Program is highly competitive, with top medical students applying for limited residency spots. According to the National Resident Matching Program's (NRMP) Code of Conduct, program directors (PDs) and associated faculty should not (1) ask illegal or coercive questions; (2) "solicit nor require post-interview contact" with applicants; nor (3) require second-look visits nor imply they are a component of the selection process. Anecdotally, violations of these rules occur, but there is minimal data to substantiate such events. Our objectives were to assess the frequency of "illegal questions" during the interview process, to determine the incidence and type of post-interview communication, and to assess how this communication affects applicants' ranking of residency programs.METHODS: We conducted a 21-question post-match survey sent to 285 applicants to our program for the 2017 match. Questions included the following topics: illegal/coercive questions, post-interview communication, second-look visits, and the applicants' perceived impact of these factors.RESULTS: A total of 166 responses were obtained and analyzed (response rate 58%), representing 39% of all candidates to submit a rank list in the 2017 Urology Match. 96/166 (58%) of applicants reported receiving follow-up communication from at least one program, of whom 79% received communication from multiple programs. 13% of those who received post-interview communication reported verbal communication. 44/96 (46%) felt communication positively influenced their ranking of the program; however, 19% felt misled to believe they had a higher chance of matching at a program based on communications. 50/166 (30%) of respondents did a second-look visit at one or more programs, and 44% reported feeling obligated to do a second-look in order to match at a particular program. Finally, 141/166 (85%) of applicants reported that illegal questions were asked during interviews, including questions regarding personal life, rank list, and other interview locations and/or number. 32% were asked specifically which program they would rank first.CONCLUSIONS: During the 2017 Match, a high proportion of urology applicants experienced violations of the NRMP Code of Conduct. Violations included illegal questions, post-interview written and verbal communication, and pressure to do second-look visits. These findings corroborate numerous anecdotal reports, and may provide the groundwork to improve the fairness of the residency application process for the future.
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