I Need a Sign: The Growing Need for a Signaling Mechanism to Improve the Residency Match

Talcott, Wesley; Evans, Suzanne B.

doi:10.1016/j.ijrobp.2020.09.008

Cited by 2 publications

(4 citation statements)

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“…Overall, participants lacked enthusiasm for all proposals, and their dislike sits in stark contrast to the opinions of other investigators calling for specific reforms. 9–11,13,17,19,26,29,31–33,38,39,51 Pilot testing of any proposed reforms would represent a major change to the current process, and such change should be met with something more than general ambivalence. Stakeholder experiences and values offer important insights about the risks to students that may come with change.…”

Section: Discussionmentioning

confidence: 99%

“…We conducted 15-minute interviews between July 24 and October 25, 2019, with data analysis completed during a 6-month period in 2020 and 2021. We asked participants their opinions of 5 residency application process reform proposals commonly cited in the literature: (1) a Match to obtain residency interviews, 19,20 (2) preference signaling, 31–34 (3) application limits, 26,38 (4) geographic preference disclosure, 39 and (5) abolishing the Match 21 (see Table 1). We also asked for opinions about potential implementation challenges of any reform.…”

Section: Methodsmentioning

confidence: 99%

“…30 Finally, geographic preference signaling indicates disclosure of the U.S. region that a student prefers for training and was successfully implemented in 2021. 31–33…”

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confidence: 99%

“…Interestingly, most published reform proposals neglect to examine stakeholder views on the application process, beyond those of the authors themselves. 19–21,25–27,29,31–34 Stakeholder participation, perspectives, and buy-in are crucial to successful reform, yet their input remains a gap in most proposals. Therefore, we sought to understand the preferences of key stakeholders regarding potential residency application process reforms.…”

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confidence: 99%

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Rejecting Reforms, Yet Calling for Change: A Qualitative Analysis of Proposed Reforms to the Residency Application Process

et al. 2022

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PurposeAnnual increases in the number of residency applications burden students and challenge programs. Several reforms to the application process have been proposed; however, stakeholder input is often overlooked. The authors examined key stakeholders' opinions about several proposed reforms to the residency application process and identified important factors to guide future reforms. MethodUsing semistructured interviews, the authors asked educational administrators and trainees to consider 5 commonly proposed reforms to the residency application process: Match to obtain residency interviews, preference signaling, application limits, geographic preference disclosure, and abolishing the Match. The authors conducted a modified content analysis of interview transcripts using qualitative and quantitative analytic techniques. Frequency analysis regarding the acceptability of the 5 proposed reforms and thematic analysis of important factors to guide reform were performed. Fifteen-minute interviews were conducted between July and October 2019, with data analysis completed during a 6-month period in 2020 and 2021. ResultsParticipants included 30 stakeholders from 9 medical specialties and 15 institutions. Most participants wanted to keep the Match process intact; however, they noted several important flaws in the system that disadvantage students and warrant change. Participants did not broadly support any of the 5 proposed reforms. Two themes were identified: principles to guide reform (fairness, transparency, equity, reducing costs to students, reducing total applications, reducing work for program directors, and avoiding unintended consequences) and unpopular reform proposals (concern that application limits threaten less competitive students and signaling adds bias to the system). ConclusionsKey stakeholders in the residency application process believe the system has important flaws that demand reform. Despite this, the most commonly proposed reforms are unacceptable to these stakeholders because they threaten fairness to students and program workload. These findings call for a larger investigation of proposed reforms with a more nationally representative stakeholder cohort.The number of residency applications submitted by U.S. medical students has increased substantially during the past 2 decades. Since the Electronic Residency Application Service (ERAS) launched in 1996, there has been a near-linear, year-over-year increase in the number of applications submitted per MD student. [1][2][3][4][5][6] These increases are not strongly correlated with the number of residency positions available in the National Resident Matching Program (NRMP) Match, 7 and they are not driven by DO or international medical students. 2,8 This trend raises questions about the sustainability of the current residency application process. [9][10][11][12][13]

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…30 Finally, geographic preference signaling indicates disclosure of the U.S. region that a student prefers for training and was successfully implemented in 2021. 31–33…”

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confidence: 99%

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