Is the SLOR in Otolaryngology Residency Applications Contributing to Rural Disparities?

If a residency applicant is passionate about bringing care to a rural community, they are unlikely to have an academic-focused career after residency. Thus, an applicant who communicates this desire could yield a “low” mark on this standardized question in the letter of recommendation, which could be detrimental to an applicant, given the overwhelmingly positive rankings observed on scale-based SLOR questions. This raises concern that the otolaryngology residency application process may be biased toward individuals interested in pursuing academic careers while concomitantly selecting against applicants passionate about bringing comprehensive clinical services to rural communities.

We suggest that the process to address the shortage of rural otolaryngologists begin with removing the SLOR question about an applicant’s likelihood of pursuing an academic career. This will allow for the otolaryngology graduate medical education system to cater to all career pathways and the diverse care needs in the U.S. We should not be so focused on training academic otolaryngologists that the importance of comprehensive otolaryngologists is overlooked. Instead, we should recruit residency applicants with diverse career goals to advance the care of all otolaryngology patients.

Dr. Falk

Dr. Falk is a third-year otolaryngology resident at Eastern Virginia Medical School at Old Dominion University in Norfolk, Va.

Dr. Mark

Dr. Mark is an associate professor at Eastern Virginia Medical School at Old Dominion University in Norfolk, Va., and the associate program director for its department of otolaryngology residency program.

Dr. Baldassari

Dr. Baldassari is a professor at Eastern Virginia Medical School at Old Dominion University’s department of otolaryngology in Norfolk, Va., and vice chair for the department’s research.

Dr. Tompkins

Dr. Tompkins is an otolaryngologist at Ohio ENT & Allergy Physicians in Columbus, Ohio, and chair of the American Academy of Otolaryngology–Head and Neck Surgery’s workforce task force.