Outcomes of Residency Reapplication in Obstetrics and Gynecology: Implications for Advising Unmatched Applicants.

OBJECTIVE

Describe the post-match pathways of OB/GYN applicants who did not match in their initial application cycle, as well as factors associated with a subsequent successful match attempt.

DESIGN

IRB-exempt observational cohort study of OB/GYN reapplicants from 2 academic institutions between 2017 and 2024.

SETTING

Two large, tertiary academic medical centers in the Midwest and Southeast.

PARTICIPANTS

Any applicants who applied to the residency programs at the institutions in 2 consecutive years, indicating an unsuccessful match and reapplication.

RESULTS

Among 287 reapplicants, 17 (6%) repeated a fourth year (most commonly for research), 234 (82%) entered the Supplemental Offer and Acceptance Program (SOAP), and 27 (9%) pursued nonclinical work. Overall, 71% (173/245) ultimately re-matched into OB/GYN. Among those repeating a fourth year, 76% (13/17) matched OB/GYN. Among SOAP participants, OB/GYN preliminary residents had the highest success with OB/GYN residency placement, with two-thirds obtaining an OB/GYN PGY-2 position. General surgery preliminary residents had a 75% OB/GYN re-match rate, followed by OB/GYN preliminaries who re-entered the Match; nonsurgical preliminary positions had lower success. Re-applicants matched in nearly equal numbers to academic and community-based programs. Among SOAP participants who had a second unsuccessful cycle, failure of course work or medical board exams (OR = 0.07, p = 0.02) and completion of a nonsurgical SOAP program (OR = 0.42, p = 0.02) was associated with lower odds of matching.

CONCLUSIONS

Overall, these results provide reassurance to applicants who do not initially match into OB/GYN and offer evidence-based guidance for advisors. When feasible, surgical preliminary pathways-particularly OB/GYN and general surgery-may optimize reapplication outcomes, while structured academic support may enhance competitiveness.