@oup.com.)

Introduction: Recruit training is the initial entry for enlisted personnel in the military. The Services execute gender-integrated recruit training differently. The U.S. Marine Corps (USMC) maintains same-gender platoons led by same-gender drill instructors in integrated companies; further integration occurs at select training events. The other Services train recruits in gender-integrated units with mixed-gender drill instructor teams. We examine recruits' experiences and perceptions of gender integration at recruit training, their desired level of integration, and preferences for increasing gender integration, comparing by Service and gender., Materials and Methods: Recruit perspectives and experiences were captured in a 19-question survey (n = 632) and 90-min focus groups (n = 260) near graduation from recruit training. Data were collected from June to November 2021. Because of the Coronavirus disease (COVID-19) pandemic restrictions, the Navy and Air Force were not conducting gender-integrated recruit training during data collection. Outcome variables were compared cross-Service by gender and within Service by gender using chi-squared tests or Fisher's exact tests, as appropriate; focus group data were analyzed using initial and secondary coding schemes. Three USMC training models, varied by level of integration, were also analyzed (Male-Only, Series Track, and Integrated Company)., Results: Significant gender differences across and within Service emerged in recruits' experience being trained by an opposite-gender instructor. Male recruits had significant differences by Service (P < .001), and USMC female recruits reported being trained by male instructors more than their male peers by female instructors (Series Track P = .002; Integrated Company P < .001). In the focus groups, recruits described common differences with how men and women embodied being a drill instructor. Significant gender differences across (both male and female P < .001) and within Service were reported for closeness of training with opposite-gender peers (Air Force P = .028; U.S. Marine Corps (USMC) Integrated Company P = .010; Army P = .048), an expected finding given varied integration during data collection. Male and female recruits had significant differences by Service in their preference for integration at the lowest unit level (both male and female P < .001), with those who experienced integrated training showing higher levels of endorsement. In the focus groups, recruits articulated benefits and challenges of gender-integrated recruit training. Significant gender differences across Service emerged in preferences for more integration in specific training activities. Within Service, female USMC Integrated Company recruits wanted more integration in tactical/field, physical fitness, and classroom training than their male peers (P < .001 for all). In the focus groups, USMC recruits of both genders desired more integrated training events, particularly those involving combat and tactical skill development., Conclusions: This study provided an opportunity to examine recruit perspectives on gender-integrated training. Services valuing opposite-gender instructor exposure in recruit training must ensure that male recruits are being taught and led by female instructors given disproportionate demographics. Recruits who experienced integrated training were more supportive of integration, indicating that this experience may increase their support for gender-integrated training units and environments. Today's recruits understand that they are entering gender-integrated working environments, and our results indicate that they expect recruit training to mirror that reality., (© The Association of Military Surgeons of the United States 2024. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Introduction: This study aims to evaluate program signaling in surgical specialties, analyze its influence on residency applications, and provide recommendations for enhancing its consistency and effectiveness., Methods: This cross-sectional study analyzed AAMC ERAS data from the 2021 to 2022 and 2023 residency match cycles, focusing on surgical specialties including general surgery, neurological surgery, obstetrics and gynecology, and orthopedic surgery., Results: A positive correlation existed between the number of signals received and the number of applicants to a program across 4 surgical specialties. 10% of programs in each specialty received between 17% and 28% of all signals. There was a negative correlation between the number of current DO residents at a program and the number of signals received. Amongst surgical specialties, those with more signals per applicant had a more equitable distribution of signals across competitive programs. University programs received the most signals, programs were less likely to receive signals if they had a higher percentage of DO residents, and IMG applicants were less likely to send signals., Conclusion: Specialties with more signals per applicant had a more equitable distribution of signals across competitive programs, and university programs received proportionally more signals than community programs. Further research is required to investigate the disparities in signaling and the impact of signaling on successful matching., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: The selection process to the British Army's Brigade of Gurkhas is rigorous, demanding and competitive. The ethos of recruitment to the Gurkhas is grounded in an overarching tenant: that selection is free, fair and transparent. The aim of this study was to retrospectively review reasons for potential recruits (PRs) to be deemed medically unsuitable or deferred suitability on medical grounds for selection to the Brigade of Gurkhas., Methods: A retrospective review was conducted by extracted data from published post-exercise reports for the past four years to ascertain numbers of PRs deemed medically fit, medically unsuitable or deferred suitability on medical grounds. The International Classification of Disease version 11 (ICD-11) codes were retrospectively assigned to code medical reasons for non-progression. Rates of medical non-progression were compared by year., Results: A total of 3154 PRs were analysed between 2018 and 2021. There was no significant difference between PRs deemed medically fit and those deemed medically suitable or deferred on medical grounds over the study period (p=0.351). There was a significant difference in the ratio of PRs deferred on medical grounds and those deemed medically unsuitable over the study period (p<0.05)., Conclusion: Selection to the Gurkhas is extremely competitive. These data demonstrate that, overall, reasons for medical deferral or unsuitability have remained constant despite the impact of a global pandemic. These data reinforce the central tenant of Gurkha selection; that it continues to be free, fair, and transparent., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: In the 2023 National Resident Matching Program (NRMP) match, there were 554 unfilled emergency medicine (EM) positions before the Supplemental Offer and Acceptance Program (SOAP). We sought to describe features of EM programs that participated in the match and the association between select program characteristics and unfilled positions., Methods: The primary outcome measures included the proportion of positions filled in relation to state and population density, hospital ownership type, and physician employment model. Secondary outcome measures included comparing program-specific attributes between filled and unfilled programs, including original accreditation type, year of original accreditation, the total number of approved training positions, length of training, urban-rural designation, hospital size by number of beds, resident-to-bed ratio, and the percentage of disproportionate share patients seen., Results: The NRMP Match had 276 unique participating EM programs with 554 unfilled positions. Six states offered 52% of the total NRMP positions available. Five states were associated with two-thirds of the unfilled positions. Public hospitals had a statistically significant higher match rate (88%) when compared to non-profit and for-profit hospitals, which had match rates of 80% and 75%, respectively ( P  < 0.001). Programs with faculty employed by a health system had the highest match rate of 87%, followed by clinician partnerships at 79% and private equity groups at 68% ( P  < 0.001 overall and between all subgroups)., Conclusion: The 2023 match in EM saw increased rates in the number of residency positions and programs that did not fill before the SOAP. Public hospitals had higher match rates than for-profit or non-profit hospitals. Residency programs that employed academic faculty through the hospital or health system were associated with higher match rates., Competing Interests: Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. No author has professional or financial relationships with any companies that are relevant to this study. There are no conflicts of interest or sources of funding to declare.

