The effects of the novel coronavirus SARS-CoV-2 on the urology match were numerous and widespread. Beginning in March of 2020, administrative bodies, including the American Association of Medical Colleges and the Society of Academic Urologists (SAU), released changes to the standard residency application process including cancellation of away subinternships, delay of Electronic Residency Application System submission and release to programs, and cancellation of in-person interviews. Programs explored a number of unique approaches to facilitate applicant exposure and fill the void, including virtual open houses, virtual subinternships, developing social media presence, updating websites, or some combination thereof. Given the novelty of these approaches, it was imperative to assess the efficacy of these contemporary offerings for applicants to guide future program efforts.

We created a 19-question survey utilizing Likert, dichotomous yes/no, and free text questions to inquire about applicant attitudes regarding social media, open houses and meet and greets, virtual subinternships, and other assorted application behaviors during the SARS-CoV-2 match era. The survey was provided to attendees registering for the American Urological Association (AUA) Medical Student Education Committee webinar entitled “Optimizing Medical Student Exposure and Interaction with Urology Remotely,” which took place on June 24, 2020, the recording of which is available on the AUA University YouTube channel. A total of 105 registrants completed the survey, representing roughly 20% of the ultimate applicant pool (see table).

Overall, applicants found virtual offerings by programs helpful in guiding their applications. For learning remotely, the AUA Medical Student Education Curriculum and Core Curriculum continued to prove valuable resources for urological education.^1–3 The creation of virtual subinternships, a herculean effort by the SAU, was also appreciated by applicants as the majority of them planned to complete at least 1. The most preferred platform for interacting with programs was Twitter. A previous study completed in 2015 found that only 30% of urology residency programs had Twitter accounts, but cursory review in 2020 revealed at least 75% of urology residency programs or departments now have a Twitter account.⁴ Accordingly, many applicants have pursued the creation of social media accounts specifically for interacting with programs. The so-called “Urology Twittersphere” provides a unique opportunity for self-promotion of applicant or program strengths while also allowing a modality of interaction and direct communication not previously available. Zoom was rated second to Twitter for preferred technology with regard to interacting with programs. The number of Zoom networking opportunities, often in the form of open houses or meet and greets, was significant, averaging 12, 1-2 hour-long events from different programs per week over the month of July 2020.

Although online outreach was perceived as a valuable tool for the urology match, applicants had reservations with regard to online assessment of their qualifications, ability to evaluate programs, and ability to build relationships with faculty, residents, and staff. The latter point is of particular importance given prior studies which identified interaction with current residents and perceived relationship between faculty and residents as 2 of the top 3 criteria in evaluating a residency program.⁵ Perhaps a degree of this trepidation was from a lack of experience with these previously underutilized modalities, as well as a lack of available guidance on how to maximize the potential of these opportunities. The variable structure of online offerings and the robust number of online events may also have contributed. Future iterations of online modality utilization in the match should consider these perceived limitations and incorporate feedback from applicants to optimize outreach efforts. These important efforts are already underway with survey studies from multiple organizations, including the SAU, being collected and analyzed to assess applicants’ experiences during the SARS-CoV-2 match era. This data will be informative.

As programs move towards a post-SARS-CoV-2 match era, we would suggest continuing the trend of increasing program visibility through the creation of curated social media accounts, updating program websites regularly, and offering online experiences for applicants to learn about programs, including use of testimonials of current residents and faculty, such as those currently being collected and hosted on UroResidency.com. Despite many residency websites undergoing overhaul in this match cycle, there remains a dearth of objective information for applicant evaluation of programs. A prior study found that applicants’ number 1 criterion in program evaluation is operative experience, yet only 1% of programs listed information regarding operative experience or case logs on their website.^5,6 Readily available online rankings such as Doximity and US News and World Report, which have variable methodology and are of questionable utility to applicants, continue to be easily accessible.

The 2021 Urology Residency Match was significantly altered due to SARS-CoV-2 necessitating novel virtual and social media-based solutions. In these initial data, just preceding the 2021 urology application cycle in late June 2020, online offerings and social media were highly utilized and felt to be valuable for guiding residency applications. As the next application cycle approaches, we hope programs continue to enhance this online and social media presence.

The authors would like to acknowledge the Medical Student Education Committee within the Office of Education of the American Urological Association for access to the survey data in this report, as well as collaborators Phillip G. Key, BS (Kalamazoo, Michigan), Jinfeng Jiang, BA (Omaha, Nebraska), Gina M. Badalato, MD (New York, New York), and Chad R. Tracy, MD (Iowa City, Iowa) who assisted with these efforts.