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JAOA/AACOM Medical Education  |   September 2019
Evaluating the Influence of Research on Match Success for Osteopathic and Allopathic Applicants to Residency Programs
Author Notes
  • From the Philadelphia College of Osteopathic Medicine in Pennsylvania. 
  • Financial Disclosures: None reported. 
  • Support: None reported. 
  •  *Address correspondence to Christopher N. Matthews, OMS III, MBA, Philadelphia College of Osteopathic Medicine, 4170 City Ave, Philadelphia, PA 1913-1610. E-mail: christophermatt@pcom.edu
     
Article Information
Medical Education / Physical Medicine and Rehabilitation / Graduate Medical Education
JAOA/AACOM Medical Education   |   September 2019
Evaluating the Influence of Research on Match Success for Osteopathic and Allopathic Applicants to Residency Programs
The Journal of the American Osteopathic Association, September 2019, Vol. 119, 588-596. doi:https://doi.org/10.7556/jaoa.2019.102
The Journal of the American Osteopathic Association, September 2019, Vol. 119, 588-596. doi:https://doi.org/10.7556/jaoa.2019.102
Web of Science® Times Cited: 4
Abstract

Context: Analyzing factors that may enhance osteopathic applicants’ likelihood of matching is warranted given that United States osteopathic and allopathic residency programs will have a single accreditation system in 2020.

Objectives: To determine the impact of research accomplishments and experiences on osteopathic and allopathic residency matching.

Methods: Analysis of variance, t test, and odds ratios were used to examine data from the National Resident Matching Program Charting Outcomes from 2016 and 2018. Relationships between match status and medical degree, specialty matching, and mean numbers of research accomplishments and experiences in the Main Residency Match were analyzed.

Results: Matched osteopathic and allopathic applicants had significantly greater numbers of research accomplishments (mean [SD], 5.18 [4.34]) than unmatched applicants (3.66 [2.87]) (P=.006). Applicants who matched (mean [SD], 2.81 [1.64]) had similar numbers of research experiences to those who did not match (2.43 [1.26]) (P=.068). Matched and unmatched allopathic applicants’ research accomplishments (5.91 [3.72]) were significantly greater than that of osteopathic applicants (2.60 [2.90]) (P<.001). Significant differences also were found between the means of research experiences of matched and unmatched osteopathic (mean [SD], 1.73 [1.21]) and allopathic applicants (3.36 [1.25], P<.001). Matched and unmatched osteopathic applicants’ had similar means for research accomplishments (mean [SD], 3.00 [3.64] and 2.20 [1.84], respectively; P=.242) and experiences (1.79 [1.31] and 1.66 [1.12], respectively; P=.664). By contrast, significant differences were found between the numbers of research accomplishments for matched (mean [SD], 6.97 [4.07]) vs unmatched (4.86 [3.02]) allopathic applicants (P=.007). The only subspecialty for which research experiences of osteopathic applicants correlated with matching was physical medicine and rehabilitation (OR, 2.75; 95% CI, 1.30-5.84).

Conclusion: Research seems to have a greater influence on matching for allopathic than osteopathic applicants. Although both osteopathic and allopathic programs have standards pertaining to scholarly activity, allopathic medical schools may place a greater emphasis on research. Increasing osteopathic medical students’ exposure to research is predicted to enhance their competitiveness for matching and help develop skills relevant to the practice of evidence-based medicine.