Objective: To determine how the use of United States Medical Licensing Examination (USMLE) score cutoffs during the screening process of the Urology Residency Match Program may affect recruitment of applicants who are underrepresented in medicine (URM)., Materials and Methods: Deidentified data from the Association of American Medical Colleges' (AAMC) Electronic Residency Application Service (ERAS) system was reviewed, representing all applicants to our institution's urology residency program from 2018 to 2022. We analyzed self-reported demographic variables including race/ethnicity, age, sex/gender, as well as USMLE Step 1 and Step 2 scores. Chi-square tests and ANOVA were used to determine the association between race/ethnicity and other sociodemographic factors and academic metrics. Applicants were stratified according to USMLE Step 1 cutoff scores and the distribution of applicants by race/ethnicity was assessed using a Gaussian nonlinear regression fit., Results: A total of 1258 applicants submitted applications to our program during the 5-year period, including 872 males (69.3%) and 386 females (30.7%). Most applicants were White (43.5%), followed by Asian (28.3%), Hispanic/Latino (11.7%), and Black (7.0%). There was an association between race/ethnicity and USMLE scores. Median USMLE Step 1 scores for White, Asian, Hispanic/Latino, and Black applicants were 242, 242, 237, and 232, respectively (P < .001). As cutoff score increases, percentage of URM applicants decreases., Conclusion: The use of cutoffs based on USMLE scores disproportionately affects URM applicants. Transitioning from numeric scores to pass/fail may enhance holistic review processes and increase the representation of URM applicants offered interviews at urology residency programs., Competing Interests: Declaration of Competing Interest The authors have no competing interests or conflicts of interest to disclose., (Published by Elsevier Inc.)

