Abstract
The residency application process is flawed, costly, and distracts from the preparation for residency. Disruptive change is needed to improve the inefficiencies in current selection processes. To determine interest in an early result acceptance program (ERAP) among stakeholders in obstetrics and gynecology (OBGYN), and to estimate its outcome in future application cycles. Surveys of stakeholders in March 2021 queried interest in ERAP across the US. Respondents included OBGYN residency applicants, members of the Association of American Medical Colleges Group on Student Affairs, OBGYN clerkship directors, and residency program directors. Statistical analysis was performed from March to April 2021. Respondents completed surveys sent by email from the Association of American Medical Colleges (to OBGYN applicants and members of the Group on Student Affairs), the Association of Professors of Gynecology and Obstetrics (to clerkship directors), and the Council on Resident Education in Obstetrics and Gynecology (to program directors). Applicants and program directors indicated their interest in participating in ERAP, and clerkship directors and members of the Group on Student Affairs indicated their likelihood of recommending ERAP using a 5-point Likert scale. Respondents included 879 (34.0%) of 2579 applicants to OBGYN, 143 (50.3%) of 284 residency program directors, 94 (41.8%) of 225 clerkship directors, and 51 (32.9%) of 155 student affairs deans. The majority of respondents reported being either somewhat or extremely likely to participate in ERAP, including 622 applicants (70.7%) and 87 program directors (60.8%). Interest in ERAP was independent of an applicant's reported board scores, medical school type, race, number of applications submitted, or number of interviews completed. Among program directors, those at university programs were more likely to participate. Stakeholders supported a limit of 3 applications for ERAP, to fill 25% to 50% of residency positions. Estimating the outcome of ERAP using these data suggests 26 280 to 52 560 fewer applications could be submitted in the regular match cycle. Stakeholders in the OBGYN application process expressed broad support for the concept of ERAP. The majority of applicants and programs indicated that they would participate, with potentially substantial positive impact on the application process. Careful pilot testing and research regarding implementation are essential to avoid worsening an already dysfunctional application process.
Highlights
The residency application process has become increasingly problematic, with heavy burdens facing applicants and residency programs.1 Applicants exceed the available positions in graduate medical education (GME) and apply to more programs each year.1,2 Regardless of their competitiveness, applicants adopt an “over-apply, over-interview” strategy.3 The costs of these behaviors are financial, educational, and emotional
This study suggests that the majority of respondents would participate, and the Variable No of positions available in early result acceptance program (ERAP) No of applicants participating in ERAPa No of applicants participating in the regular matchb No of obstetrics and gynecology (OBGYN) PGY-1 positions in available regular match Positions: applicant ratio In ERAP In regular match Applications submitted In ERAPc In regular cycled Interviews conductede Applications saved Interviews saved Reduction in interviews, %
A binding early match could reduce congestion within the application cycle, reduce waste, and allow programs and applicants to refocus their efforts during the final year of medical school
Summary
The residency application process has become increasingly problematic, with heavy burdens facing applicants and residency programs. Applicants exceed the available positions in graduate medical education (GME) and apply to more programs each year. Regardless of their competitiveness, applicants adopt an “over-apply, over-interview” strategy. The costs of these behaviors are financial, educational, and emotional. Applicants exceed the available positions in graduate medical education (GME) and apply to more programs each year.. Applicants exceed the available positions in graduate medical education (GME) and apply to more programs each year.1,2 Regardless of their competitiveness, applicants adopt an “over-apply, over-interview” strategy.. Regardless of their competitiveness, applicants adopt an “over-apply, over-interview” strategy.3 The costs of these behaviors are financial, educational, and emotional. Efforts to match into residency displace educational efforts during the last year of medical school, which could ensure an effective transition from student to resident.. If some students matched early into their top programs, this could leave other applicants and programs the opportunity to adopt a more thoughtful approach for the regular application cycle Geography itself is a key determinant in applicants’ final ranking, a decision likely made independent of the application process. Some suggest that students matching into their medical school’s own residency programs could improve their training and the care of their future patients through an enhanced transition to residency. If some students matched early into their top programs, this could leave other applicants and programs the opportunity to adopt a more thoughtful approach for the regular application cycle
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