Reliable, scientifically sound, and relevant information is critical for the practice of medicine. The term evidence-based medicine (EBM) was first introduced in the literature in 1991 as an approach to clinical decision-making based on using new evidence to determine clinical practice, as opposed to information from expert opinion.1,2 The definition of EBM has been refined to replace “new” evidence with “best” research evidence and now includes consideration of clinical expertise along with a patient's distinct values and situation to perform systematic clinical decision-making.3 The EBM approach is the current standard for clinical problem-solving and decision-making.4 Despite the shift toward EBM over the past 3 decades, a 2018 editorial5 noted that physicians are still reluctant to adopt validated information that is cost-effective and proven to improve patient outcomes. Thus, it continues to be of utmost importance that students receive instruction and gain experience in EBM, with the goals of developing an appreciation for its positive effect on patients and facilitating seamless integration into clinical practice. 
The knowledge, skills, and attributes required for using the EBM approach are often taught and learned through participation in scholarly activities. Graduate medical education (GME) programs assign scholarly projects into the following areas when reporting to the Accreditation Council of Graduate Medical Education (ACGME): abstracts (presentations/posters), book chapters, grants, leadership role, presentations, publications, research project, and teaching/education.6 In 2013, recognizing the importance for an ongoing system of evaluation and learner-focused training, the ACGME began implementing the Next Accreditation System, which includes Milestones to help monitor resident development and guide the competency-based curriculum of GME programs.7-9 The Milestone categories are based on 6 core competencies: patient care, medical knowledge, professionalism, interpersonal and communication skills, practice-based learning and improvement, and systems-based practice. Each Milestone category contains 5 levels of successive growth corresponding to educational stage. Within the category of practice-based learning and improvement, a typical graduating medical student (level 1) is expected to have knowledge and skills relevant to EBM. These skills often include basic concepts in clinical epidemiology, biostatistics, clinical reasoning, and the capacity to categorize a research study design. During residency (level 2), practice-based learning and improvement includes formulating searchable questions, identifying critical threats to study validity, and distinguishing research outcomes that directly affect patient care. Integration of EBM principles into clinical practice is expected for graduating residents.9 
In 2014, the single accreditation system (SAS) was announced,10 stating that all GME programs would be accredited by the ACGME by June 30, 2020. Graduate medical education programs have continuously evolved to best prepare future physicians and ensure that graduates are providing the highest level of care throughout their careers. This approach values lifelong learning, teaching, and research. Residents are expected to actively engage in scholarly activity; and therefore, research productivity metrics are considered by residency directors during the selection process for positions in their programs.11 The importance of research for residency applicants has not been well documented or thoroughly analyzed, especially for osteopathic applicants. The National Resident Matching Program (NRMP) Charting Outcomes in the Match reports that in 2016 and 2018, US osteopathic applicants matched at a rate of 82.0% and 82.6%, respectively, and US allopathic applicants matched at a rate of 91.9% and 91.8%, respectively.12-15 In the present study, we sought to evaluate the impact of research-related activities on matching of osteopathic and allopathic residency applicants in 2016 and 2018. 
Methods
Data
We examined the NRMP Charting Outcomes in the Match reports12-15 for 2016 US osteopathic seniors and graduates (2982) and 2018 US osteopathic seniors (4275) and 2016 and 2018 US allopathic seniors (18,187 and 18,818, respectively) to identify the role of research in obtaining an ACGME residency position in the Main Residency Match. We used terminology presented in these reports where “match success is defined as a match to the specialty of the applicant's first-ranked program because that is assumed to be the specialty of choice.”14,15 The first variable examined was research accomplishments, which the NRMP reports as research abstracts, presentations, and publications. This variable may include abstracts, poster sessions, invited national or regional podium presentations, and peer-reviewed articles. The second variable examined was the number of undefined research experiences reported by the NRMP. The data within the NRMP report was first analyzed for all specialties combined and then broken down by each specialty. 
Procedures
The data from the 2016 and 2018 NRMP were examined to extract the 2 dependent variables, which were (1) the mean number of research accomplishments and (2) the mean number of undefined research experiences. To perform an odds ratio (OR) analysis, the data were divided into binary, categorical variables. We combined the frequency of applicants who produced any research accomplishments, as defined previously, into one category, and then combined the number of applicants who reported having no research accomplishments into a separate category. This process was repeated for the variable of research experiences and for each specialty within the NRMP report. The combined data resulted in 4 groups (or cells) per variable that were examined in a 2 × 2 contingency table. For example, the frequency of applicant research accomplishments was divided into 4 groups or cells: (1) matched/with research accomplishments; (2) matched/without research accomplishments; (3) not matched/with research accomplishments; and (4) not matched/without research accomplishments. This process was repeated for the research experiences variable. 
The overall data across specialties was used for the analyses of variance (ANOVA) and the t test computations. The means for the number of research experiences and research accomplishments for each specialty were used to compare matched and unmatched applicants. These data were also used for comparing osteopathic and allopathic applicants. 
Statistical Analyses
A 2 × 2 factor ANOVA was performed to determine whether there was an interaction between match status (matched or not matched) and type of medical degree (DO or MD) across the mean number of research accomplishments and research experiences. Independent samples t tests were conducted to compare (1) mean number of research accomplishments for matched and unmatched osteopathic applicants; (2) mean number of research experiences for matched and unmatched osteopathic applicants; (3) mean number of research accomplishments for matched and unmatched allopathic applicants; and (4) mean number of research experiences for matched and unmatched allopathic applicants. The data used were means of each dependent variable for matched and unmatched applicants for each residency specialty. Odds ratios were calculated to determine the association between having matched and having research accomplishments and experiences. The ORs were calculated separately for osteopathic and allopathic applicants and by specialty. Research accomplishments and experiences were separated into binary, categorical variables: 0 or greater than or equal to 1. Odds ratios were calculated to determine the association between matching and research accomplishments and experiences. For the specialty to be included in the OR analysis, the frequency per cell, as defined previously, had to be 5 or greater. A frequency of 4 or less was excluded from the analysis. Statistical significance was defined as P<.05. The analyses were conducted with SPSS software (version 24; IBM). 
Results
Match Status, Degree Type, and Research Accomplishments and Experiences
A 2-way ANOVA was conducted that examined the effect of match status (matched and unmatched) and degree type (DO and MD) on mean number of research accomplishments. For match status, applicants who matched in 2016 and 2018 (mean [SD], 5.18 [4.34]) tended to have more research accomplishments than those who did not match (3.66 [2.87]) (Table 1). The difference between the mean number of research accomplishments between matched and unmatched applicants was significant (F3,1=7.77, P=.006) (Table 2). For degree type, osteopathic applicants (2.60 [2.90]) tended to have fewer research accomplishments than allopathic applicants (5.91 [3.72]) (Table 1). A significant difference also was found for the number of research accomplishments between osteopathic and allopathic applicants (F3,1=40.21, P<.001) (Table 2). However, these main effects are not qualified by an interaction with match status and degree type, as no statistically significant interaction between the effects of match status and degree type on research accomplishments was found (P=.213) (Table 2). These results suggest that the variation in number of research accomplishments across match status does not depend on the degree type, and the 2 independent variables—match status and degree type—are separate in their effects on the dependent variable, research accomplishments. 
Table 1.
Mean Number of Research Accomplishments and Experiences for Match Status and Medical Degreea
Variable Research Accomplishments,b Mean (SD) Research Experiences,c Mean (SD)
Match Status
 Matched 5.18 (4.34) 2.81 (1.64)
 Not matched 3.66 (2.87) 2.43 (1.26)
Medical Degree
 Allopathic 5.91 (3.72) 3.36 (1.25)
 Osteopathic 2.60 (2.90) 1.73 (1.21)

a Calculated from the 2016 and 2018 National Resident Matching Program data for osteopathic applicants and allopathic seniors.

b Research accomplishments include abstracts, presentations, and publications.

c Research experiences were not defined.

