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Mudalegundi S, Clifton M, Lifchez S, LaPorte D, Ramanathan S, Sabit AH, Woreta F. Perspectives on Application and Interview Capping in Residency Selection of Surgical Subspecialties. J Surg Educ 2024:S1931-7204(24)00203-4. [PMID: 38755046 DOI: 10.1016/j.jsurg.2024.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 03/15/2024] [Accepted: 04/15/2024] [Indexed: 05/18/2024]
Abstract
OBJECTIVE With the advent of virtual interviews, the potential for interview hoarding by applicants became of greater concern due to lack of financial constraints associated with in-person interviewing. Simultaneously, the average number of applications submitted each year is rising. Currently there is no cap to the number of applications or interviews an applicant may complete when applying to residency, with the exception of ophthalmology with a cap of 15 interviews. No studies have assessed the applicants' perspectives on an application or interview cap. We assessed the attitudes of surgical subspecialty applicants towards capping, which may be useful when considering innovations in residency selection. DESIGN/SETTING/PARTICIPANTS About 1841 applicants to the Johns Hopkins' ophthalmology, urology, plastic surgery, and orthopedic surgery residency programs from the 2022-2023 cycle were invited to respond to a 22-item questionnaire. Statistical analyses of aggregate data were conducted using R. RESULTS Of the 776/1841 (42%) responses, 288 (40%) were in support of an application cap, while 455 (63%) were in support of an interview cap. Specialty (p < 0.001), gender (p < 0.001), taking a gap year (p = 0.02), medical school region (p = 0.04), and number of interviews accepted off of a waitlist (p = 0.01) were all significantly associated with a difference in opinion regarding an application cap. Specialty (p < 0.001), USMLE Step 1 score (p = 0.004), number of interviews (p < 0.001), and number of programs ranked (p < 0.001) were all significantly associated with a difference in opinion regarding an interview cap. Of those applicants who were in support of the respective caps they believed that on average a cap should consist of 48.1 (16.1) applications and 16.0 (8.0) interviews. CONCLUSIONS Our findings highlight the desire for interview caps among the majority of applicants to surgical subspecialties and thus this innovation may be considered by other specialties in the era of virtual interviews.
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Affiliation(s)
- Shwetha Mudalegundi
- Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
| | - Marisa Clifton
- Department of Urology, Brady Urological Institute, Johns Hopkins University, Baltimore, Maryland
| | - Scott Lifchez
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Dawn LaPorte
- Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Saras Ramanathan
- Department of Ophthalmology, University of California San Francisco, San Francisco, California
| | - Ahmed H Sabit
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Fasika Woreta
- Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.
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Bowe SN, Bly RA, Whipple ME, Gray ST. Residency Selection in Otolaryngology: Past, Present, & Future. Laryngoscope 2023; 133:S1-S13. [PMID: 36951573 DOI: 10.1002/lary.30668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 01/31/2023] [Accepted: 02/25/2023] [Indexed: 03/24/2023]
Abstract
OBJECTIVES To examine the otolaryngology residency selection process, including past experiences based on the medical literature and survey analysis of our present practices to generate recommendations for future selection system design. METHODS A mixed-methods study, including a scoping review and a cross-sectional survey, was completed. Four databases were assessed for articles on otolaryngology residency selection published from January 1, 2016 through December 31, 2020. A 36-question survey was developed and distributed to 114 otolaryngology program directors. Descriptive and thematic analysis was performed. RESULTS Ultimately, 67 of 168 articles underwent data abstraction and assessment. Three themes surfaced during the analysis: effectiveness, efficiency, and equity. Regarding the survey, there were 62 participants (54.4% response rate). The three most important goals for the selection process were: (1) to fit the program culture, (2) to make good colleagues, and (3) to contribute to the program's diversity. The three biggest 'pain points' were as follows: (1) Large volume of applications, (2) Lack of reliable information about personal characteristics, and (3) Lack of reliable information about a genuine interest in the program. CONCLUSIONS Within this study, the depth and breadth of the literature on otolaryngology residency selection have been synthesized. Additionally, baseline data on selection practices within our specialty has been captured. With an informed understanding of our past and present, we can look to the future. Built upon the principles of person-environment fit theory, our proposed framework can guide research and policy discussions regarding the design of selection systems in otolaryngology, as we work to achieve more effective, efficient, and equitable outcomes. LEVEL OF EVIDENCE N/A Laryngoscope, 133:2929-2941, 2023.
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Affiliation(s)
- Sarah N Bowe
- Department of Otolaryngology-Head & Neck Surgery, San Antonio Uniformed Services Health Education Consortium, JBSA-Ft. Sam Houston, Texas, U.S.A
| | - Randall A Bly
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, U.S.A
- Seattle Children's Hospital and Research Institute, Seattle, Washington, U.S.A
| | - Mark E Whipple
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, U.S.A
- Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington, U.S.A
| | - Stacey T Gray
- Department of Otolaryngology-Head & Neck Surgery, Massachusetts Eye & Ear Infirmary, Boston, Massachusetts, U.S.A
- Department of Otolaryngology-Head & Neck Surgery, Harvard Medical School, Boston, Massachusetts, U.S.A
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De Ravin E, Frost AS, Godse NR, Shaffer AD, Jabbour N, Schaitkin BM, Newman J, Mady LJ. Changes in otolaryngology application requirements and match outcomes: Are we doing any better? World J Otorhinolaryngol Head Neck Surg 2023; 9:144-152. [PMID: 37383330 PMCID: PMC10296048 DOI: 10.1002/wjo2.79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 06/16/2022] [Accepted: 08/03/2022] [Indexed: 06/30/2023] Open
Abstract
Objectives Otolaryngology-specific requirements were piloted to minimize applicant and program burdens. We investigated the impact of introducing and then removing these requirements on Match outcomes. Methods 2014-2021 National Resident Matching Program® data were examined. The primary outcome was the impact of Otolaryngology Resident Talent Assessment (ORTA; prematch 2017, postmatch 2019) and Program-Specific Paragraph (PSP; implemented 2016, optional 2018) on applicant numbers and match rates. Secondary survey analysis assessed candidate perceptions of PSP/ORTA. Results Applicant numbers declined significantly during PSP/ORTA (18.9%; p = 0.001). With the optional PSP and postmatch ORTA, applicant numbers increased significantly (39.0%; p = 0.002). Examined individually, mandatory PSP was associated with a significant decline in applicants (p = 0.007), whereas postmatch ORTA was associated with significant increases in applicants (p = 0.010). ORTA and PSP negatively impacted the decision to apply to otolaryngology in 59.8% and 51.3% of applicants, respectively. Conversely, match rate success improved significantly from 74.8% to 91.2% during PSP/ORTA (p = 0.014), followed by a significant decline to 73.1% after PSP was made optional and ORTA moved to postmatch (p = 0.002). Conclusions ORTA and PSP correlated with decreased applicant numbers and increased match rate success. As programs seek ways to remove barriers to applying to otolaryngology, the potential consequences of an increasing pool of unmatched candidates must also be considered.
