The Radiology Residency Application Arms Race—Is Preference Signaling the Answer?

Slanetz, Priscilla J.; Ngo, Michael; Ali, Kamran; Chapman, Teresa

doi:10.1016/j.jacr.2022.02.037

Cited by 9 publications

(4 citation statements)

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“…Overall, participants lacked enthusiasm for all proposals, and their dislike sits in stark contrast to the opinions of other investigators calling for specific reforms. 9–11,13,17,19,26,29,31–33,38,39,51 Pilot testing of any proposed reforms would represent a major change to the current process, and such change should be met with something more than general ambivalence. Stakeholder experiences and values offer important insights about the risks to students that may come with change.…”

Section: Discussionmentioning

confidence: 99%

“…19,20 Pilot-testing results in otolaryngology were positive, and many specialties have performed trials of preference signaling in 2022. 9,10,12,13,17,28,29 The Association of American Medical Colleges has supported this effort with the release of a supplemental ERAS application that includes preference signaling. 30 Finally, geographic preference signaling indicates disclosure of the U.S. region that a student prefers for training and was successfully implemented in 2021.…”

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confidence: 99%

“…2,8 This trend raises questions about the sustainability of the current residency application process. [9][10][11][12][13]…”

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confidence: 99%

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Rejecting Reforms, Yet Calling for Change: A Qualitative Analysis of Proposed Reforms to the Residency Application Process

et al. 2022

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PurposeAnnual increases in the number of residency applications burden students and challenge programs. Several reforms to the application process have been proposed; however, stakeholder input is often overlooked. The authors examined key stakeholders' opinions about several proposed reforms to the residency application process and identified important factors to guide future reforms. MethodUsing semistructured interviews, the authors asked educational administrators and trainees to consider 5 commonly proposed reforms to the residency application process: Match to obtain residency interviews, preference signaling, application limits, geographic preference disclosure, and abolishing the Match. The authors conducted a modified content analysis of interview transcripts using qualitative and quantitative analytic techniques. Frequency analysis regarding the acceptability of the 5 proposed reforms and thematic analysis of important factors to guide reform were performed. Fifteen-minute interviews were conducted between July and October 2019, with data analysis completed during a 6-month period in 2020 and 2021. ResultsParticipants included 30 stakeholders from 9 medical specialties and 15 institutions. Most participants wanted to keep the Match process intact; however, they noted several important flaws in the system that disadvantage students and warrant change. Participants did not broadly support any of the 5 proposed reforms. Two themes were identified: principles to guide reform (fairness, transparency, equity, reducing costs to students, reducing total applications, reducing work for program directors, and avoiding unintended consequences) and unpopular reform proposals (concern that application limits threaten less competitive students and signaling adds bias to the system). ConclusionsKey stakeholders in the residency application process believe the system has important flaws that demand reform. Despite this, the most commonly proposed reforms are unacceptable to these stakeholders because they threaten fairness to students and program workload. These findings call for a larger investigation of proposed reforms with a more nationally representative stakeholder cohort.The number of residency applications submitted by U.S. medical students has increased substantially during the past 2 decades. Since the Electronic Residency Application Service (ERAS) launched in 1996, there has been a near-linear, year-over-year increase in the number of applications submitted per MD student. [1][2][3][4][5][6] These increases are not strongly correlated with the number of residency positions available in the National Resident Matching Program (NRMP) Match, 7 and they are not driven by DO or international medical students. 2,8 This trend raises questions about the sustainability of the current residency application process. [9][10][11][12][13]

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Section: Discussionmentioning

confidence: 99%

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Rejecting Reforms, Yet Calling for Change: A Qualitative Analysis of Proposed Reforms to the Residency Application Process

et al. 2022

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“…2 In 2023, the average US MD OHNS applicant submitted 85.6 applications, a 27% increase over the past 5 years. 3 Without intervention, this trend is expected to continue; the transition of United States Medical Licensing Examination Step (USMLE) 1 to pass fail and the adoption of virtual interviews 4 both have the potential to worsen application inflation.…”

Section: Introductionmentioning

confidence: 99%

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

Erickson,

Warren,

Pletcher

2024

The Laryngoscope

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ObjectiveThe objective of this study is to analyze a high‐signal approach for otolaryngology‐head and neck surgery (OHNS) residency applicants and calculate cost savings for programs and applicants.MethodsData from both the 2022–2024 Electronic Residency Application Service (ERAS) and a data model were used to demonstrate cost savings with a high‐signal approach. Modeled data assumed that the number of applications per applicant would be equal to the number of signals allowed. Predicted and real‐world cost savings across the five other specialties participating in a high‐signal approach were calculated.ResultsERAS data cost savings for the entire OHNS applicant pool amounted to $365,950. In the modeled data, cost savings amounted to $825,921. When extrapolated to include all five high‐signal specialties, total cost savings amounted to $2,570,464 (ERAS data) and $6,359,478 (modeled data). Otolaryngology programs were predicted to experience significant time savings, resulting in cost savings of $437,883 and $1,113,342 for ERAS data and modeled data, respectively.ConclusionsThe study highlights the advantages of a high‐signal approach, including financial advantages or increased time for programs to engage in holistic review and diversify the pool of interview candidates. Cost savings in this study were shown to be significant when extrapolated across all specialties using a high‐signal approach. Further research is needed to optimize the signaling system and confirm the favorable interview distribution and equity data from the low‐signal OHNS experience with a high‐signal approach.Level of EvidenceN/A Laryngoscope, 2024

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Resident Perspective of the Virtual Diagnostic Radiology Residency Interview Process: A National Survey From the Association of Program Directors in Radiology

et al. 2023

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The Radiology Residency Application Arms Race—Is Preference Signaling the Answer?

Cited by 9 publications

References 4 publications

Rejecting Reforms, Yet Calling for Change: A Qualitative Analysis of Proposed Reforms to the Residency Application Process

Rejecting Reforms, Yet Calling for Change: A Qualitative Analysis of Proposed Reforms to the Residency Application Process

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

Resident Perspective of the Virtual Diagnostic Radiology Residency Interview Process: A National Survey From the Association of Program Directors in Radiology

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