Table 1.
Mean Number of Research Accomplishments and Experiences for Match Status and Medical Degreea
Variable Research Accomplishments,b Mean (SD) Research Experiences,c Mean (SD)
Match Status
 Matched 5.18 (4.34) 2.81 (1.64)
 Not matched 3.66 (2.87) 2.43 (1.26)
Medical Degree
 Allopathic 5.91 (3.72) 3.36 (1.25)
 Osteopathic 2.60 (2.90) 1.73 (1.21)

a Calculated from the 2016 and 2018 National Resident Matching Program data for osteopathic applicants and allopathic seniors.

b Research accomplishments include abstracts, presentations, and publications.

c Research experiences were not defined.

×
Table 2.
Analyses of the Interaction between Match Status, Degree Type, and Research Accomplishments and Experiencesa
Research Accomplishmentsb Research Experiencesc
Variables F P Value F P Value
Matched vs not matched 7.77 .006d 3.38 .068
Osteopathic vs allopathic 40.21 <.001d 71.03 <.001d
Interaction 1.563 .213 1.42 .235

a Calculated from the 2016 and 2018 National Resident Matching Program data for osteopathic applicants and allopathic seniors using a 2-way analysis of variance.

b Research accomplishments include abstracts, presentations, and publications.

c Research experiences were not defined.

d Significant at P<.05.

Table 2.
Analyses of the Interaction between Match Status, Degree Type, and Research Accomplishments and Experiencesa
Research Accomplishmentsb Research Experiencesc
Variables F P Value F P Value
Matched vs not matched 7.77 .006d 3.38 .068
Osteopathic vs allopathic 40.21 <.001d 71.03 <.001d
Interaction 1.563 .213 1.42 .235

a Calculated from the 2016 and 2018 National Resident Matching Program data for osteopathic applicants and allopathic seniors using a 2-way analysis of variance.

b Research accomplishments include abstracts, presentations, and publications.

c Research experiences were not defined.

d Significant at P<.05.

×
A 2-way ANOVA was also conducted to compare the mean number of research experiences across match status and type of degree. Applicants who matched (mean [SD], 2.81 [1.64]) had similar numbers of research experiences to those who did not match (2.43[1.26]; F3,1=3.38, P=.068) (Table 1 and Table 2). For degree type, allopathic applicants (3.36 [1.25]) had significantly more research experiences than osteopathic applicants (1.73 [1.21]) (F3,1 71.03, P<.001) (Table 1 and Table 2). No statistically significant interaction was found between the effects of match status and degree type in research experiences (P=.235) (Table 2). 
Osteopathic Applicant Matching and Research Accomplishments and Experiences
Independent samples t tests were computed for osteopathic applicants to further investigate the effect of research accomplishments and experiences on matching status. There was no significant difference in the number of research accomplishments for osteopathic applicants who matched (mean [SD], 3.00 [3.64]) and those who did not match (2.20 [1.84]; t70=1.18, P=.242) (Table 3). Likewise, there was no significant difference in the number of research experiences for osteopathic applicants who matched (mean [SD], 1.79 [1.31]) and those who did not match (1.66 [1.12]; (t70=0.436, P=.664). These results suggest that research accomplishments and research experiences did not affect osteopathic applicant matching status. 
Table 3.
Research Accomplishments and Experiences Across All Residency Specialties for Matched and Unmatched Applicants by Degree Typea
Research Accomplishmentsb Research Experiencesc
Physician Type Matched, Mean (SD) Not Matched, Mean (SD) P Value Matched, Mean (SD) Not Matched, Mean (SD) P Value
Osteopathic 3.00 (3.64) 2.20 (1.84) .242 1.79 ± 1.31 1.66 ± 1.12 .664
Allopathic 6.97 (4.07) 4.86 (3.02) .007d 3.65 ± 1.40 3.06 ± 1.00 .026d

a Calculated from the 2016 and 2018 National Resident Matching Program data for osteopathic applicants and allopathic seniors using independent samples t tests.

b Research accomplishments include abstracts, presentations, and publications.

c Research experiences were not defined.

d Significant at P<.05.

Table 3.
Research Accomplishments and Experiences Across All Residency Specialties for Matched and Unmatched Applicants by Degree Typea
Research Accomplishmentsb Research Experiencesc
Physician Type Matched, Mean (SD) Not Matched, Mean (SD) P Value Matched, Mean (SD) Not Matched, Mean (SD) P Value
Osteopathic 3.00 (3.64) 2.20 (1.84) .242 1.79 ± 1.31 1.66 ± 1.12 .664
Allopathic 6.97 (4.07) 4.86 (3.02) .007d 3.65 ± 1.40 3.06 ± 1.00 .026d

a Calculated from the 2016 and 2018 National Resident Matching Program data for osteopathic applicants and allopathic seniors using independent samples t tests.

b Research accomplishments include abstracts, presentations, and publications.

c Research experiences were not defined.

d Significant at P<.05.

