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

Abstract

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.

Otolaryngology Applicant Perspectives on In‐person and Virtual Residency Interviews

“…In regards to geographic location of applicants, the majority of respondents were from medical schools located in the Southeast, Northeast, and Midwest, which is similar to the recent publication by Kraft et al 4 on the 2020‐2021 otolaryngology application cycle. Additionally, respondents in the current study reported the most important factors when choosing where to apply to residency were geography, program reputation, and adequate coverage of subspecialties, which is similar to those reported by Kraft et al 4 Over the past 5 years, there has been a doubling of applications received by otolaryngology programs with the average applicant submitting 84 residency applications out of a total of 120 residency programs, which is in line with the average of 86 reported by our respondents 12,13 …”

“…Additionally, respondents in the current study reported the most important factors when choosing where to apply to residency were geography, program reputation, and adequate coverage of subspecialties, which is similar to those reported by Kraft et al 4 Over the past 5 years, there has been a doubling of applications received by otolaryngology programs with the average applicant submitting 84 residency applications out of a total of 120 residency programs, which is in line with the average of 86 reported by our respondents. 12,13 Of those surveyed, almost half were offered an in-person interview with the majority (78.9%) accepting the invitation. The most common reasons for declining an in-person interview were not wanting to travel, time conflicts, dissatisfaction with the geographic location, and monetary limitations.…”

Cost Analysis of High‐Signal Approach in Otolaryngology‐Head and Neck Surgery Residency

“…However, recent data have demonstrated that with signaling in place, the distribution of interviews becomes more favorable for applicants who struggle most to receive interview offers, 19 and does not disadvantage female applicants or applicants who identify as URiM. 20 These studies are encouraging, yet further investigation is needed to ensure such findings will persist with a high-signal approach.…”

The ophthalmology residency match: a new era

“…No unintended consequence was identified for different demographic groups. Preference signalling was associated with an increased likelihood of applicants receiving interviews from signalled programmes; this held true across demographic categories of sex and self-identification as an underrepresented minority (URM) [19 ▪ ].…”

“…They conducted a thoughtful evaluation of the feasibility, palatability and theoretical impact of preference signalling. They surveyed stakeholders and simulated signalling with a computer model before launching a pilot 3 years ago [16–18,19 ▪ ,20 ▪ ]. They have reported on 2 years’ worth of experience.…”