An experimental investigation of preference misrepresentation in the residency match.
Ontology highlight
ABSTRACT:
SUBMITTER: Rees-Jones A
PROVIDER: S-EPMC6233132 | biostudies-literature | 2018 Nov
REPOSITORIES: biostudies-literature
Publications
An experimental investigation of preference misrepresentation in the residency match.
Rees-Jones Alex A Skowronek Samuel S
Proceedings of the National Academy of Sciences of the United States of America 20181023 45
The development and deployment of matching procedures that incentivize truthful preference reporting is considered one of the major successes of market design research. In this study, we test the degree to which these procedures succeed in eliminating preference misrepresentation. We administered an online experiment to 1,714 medical students immediately after their participation in the medical residency match-a leading field application of strategy-proof market design. When placed in an analogo ...[more]
Similar Datasets
Project description:BackgroundThe number of residency applications submitted by medical students rises annually, resulting in increased work and costs for residency programs and applicants, particularly in emergency medicine. We propose a solution to this problem: an optional, two-stage Match with a "summer match" stage, in which applicants can submit a limited number of applications early. This would be conducted similarly to the early decision process for college admissions. The study objectives were to explore stakeholder opinions on the feasibility of a summer match and to identify the ideal logistic parameters to operationalize this proposal.MethodsWe used exploratory qualitative methodology following a constructivist paradigm to develop an understanding of the potential impact of a summer match. We interviewed 34 key stakeholders in the U.S. residency application process identified through purposive sampling including educational administrators (program directors, designated institutional officials, medical school deans) and trainees (students, residents). We coded and thematically analyzed interview data in two stages using an inductive approach.ResultsWe identified six themes from the participant interviews that broadly reflected issues of the residency application process, value, and equity. These themes included disrupting the status quo, logistic concerns, match strategy, differential benefits, unintended consequences, and return on investment. Most study participants supported the summer match concept, with medical students and residents most in favor. We developed a theoretical summer match protocol based on these findings.ConclusionsA summer match may reduce the burdens of increasing residency applications and associated costs. Pilot testing is necessary to confirm this hypothesis and determine the impact of the proposed summer match protocol. Unintended consequences must be considered carefully during implementation.
| S-EPMC8237086 | biostudies-literature
Project description:ImportanceThe ophthalmology residency application process is critical for applicants and residency programs, and knowledge about the preferences of applicants would assist both groups in improving the process.ObjectiveTo evaluate the experiences and preferences of ophthalmology residency applicants.Design, setting, and participantsThis cross-sectional, nonvalidated survey was conducted online. All applicants to the Bascom Palmer Eye Institute ophthalmology residency program during the 2018-2019 application cycle were invited to complete the survey. Data collection occurred from April 1, 2019, to April 30, 2019.Main outcomes and measuresApplicant demographics, application submissions, interview experiences, financial considerations, match results, and suggestions for improvement of the application process.ResultsResponses were received from 185 applicants (36.4%), including 77 women (41.6%). A successful match into an ophthalmology residency was achieved by 172 respondents (93.0%). There was a mean (SD) US Medical Licensing Examination Step 1 score of 245.8 (13.3) points. Respondents applied to a mean (SD) of 76.4 (23.5) ophthalmology residency programs, received 14.0 (9.0) invitations to interview, and attended 10.3 (4.4) interviews. Choices regarding applications and interviews were based mostly on program reputation, location, and advisor recommendation. A usual lead time of at least 3 weeks between the invitation and interview was reported by 126 respondents (69.2%), which was reduced to 14 respondents (15.1%) when a wait-list was involved. The ophthalmology residency application process cost a mean (SD) of $5704 ($2831) per applicant. Respondents reported that they were most able to reduce costs through housing choices (hotel stays or similar arrangements) and least able to reduce costs by limiting the number of programs to which they applied or at which they interviewed.Conclusions and relevanceThe ophthalmology residency application process is complex and poses substantial challenges to applicants and residency programs. These findings suggest that many current applicants have difficulty selecting programs to apply to, and most respondents desired changes to the current system of interview invitations and scheduling.
| S-EPMC7068667 | biostudies-literature
Project description:BackgroundResidency program location may be an important factor for orthopedic surgery residency applicants. More than half of residents locate their practice near the site of their training, and surgical specialties (eg, otolaryngology, plastic surgery, and general surgery) have shown geographic patterns in their residency matches.ObjectiveWe analyzed geographic trends in the orthopedic surgery Match.MethodsHometown, undergraduate institution, and medical school "preresidency locations" of all allopathic, nonmilitary, orthopedic surgery residents were recorded from program websites for the 2015-2016 academic year. Program and preresidency locations were coded according to state and US census division. Statistical analysis was used to investigate associations between residency program locations and preresidency locations.ResultsOf 2662 residents in the study, 1220 of 2614 (47%), 536 of 1329 (40%), and 308 of 744 (41%) matched into the same division as their medical school, undergraduate institution, and hometown, respectively. There were significant differences among divisions (P < .001). Also, 817 of 2662 (31%), 319 of 1329 (24%), and 200 of 770 (26%) residents matched in the same state as their medical school, undergraduate institution, and hometown, respectively, with significant differences between states for medical school (P < .0001) and undergraduate institution (P < .0001), but not hometown (P = .22). Overall, 21% of residents (538 of 2612) matched at the program affiliated with their medical school.ConclusionsThere is an association among hometown, undergraduate institution, and medical school for the training program location in which orthopedic surgery residents match, with variability in locations matched at state and census division levels.
