Scholarly Engagement as an Educational Pathway to Surgical Residency Match: A Retrospective Cohort Study

Abstract Background Research engagement and scholarly productivity are increasingly emphasized during residency selection, particularly in competitive surgical specialties. However, it remains unclear which educational and scholarly characteristics are associated with matching into surgical versus non-surgical specialties among medical school graduates. This study compared these characteristics and identified factors independently associated with surgical residency match. Methods We conducted a retrospective cohort study of 590 medical students graduating from a large urban academic medical center between 2021 and 2025. Educational characteristics, academic performance, and research experiences were obtained from institutional records. Publication data were identified through structured PubMed searches and manually verified. Multivariable logistic regression was performed to identify factors independently associated with matching into a surgical specialty. Results Of 590 graduates, 181 (30.7%) matched into surgical specialties. Compared with graduates entering non-surgical specialties, those matching into surgical specialties were more likely to have completed a dedicated research year (37.6% vs. 22.0%, p < 0.001) and had significantly greater first-author publication productivity ( p < 0.001). In multivariable analyses, completion of a research year was independently associated with surgical specialty match (odds ratio [OR] 1.82, 95% confidence interval [CI] 1.16–2.84). Compared with graduates without first-author publications, those with 2–4 first-author publications (OR 3.39, 95% CI 2.06–5.56) and ≥ 5 first-author publications (OR 5.04, 95% CI 2.49–10.18) were significantly more likely to match into surgical specialties. Undergraduate academic background and United States Medical Licensing Examination Step 2 Clinical Knowledge scores were not independently associated with surgical specialty match. Conclusions Among graduates from a single medical school, research engagement and first-author scholarly productivity were independently associated with matching into surgical specialties, whereas undergraduate academic background and Step 2 Clinical Knowledge performance were not. These findings may inform medical student advising, mentorship, and institutional efforts to promote equitable access to research opportunities that support career exploration and residency preparation.