Variable Practice, Variable Results: Impact of Postinterview Communication Practices Among Critical Care Medicine/Pulmonary and Critical Care Medicine Fellowship Applicants and Program Directors

Abstract

BackgroundWhile post-interview communication (PIC) guidelines exist, adherence is voluntary. There are no studies of PIC practices in Critical Care Medicine (CCM) and Pulmonary and Critical Care Medicine (PCCM) fellowship recruitment. Research QuestionWhat is the frequency, format, goals, and content of PIC between CCM/PCCM applicants and program directors (PD)? What is the impact of PIC on applicant and program rank order lists (ROL)? Study Design and MethodsCCM/PCCM applicants and PDs were separately surveyed after the 2022-2023 National Resident Matching Program Specialty Match. Surveys included multiple-choice, Likert-scale, and two free text questions. Thematic content analysis of free text responses was performed. ResultsOne-third of eligible participants responded (applicants: n=373, 34%; PDs: n=86, 32%). Applicant respondents applied to CCM (19%), PCCM (69%), or both (12%). PDs represented CCM (17%), PCCM (57%), or both (26%) programs. Applicant (66%) and PD (49%) respondents reported initiating PIC. PIC did not impact ROL decision for most applicants (73%) or PDs (83%), though 21% of applicants and 17% of PDs moved programs or applicants up on their ROL in response to PIC. A quarter (23%) of applicants strongly agreed or agreed that PIC was helpful in creating their ROL, 27% strongly disagreed or disagreed, and 29% were neutral. PIC challenges identified by both groups included time, lack of uniformity, peer pressure, misleading language, and uncertainty about motives, rules, and response protocols. InterpretationPIC is common among CCM/PCCM applicants and PDs. About 50% of applicants and 20% of PDs share ranking intentions via PIC. While PIC did not impact ROL for most applicants and PDs, a minority of applicants and PDs moved programs up on their ROL after receiving PIC from the other party. Applicants have mixed perspectives on PIC value. Applicants and PDs alike desire clear guidance on PIC to minimize ambiguous and misleading communication.