×
Allopathic Medical Student Matching and Research Accomplishments and Experiences
Independent samples t tests were conducted to compare research accomplishments and experiences across match status for allopathic applicants. There was a significant difference in the number of research accomplishments for allopathic applicants who matched (mean [SD], 6.97 [4.07]) and did not match (4.86 [3.02]; t86= 2.762, P=.007) (Table 3). Similarly, there was a significant difference in the number of research experiences for allopathic applicants who matched (mean [SD], 3.65 [1.40]) and did not match (3.06 [1.00]) (t86=2.26, P=0.026). For both comparisons, allopathic applicants who matched tended to have a higher mean number of research accomplishments and research experiences than those who did not match. 
Specialty Matching and Research Accomplishments and Experiences
An OR analysis was performed to compare frequencies across 2 binary categorical variables—match status and research accomplishments or experiences (Table 4). For osteopathic applicants, no specialties had a positive association between matching and having research accomplishments. By contrast, allopathic applicants who matched were more likely to have had research accomplishments than those who did not match for the following specialties in descending order of magnitude: dermatology (OR, 4.23; 95% CI, 1.35-13.30); anesthesiology (OR, 2.37; 95% CI, 1.34-4.17); orthopedic surgery (OR, 2.18; 95% CI, 1.38-3.44); physical medicine and rehabilitation (PM&R) (OR, 2.01; 95% CI, 1.07-3.80); general surgery (OR, 2.01; 95% CI, 1.41-2.86); and emergency medicine (OR, 1.44; 95% CI, 1.08-1.92) (Table 4). These results suggest that allopathic applicants were more likely to match to the identified specialty if they had a history of any number of research accomplishments. 
Table 4.
Effects of Research Accomplishments and Experiences on Matching of Osteopathic and Allopathic Applicants by Specialtya
Research Accomplishmentsb Research Experiencesc
Specialty MD OR MD 95% CI DO OR DO 95% CI MD OR MD 95% CI DO OR DO 95% CI
Anesthesiology 2.37d 1.34-4.17 0.68 0.33-1.41 3.30d 1.67-6.50 NA NA
Dermatology 4.23d 1.35-13.30 NA NA NA NA NA NA
Diagnostic radiology 1.00 0.45-2.23 0.79 0.32-1.99 NA NA 0.98 0.37-2.55
Emergency medicine 1.44d 1.08-1.92 0.60d 0.40-0.91 0.98 0.62-1.56 0.60d 0.37-0.99
Family medicine 1.08 0.70-1.66 0.76 0.46-1.26 0.94 0.54-1.63 1.28 0.77-2.13
General surgery 2.01d 1.41-2.86 0.98 0.53-1.83 2.03d 1.19-3.48 0.66 0.27-1.59
Internal medicine 1.38 0.85-2.25 0.48d 0.28-0.82 1.93d 1.03-3.62 0.37d 0.18-0.78
Internal medicine/ pediatrics 1.55 0.77-3.12 NA NA 1.74 0.70-4.30 NA NA
Neurology 2.48 0.98-6.30 1.87 0.68-5.15 NA NA NA NA
Obstetrics and gynecology 1.38 0.91-2.08 0.85 0.52-1.39 1.73 0.89-3.35 1.21 0.67-2.17
Orthopaedic surgery 2.18d 1.38-3.44 NA NA NA NA NA NA
Pediatrics 1.01 0.53-1.95 1.19 0.69-2.03 1.42 0.61-3.31 0.91 0.48-1.75
PM&R 2.01d 1.07-3.80 1.36 0.70-2.63 NA NA 2.75d 1.30-5.84
Psychiatry 1.18 0.82-1.68 0.95 0.61-1.48 1.32 0.85-2.06 1.08 0.65-1.78

a Calculated from the 2016 and 2018 National Resident Matching Program data from the 2016 and 2018 NRMP reports for osteopathic applicants and allopathic seniors.

b Research accomplishments include abstracts, presentations, and publications.

c Research experiences were not defined.

d The value is statistically significant.

Abbreviations: DO, osteopathic applicants; MD, allopathic applicants; NA, not available; PM&R, physical medicine and rehabilitation.

Table 4.
Effects of Research Accomplishments and Experiences on Matching of Osteopathic and Allopathic Applicants by Specialtya
Research Accomplishmentsb Research Experiencesc
Specialty MD OR MD 95% CI DO OR DO 95% CI MD OR MD 95% CI DO OR DO 95% CI
Anesthesiology 2.37d 1.34-4.17 0.68 0.33-1.41 3.30d 1.67-6.50 NA NA
Dermatology 4.23d 1.35-13.30 NA NA NA NA NA NA
Diagnostic radiology 1.00 0.45-2.23 0.79 0.32-1.99 NA NA 0.98 0.37-2.55
Emergency medicine 1.44d 1.08-1.92 0.60d 0.40-0.91 0.98 0.62-1.56 0.60d 0.37-0.99
Family medicine 1.08 0.70-1.66 0.76 0.46-1.26 0.94 0.54-1.63 1.28 0.77-2.13
General surgery 2.01d 1.41-2.86 0.98 0.53-1.83 2.03d 1.19-3.48 0.66 0.27-1.59
Internal medicine 1.38 0.85-2.25 0.48d 0.28-0.82 1.93d 1.03-3.62 0.37d 0.18-0.78
Internal medicine/ pediatrics 1.55 0.77-3.12 NA NA 1.74 0.70-4.30 NA NA
Neurology 2.48 0.98-6.30 1.87 0.68-5.15 NA NA NA NA
Obstetrics and gynecology 1.38 0.91-2.08 0.85 0.52-1.39 1.73 0.89-3.35 1.21 0.67-2.17
Orthopaedic surgery 2.18d 1.38-3.44 NA NA NA NA NA NA
Pediatrics 1.01 0.53-1.95 1.19 0.69-2.03 1.42 0.61-3.31 0.91 0.48-1.75
PM&R 2.01d 1.07-3.80 1.36 0.70-2.63 NA NA 2.75d 1.30-5.84
Psychiatry 1.18 0.82-1.68 0.95 0.61-1.48 1.32 0.85-2.06 1.08 0.65-1.78

a Calculated from the 2016 and 2018 National Resident Matching Program data from the 2016 and 2018 NRMP reports for osteopathic applicants and allopathic seniors.