Self-reported physical fitness has advantages in cost and time over objective methods, but previous studies demonstrate equivocal conclusions regarding validity. Methods for self-reporting are usually based on subjective judgements, while another approach includes performing field tests at home. The Norwegian military relies on the latter method for conscript selection, but its validity is unknown and should be investigated. In total 14,166 young men and women were included in the study. During conscript selection step one, the subjects were requested to perform 3,000 m run, push-up, pull-up and standing long jump tests at home, and report the results online ("self-reported measurements"). Step two took place at a conscript selection centre 1-18 months later. Here, the subjects completed a maximal treadmill test, seated medicine ball throw, pull-up and standing long jump tests ("objective measurements"). The results demonstrated correlation coefficients from 0.29 to 0.82 ( P  < 0.05) for self-reported vs. objective measurements, with the highest association found for self-reported and objectively measured pull-ups. Kappa values ranged from 0.05 to 0.34 ( P  < 0.05), with pull-ups demonstrating the highest agreement. More women than men over-reported their physical fitness. Among men and women indicating similar self-reported fitness, men's objective fitness was higher for all objective tests (effect sizes from 0.5 to 3.0). In conclusion, large variations in correlation coefficients were observed between self-reported and objectively measured physical fitness, while the kappa values indicated poor to fair agreement. The finding that more women than men over-reported their fitness level contradicts most previous studies. Highlights Low, moderate, and high correlations, and poor to fair agreements (kappa values), were observed between self-reported and objectively measured endurance and muscle strength variables.More women than men overreported their actual fitness level.Self-reported fitness based on performing field tests at home may be a feasible alternative to traditional methods which rely on self-perceived fitness.

Faculty hiring and retention determine the composition of the US academic workforce and directly shape educational outcomes 1 , careers 2 , the development and spread of ideas 3 and research priorities 4,5 . However, hiring and retention are dynamic, reflecting societal and academic priorities, generational turnover and efforts to diversify the professoriate along gender 6-8 , racial 9 and socioeconomic 10 lines. A comprehensive study of the structure and dynamics of the US professoriate would elucidate the effects of these efforts and the processes that shape scholarship more broadly. Here we analyse the academic employment and doctoral education of tenure-track faculty at all PhD-granting US universities over the decade 2011-2020, quantifying stark inequalities in faculty production, prestige, retention and gender. Our analyses show universal inequalities in which a small minority of universities supply a large majority of faculty across fields, exacerbated by patterns of attrition and reflecting steep hierarchies of prestige. We identify markedly higher attrition rates among faculty trained outside the United States or employed by their doctoral university. Our results indicate that gains in women's representation over this decade result from demographic turnover and earlier changes made to hiring, and are unlikely to lead to long-term gender parity in most fields. These analyses quantify the dynamics of US faculty hiring and retention, and will support efforts to improve the organization, composition and scholarship of the US academic workforce., (© 2022. The Author(s).)

Competing Interests: Competing interests: none declared

Competing Interests: Competing interests: EW and FR none declared. AB was a reserve list candidate last year.

Competing Interests: Competing interests: AMR is deputy director of NIHR Health and Social Care Workforce Policy Research Unit, King’s College, London. AH none declared.

Objective: Integrated vascular surgery residency (IVSR) applicant perspective about the match process has been rarely studied, yet this has important implications on trainee recruitment. We sought to better understand the nature of the interview process and post-interview communication and its impact on students' ranking choices., Methods: A voluntary and anonymous survey was sent to students who matched to IVSR in 2020, inquiring about interviews, post-interview communications, and factors influencing students' rank lists., Results: Seventy of the 73 matched students completed the survey (96% response rate; 23 female and 47 male respondents). Applicants reported they were asked questions about other programs of interest (81.4%), top choice programs (65.7%), marital status (32.9%), family planning (7.1%), and religion (1.4%) during interviews. Female applicants were more frequently asked questions about family planning (17.4% vs 2.1%; P < .01) and marital status (52.5% vs 23.4%; P < .01) compared with male applicants. After interviews, 92.9% of applicants notified their top choice program of their ranking preference. Of applicants, 61.4% received post-interview communication with regards to ranking from at least one program, initiated by program directors in 81.3% of instances. Among these applicants, 58.1% reported that the post-interview communication had an impact on their rank list, and 46.5% matched at a program by which they were contacted. Of applicants, 5.7% were asked by a program to reveal their ranking of the program, and 11.4% were promised by a program to be ranked first if the applicant reciprocally ranked them first. Female and male applicants weighed program culture, operative volume, mentorship, and prestige equally in making their rank list. Male applicants weighed the sub-internship experience more significantly; however, female applicants weighed the sub-internship experience, personal relationships in certain cities, dedicated professional development years, and large female representation in the program more heavily (P < .02)., Conclusions: This study provides insight into the interview experience and impactful factors for the vascular surgery match. Both female and male applicants were asked a high number of questions about personal matters unrelated to medical school performance. Female applicants, however, experienced a higher proportion of these instances, particularly regarding family planning. These findings demonstrate the factors that are important to applicants in the match process and raises awareness of potential challenges in the interview and recruitment process., (Copyright © 2021 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.)

