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.