b Research accomplishments include abstracts, presentations, and publications.

c Research experiences were not defined.

d The value is statistically significant.

Abbreviations: DO, osteopathic applicants; MD, allopathic applicants; NA, not available; PM&R, physical medicine and rehabilitation.

×
Only 1 specialty, PM&R, had a positive association between research experiences and matching for osteopathic applicants (Table 4). Those who successfully matched into PM&R were 2.75 times more likely to have had research experiences than those who did not match (OR, 2.75; 95% CI, 1.30-5.84). By contrast, allopathic applicants who matched were significantly more likely to have had research experiences than those who did not match for the following specialties in descending order of magnitude: anesthesiology (OR, 3.30; 95% CI, 1.67-6.50); general surgery (OR, 2.03; 95% CI, 1.19-3.48); and internal medicine (OR, 1.93; 95% CI, 1.03-3.62) (Table 4). These results suggest that allopathic applicants with a history of any form of research experience were more likely to match in the identified specialties. 
Discussion
With the SAS taking full effect in 2020, osteopathic applicants should be informed of the relevant factors involved in matching into ACGME-accredited programs. Prior studies have compared osteopathic and allopathic applicants in areas such as the National Board of Medical Examiners Comprehensive Basic Sciences Examination20 and have used NRMP data to compare osteopathic and allopathic interest in a limited number of specific specialties.21 However, to our knowledge, no other study has used NRMP data to compare the amount of research between osteopathic and allopathic applicants. 
United States allopathic applicants make up the largest cohort (50.7% [18,818 of 37,103] in 2018) of the NRMP active applicants.14 Our analysis demonstrates a correlation between research accomplishments and matching for allopathic applicants in 2016 and 2018. This finding is in agreement with previous studies using the NRMP data to evaluate the impact of research on allopathic applicants matching in surgical residencies.16-19 We have expanded on these previous studies to include all specialties. Matched allopathic applicants were more likely to have had research accomplishments than those who did not match for anesthesiology, dermatology, emergency medicine, general surgery, orthopaedic surgery, and PM&R. Research experiences were not as significant as research accomplishments for allopathic applicants by specialty. 
A notable finding from the current study is that osteopathic applicants had fewer research accomplishments and experiences than allopathic applicants. The only specialty for osteopathic applicants in which research experiences had a significant impact on matching was PM&R. Overall, research was not as great of a factor for matching of osteopathic applicants as allopathic applicants. Although the reasons for this discrepancy have not been identified, one related factor may be that the research and scholarly activity requirements were historically less stringent for osteopathic than allopathic GME program accreditation.22,23 It is also possible that, compared with osteopathic medical education, a greater emphasis is placed on research education and practice in allopathic medical education. 
Research accomplishments and experiences are not the only factors that contribute to matching success. The process takes into consideration a variety of applicant accomplishments and characteristics, such as medical board scores, performance in clinical rotations, letters of recommendation, and interview impressions.11 However, the significant difference between the number of osteopathic and allopathic research accomplishments and experiences and the correlation between allopathic applicants’ matching and research indicates that this metric does have weight in the evaluation process. Therefore, the potential impact of research should be considered as osteopathic applicants enter into a significantly larger pool of applicants that are mainly allopathic applicants within the Main Match. In the 2016 and 2018 Main Match, US osteopathic applicants matched at a rate of about 10% less than US allopathic applicants.12-15 
Applicants who are familiar with the principles and practice of research are expected to have a smoother transition into residency. The emphasis on scholarship is well founded because research-related activities reinforce the skills and perspectives fundamental to the practice of EBM. 
Limitations
There were several limitations to our study. First, the NRMP Charting Outcomes in the Match reports were self-reported and optional; therefore, some data are missing and may be misreported. However, the NRMP is the largest match program to date, and, to our knowledge, the reports represent the most comprehensive compilation of medical student characteristics with regard to residency matching. Second, we were unable to analyze data from the 2017 Main Match because the Charting Outcomes in the Match reports are not published every year. Therefore, we analyzed the most recent reports for osteopathic and allopathic applicants, which were from 2016 and 2018. Furthermore, the NRMP did not publish separate reports for osteopathic applicants prior to 2016. For this reason, a longitudinal study could not be conducted. Third, osteopathic applicants during 2016 and 2018 still had the option to participate in the AOA Match through the National Matching Services, which matched participating osteopathic applicants to osteopathic programs accredited by the American Osteopathic Association. Surveys of research achievements were not performed in past osteopathic National Matching Services reports, the most recent of which was published in 2014. Thus, we recognize that our findings are not generalizable to all osteopathic applicants for residency. Fourth, an OR analysis could not be performed if the frequency per group for each specialty was 4 or less, and therefore, the following specialties were not analyzed in this manner: child neurology, interventional radiology, neurological surgery, otolaryngology, pathology, plastic surgery, radiation oncology, and vascular surgery. 
Future Studies
Future studies will investigate the importance of research for applicants in the match once the SAS has gone into effect. It may also be important to analyze the effect of research for applicants in smaller matches, such as the military, urology, and San Francisco matches. Studies could be designed to evaluate the emphasis of research at the undergraduate medical education level and the effect of previous research accomplishments and experiences on residents’ attitudes toward and productivity in scholarly activities. 
