2053 Impact of Private Versus Public Education on Matching into Top Neurological Surgery Residency Programs

INTRODUCTION: Highly ranked neurosurgery programs exhibit a preference for private medical school applicants. Additionally, graduation from elite private high schools is associated with enrollment in prestigious undergraduate institutions. METHODS: Publicly available online data were used to identify education for all current neurosurgery residents nationwide. Medical and undergraduate school rankings were obtained from Doximity. The eight “Ivy League” schools plus Duke, MIT, University of Chicago, and Stanford were designated as “Ivy+.” Descriptive statistics and Fischer’s exact tests were performed using R software. RESULTS: Data was collected from 104 of 117 (89%) total neurosurgery residency programs. 50% of current residents graduated from private medical schools and 57% from private undergraduate institutions. Residents in the five highest-ranked programs were significantly more likely than residents from “bottom-third” programs to have matriculated from private medical schools (60% vs 36%, p<.0001), and private undergraduate institutions (63% vs 48%, p<.05). Residents who attended both private undergraduate and medical institutions were almost two times more common in top 5 than bottom-third programs (43% vs 23%, p<0.01). Residents who exclusively attended public institutions were less common in top 5 than bottom-third programs (21% vs 35%, p<0.01). Private (15% vs 10%, p<0.05) and Ivy+ (23% vs 10%, p<0.001) medical school graduates were more likely to match into top 5 residency programs than public medical school graduates. CONCLUSIONS: Those who attend private institutions are more likely to match into top 5 residency programs. With objective measures nationally trending towards pass-fail grading, it is imperative to investigate factors associated with matching at top programs and focus on interventions to promote holistic application review.