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Affiliation(s)
- Emma De Ravin
- Department of Otorhinolaryngology—Head and Neck SurgeryUniversity of Pennsylvania Health SystemPhiladelphiaPennsylvaniaUSA
| | | | - Neal R. Godse
- Head and Neck InstituteCleveland ClinicClevelandOhioUSA
| | - Amber D. Shaffer
- Division of Pediatric OtolaryngologyChildren's Hospital of Pittsburgh of UPMCPittsburghPennsylvaniaUSA
| | - Noel Jabbour
- Division of Pediatric OtolaryngologyChildren's Hospital of Pittsburgh of UPMCPittsburghPennsylvaniaUSA
- Department of OtolaryngologyUniversity of Pittsburgh Medical CenterPittsburghPennsylvaniaUSA
| | - Barry M. Schaitkin
- Department of OtolaryngologyUniversity of Pittsburgh Medical CenterPittsburghPennsylvaniaUSA
| | - Jason Newman
- Department of Otolaryngology – Head and Neck SurgeryMedical University of South CarolinaCharlestonSouth CarolinaUSA
- MUSC Hollings Cancer CenterCharlestonSouth CarolinaUSA
| | - Leila J. Mady
- Department of Otolaryngology – Head and Neck SurgeryThomas Jefferson UniversityPhiladelphiaPennsylvaniaUSA
- Cancer Risk and Control Program of ExcellenceSidney Kimmel Cancer CenterPhiladelphiaPennsylvaniaUSA
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Mitton TJ, Elder R, Hunter JB. A Simulation of the Effect of Interview Caps on the National Resident Matching Program Match in Otolaryngology. Acad Med 2023; 98:448-454. [PMID: 36515560 DOI: 10.1097/acm.0000000000005122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Concerns regarding interview hoarding in the Match process have led to calls for a cap on the number of interviews an applicant can accept. However, no study has examined the effects of interview caps on applicants or a specialty. The authors created a simulation otolaryngology Match to analyze the effects of interview caps. The simulation included 120 residency programs, 360 positions, and 570 applicants (each assigned a competitiveness weighted value). Programs created interview lists (subject to 4 different interview cap conditions: no, 16, 12, and 8 cap) using weighted random selection and the competitiveness weighted values. Programs then selected 3 interviewees to fill their positions via weighted random selection using the competitiveness weighted values. Data analysis explored the effects of interview caps on individual applicants' probability of matching, the probability of matching with a certain number of interviews, and the average matched applicant competitiveness rank using one-way analysis of variance. The introduction of interview caps caused interviews to be distributed more equally among applicants. The 12-interview cap caused the applicants in the 100th competitiveness percentile to see their probability of matching fall from 99.3% to 67.2% ( P < .001). Applicants with ≥ 12 interviews had a probability of matching of 94.4% when there was no cap, compared to 76.9% with a 12-interview cap ( P < .001). The average competitiveness rank of matched applicants fell from 191 with no cap to 245 with a 12-interview cap ( P < .001). Interview caps in the otolaryngology Match may create major distortions in the probability of matching, leading to much lower chances of matching for more competitive applicants, lower probabilities of matching with certain numbers of interviews, and a decreased average competitiveness of matched applicants.
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Affiliation(s)
- Tanner J Mitton
- T.J. Mitton is a medical student, UT Southwestern Medical Center, Dallas, TexasORCID: http://orcid.org/0000-0002-2055-1614
| | - Ryan Elder
- R. Elder is a cybersecurity professional, New York, New York
| | - Jacob B Hunter
- J.B. Hunter is associate professor, Department of Otolaryngology-Head and Neck Surgery, UT Southwestern Medical Center, Dallas, Texas
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Rees CA, Ryder HF. Machine Learning for The Prediction of Ranked Applicants and Matriculants to an Internal Medicine Residency Program. Teach Learn Med 2022:1-10. [PMID: 35591808 DOI: 10.1080/10401334.2022.2059664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 03/07/2022] [Indexed: 06/15/2023]
Abstract
Phenomenon: Residency programs throughout the country each receive hundreds to thousands of applications every year. Holistic review of this many applications is challenging, and to-date, few tools exist to streamline or assist in the process for selecting candidates to interview and rank. Machine learning could assist programs in predicting which applicants are likely to be ranked, and among ranked applicants, which are likely to matriculate.Approach: In the present study, we used the machine learning algorithm Random Forest (RF) to differentiate between ranked and unranked applicants as well as matriculants and ranked non-matriculants to an internal medicine residency program in northern New England over a three-year period. In total, 5,067 ERAS applications were received during the 2016-17, 2017-18, and 2018-19 application cycles. Of these, 4,256 (84.0%) were unranked applicants, 754 (14.9%) were ranked non-matriculants, and 57 (1.12%) were ranked matriculants.Findings: For differentiating between ranked and unranked applicants, the RF algorithm achieved an area under the receiver operating characteristic (AUROC) curve of 0.925 (95% CI: 0.918-0.932) and area under the precision-recall curve (AUPRC) of 0.652 (0.611-0.685), while for differentiating between matriculants and ranked non-matriculants, the AUROC was 0.597 (95% CI: 0.516-0.680) and AUPRC was 0.114 (0.075-0.167). The ranks of matriculated applicants were significantly higher using the algorithmic rank list as compared with the actual rank list for the 2017-18 (median rank: 98 versus 204, p < .001) and 2018-19 cycles (74 versus 192, p = .006), but not the 2016-17 cycle (97 versus 144, p = .37).Insights: The RF algorithm predicted which applicants among the overall applicant pool were ranked with impressive accuracy and identified matriculants among ranked candidates with modest but better-than-random accuracy. This approach could assist residency programs with triaging applicants based on the likelihood of a candidate being ranked and/or matriculating.