Conclusion
Evidence of scholarly activity, such as research, will be a requirement for all residency programs in the upcoming SAS because scholarly activity is used to facilitate the learning and practice of evidence-based medicine. Overall, compared with osteopathic applicants, both matched and unmatched allopathic applicants have a significantly greater number of research achievements. With the upcoming SAS, increasing opportunities for osteopathic applicants to engage in research during undergraduate medical education is expected to enhance their competitiveness for matching and prepare them for evidence-based practice. 
Acknowledgment
We acknowledge the National Resident Matching Program for their cooperation in the preparation of this manuscript. 
References
Guyatt GH. Evidence-based medicine [editorial]. ACP J Club. 1991;114(2):A16. doi: 10.7326/ACPJC-1991-114-2-A16
Guyatt G, Cairns J, Churchill D, et al. Evidence-based medicine: a new approach to teaching the practice of medicine. JAMA.1992;268(17):2420-2425. doi: 10.1001/jama.1992.03490170092032 [CrossRef] [PubMed]
Straus SE, Glasziou P, Richardson WS, Haynes RB. Evidence-Based Medicine: How to Practice and Teach EBM. 5th ed. Edinburgh, Scotland: Elsevier; 2019.
Pfennig A, Hölter G. Evidence-based medicine is the gold standard for medical guidelines. Psychiatr Prax. 2011;38(5):218-20. doi: 10.1055/s-0031-1276830 [CrossRef] [PubMed]
Ebell MH, Shaughnessy AF, Slawson DC. Why are we so slow to adopt some evidence-based practices? Am Fam Physician. 2018;98(12):709-710. [PubMed]
Stella JJ, Lamb DL, Stain SC, Termuhlen PM. Understanding ACGME scholarly activity requirements for general surgery programs in the era of single accreditation and the next accreditation system. Am Surg. 2018;84(2):e40-e43.
Swing SR, Beeson MS, Carraccio C, et al. Educational milestone development in the first 7 specialties to enter the next accreditation system. J Grad Med Educ. 2013;5(1):98-106. doi: 10.4300/JGME-05-01-33 [CrossRef] [PubMed]
Nasca TJ, Weiss KB, Bagian JP, Brigham TP. The accreditation system after the “next accreditation system.” Acad Med. 2014;89(1):27-29. doi: 10.1097/ACM.0000000000000068 [CrossRef] [PubMed]
Holmboe ES, Edgar L, Hamstra S. The Milestones Guidebook. Chicago, IL: Accreditation Council for Graduate Medical Education; 2016.
Allopathic and osteopathic medical communities commit to a single graduate medical education accreditation system. CISION PR Newswire website. https://www.prnewswire.com/news-releases/allopathic-and-osteopathic-medical-communities-commit-to-a-single-graduate-medical-education-accreditation-system-247308221.html. Accessed July 26, 2019.
Results of the 2018 NRMP Program Director Survey. Washington, DC: National Resident Matching Program; 2018. https://www.nrmp.org/wp-content/uploads/2018/07/NRMP-2018-Program-Director-Survey-for-WWW.pdf. Accessed July 26, 2019.
National Resident Matching Program. Charting Outcomes in the Match: U.S. Allopathic Seniors, 2016. Washington, DC: National Resident Matching Program; 2016. https://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-US-Allopathic-Seniors-2016.pdf. Accessed July 26, 2019.
National Resident Matching Program. Charting Outcomes in the Match: Senior Students of U.S. Osteopathic Medical Schools, 2016. Washington, DC: National Resident Matching Program; 2016. http://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-US-Osteopathic-2016.pdf. Accessed July 26, 2019.
National Resident Matching Program. Charting Outcomes in the Match: U.S. Allopathic Seniors, 2018. Washington, DC: National Resident Matching Program; 2018. https://www.nrmp.org/wp-content/uploads/2018/06/Charting-Outcomes-in-the-Match-2018-Seniors.pdf. Accessed July 26, 2019.
National Resident Matching Program. Charting Outcomes in the Match: Senior Students of U.S. Osteopathic Medical Schools, 2018. Washington, DC: National Resident Matching Program; 2018. http://www.nrmp.org/wp-content/uploads/2018/06/Charting-Outcomes-in-the-Match-2018-Osteo.pdf. Accessed July 26, 2019.
Rinard JR, Mahabir RC. Successfully matching into surgical specialties: an analysis of national resident matching program data. J Grad Med Educ. 2010;2(3):316-321. doi: 10.4300/JGME-D-09-00020.1 [CrossRef] [PubMed]
Leschke JM, Hunt MA. Electronic residency application service application characteristics associated with successful residency matching in neurosurgery in 2009-2016. World Neurosurg. 2018;113:e529-e534. doi: 10.1016/j.wneu.2018.02.082 [CrossRef] [PubMed]
Abraham JT, Nguyen AV, Weber RA. Integrated plastic surgery residency applicant trends and comparison with other surgical specialties. Ann Plast Surg. 2018;80(2):164-170. doi: 10.1097/SAP.0000000000001199 [PubMed]
Schrock JB, Kraeutler MJ, Dayton MR, McCarty EC. A comparison of matched and unmatched orthopaedic surgery residency applicants from 2006 to 2014: data from the National Resident Matching Program. J Bone Joint Surg Am. 2017;99(1):e1. doi: 10.2106/JBJS.16.00293 [CrossRef] [PubMed]
Davis G, Gayer GG. Comparison of basic science knowledge between DO and MD applicants. J Am Osteopath Assoc. 2017;117(2):114-123. doi: 10.7556/jaoa.2017.022 [CrossRef] [PubMed]
Ramos RL, Cuoco JA, Guercio E, Levitan T. Quantitative description of medical student interest in neurology and psychiatry. J Am Osteopath Assoc. 2016;116(7):462-471. doi: 10.7556/jaoa.2016.090 [CrossRef] [PubMed]
Antony M, Savino J, Ashurst J. Difference in R01 grant funding among osteopathic and allopathic emergency physicians over the last decade. West J Emerg Med. 2017;18(4):621-623. doi: 10.5811/westjem.2017.1.32964 [CrossRef] [PubMed]
ACGME Common Program Requirements. Chicago, IL: Accreditation Council for Graduate Medical Education; 2017. https://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/CPRs_2017-07-01.pdf. Accessed March 17, 2019.
The Basic Documents for Postdoctoral Training. Chicago, IL: American Osteopathic Association; 2019. https://osteopathic.org/wp-content/uploads/2018/03/aoa-basic-document-for-postdoctoral-training.pdf. Accessed March 17, 2019.
Table 1.
Mean Number of Research Accomplishments and Experiences for Match Status and Medical Degreea
Variable Research Accomplishments,b Mean (SD) Research Experiences,c Mean (SD)
Match Status
 Matched 5.18 (4.34) 2.81 (1.64)
 Not matched 3.66 (2.87) 2.43 (1.26)
Medical Degree
 Allopathic 5.91 (3.72) 3.36 (1.25)
 Osteopathic 2.60 (2.90) 1.73 (1.21)

