Post Interview Communication

Academic Medicine, Vol. 87, No. 10 / October 2012 1434 Residency Application Process In 2010, more tha n 27,000 U .S. senior medical students applied to first- and second-year residency positions in the National Resident Matching Program (NRMP) Main Residency Match. 1 During the matching process each year , many residency applicants’ formal interviews with residency programs are followed by informal communications. Therefore, the NRMP’s Match Participation Agreement for Applicants and Programs (MP A) includes language that restricts communications between these parties. For the 2010 Match, the MPA specified: One of the purposes of the Matching Program is to allow both applicants and programs to make selection decisions on a uniform schedule and without coercion or undue or unwarranted pressure. Both applicants and programs may express their interest in each other; however, they shall not solicit verbal or written statements implying a commitment. 2 Prior studies have suggested that, despite these restrictions, explicit violations of MPA terms may occur and may involve communicat ions between programs and applicants. 3–12 Communicati ng with programs appears to have strong effects on applicants’ ranking decisions. In studies of pediatrics- and surgery- bound students, 10% to 35% of respondents reported that they had altered their rank order lists in response to postinterview communications from programs. 6,8 A multicenter study exploring communications during the 2001 Match noted that 55% of the responding students felt pressured to offer reassurances to residency programs. 3 Since the 2001 Match, the number of residenc y program applicants has increased rapidly, in part because of the rising numbers of graduates of MD-granting, DO-granti ng, and international medical schools. This trend, along with slower growth in residency positions, has resulted in an increasingly competitive Match. 1 Residency applicants face intense competition to match to their program of choice, so it is important to understand the prevalence and nature of communications that occur between programs and applicants in today’s environment in order to help students and programs interpret one another’s statements of interest. We thus conducted a multischool study to examine the frequency and nature of postinterview communicati ons as reported by U.S. senior medical students who participated in the 2010 Match. We explored whether students considered such communications to be stressful and to have effects on their ranking decisions. We also investigated the ways in which Abstract Purpose To examine the frequency and nature of postinterview communications between programs and applicants during the National Resident Matching Program (NRMP) Main Residency Match. Method 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. Results 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 rst; 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). Conclusions 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. Acad Med. 2012;87:1434–1442. First published online August 21, 2012 doi: 10.1097/ACM.0b013e31826772a6 The Prevalence and Nature of Postinterview Communications Between Residency Programs and Applicants During the Match Anupam B. Jena, MD, PhD, Vineet M. Arora, MD, MAPP, Karen E. Hauer, MD, Steven Durning, MD, PhD, Nicole Borges, PhD, Nancy Oriol, MD, D. Michael Elnicki, MD, Mark J. Fagan, MD, Heather E. Harrell, MD, Dario Torre, MD, Meryl Prochaska, David O. Meltzer, MD, PhD, and Shalini Reddy, MD Please see the end of this article for information about the authors. Correspondence should be addressed to Dr. Jena, Department of Health Care Policy, Harvard Medical School, 180 Longwood Ave., Boston, MA 02115- 5899; telephone: (773) 209-8005; e-mail: [email protected]. Supplemental digital content for this article is available at http://links.lww.com/ACADMED/A105.

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Post Interview Communication