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Affiliation(s)
- Christiaan A Rees
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Hilary F Ryder
- Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
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Markle JC, Ahmed H, Pandya K, Parikh A, Bolok Y, Fehlman J, Aitharaju V, Bastian R, Dey S, Chalasani M, Chanamolu M, Pedersen K, Ganios N, Pham V, Mansur S, Law JC. Transparency in the Ophthalmology Residency Match: Background, Study, and Implications. Cureus 2021; 13:e19826. [PMID: 34963843 PMCID: PMC8702383 DOI: 10.7759/cureus.19826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2021] [Indexed: 11/05/2022] Open
Abstract
Background Medical students are applying to dramatically more ophthalmology residency programs than in the past, causing an increased administrative burden for programs and financial harm to students. This study considers the background of this situation and looks at how a lack of transparency surrounding potential residency match filters contributes. Furthermore, this study raises several potential solutions to this lack of transparency that may increase the functionality of the ophthalmology residency match. Objective The purpose of this study was to determine the availability and consistency of potential ophthalmology residency match filters through training program websites and the American Medical Association's (AMA) Residency & Fellowship Database (FREIDA). Methods This study was a cross-sectional observational study of ophthalmology residency program websites and AMA's FREIDA database entries. For 119 ophthalmology residency programs, five potential filters were evaluated for both availability and consistency on individual residency websites and FREIDA. These filters were: (1) whether a program required a minimum United States Medical Licensing Examination (USMLE) Step 1 score; (2) minimum number of letters of recommendation required; 3) whether a minimum USMLE Step 2 score was required; (4) if the program accepts the Comprehensive Osteopathic Medical Licensing Examination (COMLEX) sequence in lieu of the USMLE; and (5) ability of the residency to sponsor a visa (J-1, H-1B, or F-1). Each program's website and FREIDA entry were independently evaluated by two authors to increase validity, with a third author brought in to break the tie in case of a disagreement. Results Only two ophthalmology residency programs had information about all five filters both available and consistent on their website and FREIDA. Inter-reviewer reliability was 92.5%. Conclusions Information about potential filters used in the ophthalmology residency match is neither publicly available nor consistent. This lack of transparency may contribute to the phenomenon of medical students applying to dramatically more ophthalmology residency programs. A standardized database of these filters is needed to increase transparency to applicants, which may reduce the expenses of medical students and the workload of program directors.
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Affiliation(s)
- Jonathan C Markle
- School of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Harris Ahmed
- Department of Ophthalmology, Loma Linda University Medical Center, Loma Linda, USA
| | - Kishan Pandya
- School of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Ankur Parikh
- Department of Ophthalmology, University of Cincinnati Medical Center, Cincinnati, USA
| | - Youstina Bolok
- School of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Jared Fehlman
- School of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Varun Aitharaju
- School of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Riley Bastian
- School of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Shreya Dey
- School of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Meghana Chalasani
- School of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Meghana Chanamolu
- School of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Karina Pedersen
- School of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Natalie Ganios
- School of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Vincent Pham
- School of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Shabnam Mansur
- School of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Janice C Law
- Department of Ophthalmology, Vanderbilt University Medical Center, Nashville, USA
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Asaad M, Elmorsi R, Ferry AM, Rajesh A, Maricevich RS. The Experience of Virtual Interviews in Resident Selection: A Survey of Program Directors in Surgery. J Surg Res 2021; 270:208-13. [PMID: 34706297 DOI: 10.1016/j.jss.2021.09.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 09/10/2021] [Accepted: 09/16/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND MATCH 2021 was short of the classic "in-person" component. Herein, we assess the impact of virtual interviews (VIs) on resident selection, from the perspectives of program directors (PDs) across all surgical specialties. MATERIALS AND METHODS We conducted a cross-sectional survey-based study of ACGME-accredited US residency program directors (PDs) of all surgical specialties. The survey was designed based on a review of relevant literature and inquired about the strengths, limitations, and overall utility of VIs. RESULTS A total of 365 PDs responded to our survey. Almost all respondents (90%) found VIs to be less expensive than in-person interviews, while only 34% agree that VIs were less time-consuming. Only a median of 5% of interviews was complicated by technical difficulties. Most PDs found it more challenging to assess applicants' fit (75%), personality and communication skills (71%), and commitment to specialty (60%). Only 14% found VIs to be overall better for assessing residency applicants. In future cycles, most PDs are planning to host both virtual and in-person interviews (57%), while 35% and 8% will host exclusive in-person and virtual interviews, respectively. CONCLUSIONS VIs are a novel way of dealing with the restrictions imposed by COVID-19. Despite their cost and time benefit, they present particular challenges in evaluating residency applicants. A combination of both virtual and in-person interviews will likely be implemented in the coming cycles.
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Mamidi IS, Gu A, Mulcahy CF, Wei C, Zapanta PE. Perceived Impact of USMLE Step 1 Score Reporting to Pass/Fail on Otolaryngology Applicant Selection. Ann Otol Rhinol Laryngol 2021; 131:506-511. [PMID: 34192891 DOI: 10.1177/00034894211028436] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Recently, the decision was made to transition the United States Medical Licensing Examination (USMLE) Step 1 score from a three-digit numerical score to a pass/fail system. Historically, Step 1 scores have been important for otolaryngology resident applicant selection. The purpose of this study was to understand and evaluate otolaryngology residency program directors' (OPDs) opinions on the impact following the change in Step 1 score reporting. METHODS A 22-question survey administered through Qualtrics was sent to 113 academic otolaryngology residency program directors in April 2020. Information about demographics, impressions on the new Step 1 score format, anticipated changes in applicant selection, impact on mental health, and importance of various other factors in selecting applicants were queried. Descriptive statistics were used to analyze survey results. RESULTS A total of 41 out of 113 (36.3%) OPDs completed this survey. A majority of surveyed OPDs (80.5%) do not support the decision to change Step 1 to a pass/fail system. In the absence of a three digit numeric USMLE Step 1 score, OPDs indicated prioritization of away rotations, letters of recommendation (LORs), personal prior knowledge of the applicant, grades in required clerkship, and class ranking or quartile. 53.7% of OPDs anticipate requiring USMLE Step 2 Clinical Knowledge for interview consideration following this change. CONCLUSION OPDs believe a pass/fail Step 1 score will decrease the importance of this exam and that this change will lead to the implementation and evaluation of additional metrics such as a required Step 2 CK score.
