Finding Them a Spot: A Successful Preliminary Match Curriculum

Abstract

Nondesignated preliminary residents (N-DPRs) in General Surgery face difficult challenges of overcoming failure to match and quickly reentering the match again with little time to significantly improve their application. Programs with N-DPRs should take seriously their responsibility for helping these residents obtain a successful career path just as they do for their categorical residents. This study evaluates an intervention to improve the matching of N-DPRs into desired positions. We evaluated the match results of N-DPRs at a single institution over an 8-year period. The first 4 years served as the historical control (Group 1), while the following 4 years of N-DPRs underwent a focused intervention (Group 2). Group 2 underwent an 8-step process: (1) a phone call shortly after supplemental offer and acceptance program (SOAP) to discuss strategy, (2) a 1-hour N-DPR specific orientation, (3) targeted meetings to identify reasons for an unsuccessful match, and personal statement revision in July, (4) mock interviews in August, (5) mid-interview cycle meetings to review strategy and trajectory, (6) meetings in January to prioritize rank lists, (7) meetings the week before the match to discuss plan if match is unsuccessful, and (8) meeting on Monday of Match Week. We determined the N-DPRs initial choice of specialty, specialty obtained after their N-DPR year, and career choice changes that occurred during their preliminary years for both groups. Comparisons and statistical analysis were then completed. There were 40 N-DPRs in the program over the last 8 years. Group 1, the 4 years before the curriculum, had only 13 of the 16 (81%) N-DPRs obtain a desired position. Group 2, the 4 years following intervention, had all 24 (100%) N-DPRs obtain a desired position. This was a significant improvement (number needed to treat (NNT) = 5.38, p = 0.027). There were no significant differences between groups in regard to the N-DPRs maintaining their original specialty of choice (44% vs 50%). The implementation of an N-DPR curriculum significantly improved the probability of N-DPRs to obtain desired positions. Over half of the N-DPRs obtained a position in a specialty different from what they originally applied. Programs should consider aiding N-DPRs in navigating toward a different career path.