Making Our Preference Known: Preference Signaling in the Emergency Medicine Residency Application

Pelletier-Bui, Alexis; Schnapp, Benjamin; Smith, Lee; Franzen, Douglas; Werley, Elizabeth Barrall; McDonough, Erin; Camejo, Melanie

doi:10.5811/westjem.2021.10.53996

Cited by 12 publications

(10 citation statements)

References 12 publications

(22 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 13 , 14 Emergency medicine is currently piloting this system for the 2022–2023 application cycle. 15 Programs are now caught between managing large volumes of applications and the understandable fears evolving out of a difficult match year. Any interventions must respect both of those realities and will require careful implementation to minimize the chances of an overcorrection.…”

Section: Discussionmentioning

confidence: 99%

Deciphering a Changing Match Environment in Emergency Medicine and Identifying Residency Program Needs

Murano

Weizberg

Burns

et al. 2023

WestJEM

View full text Add to dashboard Cite

Introduction: The Match in emergency medicine (EM) is historically competitive for applicants; however, the 2022 residency Match had a large number of unfilled positions. We sought to characterize the impact of and response to the Match on programs and determine programs’ needs for successful recruitment strategies. Methods: We conducted a web-based survey of EM residency program leadership during March–April 2022. Program characteristics were generated from publicly available data, and descriptive statistics were generated. We analyzed free-text responses thematically. Results: There were 133/277 (48%) categorical EM residency programs that responded. Of those, 53.8% (70/130) reported a negative impression of their Match results; 17.7% (23/130) positive; and the remainder neutral (28.5%; 37/130). Three- and four-year programs did not differ in their risk of unfilled status. Hybrid programs had a higher likelihood of going unfilled (odds ratio [OR] 4.52, confidence interval [CI] 1.7- 12.04) vs community (OR 1.62, CI 0.68-3.86) or university programs (0.16, 0.0-0.49). Unfilled programs were geographically concentrated. The quality of applicants was perceived the same as previous years and did not differ between filled and unfilled programs. Respondents worried the expansion of EM residency positions and perceptions of the EM job market were major factors influencing the Match. They expressed interest in introducing changes to the interview process, including caps on applications and interviews, as well as a need for more structural support for programs and the specialty. Conclusion: This survey identifies impacts of the changed match environment on a broad range of programs and identifies specific needs. Future work should be directed toward a deeper understanding of the factors contributing to changes in the specialty and the development of evidence-based interventions.

show abstract

Section: Discussionmentioning

confidence: 99%

Deciphering a Changing Match Environment in Emergency Medicine and Identifying Residency Program Needs

Murano

Weizberg

Burns

et al. 2023

WestJEM

View full text Add to dashboard Cite

show abstract

“…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%

“…19,20 Pilot-testing results in otolaryngology were positive, and many specialties have performed trials of preference signaling in 2022. 9,10,12,13,17,28,29 The Association of American Medical Colleges has supported this effort with the release of a supplemental ERAS application that includes preference signaling. 30 Finally, geographic preference signaling indicates disclosure of the U.S. region that a student prefers for training and was successfully implemented in 2021.…”

mentioning

confidence: 99%

See 1 more Smart Citation

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

et al. 2022

View full text Add to dashboard Cite

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]

show abstract

“…Successful implementation of the PSP is hoped to assist both programs and applicants in matriculating residents with a genuine desire to attend a specific institution. 9 Frameworks similar to the orthopaedic surgery PSP have been used by other medical specialties in the match process with positive results, [9][10][11][12][13] but there is a paucity of litera-ture on perceptions within orthopaedics and on implications of this change for the application process. 14,15 This study reports orthopaedic surgery residency applicant and program director (PD) perspectives on the effects of preference signaling on the orthopaedic match.…”

mentioning

confidence: 99%

Perceptions of Preference Signaling in Orthopaedic Surgery: A Survey of Applicants and Program Directors

Minhas,

Berkay,

Hudson

et al. 2023

J Am Acad Orthop Surg

View full text Add to dashboard Cite

Introduction: To improve transparency between candidates and training programs, a preference signaling program (PSP) was implemented before the 2022 to 2023 orthopaedic surgery match. The PSP allows applicants to ‘signal’ up to 30 programs, informing the program of the applicant's particular interest in interviewing for their available position(s). This study reports the perspectives of orthopaedic surgery residency applicants and program directors (PDs) on the effects of preference signaling on the orthopaedic match. Methods: Electronic surveys were distributed to PDs and applicants. Results: Almost all programs participated in the PSP (90%), and most of the applicants (97.6%) used 25 to 30 of their allotted preference signals. Most of the applicants (67.2%) thought that their likelihood of obtaining an interview was improved at ‘signaled’ programs but decreased at programs without a ‘signal’ designation (85.3%). Both applicants and PDs considered preference signaling to be one of the three most important factors for interview selection, along with Step 2 CK score and letters of recommendation. The applicants did not think that their likelihood of matching would improve with fewer allotted signaling tokens (35.2%), and 55.2% of PDs believed 21 to 30 tokens were optimal. Conclusion: Preference signaling is highly regarded by applicants and PDs. Signaling a program will likely improve an applicant's chance to interview. The optimal number of signaling tokens remains unknown, although both groups favored a larger allotment of tokens than has been seen in other specialties. Universal guidelines and recommendations for applicants and PDs would improve the utility of preference signaling.

show abstract

Making Our Preference Known: Preference Signaling in the Emergency Medicine Residency Application

Abstract: n/a

Cited by 12 publications

References 12 publications

Deciphering a Changing Match Environment in Emergency Medicine and Identifying Residency Program Needs

Deciphering a Changing Match Environment in Emergency Medicine and Identifying Residency Program Needs

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

Perceptions of Preference Signaling in Orthopaedic Surgery: A Survey of Applicants and Program Directors

Contact Info

Product

Resources

About