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Affiliation(s)
- Ishwarya S Mamidi
- Division of Otolaryngology, George Washington University Hospital, University School of Medicine and Health Sciences, Washington, DC, USA
| | - Alex Gu
- Division of Otolaryngology, George Washington University Hospital, University School of Medicine and Health Sciences, Washington, DC, USA
| | - Collin F Mulcahy
- Division of Otolaryngology, George Washington University Hospital, University School of Medicine and Health Sciences, Washington, DC, USA
| | - Chapman Wei
- Division of Otolaryngology, George Washington University Hospital, University School of Medicine and Health Sciences, Washington, DC, USA
| | - Philip E Zapanta
- Division of Otolaryngology, George Washington University Hospital, University School of Medicine and Health Sciences, Washington, DC, USA
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Zastrow RK, Burk-Rafel J, London DA. Systems-Level Reforms to the US Resident Selection Process: A Scoping Review. J Grad Med Educ 2021; 13:355-370. [PMID: 34178261 PMCID: PMC8207920 DOI: 10.4300/jgme-d-20-01381.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 01/18/2021] [Accepted: 02/18/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Calls to reform the US resident selection process are growing, given increasing competition and inefficiencies of the current system. Though numerous reforms have been proposed, they have not been comprehensively cataloged. OBJECTIVE This scoping review was conducted to characterize and categorize literature proposing systems-level reforms to the resident selection process. METHODS Following Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, searches of Embase, MEDLINE, Scopus, and Web of Science databases were performed for references published from January 2005 to February 2020. Articles were included if they proposed reforms that were applicable or generalizable to all applicants, medical schools, or residency programs. An inductive approach to qualitative content analysis was used to generate codes and higher-order categories. RESULTS Of 10 407 unique references screened, 116 met our inclusion criteria. Qualitative analysis generated 34 codes that were grouped into 14 categories according to the broad stages of resident selection: application submission, application review, interviews, and the Match. The most commonly proposed reforms were implementation of an application cap (n = 28), creation of a standardized program database (n = 21), utilization of standardized letters of evaluation (n = 20), and pre-interview screening (n = 13). CONCLUSIONS This scoping review collated and categorized proposed reforms to the resident selection process, developing a common language and framework to facilitate national conversations and change.
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Affiliation(s)
- Ryley K. Zastrow
- Ryley K. Zastrow, BS, is a Fourth-Year Medical Student, Department of Medical Education, Icahn School of Medicine at Mount Sinai
| | - Jesse Burk-Rafel
- Jesse Burk-Rafel, MD, MRes, is Assistant Professor, Department of Internal Medicine, and Assistant Director of UME-GME Innovation, Institute for Innovations in Medical Education, NYU Grossman School of Medicine
| | - Daniel A. London
- At the time of writing, Daniel A. London, MD, MS, was an Orthopaedic Surgery Resident, Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, and is currently a Hand Surgery Fellow, Mary S. Stern Hand Surgery Fellowship, TriHealth
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Nilsen KM, Walling A, Grothusen J, Irwin G, Meyer M, Unruh G. Time and Financial Costs for Students Participating in the National Residency Matching Program (the Match ©): 2015 to 2020. Kans J Med 2021; 14:53-63. [PMID: 33763180 PMCID: PMC7984744 DOI: 10.17161/kjm.vol1414568] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 11/12/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction The purpose of this study was to provide information to assist students, faculty, and staff in making critical career-determining decisions regarding the residency NRMP “Match©” process. Methods A 47-item survey questionnaire was developed and piloted on a regional medical school campus in 2015. The revised questionnaire was distributed each year from 2016 to 2020 to fourth-year medical students after rank lists had been submitted. The questionnaire incorporated a request for comments about the interviewing experience and suggestions to improve the process. This narrative feedback was coded using a thematic analysis. Results The overall response rate was 86.1% (897/1,042). Annual response rates ranged from 70.0% in 2020 to 97.0% in 2018. Respondents’ average age was 27.3 (± 2.7) years and 50.0% (448/897) were male. Most applied to family medicine (164/897; 18.2%) and internal medicine (140/897; 15.6%). Eight specialties had fewer than ten applicants over the six-year period. The number of students applying to individual specialties fluctuated annually, but no specialty showed a consistent upward or downward trend over the study period. Conclusions This study found huge differences in numbers of applications, expenses, and days interviewing. Students crave more guidance, a more efficient system, transparent communication with programs, and less pressure during the process. Reducing escalating volumes of applications is central to improving the system. Despite efforts to inform applicants better, student behavior is unlikely to change until they feel safe in the belief that lower and more realistic numbers of applications and interviews are likely to result in securing an appropriate residency position.
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Affiliation(s)
- Kari M Nilsen
- Department of Family and Community Medicine, University of Kansas School of Medicine-Wichita, Wichita, KS
| | - Anne Walling
- Department of Family and Community Medicine, University of Kansas School of Medicine-Wichita, Wichita, KS
| | - Jill Grothusen
- Department of Family Medicine and Community Health, University of Kansas School of Medicine-Kansas City, Kansas City, KS
| | - Gretchen Irwin
- Office of Graduate Medical Education, University of Kansas School of Medicine-Wichita, Wichita, KS
| | - Mark Meyer
- Office of Student Affairs, University of Kansas School of Medicine-Kansas City, KS
| | - Greg Unruh
- Office of Graduate Medical Education, University of Kansas School of Medicine-Kansas City, KS
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Abstract
Over the past decade, the number of residency applications submitted per applicant has nearly doubled. This epidemic of “Application Fever” is expensive for applicants, burdensome for programs, and ultimately does not improve overall Match outcomes. In this review, we discuss the phenomenon of Application Fever, with a focus on contributing factors and costs of this behavior. Application Fever has its origins in the early 1990s. At that time, the number of residency applicants began to outpace the number of available positions. Because an applicant who applies to more residency programs has a greater probability of securing a residency position than an otherwise equivalent applicant who applies to fewer, "overapplication" became a dominant strategy and residency applicants began to apply to more residency programs each year. This trend was enhanced and enabled by the introduction of the Electronic Residency Application Service (ERAS). Although Application Fever is a rational decision for applicants, it imposes a substantial evaluative burden on program directors and necessitates the use of convenience screening metrics. We then briefly review potential solutions, including informational strategies, application limits, and marketplace incentives to reduce application numbers. Although a fixed cap on applications would reduce application numbers and facilitate a holistic selection process, greater transparency from residency programs regarding their selection criteria would be required to help applicants choose where to apply. To improve the residency application process for programs and applicants alike, we call upon the medical community to further study Application Fever and carefully consider solutions, including fixed application caps.
