Abstract
The rising numbers of residency applications along with fears of a constrained graduate medical education environment have created pressures on residency applicants. Anecdotal evidence suggests substantial challenges with the process of offering residency interviews. This narrative review is designed to identify and propose solutions for the current problems in the process of offering residency interviews. We used PubMed and web browser searches to identify relevant studies and reports. Materials were assessed for relevance to the current process of distributing residency interviews. There is limited relevant literature and the quality is poor overall. We were able to identify several key problem areas including uncertain timing of interview offers; disruption caused by the timing of interview offers; imbalance of interview offers and available positions; and a lack of clarity around waitlist and rejection status. In addition, the couples match and need for coordination of interviews creates a special case. Many of the problems related to residency interview offers are amenable to program-level interventions, which may serve as best practices for residency programs, focusing on clear communication of processes as well as attention to factors such as offer-timing and numbers. We provide potential strategies for programs as well as a call for additional research to better understand the problem and solutions.
Highlights
It is increasingly apparent that the process by which interview offers are distributed to medical students in the residency application process is becoming a source of substantial stress to participants and a disruption to their educational environment and personal life
The authors were drawn from members and leadership of the Application Process Improvement Committee convened by the Council of Residency Directors in Emergency Medicine (CORD) and have all been involved in specialty-based initiatives to address the recent increase in residency application numbers
We reviewed articles iteratively and decided by consensus which were relevant to include; any disagreements were adjudicated through the lead authors (LH and DF)
Summary
It is increasingly apparent that the process by which interview offers are distributed to medical students in the residency application process is becoming a source of substantial stress to participants and a disruption to their educational environment and personal life. Little direct data exists on the extent of the problem and its impact; extensive anecdotal evidence exists and clearly resonates with match participants. These anecdotes from both traditional peer-reviewed and online sources cite problems such as avoiding or compromising participation in educational activities, compromised personal life, and involving multiple friends and family members to manage responses.[1,2,3,4] While evidence is mixed as to the predictive value of the residency interview for future performance, it is heavily weighted in candidate decisions, and serves as a de facto gatekeeper for inclusion on a program’s rank order list and potential placement at that residency program.[5,6].
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