R. Brown1, A. Grippin2, S. C. Kamran3, F. Chino4, and N. Vapiwala5; 1Department of Radiation Oncology, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, 2University of Florida, Department of Neurosurgery, Gainesville, FL, 3Massachusetts General Hospital, Boston, MA, 4Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, 5Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA
Purpose/Objective(s): Graduation from elite private high schools is strongly associated with matriculation into highly ranked undergraduate institutions. We hypothesized that private secondary education would similarly influence match and matriculation into “top tier” RO residency programs. Materials/
Methods: Rankings for all US RO programs were obtained from Doximity. Publicly available online data sources were used to identify the postsecondary education (college and medical school) of current residents (class of 2024-2027). The eight “Ivy League” schools plus Duke, MIT, University of Chicago, and Stanford were designated as “Ivy+.” Comparisons were completed with Fischer’s exact tests, Mann-Whitney U, and multiple linear regression. Results: Medical and undergraduate institutions were identified for 96% and 81% of total residents (N=730), respectively from 94 RO programs. Private undergraduate programs were more prevalent (57% vs 43%), but medical schools were balanced between public and private (52% vs 48%). Residents in the five highest ranked (“top 5”) radiation oncology residency programs were significantly more likely than residents from “bottom third” programs to have matriculated from private undergraduate institutions (71% vs 52%, p=0.010), private medical schools (76% vs 39%, p<0.001), and medical schools with an active radiation oncology residency program (79% vs 44%, p<0.001). Residents who exclusively attended private institutions were more than 4 times more common in “top 5” programs than in “bottom third” programs (60% vs 11%, p<0.001). Residents who attended exclusively public institutions were less common in “top 5” programs (12% vs 19%, p<0.001). Overall, graduates of private schools were more likely to be in a “top 5” program, including undergraduate (21% vs 11%, p=0.005), and medical school (26% vs 7.3%, p<0.001). Residents with exclusively private education were four times more likely to be at a “top 5” program than those who received exclusively public education (30% vs. 7% p<0.001). Graduates from Ivy+ medical schools and non-Ivy+ private medical schools were eight times more likely (58% vs 7.3%, p<0.001), and twice as likely (14% vs 7%, p=0.003) to match into “top 5” residency program as those who went to public schools. On multivariate analysis including home program bias, only private medical school (p<0.001), home radiation oncology program (p<0.001), and exclusive private education (p<0.001) were each independently associated with matching into a “top 5” program. Conclusion: Applicants who attend private institutions are more likely to match into highly ranked programs than those from public institutions. Future work should consider confounding factors associated with matching at “top tier” programs and focus on interventions to promote holistic application review.