Numerous field experiments based on the correspondence testing procedure have documented that gender bias influences personnel selection processes. Nowadays, algorithms and job platforms are used for personnel selection processes because of their supposed neutrality, efficiency, and costs savings. However, previous research has shown that algorithms can exhibit and even amplify gender bias. The present research aimed to explore a possible gender bias in automated-job alerts generated in InfoJobs, a popular job platform in Spain. Based on the correspondence testing procedure, we designed eight matched resumes in which we manipulated the gender of the candidate for two different professional sectors (female-dominated vs. male-dominated) and two different levels of age (24 vs. 38). We examined the 3,438 offers received. No significant differences were observed in the automated-job alerts received by female and male candidates as a function of occupation category, salary, and the number of long-term contracts included in the alerts. However, we found significant differences between the female-dominated and the male-dominated sectors in all the mentioned variables. Some limitations and implications of the study are discussed. The data and materials for this research are available at the Open Science Framework, https://osf.io/kptca/., Competing Interests: The authors have declared that no competing interests exist.

Objectives: The aim of this study was to investigate the extent to which Australian Football League (AFL) draft outcome is associated with physical performance and/or in-game movement profile., Design: Observational cohort design., Methods: Physical testing results and in-game global positioning system (GPS) data were collated from Victorian-based, draft-eligible participants in the under 18 boys NAB League competition (n = 450; age = 17.1 ± 0.3 y). Players were grouped by position as nomadic, fixed-position or fixed&ruck., Results: Individually, variables that best distinguish drafted and non-drafted players were: estimated V̇O 2 max (all-position, nomadic, fixed&ruck: d = 0.60, 0.64, 0.53), standing vertical jump (d = 0.57, 0.58, 0.53), running vertical jump (d = 0.52, 0.51, 0.56), AFL agility (d = 0.49, 0.44, 0.67) and 20-m speed (all-position, nomadic: d = 0.50, 0.61). Factor analysis prior to binary logistic regression assessed the probability of factors influencing position-specific draft outcome. AFL agility (all-position, fixed&ruck: OR = 4.58, 15.86), anthropometry (all-position, nomadic, fixed, fixed&ruck: OR = 2.55, 2.06, 11.41, 7.99), and jumping (all-position, nomadic, fixed&ruck: OR = 1.75, 1.69, 2.68) were the factors most associated with positive draft outcome. More game involvement (fixed&ruck: OR = 2.22), sprinting (all-position, fixed&ruck: OR = 1.45, 2.06) and less non-sprinting activities (all-position, nomadic: OR = 0.64, 0.61) were associated with positive draft outcome. The fixed&ruck model was the best performing (χ 2 (115) = 30.59, p < 0.001, AUC = 84.7%)., Conclusions: Physical testing-related factors were most likely to influence draft outcome, where larger and more agile players were desirable draft picks. In-game movement profile had some bearing on draft outcome in all positional groups with the exception of fixed., (Copyright © 2021 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