a Calculated from the 2016 and 2018 National Resident Matching Program data for osteopathic applicants and allopathic seniors.

b Research accomplishments include abstracts, presentations, and publications.

c Research experiences were not defined.

Table 1.
Mean Number of Research Accomplishments and Experiences for Match Status and Medical Degreea
Variable Research Accomplishments,b Mean (SD) Research Experiences,c Mean (SD)
Match Status
 Matched 5.18 (4.34) 2.81 (1.64)
 Not matched 3.66 (2.87) 2.43 (1.26)
Medical Degree
 Allopathic 5.91 (3.72) 3.36 (1.25)
 Osteopathic 2.60 (2.90) 1.73 (1.21)

a Calculated from the 2016 and 2018 National Resident Matching Program data for osteopathic applicants and allopathic seniors.

b Research accomplishments include abstracts, presentations, and publications.

c Research experiences were not defined.

×
Table 2.
Analyses of the Interaction between Match Status, Degree Type, and Research Accomplishments and Experiencesa
Research Accomplishmentsb Research Experiencesc
Variables F P Value F P Value
Matched vs not matched 7.77 .006d 3.38 .068
Osteopathic vs allopathic 40.21 <.001d 71.03 <.001d
Interaction 1.563 .213 1.42 .235

a Calculated from the 2016 and 2018 National Resident Matching Program data for osteopathic applicants and allopathic seniors using a 2-way analysis of variance.

b Research accomplishments include abstracts, presentations, and publications.

c Research experiences were not defined.

d Significant at P<.05.

Table 2.
Analyses of the Interaction between Match Status, Degree Type, and Research Accomplishments and Experiencesa
Research Accomplishmentsb Research Experiencesc
Variables F P Value F P Value
Matched vs not matched 7.77 .006d 3.38 .068
Osteopathic vs allopathic 40.21 <.001d 71.03 <.001d
Interaction 1.563 .213 1.42 .235

a Calculated from the 2016 and 2018 National Resident Matching Program data for osteopathic applicants and allopathic seniors using a 2-way analysis of variance.

b Research accomplishments include abstracts, presentations, and publications.

c Research experiences were not defined.

d Significant at P<.05.

×
Table 3.
Research Accomplishments and Experiences Across All Residency Specialties for Matched and Unmatched Applicants by Degree Typea
Research Accomplishmentsb Research Experiencesc
Physician Type Matched, Mean (SD) Not Matched, Mean (SD) P Value Matched, Mean (SD) Not Matched, Mean (SD) P Value
Osteopathic 3.00 (3.64) 2.20 (1.84) .242 1.79 ± 1.31 1.66 ± 1.12 .664
Allopathic 6.97 (4.07) 4.86 (3.02) .007d 3.65 ± 1.40 3.06 ± 1.00 .026d

a Calculated from the 2016 and 2018 National Resident Matching Program data for osteopathic applicants and allopathic seniors using independent samples t tests.

b Research accomplishments include abstracts, presentations, and publications.

c Research experiences were not defined.

d Significant at P<.05.

