2051 Mapping the Path to Neurosurgery: A Migration of Residents

INTRODUCTION: The introduction of geographical preferences to the ERAS application was met with mixed reactions by programs and applicants alike. In neurosurgery, which has relatively few residency positions, the perception of interest and willingness to move can drastically impact an applicant’s ability to match. While geographic signaling may help in some scenarios, the uneven distribution of programs throughout the regions has led to many applicants being wary of this feature. METHODS: We used public domain sources to collect data on all residents who attended an LCME-accredited medical school in the United States and matched to an ACGME-accredited neurosurgery residency between 2015 – 2024. We used the ERAS geographic regions to create three regions: East, Central, and West. RESULTS: There were 2080 residents who matched into neurosurgery after attending a US medical school. Of these, 1013 (48.7%) came from the East, 830 (39.9%) from Central, and 236 (11.3%) from the West. All regions matched applicants from their region at higher rates than applicants from outside their region matching 61.0%, 61.6%, and 47.4% in East, Central, and West, respectively. Of those matching within their region, many matched within the same state as their medical school (45.5% in East, 47.9% in Central, and 78.6% in West). For those that matched outside of their region, applicants were more likely to match in the East (25.7% from Central, 29.2% from West) than in Central (25.3% from East, 23.3% from West) or West (12.9% from East, 11.8% from Central). CONCLUSIONS: Applicants are most likely to match in the region they attended medical school. Applicants hoping to match outside of this region may benefit from using the geographic preference tool or completing visiting clerkships in these regions.