The Impact of Holistic Review of Urology Residency Applications on Selection for Interview During the COVID-19 Pandemic

OBJECTIVE To investigate the impact of a holistic review of urology residency applications on interview selec-tion at our institution during the COVID-19 pandemic. METHODS In the 2019-2020 cycle, applicants were filtered by a Step 1 score of 230 and whether they applied from selected east coast medical schools. For the 2020-2021 and 2021-2022 cycles, we implemented a scoring system which focused on desirable attributes based on our program training needs and resources. We compared applicant and interviewee demographics and United States Medical Licens-ing Examination (USMLE) scores using descriptive statistics and 1-way analysis of variance tests. RESULTS A total of 282, 300, and 367 students applied to our residency program with 50, 45, and 52 selected for interviews during the 2019-2020, 2020-2021, and 2021-2022 cycles, respectively. Compared to 2019-2020, the 2020-2021 and 2021-2022 interviewee cohorts comprised of more non-tri-state applicants (36%, 55.6%, and 46.2%, respectively). Underrepresented minority repre-sentation increased for the 2020-2021 interviewee cohort; however, this was not observed in 2021-2022 (16%, 24.4%, 15.4%, respectively). Additionally, USMLE Step 1 and 2 scores were similar between interviewee cohorts in 2019-2020, 2020-2021 and 2021-2022, respectively (Step 1: 244.2 +/- 8.8, 242 +/- 12.1, 242.8 +/- 12.4, P = .624) (Step 2: 249.1 +/- 11.5, 251.5 +/- 10.5, 254.4 +/- 10.8, P = .143). CONCLUSION Utilizing a comprehensive review resulted in a geographically diverse interview pool and no signif-icant difference in academic performance among interviewees. Holistic review provides an alter-native, balanced evaluation of residency applicants which may increase diversity in urology. UROLOGY 173: 34-40, 2023. (c) 2022 Elsevier Inc.