A Novel Approach to the National Resident Matching Program—The Star System

Salehi, Parsa P; Benito, Daniel A.; Michaelides, Elias

doi:10.1001/jamaoto.2018.0068

Cited by 43 publications

(108 citation statements)

References 7 publications

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“…It has been suggested that the reduction in applications is partly a consequence of the intentional attempt of the specialty to do so. For example, a separate paragraph explaining an applicant's specific interest in a program was aimed at preventing a shotgun approach to the application process . Additionally, an optional talent assessment interview was offered in addition to program specific interviews .…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, an optional talent assessment interview was offered in addition to program specific interviews . Some feel that this made the application process discouraging, which created a negative perception of our specialty leading to the unintended consequence of too few applications . The intent with Oto‐HNS interest groups is to offer encouraging advice, which is a necessary counter to the shadow that exists currently.…”

Section: Discussionmentioning

confidence: 99%

“…For example, a separate paragraph explaining an applicant's specific interest in a program was aimed at preventing a shotgun approach to the application process. 10,11 Additionally, an optional talent assessment interview was offered in addition to program specific interviews. 12 Some feel that this made the Fig.…”

Section: Discussionmentioning

confidence: 99%

“…application process discouraging, which created a negative perception of our specialty leading to the unintended consequence of too few applications. 11 The intent with Oto-HNS interest groups is to offer encouraging advice, which is a necessary counter to the shadow that exists currently. At our institution, our intent is not to coax every student who attends meetings to apply to the residency.…”

Section: Discussionmentioning

confidence: 99%

“…The downward trend in Oto-HNS applications is relatively unexpected, considering that just a few years ago, the specialty was one of the more competitive specialties. 11 However, just prior to these current match concerns, Kaplan et al suggested that there were inconsistencies in students and residency program director expectations about the specialty and application process. 15 It was suggested that "… Otolaryngologists tend to be viewed as a distinctive group of physicians who love what they do, are exceptionally collegial, and tend to be humanistic."…”

Section: Discussionmentioning

confidence: 99%

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Otolaryngology interest groups: A potential solution to the residency match crisis

Naples

Canfarotta

Tabtabai

et al. 2018

Laryngoscope Investig Oto

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Objective To determine whether medical student Otolaryngology–Head and Neck Surgery (Oto‐HNS) interest groups increase student and resident interest in the specialty and influence decisions to apply to Oto‐HNS residency. Methods Two web‐based surveys were distributed by the Division of Otolaryngology–Head and Neck Surgery at UConn Health: one to current medical students at the University of Connecticut School of Medicine and the other to currents residents at Accreditation Council for Graduate Medical Education–approved otolaryngology training programs. Results Fifty medical students and 89 residents completed the surveys. Several components were assessed in these surveys, including factors contributing to the selection process, interest group availability, attendance of meetings, availability of otolaryngology mentors, and interest in the specialty. A majority of medical students noted that interest groups play a role in influencing their interest in a medical specialty (56%). Medical students who attended Oto‐HNS interest group were more likely to consider applying for otolaryngology residency ( P < .0001) and had improved understanding of otolaryngology than those that did not attend ( P = .0003). Residents who attended interest group meetings were more likely to be influenced to apply to otolaryngology than those that did not attend. Conclusion Oto‐HNS interest groups improve medical student understanding of the specialty. Medical students and residents who participated in interest groups were more likely to be influenced positively regarding the specialty than those that did not attend. Oto‐HNS interest groups may foster greater interest in otolaryngology residency and offer a potential solution to the current match concerns. Level of Evidence xx

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Otolaryngology interest groups: A potential solution to the residency match crisis

Naples

Canfarotta

Tabtabai

et al. 2018

Laryngoscope Investig Oto

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Interview Invitations for Otolaryngology Residency Positions Across Demographic Groups Following Implementation of Preference Signaling