| S-EPMC6108356 | biostudies-literature
Project description:BackgroundOrthopaedic surgery is one of the most competitive specialties, resulting in many applicants going unmatched. Many unmatched applicants pursue a preliminary internship or research fellowship, but whether these activities make them more successful in subsequent match cycles has not been studied.ObjectiveTo determine the effectiveness of activities during the intervening period on match success in a subsequent cycle.MethodsAfter reviewing rank order lists for our program and National Resident Matching Program correspondence from 1994 to 2013, we identified 198 of 1216 ranked applicants (16.3%) who did not initially match. Of these, 57 applicants who matched through the Supplemental Offer and Acceptance Program did not reapply to orthopaedics or trained overseas.ResultsOf 141 reapplicants, 56 matched into orthopaedic surgery, with 87.5% (P < .001) matching at a program in the same region where they had either completed their medical degree or postgraduate year, and 37.5% matching at their home institution (P < .001). Successful reapplicants after a research fellowship had a significantly higher number of publications than unsuccessful reapplicants (P < .05). There was no significant difference in success after research or internship (P = .80) and no significant difference in success rates for US versus international reapplicants (P = .43).ConclusionsSuccess of reapplication into orthopaedic surgery may be less dependent on the route taken during the interim period, and more dependent on developing relationships with faculty at a local or regional institution.
| S-EPMC4763390 | biostudies-literature
Project description:BackgroundInterview experiences and postinterview communication during the residency match process can cause distress for applicants, and deserve further study.ObjectiveWe both quantified and qualified the nature of various interview behaviors during the 2015-2016 National Resident Matching Program (NRMP) Match and collected applicant perspectives on postinterview communication and preferences for policy change.MethodsAn anonymous, 31-question survey was sent to residency candidates applying to 8 residency programs at a single academic institution regarding their experiences at all programs where they interviewed.ResultsOf 6693 candidates surveyed, 2079 (31%) responded. Regarding interview experiences, applicants reported being asked at least once about other interviews, marital status, and children at the following rates: 72%, 38%, and 17%, respectively, and such questions arose at a reported mean of 25%, 14%, and 5% of programs, respectively. Female applicants were more frequently asked about children than male applicants (22% versus 14%, P < .0001). Overall, 91% of respondents engaged in postinterview communication. A total of 70% of respondents informed their top program that they had ranked it highly; 70% of this subset reported associated distress, and 78% reported doing this to improve match success. A total of 71% would feel relief if postinterview communication was actively discouraged, and 51% would prefer applicants to be prohibited from notifying programs of their rank.ConclusionsApplicants to several residency programs reported being asked questions that violate the NRMP Code of Conduct. The majority of applicants would prefer postinterview communication to be more regulated and less prevalent.
| S-EPMC6108351 | biostudies-literature
Project description:ObjectiveTo determine whether medical student Otolaryngology-Head and Neck Surgery (Oto-HNS) interest groups increase student and resident interest in the specialty and influence decisions to apply to Oto-HNS residency.MethodsTwo web-based surveys were distributed by the Division of Otolaryngology-Head and Neck Surgery at UConn Health: one to current medical students at the University of Connecticut School of Medicine and the other to currents residents at Accreditation Council for Graduate Medical Education-approved otolaryngology training programs.ResultsFifty medical students and 89 residents completed the surveys. Several components were assessed in these surveys, including factors contributing to the selection process, interest group availability, attendance of meetings, availability of otolaryngology mentors, and interest in the specialty. A majority of medical students noted that interest groups play a role in influencing their interest in a medical specialty (56%). Medical students who attended Oto-HNS interest group were more likely to consider applying for otolaryngology residency (P < .0001) and had improved understanding of otolaryngology than those that did not attend (P = .0003). Residents who attended interest group meetings were more likely to be influenced to apply to otolaryngology than those that did not attend.ConclusionOto-HNS interest groups improve medical student understanding of the specialty. Medical students and residents who participated in interest groups were more likely to be influenced positively regarding the specialty than those that did not attend. Oto-HNS interest groups may foster greater interest in otolaryngology residency and offer a potential solution to the current match concerns.Level of evidencexx.
