Otolaryngology Applicants without Home Residency Programs Receive Fewer Interviews and Matches

CLINICAL QUESTION

What are the differences in otolaryngology interview and match outcomes between applicants with and without home residency programs?

BOTTOM LINE

Applicants with no home program (NHP) received fewer interviews and had lower match rates; away rotations may be especially important for applicants with NHP.

BACKGROUND: Students without home residency programs often face barriers to accessing resources such as early specialty exposure, specialty-specific mentorship, and research. The United States Medical Licensing Examination’s transition to pass/fail may exacerbate these disadvantages. These factors have important diversity, equity, and inclusion implications in otolaryngology residency selection and medical education.

STUDY DESIGN: Survey data study

SETTING: Department of Otolaryngology–Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Mich.

SYNOPSIS: Researchers analyzed responses from fourth-year otolaryngology applicants who participated in the Texas Seeking Transparency in Applications in Residency survey between 2019 and 2023. Of 633 applicants in the study, 544 had a home program (HP) and 89 had NHP. Findings showed that applicants with NHP had completed more away rotations than those with an HP (2.2 versus 1.5, respectively), potentially constituting a significant cost barrier for the former group. Despite no difference in mean number of applications submitted between the two groups, applicants with an HP received significantly more interviews (14.7 versus 11.8), attended more interviews (12.4 versus 11.3), and had a higher match rate (81.8% versus 70.8%) than applicants with NHP. Applicants with NHP were interviewed at and matched at more away rotation institutions (1.9 versus 1.3 and 33.7% versus 23.9%, respectively). There were no significant differences in honors in specialty, number of clerkship honors, quartile rank, licensing exam scores, publications, research or volunteer experiences, or leadership positions between the groups. Authors state that subjective measures, such as letters of recommendation, likely hold significant weight. They enumerate the inherent opportunities that applicants with HPs enjoy. Study limitations included a limited-size study population.

CITATION: Tu LJ, et al. How does lacking a home program impact otolaryngology applicants? Laryngoscope. 2024;134:4494-4500. doi:10.1002/lary.31571.