Objective: As a result of COVID-19 pandemic, the 2021 US residency MATCH was devoid of the traditional in-person interviews. Herein, we assess the impact of Virtual Interviews (VIs) on resident selection, from the perspectives of Orthopedic Surgery (OS) Program Directors (PDs)., Materials and Methods: A 14-item survey was sent to PDs of ACGME-accredited OS residencies. Questions were designed to assess the pros, cons, and robustness of VIs compared to their antecedent in-person format., Results: Forty-seven PDs responded to our survey. VIs antagonized PDs' ability to assess applicants' fit to program (76.6%), commitment to specialty (64%), and interpersonal skills (68.1%). This led to heavier dependence upon applicants' portfolios (64%). Almost all respondents (97.9%) found VIs to be more cost-efficient, saving a median of $3000 in interview-related expenses. Overall, only 8.5% of PDs were willing to conduct exclusive VIs in future cycles, compared to the majority in favor of dual formats (51.5%) or exclusive in-person interviews (40.4%)., Conclusions: VIs have been an overall success, making most PDs opt for dual interview formats in future cycles. How this technology is further implemented in the future remains to be seen.

Objective: Integrated vascular surgery residency is among the most competitive specialties, but little is known about the applicant perspective. The coronavirus disease 2019 outbreak impacted the 2021 integrated vascular surgery residency match because of travel restrictions. We sought to better understand pre-pandemic applicant recruitment strategies, logistics of away rotations, and the residency interview process to identify areas for improvement in the application process., Methods: An anonymous survey was sent to matched students in 2020, inquiring about motivations for pursuing vascular surgery (VS), logistic of away rotations and interviews, and factors influencing students' rank lists., Results: Seventy of the 73 matched students completed the survey (95.9% response rate). The median age was 27 (range, 25-41); 32.9% were female, 91.4% were U.S. medical students, and 77.1% were from institutions with a VS training program. Factors most strongly influencing the decision to choose VS as a career were interest in open vascular procedures, endovascular procedures, perceived job satisfaction, emerging technologies, and influence of a mentor. The prospect of the job market, future salary, and competitiveness of the application process had the least impact. Of the matched students, 82.9% completed an away rotation (median, 2; range, 1-4), with 51.7% of students paying a total cost of more than $2500. Fifty percent of students matched either at their home institution or where they had performed an away rotation. Students reported application submissions to a median of 50 programs (range, 1-70) and interviewed at 17 (range, 1-28), with 40% of students paying a total of more than $4000 for interview costs. The most significant factors affecting students' rank lists included program culture, open aortic surgical volume, geography, and complex endovascular procedure volume. Tours of facilities, resident salary, and male/female distribution had the least importance., Conclusions: Successfully matched applicants in 2020 prioritized operative case volume and program collegiality when ranking programs. Despite their high cost, away rotations played an important role in the Match, suggesting that time spent at potential institutions allowed ideal assessment of factors for students. The high average number of away rotations and in-person interviews performed in 2019-2020 was limited for the 2021 Match due to coronavirus disease 2019 restrictions. Programs will have to continue developing creative alternatives or additions to away rotations and the application processes to assure continued success in future post-pandemic Match cycles., (Copyright © 2021 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.)

