The Prevalence and Nature of Postinterview Communications Between Residency Programs and Applicants During the Match

Dr. Jena was a third-year resident, Department of Medicine, Massachusetts General Hospital, at the time of writing. He is now assistant professor of health care policy, Harvard Medical School, and assistant physician, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts. Dr. Arora is associate professor of medicine, assistant dean for scholarship and discovery, and associate program director, Internal Medicine Residency Program, University of Chicago Pritzker School of Medicine, Chicago, Illinois. Dr. Hauer is professor of medicine and director of internal medicine clerkships, University of California, San Francisco, School of Medicine, San Francisco, California. Dr. Durning is professor of medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland. Dr. Borges is professor, Department of Community Health, and assistant dean of medical education research and evaluation, Wright State University Boonshoft School of Medicine, Dayton, Ohio. Dr. Oriol is dean for students, Harvard Medical School, Boston, Massachusetts. Dr. Elnicki is professor of medicine and director, Combined Ambulatory Medicine Pediatrics Clerkship, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Dr. Fagan is professor of medicine and internal medicine clerkship director, Brown University Warren Alpert School of Medicine, Providence, Rhode Island. Dr. Harrell is associate professor of medicine and internal medicine clerkship director, University of Florida College of Medicine, Gainesville, Florida. Dr. Torre is associate professor of medicine and associate program director, Internal Medicine Residency Program, Drexel University School of Medicine, Philadelphia, Pennsylvania. Ms. Prochaska is a second-year student, Loyola University Chicago School of Law, Chicago, Illinois
Academic medicine: journal of the Association of American Medical Colleges (Impact Factor: 2.93). 08/2012; 87(10):1434-1442. DOI: 10.1097/ACM.0b013e31826772a6
Source: PubMed


To examine the frequency and nature of postinterview communications between programs and applicants during the National Resident Matching Program (NRMP) Main Residency Match.

The authors surveyed senior medical students at seven U.S. medical schools about postinterview communications with residency programs during the 2010 Match and analyzed the data.

The response rate was 68.2% (564/827). Among respondents, 86.4% reported communicating with residency programs. Most (59.9%) reported telling more than one program they would rank it highly; 1.1% reported telling more than one they would rank it first. Students reported that programs told them they would be "ranked to match" (34.6%), be "ranked highly" (52.8%), or "fit well" (76.2%). Almost one-fifth (18.6 %) reported feeling assured by a program that they would match there but did not despite ranking that program first; 23.4% reported altering their rank order list based on communications with programs. In multivariate analysis, applicants to more competitive specialties were less likely to report being told they would be "ranked to match" (relative risk [RR] 0.72, 95% confidence interval [CI] 0.52-0.99). Applicants were more likely to report being told that they would be "ranked to match" if they received honors in the specialty clerkship (RR 1.39, 95% CI 1.10-1.77) or were members of Alpha Omega Alpha (RR 1.72, 95% CI 1.37-2.17).

Reports of nonbinding communications with programs were frequent. Students should be advised to interpret any comments made by programs cautiously. Reported violations of the NRMP's Match Participation Agreement were uncommon.

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    ABSTRACT: Background: The authors studied residency applicant attitudes toward rank list creation, communication with programs, and the impact of these factors on their performance in the Match. Methods: An anonymous, 26-question, multiple-choice, online survey was distributed to the program coordinators of every Accreditation Council for Graduate Medical Education-accredited program participating in the National Resident Matching Program for whom e-mail addresses were available. The survey addressed five areas: (1) demographics and interview characteristics, (2) preinterview and interview factors, (3) postinterview contact, (4) importance of various factors in rank list creation, and (5) Match outcome. Survey responses were analyzed with Microsoft Excel. Results: A total of 1179 responses were received. It was not possible to calculate a response rate, because the number of residents receiving the survey was not known. The majority of respondents (78 percent) reported postinterview contact with a program. A large portion of respondents (42 percent) considered such contact to be important in the creation of their rank lists. Half of all respondents admitted to exaggerating their interest in a program during or after an interview. The majority of respondents (87.5 percent) received no assistance in covering the costs of "second-look" visits to programs. Conclusions: Applicants may be modifying their rank lists in response to post-interview contact from programs; furthermore, they usually have no assistance in paying for the cost of second looks. To level the playing field for students and programs alike, the authors propose that the National Resident Matching Program modify residency interview rules to (1) disallow any postinterview contact between programs and students, and (2) disallow second looks.
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    ABSTRACT: Studies show postinterview communication from applicants may affect their placement on the program's National Resident Matching Program (NRMP) rank order list. To determine whether postinterview correspondence from applicants to a residency program is associated with the applicant's subsequent position on the program's rank list. During 2 recruitment seasons, we collected postinterview correspondence from applicants to 1 residency program. Applicant characteristics and the content and timing of correspondence were compared with the applicant's position on the program's rank list. Data were analyzed using the Pearson χ(2) test. Of 470 applicants interviewed, 290 (61.7%) sent unsolicited correspondence to the program after interviewing. Ten percent (29 of 290) stated they planned to rank the program first, 11.7% (34 of 290) that they planned to rank it highly, and 78.3% (227 of 290) gave no indication of ranking intentions. Applicants who corresponded were no more likely to be ranked in the top 2 quartiles on the rank list than those who did not (P = .32) nor were applicants who communicated plans to rank the program "first" or "highly" ranked higher than other corresponding applicants (P = .34). Of the 16 applicants who planned to rank the program "first" and who were ranked in the program's match range, 5 did not match with the program, suggesting they may have misled the program. Postinterview correspondence by applicants was not associated with position on the rank order list. Correspondence does not benefit the applicant and can lead to misleading statements, which may violate the NRMP participation agreement.
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