et al. 2023

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ImportancePreference signaling is a new initiative in the residency application process that has been adopted by 17 specialties that include more than 80% of applicants in the 2023 National Resident Matching cycle. The association of signals with interview selection rate across applicant demographics has not been fully examined.ObjectiveTo assess the validity of survey-based data on the association of preference signals with interview offers and describe the variation across demographic groups.Design, Setting, and ParticipantsThis cross-sectional study examined the interview selection outcomes across demographic groups for applications with and without signals in the 2021 Otolaryngology National Resident Matching cycle. Data were obtained from a post-hoc collaboration between the Association of American Medical Colleges and the Otolaryngology Program Directors Organization evaluating the first preference signaling program used in residency application. Participants included otolaryngology residency applicants in the 2021 application cycle. Data were analyzed from June to July 2022.ExposuresApplicants were provided the option of submitting 5 signals to otolaryngology residency programs to indicate specific interest. Signals were used by programs when selecting candidates to interview.Main Outcomes and MeasuresThe main outcome of interest was the association of signaling with interview selection. A series of logistic regression analyses were conducted at the individual program level. Each program within the 3 program cohorts (overall, gender, and URM status) was evaluated with 2 models.ResultsOf 636 otolaryngology applicants, 548 (86%) participated in preference signaling, including 337 men (61%) and 85 applicants (16%) who identified as underrepresented in medicine, including American Indian or Alaska Native; Black or African American; Hispanic, Latino, or of Spanish origin; or Native Hawaiian or other Pacific Islander. The median interview selection rate for applications with a signal (48% [95% CI, 27%-68%]) was significantly higher than for applications without a signal (10% [95% CI, 7%-13%]). No difference was observed in median interview selection rates with or without signals when comparing male (46% [95% CI, 24%-71%] vs 7% [95% CI, 5%-12%]) and female (50% [95% CI, 20%-80%] vs 12% [95% CI, 8%-18%]) applicants or when comparing applicants who identified as URM (53% [95% CI, 16%-88%] vs 15% [95% CI, 8%-26%]) with those who did not identify as URM (49% [95% CI, 32%-68%] vs 8% [95% CI, 5%-12%]).Conclusions and RelevanceIn this cross-sectional study of otolaryngology residency applicants, preference signaling was associated with an increased likelihood of applicants being selected for interview by signaled programs. This correlation was robust and present across the demographic categories of gender and self-identification as URM. Future research should explore the associations of signaling across a broad range of specialties and the associations of signals with inclusion and position on rank order lists and match outcomes.

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Preference Signaling in the National Resident Matching Program

Chen

Deng

Gray

2018

JAMA Otolaryngol Head Neck Surg

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To the Editor In their Viewpoint, Salehi et al 1 proposed a "star system" in which otolaryngology residency applicants can indicate particular interest in programs, similar to a "rose-sending system" previously suggested in orthopedic surgery. 2 In the economics literature, these systems are known as preference signaling mechanisms and have been successfully implemented in the American Economic Association (AEA) job market for economics graduate students since 2006. Its rationale, design, and outcomes should inform the current proposal. 3 Residency placement involves 2 phases: information sharing via electronic applications and interviews, then matching the preferences of interviewees and programs. The latter phase is accomplished by an algorithm that the National Resident Matching Program ("the Match") administers. This algorithm was a basis for awarding the 2012 Nobel Prize in Economics to Lloyd Shapley and Alvin Roth. Roth notes that the former phase, however, is congested in that not all interested candidates can be adequately considered. 2 Medical students submit excessive applications, inundating faculty who have limited time to read files. Interviewing is costly for both programs and applicants and thus a scarce opportunity. To avoid unfilled positions in the Match, resource-limited programs must consider at the preinterview stage not simply whether an applicant is attractive, but also whether she is attainable.Signaling can mitigate interview congestion. 2 For example, a strong applicant who has an unexpected geographic preference may choose to signal to an average program in that locale who might otherwise have dismissed the applicant as out of their league. 3 Ensuring a limited number of signals provides credibility. 4 Salehi et al 1 suggested that applicants be allowed to send stars to a maximum of 10 programs, 1 but this is likely too high to be effective. Roth helped design the AEA job market to limit applicants to 2 signals each so that their scarcity provides stronger informative value. 2 Moreover, a limit of 2 signals should reassure applicants that programs would not erroneously infer unattainability from the absence of a signal. After all, about one-third of US MD students match outside of their top 2 ranks. 5 Limited signaling mechanisms are shown to increase the chance of receiving a preferred interview. 3,4 If implemented correctly, signaling may play a valuable role in optimizing the resident selection process.

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A Novel Approach to the National Resident Matching Program—The Star System

Cited by 43 publications

References 7 publications

Otolaryngology interest groups: A potential solution to the residency match crisis

Otolaryngology interest groups: A potential solution to the residency match crisis

Interview Invitations for Otolaryngology Residency Positions Across Demographic Groups Following Implementation of Preference Signaling

Preference Signaling in the National Resident Matching Program

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