Although there have been up-and-down swings, the underlying interest in otolaryngology has always been there. —Michael G. Stewart, MD
Explore This IssueFebruary 2020
The challenge this can create for residency programs, however, is a difficulty in finding applicants who actually want to be at their program. “From this side of the desk, it’s difficult to know who’s really interested,” added Dr. Cabrera-Muffly. “Unless someone has clearly given a reason they want to be here, I don’t know which applicants are truly interested in our program.”
Cause and Effect
To understand why numbers are rising, it’s important to examine the factors that caused them to dip in the first place. But there are differing opinions on these factors, and how—or whether—they affected the match process at all.
Caution in recommending otolaryngology. For many years, otolaryngology was considered difficult to match in, Dr. Abaza said. She added that this has been a factor in anxiety among medical school applicants to the match, fueling the high number of applications per applicant. Even those who shouldn’t worry about matching, she said, are concerned.
“I’ve heard from students interested in otolaryngology who were counseled by their advisors outside otolaryngology that the specialty was so competitive that if they didn’t take a year for research, have a PhD, or have a certain board score, they couldn’t match,” added Dr. Stewart. “I do think we as a specialty bear some co-blame in sending a message to our own applicants that it’s pretty hard to get into otolaryngology, but in the last two years, we’ve been more proactive about reaching out and letting them know what a wonderful specialty it is.”
Dr. Chang noted that many students who did not match previously have been entering the match again. “Many have decided to do a year of research before reapplying, to make themselves more competitive.”
Taking steps to enhance a CV, like adding a year of research, may not help in a competitive match year, however. “We have a person currently doing a research year to make her application better,” said Dr. Cabrera-Muffly. “She’s a fabulous applicant, but I told her I can’t guarantee that she’s going to get a spot. This year, even the best applicants may slip through the cracks. There are so many variables, including how well they interview and whether they applied to the right programs.”
Personal statement paragraph. In 2016, the program-specific personal statement paragraph became a mandatory requirement for each otolaryngology application, and many feared that it would be an obstacle. By the 2018 match, the paragraph was no longer considered mandatory.
While Dr. Chang doesn’t believe the paragraph diminished the number of applications per applicant, it may have partially factored in the dip in applicants. “The number of the applications per applicant when the paragraph was introduced was 61; in 2017 it was 58. In 2018, when the paragraph stopped being mandatory, the number was 60. That’s fairly steady, but since then it has risen. I think the real issue was that, for most programs, the paragraph provided little insight, and there was little in-depth information available for applicants to really differentiate the programs.”
Otolaryngology Resident Talent Assessment (ORTA). Completion of the ORTA, a phone-based pre-interview survey to assess personality traits, was required before the match when it was first introduced. Last year, students were invited to take the ORTA after matching.
“I think deciding to do the ORTA after the match, along with making the program-specific paragraph optional, really changed the number of applicants over the last two years,” said Dr. Cabrera-Muffly. “Last year was quite competitive, and this year is even more so.”
Dr. Abaza believes the problem was one of timing. “I think part of the struggle was when the ORTA was placed on the application—just weeks before they were due,” she said. “I think that made it a huge burden, particularly in the first couple of years.”
However, Dr. Stewart doesn’t believe that the ORTA by itself caused a dip in otolaryngology applications. “I don’t think that students who prepared for a specialty their entire medical school career found out they were expected to do a 45-minute phone interview and said, ‘Forget it—I’m doing something else.’ I do think ORTA can be a helpful tool in deciding who’s the best fit for our specialty. Personality assessments are a hiring standard in many industries, and the ORTA hopefully can give programs information about how applicants’ personality characteristics correlate with successful otolaryngologists.”