Background: The American Orthopaedic Association (AOA) released the standardized letter of recommendation (SLOR) form to provide standardized information to evaluators of orthopaedic residency applicants. The SLOR associates numerical data to an applicant's letter of recommendation. However, it remains unclear whether the new letter form effectively distinguishes among orthopaedic applicants, for whom letters are perceived to suffer from "grade inflation." In addition, it is unknown whether letters from more experienced faculty members differ in important ways from those written by less experienced faculty., Questions/purposes: (1) What proportion of SLOR recipients were rated in the top 10th percentile and top one-third of the applicant pool? (2) Did letters from program leaders (program directors and department chairs) demonstrate lower aggregate SLOR scores compared with letters written by other faculty members? (3) Did letters from away rotation program leaders demonstrate lower aggregate SLOR scores compared with letters written by faculty at the applicant's home institution?, Methods: This was a retrospective, single institution study examining 559 applications from the 2018 orthopaedic match. Inclusion criteria were all applications submitted to this residency. Exclusion criteria included all letters without an associated SLOR. In all, 1852 letters were received; of these, 26% (476) were excluded, and 74% (1376) were analyzed for SLOR data. We excluded 12% (169 of 1376) of letters that did not include a final summative score. Program leaders were defined as orthopaedic chairs and program directors. Away rotation letters were defined as letters written by faculty during an applicant's away rotation. Our study questions were answered accounting for each subcategory on the SLOR (scale 1-10) and the final ranking (scale 1-5) to form an aggregated score from the SLOR form for each letter. All SLOR questions were included in the creation of these scores. Correlations between program leaders and other faculty letter writers were assessed using a chi-square test. We considered a 1-point difference on 5-point scales to be a clinically important difference and a 2-point difference on 10-point scales to be clinically important., Results: We found that 36% (437 of 1207) of the letters we reviewed indicated the candidate was in the top 10th percentile of all applicants evaluated, and 51% (619 of 1207) of the letters we reviewed indicated the candidate was in the top one-third of all applicants evaluated. We found no clinically important difference between program leaders and other faculty members in terms of summative scores on the SLOR (1.9 ± 0.7 versus 1.7 ± 0.7, mean difference -0.2 [95% CI -0.3 to 0.1]; p < 0.001). We also found no clinically important difference between home program letter writers and away program letter writers in terms of the mean summative scores (1.9 ± 0.7 versus 1.7 ± 0.7, mean difference 0.2; p < 0.001)., Conclusion: In light of these discoveries, programs should examine the data obtained from SLOR forms carefully. SLOR scores skew very positively, which may benefit weaker applicants and harm stronger applicants. Program leaders give summative scores that do not differ substantially from junior faculty, suggesting there is no important difference in grade inflation between these faculty types, and as such, there is no strong need to adjust scores by faculty level. Likewise, away rotation letter writers' summative scores were not substantially different from those of home institution letters writers, indicating that there is no need to adjust scores between these groups either. Based on these findings, we should interpret letters with the understanding that overall there is substantial grade inflation. However, while weight used to be given to letters written by senior faculty members and those obtained on away rotations, we should now examine them equally, rather than trying to adjust them for overly high or low scores., Level of Evidence: Level III, therapeutic study., Competing Interests: All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research® editors and board members are on file with the publication and can be viewed on request. Each author certifies that neither he, nor any member of his immediate family, has funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article., (Copyright © 2021 by the Association of Bone and Joint Surgeons.)

Background: Research output is one element of a multifactorial process that residency programs consider when evaluating applicants. However, there are minimal data assessing research productivity on admittance into research-oriented integrated vascular surgery residency (RO-IVSR) programs. The purpose of this study was to evaluate the association of peer-reviewed research and the RO-IVSR match process., Material and Methods: Vascular surgery residents who matched into an RO-IVSR in 2015-2017 were divided into those matching an RO-IVSR top 10 program versus other. Total publications, first authorships, and type of research were compared between groups. Mann-Whitney U-tests were then performed between discrete levels of research productivity (0-1 versus ≥2 publications) to detect differences in ability to match a top 10 program., Results: One hundred and fifty-eight residents published a total of 214 original research articles (83%), 26 case reports (10%), and 19 systematic reviews (7%). There were 66 first authorships (25%). Median total publications at RO-IVSR top 10 versus other programs were 2 versus 1 (P < 0.01). Top 10 IVSR had a significant difference in median publications for all other research categories. The ability to match into a top 10 program by discrete levels of research productivity at 0-1 versus 2+ showed significance (P < 0.05) in all research categories, including total publications, first authorships, and H-index., Conclusions: There was significantly higher research productivity among medical students who matriculate to top 10 IVSR programs. Furthermore, having 2 or more publications significantly increased the likelihood of attending a top 10 program. Thus, top programs likely use an applicants' research productivity as a distinct qualification category and a marker of future success., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: The COVID crisis hit during the interview season for the Complex General Surgical Oncology (CGSO) fellowship. With minimal time to adapt, all programs transitioned to virtual interviews. Here we describe the experience of both program directors (PDs) and candidates with virtual interviews, and provide guidelines for implementation based on the results., Methods: Surveys regarding interview day specifics and perceptions were created for CGSO fellowship PDs and candidates. They were distributed at the conclusion of the season, prior to match., Results: Thirty (94%) PDs and 64 (79%) candidates responded. Eighty-three% of PDs and 79% of candidates agreed or strongly agreed that they felt comfortable creating a rank list. If given the choice, 60% of PDs and 45% of candidates would choose virtual interviews over in-person interviews. The majority of candidates found PD overviews, fellows only sessions and pre-interview materials helpful., Conclusion: Overall, the majority of PDs and candidates felt comfortable creating a rank list; however, more PDs preferred virtual interviews for the future. Our results also confirm key components of a virtual interview day., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: There is a growing deficit of rural surgeons, and preparation to meet this need is inadequate. More research into stratifying factors that specifically influence choice in rural versus urban practice is needed., Methods: An institutional review board-approved survey related to factors influencing rural practice selection and increasing rural recruitment was distributed through the American College of Surgeons. The results were analyzed descriptively and thematically., Results: Of 416 respondents (74% male), 287 (69%) had previous rural experience. Of those, 71 (25%) did not choose rural practice; lack of professional or hospital support (30%) and lifestyle (26%) were the primary reasons. A broad scope of practice was most important among surgeons (52%), who chose rural practice without any previous rural experience. Over 60% of urban practitioners agreed that improved lifestyle and financial advantages would attract them to rural practice. The thematic analysis suggested institutional support, affiliation with academic institutions, and less focus on subspecialty fellowship could help increase the number of rural surgeons., Conclusions: Many factors influence surgeons' decisions on practice location. Providing appropriate hospital support in rural areas and promoting specific aspects of rural practice, including broad scope of practice to those in training could help grow interest in rural surgery. Strong collaboration with academic institutions for teaching, learning, and mentoring opportunities for rural surgeons could also lead to higher satisfaction, security, and potentially higher retention rate. These results provide a foundation to help focus specific efforts and resources in the recruitment and retention of rural surgeons., (Copyright © 2021 Elsevier Inc. All rights reserved.)