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Affiliation(s)
| | - Ilana S Rosman
- Dermatology, Washington University School of Medicine, St. Louis, USA
| | - John C Carlson
- Pediatrics, Tulane University School of Medicine, New Orleans, USA
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Salehi PP, Heiser A, Salehi P, Torabi SJ, Fine RL, Judson B, Azizzadeh B, Lee YH. Otolaryngology Applicant Characteristics and Trends: Comparing OTO-HNS with Peer Specialties. Ann Otol Rhinol Laryngol 2021; 130:929-940. [PMID: 33435722 DOI: 10.1177/0003489420987408] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To evaluate the recent Otolaryngology-Head and Neck Surgery (OTO-HNS) applicant characteristics, to identify which applicant characteristics are associated with successful match into OTO-HNS, and to compare OTO-HNS applicant trends and characteristics to that of peer surgical specialties (PS). MATERIALS AND METHODS Data were obtained from official reports by the National Residency Matching Program (NRMP) for OTO-HNS, plastic and reconstructive surgery, orthopedic surgery, neurosurgery, and dermatology from 2006 to 2019. Alpha Omega Alpha (AOA) membership, United States Medical Licensing Examination (USMLE) scores, research productivity, graduation from a top-40 NIH-funded U.S. medical school, and additional graduate degree were recorded. Odds ratios (OR) were calculated to evaluate the relationship between applicant qualifications and match success. RESULTS From 2014 to 2018, the OTO-HNS applicant pool shrunk from 443 to 333, representing the largest drop of all PS. Furthermore, OTO-HNS reported the most unfilled positions and highest match rates in 2017 (n = 14; 92.1%) and 2018 (n = 12; 94.6%) among any PS. Despite recent trends, 2019 NRMP data revealed a 38.74% increase in OTO-HNS applicant numbers compared to 2018. AOA membership (OR, 7.3; P = .030), USMLE Step 2 scores between 241 and 260 (OR, 6.5; P = .009), and research productivity (OR, 5.6; P = .005) significantly increased the odds of matching into OTO-HNS. CONCLUSIONS Despite recent fluctuations in application trends, OTO-HNS continues to successfully match highly qualified applicants, including applicants with AOA membership, high Step 2 scores, and high research productivity. An understanding of the qualifications used to evaluate residency applicants may be helpful to both applicants and residency programs of OTO-HNS.
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Affiliation(s)
- Parsa P Salehi
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Yale University School of Medicine, New Haven, CT, USA
| | - Alyssa Heiser
- Department of Otolaryngology-Head and Neck Surgery, University of Vermont College of Medicine, Burlington, VT, USA
| | - Pauniz Salehi
- College of Human Ecology, Department of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Sina J Torabi
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Yale University School of Medicine, New Haven, CT, USA
| | - Rebecca L Fine
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Benjamin Judson
- Department of Surgery, Otolaryngology-Head and Neck Surgery, Yale University School of Medicine, New Haven, CT, USA
| | - Babak Azizzadeh
- Center for Advanced Facial Plastic Surgery, Beverly Hills, CA, USA.,Division of Head and Neck Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA, USA
| | - Yan H Lee
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Yale University School of Medicine, New Haven, CT, USA
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Abstract
The 2019 novel coronavirus (COVID-19) pandemic has led to dramatic changes in the 2020 residency application cycle, including halting away rotations and delaying the application timeline. These stressors are laid on top of a resident selection process already under duress with exploding application and interview numbers-the latter likely to be exacerbated with the widespread shift to virtual interviewing. Leveraging their trainee perspective, the authors propose enforcing a cap on the number of interviews that applicants may attend through a novel interview ticket system (ITS). Specialties electing to participate in the ITS would select an evidence-based, specialty-specific interview cap. Applicants would then receive unique electronic tickets-equal in number to the cap-that would be given to participating programs at the time of an interview, when the tickets would be marked as used. The system would be self-enforcing and would ensure each interview represents genuine interest between applicant and program, while potentially increasing the number of interviews-and thus match rate-for less competitive applicants. Limitations of the ITS and alternative approaches for interview capping, including an honor code system, are also discussed. Finally, in the context of capped interview numbers, the authors emphasize the need for transparent preinterview data from programs to inform applicants and their advisors on which interviews to attend, learning from prior experiences and studies on virtual interviewing, adherence to best practices for interviewing, and careful consideration of how virtual interviews may shift inequities in the resident selection process.