Table 3.
Research Accomplishments and Experiences Across All Residency Specialties for Matched and Unmatched Applicants by Degree Typea
Research Accomplishmentsb Research Experiencesc
Physician Type Matched, Mean (SD) Not Matched, Mean (SD) P Value Matched, Mean (SD) Not Matched, Mean (SD) P Value
Osteopathic 3.00 (3.64) 2.20 (1.84) .242 1.79 ± 1.31 1.66 ± 1.12 .664
Allopathic 6.97 (4.07) 4.86 (3.02) .007d 3.65 ± 1.40 3.06 ± 1.00 .026d

a Calculated from the 2016 and 2018 National Resident Matching Program data for osteopathic applicants and allopathic seniors using independent samples t tests.

b Research accomplishments include abstracts, presentations, and publications.

c Research experiences were not defined.

d Significant at P<.05.

×
Table 4.
Effects of Research Accomplishments and Experiences on Matching of Osteopathic and Allopathic Applicants by Specialtya
Research Accomplishmentsb Research Experiencesc
Specialty MD OR MD 95% CI DO OR DO 95% CI MD OR MD 95% CI DO OR DO 95% CI
Anesthesiology 2.37d 1.34-4.17 0.68 0.33-1.41 3.30d 1.67-6.50 NA NA
Dermatology 4.23d 1.35-13.30 NA NA NA NA NA NA
Diagnostic radiology 1.00 0.45-2.23 0.79 0.32-1.99 NA NA 0.98 0.37-2.55
Emergency medicine 1.44d 1.08-1.92 0.60d 0.40-0.91 0.98 0.62-1.56 0.60d 0.37-0.99
Family medicine 1.08 0.70-1.66 0.76 0.46-1.26 0.94 0.54-1.63 1.28 0.77-2.13
General surgery 2.01d 1.41-2.86 0.98 0.53-1.83 2.03d 1.19-3.48 0.66 0.27-1.59
Internal medicine 1.38 0.85-2.25 0.48d 0.28-0.82 1.93d 1.03-3.62 0.37d 0.18-0.78
Internal medicine/ pediatrics 1.55 0.77-3.12 NA NA 1.74 0.70-4.30 NA NA
Neurology 2.48 0.98-6.30 1.87 0.68-5.15 NA NA NA NA
Obstetrics and gynecology 1.38 0.91-2.08 0.85 0.52-1.39 1.73 0.89-3.35 1.21 0.67-2.17
Orthopaedic surgery 2.18d 1.38-3.44 NA NA NA NA NA NA
Pediatrics 1.01 0.53-1.95 1.19 0.69-2.03 1.42 0.61-3.31 0.91 0.48-1.75
PM&R 2.01d 1.07-3.80 1.36 0.70-2.63 NA NA 2.75d 1.30-5.84
Psychiatry 1.18 0.82-1.68 0.95 0.61-1.48 1.32 0.85-2.06 1.08 0.65-1.78

a Calculated from the 2016 and 2018 National Resident Matching Program data from the 2016 and 2018 NRMP reports for osteopathic applicants and allopathic seniors.

b Research accomplishments include abstracts, presentations, and publications.

c Research experiences were not defined.

d The value is statistically significant.

Abbreviations: DO, osteopathic applicants; MD, allopathic applicants; NA, not available; PM&R, physical medicine and rehabilitation.

Table 4.
Effects of Research Accomplishments and Experiences on Matching of Osteopathic and Allopathic Applicants by Specialtya
Research Accomplishmentsb Research Experiencesc
Specialty MD OR MD 95% CI DO OR DO 95% CI MD OR MD 95% CI DO OR DO 95% CI
Anesthesiology 2.37d 1.34-4.17 0.68 0.33-1.41 3.30d 1.67-6.50 NA NA
Dermatology 4.23d 1.35-13.30 NA NA NA NA NA NA
Diagnostic radiology 1.00 0.45-2.23 0.79 0.32-1.99 NA NA 0.98 0.37-2.55
Emergency medicine 1.44d 1.08-1.92 0.60d 0.40-0.91 0.98 0.62-1.56 0.60d 0.37-0.99
Family medicine 1.08 0.70-1.66 0.76 0.46-1.26 0.94 0.54-1.63 1.28 0.77-2.13
General surgery 2.01d 1.41-2.86 0.98 0.53-1.83 2.03d 1.19-3.48 0.66 0.27-1.59
Internal medicine 1.38 0.85-2.25 0.48d 0.28-0.82 1.93d 1.03-3.62 0.37d 0.18-0.78
Internal medicine/ pediatrics 1.55 0.77-3.12 NA NA 1.74 0.70-4.30 NA NA
Neurology 2.48 0.98-6.30 1.87 0.68-5.15 NA NA NA NA
Obstetrics and gynecology 1.38 0.91-2.08 0.85 0.52-1.39 1.73 0.89-3.35 1.21 0.67-2.17
Orthopaedic surgery 2.18d 1.38-3.44 NA NA NA NA NA NA
Pediatrics 1.01 0.53-1.95 1.19 0.69-2.03 1.42 0.61-3.31 0.91 0.48-1.75
PM&R 2.01d 1.07-3.80 1.36 0.70-2.63 NA NA 2.75d 1.30-5.84
Psychiatry 1.18 0.82-1.68 0.95 0.61-1.48 1.32 0.85-2.06 1.08 0.65-1.78

a Calculated from the 2016 and 2018 National Resident Matching Program data from the 2016 and 2018 NRMP reports for osteopathic applicants and allopathic seniors.

b Research accomplishments include abstracts, presentations, and publications.

c Research experiences were not defined.

d The value is statistically significant.

Abbreviations: DO, osteopathic applicants; MD, allopathic applicants; NA, not available; PM&R, physical medicine and rehabilitation.

×