To investigate the extent to which dermatology programs use social media to connect with applicants, we conducted a search of all 140 residency programs on Instagram, Facebook, Twitter, and YouTube. Our search revealed 74 (53%) Instagram, 21 (15%) Facebook, 20 (14%) Twitter, and four (3%) YouTube accounts for dermatology programs, with the number of Instagram accounts increasing five-fold from the end of 2019 to present. Our results demonstrate that conditions created during the coronavirus disease 2019 (COVID-19) pandemic accelerated dermatology residency programs' acceptance of social media, particularly Instagram, as a means to communicate and share information with applicants.

Background: Given the competition in the integrated plastic surgery Match, away rotations are ubiquitous among plastic surgery applicants to differentiate their applications. This study aimed to characterize how performing an away rotation affects rank order and Match outcomes for integrated plastic surgery programs., Methods: An online survey was designed and distributed to the top 25 integrated plastic surgery programs in the United States as determined by Doximity. Programs were polled about away rotation structure, position of rotators on their 2018 to 2019 rank list, and composition of current resident classes., Results: Twenty-five programs completed the survey (response rate, 100 percent). On average, programs interviewed 34.9 applicants (range, 22 to 50 applicants) and ranked 32.8 applicants (range, 10 to 50 applicants). Most "ranked-to-match" positions were occupied by home students or away rotators (60.9 percent). Rank order of home students, away rotators, and nonrotators varied significantly (p < 0.001), with median rank order of home students [5 (interquartile range, 1 to 9)] and rotators [14 (interquartile range, 6 to 27)] higher than nonrotators [17 (interquartile range, 10 to 29)]. Rank orders of away rotators tended to follow a bimodal distribution. Furthermore, 64.4 percent of integrated residents were either a home student or away rotator at their matched integrated program, with 20 percent of residency programs composed of greater than 70 percent of away rotators/home students across postgraduate years 1 through 6 classes., Conclusions: For integrated plastic surgery programs, the majority of ranked-to-match students on rank lists and current residents were either home students or away rotators at their respective program. Performing well on an away rotation appears to confer significant benefit to the applicant applying in the integrated plastic surgery Match., (Copyright © 2021 by the American Society of Plastic Surgeons.)