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Affiliation(s)
- Jesse Burk-Rafel
- J. Burk-Rafel is assistant professor of internal medicine and assistant director of UME-GME innovation, Institute for Innovations in Medical Education, NYU Grossman School of Medicine, New York, New York. At the time this article was written, he was an internal medicine resident, NYU Langone Health, New York, New York
| | - Taylor C Standiford
- T.C. Standiford is a fourth-year medical student, University of Michigan Medical School, Ann Arbor, Michigan
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Soeprono TM, Pellegrino LD, Murray SB, Ratzliff A. Considerations for Program Directors in the 2020-2021 Remote Resident Recruitment. Acad Psychiatry 2020; 44:664-668. [PMID: 33106955 PMCID: PMC7588282 DOI: 10.1007/s40596-020-01326-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 09/29/2020] [Indexed: 06/11/2023]
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15
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Salehi PP, Heiser A, Salehi P, Manes RP, Judson BL, Azizzadeh B, Lee YH. Ideas and Innovations to Improve the Otolaryngology–Head and Neck Surgery Residency Application and Selection Process. Otolaryngol Head Neck Surg 2020; 164:1001-1010. [DOI: 10.1177/0194599820961989] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective To (1) summarize strategies proposed in the recent otolaryngology–head and neck surgery (OTO-HNS) literature for improving the residency application and selection process, (2) evaluate the effects of recently implemented changes to the OTO-HNS match, and (3) discuss recommendations for future changes to the OTO-HNS residency application and selection process. Data Sources PubMed, Medline Ovid database, and article reference lists. Review Methods A structured literature search was performed to identify current English language articles relating to the objectives of this study using the aforementioned data sources, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines. The search was limited to submissions published between January 1, 2015, and January 1, 2020. Conclusions Numerous proposals have been made for improving the otolaryngology residency application and selection process and addressing the competitive nature of the Match. These proposals include but are not limited to mandating a secondary essay, implementing consortia and early match processes, using a signaling system, conducting regional and web-based interviews, offering early engagement with interest groups, instituting a hard cap on applications, increasing costs of applying, counseling self-restraint to prospective applicants, and creating application filters. Implications for Practice As the volume of literature surrounding the OTO-HNS Match continues to increase, this review aims to provide a summary of past proposals and serve as a guide for possible future innovations. We propose 3 initiatives that may improve the residency application and selection process for both program and resident, with minimal impact to the current National Resident Matching Program (NRMP) Match structure.
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Affiliation(s)
- Parsa P. Salehi
- Department of Surgery, Division of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Alyssa Heiser
- Department of Otolaryngology–Head and Neck Surgery, The University of Vermont Medical Center, Burlington, Vermont, USA
| | - Pauniz Salehi
- College of Human Ecology, Cornell University, Ithaca, New York, USA
| | - R. Peter Manes
- Department of Surgery, Division of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Benjamin L. Judson
- Department of Surgery, Division of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Babak Azizzadeh
- Center for Advanced Facial Plastic Surgery, Beverly Hills, California, USA
- Division of Head and Neck Surgery, Department of Otolaryngology–Head and Neck Surgery, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California, USA
| | - Yan Ho Lee
- Department of Surgery, Division of Otolaryngology, Yale University School of Medicine, New Haven, Connecticut, USA
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Abstract
In 2016, 1,137 fourth year medical students submitted applications for orthopedic surgery residency positions. Students applied to an average of 79 programs, resulting in in a total of 89,846 applications being submitted for 727 first year residency positions. This ratio of 124 applications per position is two SDs above the mean relative to other medical specialties. The average applicant for orthopaedic surgery residency attends 2.4 away rotations, as attending 2 away rotations increases an applicant's odds of matching, and submits 83 applications. This excessive number of applications overburdens programs, subjects applicants to considerable costs, and diminishes the quality of fit between interviewees and programs. Eighty-three percent of program directors use step 1 United States Medical Licensing Examination scores as a screening tool to decrease the number of applications necessary for review. The average matched applicant attended 11.5 interviews, and Step 1 scores, research productivity, and Alpha Omega Alpha (AOA) status can be used to predict the number of applications necessary to obtain 12 interviews. AOA membership has the strongest influence on interview yield. Applicants report spending an average of approximately $7,000 on the interview process, and 72% borrow money to cover these costs. Post-interview contact, although forbidden by the National Resident Matching Program , has been reported by 60% to 64% of applicants.
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Fernandez C, Lopez BL, Kushner M, Leiby BE, Den RB. Overemphasis of Step 1 Scores May Affect Application Pool Diversity in Radiation Oncology. Pract Radiat Oncol 2019; 10:e3-e7. [PMID: 31369886 DOI: 10.1016/j.prro.2019.07.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 07/15/2019] [Accepted: 07/22/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE Many radiation oncology programs use Step 1 score metrics as a surrogate for intelligence and success to screen applicants. The impact of this practice on radiation oncology applicant pool diversity is unknown. METHODS AND MATERIALS Electronic Residency Application Service applications submitted to our institution between 2015 and 2018 match cycles were reviewed. Sex, age, race/ethnicity, and Step 1 scores were collected. Groupings by characteristics were sex (female vs male), age ≤30 versus >30 years, and race/ethnicity by underrepresented minority (URM) versus non-URM status. URMs were defined as Black/African American, Hispanic, Native American/Alaskan Native, and Hawaiian/Pacific Islander. Step 1 scores were divided based on scores of 220 and 240. The association between applicant demographics and Step 1 scores was assessed using proportional odds logistic regression for ordinal outcomes. RESULTS Eight hundred ten applicants with Step 1 scores ranging from 188 to 275 were collected, representing nearly 90% of all applicants during the 2015 to 2018 Electronic Residency Application Service cycles. Twenty-nine percent were female, 29% were >30 years of age, and 10% were URMs. Increasing Step 1 score requirements disproportionately decreased representation of applicants who were female versus male at 240 (-51% vs -31%), >30 versus ≤30 years old at 220 (-28% vs -6%) and 240 (-55% vs -26%), and URMs versus non-URMs at 220 (-34% vs -9%) and 240 (-61% vs -34%). On analysis, Step 1 score requirements had a statistically significantly impact on applicant distributions based on sex, age, and URM status (P < .001). CONCLUSIONS Overemphasis of Step 1 scores may reduce the diversity of the radiation oncology applicant pool. Further evaluation of practices that counter the stated American Society of Clinical Oncology, American Society of Radiation Oncology, and American College of Radiology diversity missions should be pursued to improve understanding of barriers and biases.
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Affiliation(s)
- Christian Fernandez
- Department of Radiation Oncology, Sidney Kimmel Medical College & Cancer Center at Thomas Jefferson University, Philadelphia, Pennsylvania.
| | - Bernard L Lopez
- Department of Emergency Medicine, Sidney Kimmel Medical College & Cancer Center at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Marlene Kushner
- Department of Radiation Oncology, Sidney Kimmel Medical College & Cancer Center at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Benjamin E Leiby
- Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Robert B Den
- Department of Radiation Oncology, Sidney Kimmel Medical College & Cancer Center at Thomas Jefferson University, Philadelphia, Pennsylvania
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Affiliation(s)
- Robert T Sataloff
- Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, PA, USA
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19
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Abstract
An alarming trend of declining applications to otolaryngology-head and neck surgery has surfaced over the past 3 years. There are many possible explanations for this decline, and a recent publication has implicated "impossible" qualifications as the reason for this decline. While these qualifications may deter a significant number of potential applicants, they have not changed significantly in the past 5 years and do not seem to explain a sudden decline. This commentary argues that the program-specific paragraph, which was introduced in 2015, may be at least in part responsible.
