Match Applicants Uncomfortable with Some Types of Post-Interview Contact

by ENTtoday •

Comment: This article relates to the residency match experience, which I think is important in our current situation of an increasing number of programs going unmatched. The study says that interviewees report significant match communication violations, which cause distress and violate the NRMP code of conduct. Adhering to this code will improve the interview process for both applicants and programs alike and make this a less stressful and intimidating process. —Tanya K. Meyer, MD

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.

Citation: Berruiochoa C, Reddy CA, Dorsey S, et al. The residency match: Interview experiences, postinterview communication, and associated distress. J Grad Med Ed. 2018;10:403–408.