Abstract

BackgroundThe U.S. residency recruitment process is expensive and time-consuming because of application inflation and over-invitation.ObjectiveUsing interview and match data, we quantify the predicted effects if anesthesiology residency programs excluded interviews for applicants who are very unlikely to match.MethodsWe previously published the validity and accuracy of the logistic regression model based on data from interview scheduling software used by 32 U.S. anesthesiology residency programs and 1300 applicants from 2015-18. Data used were program region, applicant address, numbers of interviews of the interviewee, medical school US News and World Report (USNWR) rank, the difference between United States Medical Licensing Exam (USMLE) Step 1 and 2 Clinical Knowledge (CK) scores, and the historical average of USMLE scores of program residents. In the current study completed in 2020, the predicted probabilities and their variances were summed among interviewees for 30 deidentified programs.ResultsFor anesthesiology, the median residency program could reduce their interviews by 16.9% (97.5% confidence interval 8.5%-24.1%) supposing they would not invite applicants if the 99% upper prediction limit for the probability of matching was less than 10.0%. The corresponding median savings would be 0.80 interviews per matched spot (0.34-1.33). In doing so, the median program would sustain a risk of 5.3% (97.5% confidence interval 2.3%-7.9%) of having at least one interviewee removed from their final rank-to-match list.ConclusionUsing novel interview data and analyses, we demonstrate that residency programs can substantively reduce interviews with less effect on rank-to-match lists. The data-driven approach to manage marginal interviews allows program leadership to better weigh costs and benefits when composing their annual list of interviewees.

Highlights

  • United States residency programs have seen an increased number of applications and interviews in the last five years, which imposes a large cost burden to applicants and programs alike [1,2]

  • The median program would sustain a risk of 5.3% (97.5% confidence interval 2.3%-7.9%) of having at least one interviewee removed from their final rank-tomatch list

  • Data used were whether the interviewee was currently located in the same state as the program, regional location, numbers of interviews, medical school rank, and the difference between United States Medical Licensing Exam (USMLE) Step 1 and 2 Clinical Knowledge (CK) scores and the programs’ historic average for residents

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Summary

Introduction

United States residency programs have seen an increased number of applications and interviews in the last five years (denoted “application inflation”), which imposes a large cost burden to applicants and programs alike [1,2]. Our prior work demonstrated the novel use of interview data from anesthesiology residencies to quantitate the effect of an applicant being from the same state on the probability of matching at a residency program [8]. An applicant living in the same state as the residency program could have 5.42 fewer total interviews (97.5% confidence interval 3.02-7.81) [9] while having the same odds of matching; the state was the significant predictor, not matching medical school [8]. This finding was novel and timely given that a survey. The U.S residency recruitment process is expensive and time-consuming because of application inflation and over-invitation

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