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Affiliation(s)
- Scott Kramer
- 1 Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
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20
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Stepan KO, Kaul VF, Raquib AR, Kozin ED, Sethi RK, Malkin BD, Gray ST, Teng MS. An Evaluation of the Program-Specific Paragraph in the Otolaryngology Residency Application. Laryngoscope 2018; 128:2508-2513. [DOI: 10.1002/lary.27553] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2018] [Indexed: 11/07/2022]
Affiliation(s)
- Katelyn O. Stepan
- Department of Otolaryngology; Icahn School of Medicine at Mount Sinai; New York New York
| | - Vivian F. Kaul
- Department of Otolaryngology; Icahn School of Medicine at Mount Sinai; New York New York
| | - Aaishah R. Raquib
- Department of Otolaryngology; Massachusetts Eye and Ear; Boston Massachusetts
- Department of Otolaryngology; Harvard Medical School; Boston Massachusetts U.S.A
| | - Elliott D. Kozin
- Department of Otolaryngology; Massachusetts Eye and Ear; Boston Massachusetts
- Department of Otolaryngology; Harvard Medical School; Boston Massachusetts U.S.A
| | - Rosh K. Sethi
- Department of Otolaryngology; Massachusetts Eye and Ear; Boston Massachusetts
- Department of Otolaryngology; Harvard Medical School; Boston Massachusetts U.S.A
| | - Benjamin D. Malkin
- Department of Otolaryngology; Icahn School of Medicine at Mount Sinai; New York New York
| | - Stacey T. Gray
- Department of Otolaryngology; Massachusetts Eye and Ear; Boston Massachusetts
- Department of Otolaryngology; Harvard Medical School; Boston Massachusetts U.S.A
| | - Marita S. Teng
- Department of Otolaryngology; Icahn School of Medicine at Mount Sinai; New York New York
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21
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Abstract
The field of otolaryngology has historically enjoyed extreme interest among residency applicants. However, in the past few years, the number of applicants has precipitously dropped, so that there is no longer a significant excess of applications. It remains important for academic programs to promote student interest in otolaryngology, to break down barriers that may dissuade excellent candidates, and to widen the welcome.
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Affiliation(s)
- C W David Chang
- 1 Department of Otolaryngology-Head and Neck Surgery, University of Missouri, Columbia, Missouri, USA
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22
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Abstract
Importance It has been nearly 25 years since medical students were queried regarding their perspectives on otolaryngology-head and neck surgery (OHNS) residency selection. Understanding this viewpoint is critical to improving the current application process. Objective To evaluate the perceptions of 2016 OHNS residency applicants regarding the application process and offer suggestions for reform. Design, Setting, and Participants In this cross-sectional study of anonymous online survey data, a 14-question survey was designed based on resources obtained from a computerized PubMed, Ovid, and GoogleScholar database search of the English language from January 1, 1990, through December 31, 2015, was conducted using the following search terms: (medical student OR applicant) AND (application OR match) AND otolaryngology. The survey was administered to 2016 OHNS residency applicants to examine 4 primary areas: current attitudes toward the match, effect of the new Otolaryngology Program Directors Organization personal statement mandate, sources of advice and information, and suggestions for improvement. In January 2016, an email was sent to 100 program directors asking them to distribute the survey to current OHNS applicants at their institution. One follow-up reminder email was sent in February 2016. A link to the survey was posted on the Otomatch.com homepage on January 28, 2016, with the last response received on March 28, 2016. Main Outcome and Measures Survey responses regarding the residency application process. Results A total of 150 of 370 residency applicants (40.5%) responded to the survey. Of these, 125 respondents (90.6%) noted applying to programs in which they had no specific interest simply to improve their chances of matching. Applicants intended to apply to more programs than they actually did (63.6 vs 60.8; r = 0.19; 95% CI, -0.03 to 0.40). Program directors advised fewer applications than other sources; however, 58 respondents (38.7%) did not receive advice from a program director. A total of 121 respondents (80.7%) found online program information to be insufficient. Finally, 90 of 140 respondents (64.3%) noted that they would agree to a hard cap on applications, among other suggestions for improvement. Conclusions and Relevance Several main themes emerged from the data, providing a foundation for process improvement opportunities: careful consideration to applicant mentorship, including peers; uniform set of criteria for residency program websites; and investigating alternative match platforms, which may allow hard caps, flagging programs of higher interest, or wave application cycles. Overall, the otolaryngology applicant provides a unique perspective regarding the current state of the match and potential opportunities for system-wide improvement.
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Affiliation(s)
- Matthew Ward
- Department of Otolaryngology-Head and Neck Surgery, San Antonio Uniformed Services Health Education Consortium, Ft Sam Houston, Texas
| | - Christian Pingree
- Department of Otolaryngology-Head and Neck Surgery, San Antonio Uniformed Services Health Education Consortium, Ft Sam Houston, Texas
| | - Adrienne M Laury
- Department of Otolaryngology-Head and Neck Surgery, San Antonio Uniformed Services Health Education Consortium, Ft Sam Houston, Texas
| | - Sarah N Bowe
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye & Ear Infirmary, Boston
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23
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Abstract
Objectives To identify how applicants to otolaryngology residency determine how to apply to, interview with, and rank programs on the interview trail and to determine the extent of the financial burden of the otolaryngology interview trail. Study Design Web-based survey distributed in March and April 2016. Setting Otolaryngology residency applicants throughout the United States. Subjects and Methods Applicants to otolaryngology residency during the 2016 match cycle and current otolaryngology residents were surveyed. Results Median number of applications, interview offers, interviews attended, and programs ranked was not different during the 2016 match and the previous 5 match years. The most important factor affecting the number of applications was the need to apply widely to ensure sufficient interview offers. The most common reason for declining an interview offer was scheduling conflict. Applicants during the 2016 match spent a median of $5400 applying and interviewing for otolaryngology residency. Conclusions Median number of applications, interview offers, interviews attended, and programs ranked has not changed. The most cited reason for applying to many programs was to increase the chances of matching, but this is not statistically likely to increase match success. We advocate for continued attempts to make the otolaryngology match process more transparent for both applicants and resident selection committees, but recognize that applicants are likely to continue to overapply for otolaryngology residency positions.