Background: Nurses are a difficult population to recruit for research. Barriers to recruitment of nurses include survey fatigue, hospital structures and institutional review boards as gatekeepers to accessing participants, and limited generalizability of findings. Social media present innovative opportunities to recruit participants for survey research. However, there is limited information about best practices for recruiting nurses through social media., Objectives: The aim of this report was to examine the advantages and disadvantages of and determine the best practices for recruiting nurses for survey studies via social media., Methods: We examined recruitment strategies of three survey studies involving nurse participants. Each study used social exchange theory and leverage-saliency theory to guide recruitment. The studies included were (a) the Travel Nurse Onboarding Study, which recruited participants from a single closed group on Facebook; (b) the Presenteeism and Nursing Study where participants were recruited using association listservs, healthcare organizations, and paid ads and postings on social media; and (c) the Pain and Nursing Study in which participants were recruited through social media, association listservs, and in person at conferences., Results: Social media offer accessible, low-cost, high-yield approaches to recruitment of nurses for survey studies., Discussion: Useful strategies for crafting effective recruitment via social media are presented, including how, where, when, and how often to post. The generalizability of social media research is also discussed. Suggestions are provided for researchers using social media as well as guidelines for institutional review boards to address gray areas of social media research. Data integrity protection techniques are proposed to ensure social media survey data are not corrupted by malicious bots. This report outlines best practices for the recruitment of nurses for survey studies using social media., Competing Interests: The authors have no conflicts of interest to report., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

The COVID-19 pandemic has presented unique challenges to medical education. With the lack of in-person away rotations for the 2020-2021 residency application cycle, virtual rotations have surfaced as an alternative. The virtual rotations that the authors participated in allowed for active participation in various resident educational activities such as journal club, grand rounds, and morning conferences. One critical aspect of virtual rotations was the one-on-one meetings with the program leadership. In addition to a virtual tour of the hospital and campus, many programs offered virtual social hours with the residents to converse about the program, the city, and the match process. A few programs even allowed applicants to attend virtually live-streamed surgeries. These rotations offer students, especially those without a corresponding home program, an invaluable opportunity to express their interest in a particular program and gain foundational knowledge about the specialty. Virtual rotations also provide underrepresented minorities and international medical graduates with clinical exposure, mentorship, and networking opportunities, mitigating some of the challenges presented by COVID-19., (Copyright © 2020 Elsevier Inc. All rights reserved.)

In a study of US Marine recruits, seroprevalence of severe acute respiratory syndrome coronavirus 2 IgG was 9.0%. Hispanic and non-Hispanic Black participants and participants from states affected earlier in the pandemic had higher seropositivity rates. These results suggest the need for targeted public health strategies among young adults at increased risk for infection.

The purpose of this article is to simultaneously advance theory and practice by understanding how the Coronavirus disease 2019 (COVID-19) pandemic relates to new hire engagement. Prior research suggests starting a new job is an uncertain experience; we theorize that the COVID-19 pandemic creates additional environmental stressors that affect new hire engagement. First, we hypothesize that the occurrence of COVID-19 and unemployment rates relate negatively to engagement. Second, we theorize that the effects of the pandemic become more disruptive on new hire engagement as they gain tenure within the organization. Third, drawing from strategic management theory, we test whether States that introduce stronger COVID-19 policies help enhance the engagement of new hires. Examining a U.S. national sample of 12,577 newly hired (90 days or less) quick service restaurant employees across 9 months (January-September, 2020), we find support for these hypotheses. Subsequent model comparisons suggest there may be health stressors that shape engagement more strongly than purely economic stressors. These findings may be important because they highlight the experiences of workers more likely to be exposed to the pandemic and affected by COVID-related policies. Should the results generalize to other samples and jobs, this study offers potentially new research directions for understanding relationships between macro stressors and new hire perceptions and socialization. It also offers practical implications by helping organizations understand the importance of explicitly managing job insecurity, particularly in terms of COVID-19 policy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Underrepresentation of racial and ethnic minority populations in clinical research persists in the United States, highlighting the unmet ideals of generalizability and equity of research findings and products. Previous systematic reviews exploring various facets of this phenomenon concluded that community engagement with minority groups may effectively promote recruitment and retention, but the ways in which community-engaged approaches have been used for recruitment have not been examined. We performed a scoping review of the literature to identify studies of community-engaged recruitment processes. The search resulted in 2842 articles, of which 66 met inclusion criteria. These articles demonstrated a relatively large literature base of descriptive studies conveying details of community engagement approaches to enhance recruitment of minority research participants. We summarize key aspects of current practices across the spectrum of community engagement. A gap in the literature is the relative lack of the comparative studies among different engagement strategies., (Copyright © 2020 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.)