Explore This IssueSeptember 2018
How would policy changes to National Resident Matching Program (NRMP) post-interview behaviors affect applicant distress?
Background: The NRMP’s Institutional, Program, and Applicant Match Participation Agreement (MPA) and Code of Conduct (COC) were established to prohibit undesirable interview behaviors and forbid coercion of applicants to declare a program’s ranking. Significant improvements have been made, but there is evidence of interview behavior that violates the spirit of the match during the post-interview period.
Study design: An anonymous, 31-question survey sent to residency candidates applying to eight residency programs at a single academic institution.
Setting: Cleveland Clinic, Cleveland, Ohio.
Synopsis: A total of 2,079 (31%) recipients responded. Of those, 72% were asked at least once about other interviews. A total of 38% were asked at least once about marital status, and 15% at least once how highly they would rank a program. Questions arose at similar rates for men and women except one: Although a total of 17% were asked at least once about children, women were asked 50% more frequently than men. Overall, 91% engaged in post-interview communication at one or more of the programs at which they interviewed (77% initiated the contact). Seventy percent of all applicants informed their top program they had ranked it highly, and 20% of applicants reported changing their rank list based on post-interview communication. Sixty-one percent of respondents would feel distress at knowing a program had ranked them to match prior to the rank order list deadline because of a pressure to affirm mutual interest. Overall, 71% of respondents would feel relieved if post-interview communication was explicitly discouraged by programs, while 50% said post-interview communication was fine if no NRMP rules were violated. Limitations included potential recall bias and bias toward negative experiences, a relatively low response rate, and single institution participation.
Bottom line: Applicants to several residency programs reported being asked questions that violate the NRMP COC, and the majority would prefer post-interview communication to be more regulated and less prevalent.