| S-EPMC6383298 | biostudies-literature
Project description:BackgroundDespite unprecedented changes to undergraduate medical education and the residency selection process during the COVID-19 pandemic, there is little objective evidence on how the pandemic affected match outcomes such as matched applicant characteristics, interview distribution, geographic clustering, and associated costs. We investigated COVID-19's impact on the residency match by comparing surgery applicants' characteristics, interview distribution, and related costs from 2018 to 2020 to 2021.MethodsData from the Texas Seeking Transparency in Applications to Residency initiative were analyzed. Descriptive statistics, bivariate testing, and sensitivity analysis were performed to compare matched applicants in surgical specialties from 2018-2020 to 2021.ResultsThis study included 5,258 applicants who matched into 10 surgical specialties from 2018 to 2021. In 2021, there was a decrease in proportion of students who reported a geographic connection to their matched program (38.4% vs 42.1%; P = .021) and no significant difference in number of interviews attended (mean [SD], 13.1 [6.2] vs 13.3 [4.7]; P = .136) compared to prior years. Applicants in 2021 had more research experiences and fewer honored clerkships (both P < .001), and these associations persisted in sensitivity analysis. Matched applicants in 2021 reported significantly lower total costs associated with the residency application process compared to 2018 to 2020 (mean [SD] $1,959 [1,275] vs $6,756 [4,081]; P < .001).ConclusionAlthough COVID-19 appeared to result in a reduction in number of honored clerkships, it may have provided more opportunities for students to engage in research. Overall, the adoption of virtual interviews and away rotations may have successfully mitigated some of the adverse consequences of the pandemic on the residency match for surgical specialties.
| S-EPMC8648584 | biostudies-literature
Project description:IntroductionThe 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.MethodsWe 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.ResultsThere 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.ConclusionThis 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.
| S-EPMC9897243 | biostudies-literature
Project description:Interviews for the integrated plastic surgery residency match took place in a virtual format for the 2020-2021 application cycle. Current literature lacks the perspectives of program directors (PDs) on virtual interviews compared with traditional in-person interviews.MethodsFollowing institutional review board approval, an anonymous 17-question survey was distributed by email to 82 program directors of integrated plastic surgery residency programs in the United States. Participants were asked baseline program information, the number of positions and interview invites offered, and their perspectives on various aspects of the virtual interview process.ResultsSixty-two (75.6%) PDs completed the survey. Thirty-seven percent reported increasing the number of interview offers per available residency spot. On a five-point Likert scale (1, not well at all; 5, extremely well), PDs showed no significant differences in their ability judge an applicant's professionalism (3.1 ± 1.1), interpersonal and communication skills (3.2 ± 1.1), and "fit" with their program (2.9 ± 0.9) during virtual interviews (P = 0.360). Sixty-eight percent reported being satisfied (15.3% extremely satisfied, 52.5% somewhat satisfied) with the virtual interview process, though 76.3% preferred in-person interviews.ConclusionsThis study is the first to provide insight into PDs' impressions of virtual residency interviews. Although most reported being satisfied with the virtual interview process, the majority still preferred in-person interviews. Further long-term studies evaluating the pros and cons of each interview modality may provide more information on whether virtual interviews could become a sustainable alternative to the traditional in-person residency interview.
| S-EPMC8376389 | biostudies-literature
Project description:PurposeThe COVID-19 pandemic modified the Residency Match process for fourth-year medical students. In-person away rotations were discouraged, interviews were virtual, and traditional factors used to rank programs were absent. Here, we compare survey results administered to both the 2020 and 2021 Match applicants to assess the influence of the pandemic on the radiation oncology (RO) Match process.MethodsAn institutional review board-approved prospective cross-sectional study was conducted. The 2020 and 2021 RO Match applicants at a large RO program were invited to participate. Descriptive summary statistics were assessed.ResultsThe 2020 and 2021 Matches each had 76 applicants complete the survey with response rates of 54% and 57%, respectively. The 2 groups were predominantly white, cisgender male, single, and without children. Whereas 11% of 2020 applicants did not complete away rotations, 45% of 2021 applicants did not. For 2021 Match applicants, 65% of away rotations were performed virtually, whereas 51% were not for medical school credit. Of the applicants, 84% were satisfied with virtual interviews and 72% felt cost savings were worth not having in-person interviews. Whereas 49% of Match 2020 applicants spent >$5000 in interview costs, 0% of the Match 2021 applicants did so, with 45% spending <$100. Postinterview communications from programs increased during the pandemic from 36% to 42% in 2020 Match and 2021 Match, respectively. Although program culture was the most common factor influencing 2021 Match applicants program rankings, half of applicants did not gain a sense of program culture during virtual interviews.ConclusionsWe found 2021 Match applicants completed fewer away rotations, were satisfied with virtual interviews/reduced costs, and did not gain a sense of program culture through virtual rotations/interviews despite it being the most important ranking factor reported. This study supports further exploration of virtual away rotations and virtual interviews moving forward beyond the pandemic.
| S-EPMC8555343 | biostudies-literature