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Affiliation(s)
- Cristina Cabrera-Muffly
- 1 Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - C W David Chang
- 2 Department of Otolaryngology-Head and Neck Surgery, University of Missouri School of Medicine, Columbia, Missouri, USA
| | - Liana Puscas
- 3 Division of Otolaryngology-Head and Neck Surgery, Duke University, Durham, North Carolina, USA
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Polacco MA, Lally J, Walls A, Harrold LR, Malekzadeh S, Chen EY. Digging into Debt: The Financial Burden Associated with the Otolaryngology Match. Otolaryngol Head Neck Surg 2017; 156:1091-1096. [DOI: 10.1177/0194599816686538] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective To quantify the cost incurred during the match process for otolaryngology applicants, determine sources of expenditures, and highlight potential methods to alleviate financial burden of the match process. Study Design Cross-sectional. Study Setting Online survey. Subjects and Methods An electronic survey was sent via email to those who applied to the otolaryngology residency programs at Dartmouth-Hitchcock Medical Center and MedStar Georgetown University Hospital during the 2016 application cycle. Questions regarding demographics and experiences with the match were multiple choice, and questions regarding cost were open answer. Data were downloaded and analyzed on Excel and Minitab software. Results Twenty-eight percent of the total 370 applicants completed the survey. The mean cost of away rotations was $2500 (95% confidence interval [CI], $2224-$2776). With application fees and the cost of interviewing, the mean total cost of applying for the 2016 otolaryngology match was $6400 (95% CI, $5710-$7090), with a total range of $1200 to $20,000. Twenty-eight percent of students did not have sufficient funds for applying and interviewing despite seeking out additional monetary resources. Conclusion In 2016, otolaryngology applicants spent a mean of $8900 (95% CI, $7935-$9865) on away rotations, applications, and interviewing. Half of the applicants obtained additional funding to cover this cost, while 28% still did not have sufficient funding. Methods of decreasing cost may include instituting a cap on application number, videoconferencing interviews, regionalizing interviews, and adjusting the interview timeline.
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Affiliation(s)
- Marc A. Polacco
- Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Jack Lally
- MedStar Georgetown University Hospital, Washington, DC, USA
| | - Andrew Walls
- Yale New Haven Hospital, New Haven, Connecticut, USA
| | | | | | - Eunice Y. Chen
- Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
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25
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Affiliation(s)
- Jeffrey S. Berger
- Corresponding author: Jeffrey S. Berger, MD, MBA, George Washington Hospital, Second Floor, 900 23rd Street NW, Washington, DC 20037, 202.715.4750,
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Kominsky AH, Bryson PC, Benninger MS, Tierney WS. Variability of Ratings in the Otolaryngology Standardized Letter of Recommendation. Otolaryngol Head Neck Surg 2016; 154:287-93. [DOI: 10.1177/0194599815623525] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 12/01/2015] [Indexed: 11/17/2022]
Abstract
Objective To determine the variability of ratings given to students on the otolaryngology standardized letter of recommendation (SLOR). Study Design Retrospective review. Setting Academic otolaryngology training program. Subjects and Methods 496 SLORs to the Cleveland Clinic Otolaryngology Training Program were reviewed. The SLORs were extracted from the applications and analyzed. The distributions of ratings across the 10 categories were statistically analyzed including distribution and standard deviation. Rankings were grouped into deciles for this analysis. Results Ratings across the 10 domains revealed clustering of results across the top 2 deciles. The distribution of the bell-shaped curve was shifted significantly to the left, representing the upper deciles. No evidence of gender or geographic bias was found. Longer length of time of association between the applicant and the letter writer correlated to a higher ranking. Conclusion The explosion of applications being sent out by candidates for otolaryngology residency programs has prompted the implementation of the SLOR. The lack of variation in the ratings across the 10 domains does not allow for differentiation among student applicants. Reliance on the narrative letter of recommendation attached to the SLOR still remains the most significant way to differentiate among applicants. Refinements will need to be made in either the structure or use of the SLOR for it to be a more useful tool.
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Affiliation(s)
| | - Paul C. Bryson
- Cleveland Clinic Head and Neck Institute, Cleveland, Ohio, USA
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27
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Abstract
Otolaryngology is viewed as a competitive residency program, and as a result, a high number of applications are submitted by each applicant. A look at the data quantifies the cost and the challenges.
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Affiliation(s)
- C W David Chang
- Department of Otolaryngology-Head and Neck Surgery, University of Missouri, Columbia, Missouri, USA
| | - Benjamin F Erhardt
- Department of Otolaryngology-Head and Neck Surgery, University of Missouri, Columbia, Missouri, USA
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28
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Kaplan AB, Riedy KN, Grundfast KM. Increasing Competitiveness for an Otolaryngology Residency: Where We Are and Concerns about the Future. Otolaryngol Head Neck Surg 2015; 153:699-701. [PMID: 26187905 DOI: 10.1177/0194599815593734] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 06/09/2015] [Indexed: 11/16/2022]
Abstract
For graduating medical students, securing a residency in otolaryngology-head and neck surgery has become exceedingly difficult. This commentary explores the ways that applicants and residency programs are reacting to the increasing competitiveness in applying to, interviewing for, and matching to an otolaryngology residency. The commonly held perceptions of applicants are compared to perspectives held by residency program directors and resident selection committees. Unintended consequences of the growing trend for medical students to add a research year to their curriculum are presented. Some cautions and suggestions about how to improve the application and selection process are offered.
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Affiliation(s)
- Alyson B Kaplan
- Department of Otolaryngology, Boston University School of Medicine, Boston, Massachusetts, USA Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center, Boston, Massachusetts, USA
| | - Katherine N Riedy
- Department of Otolaryngology, Boston University School of Medicine, Boston, Massachusetts, USA Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center, Boston, Massachusetts, USA
| | - Kenneth M Grundfast
- Department of Otolaryngology, Boston University School of Medicine, Boston, Massachusetts, USA Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center, Boston, Massachusetts, USA
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