1
|
Mudalegundi S, Clifton M, Lifchez S, LaPorte D, Ramanathan S, Sabit AH, Woreta F. Perspectives on Application and Interview Capping in Residency Selection of Surgical Subspecialties. JOURNAL OF SURGICAL EDUCATION 2024; 81:1013-1023. [PMID: 38755046 DOI: 10.1016/j.jsurg.2024.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 03/15/2024] [Accepted: 04/15/2024] [Indexed: 05/18/2024]
Abstract
OBJECTIVE With the advent of virtual interviews, the potential for interview hoarding by applicants became of greater concern due to lack of financial constraints associated with in-person interviewing. Simultaneously, the average number of applications submitted each year is rising. Currently there is no cap to the number of applications or interviews an applicant may complete when applying to residency, with the exception of ophthalmology with a cap of 15 interviews. No studies have assessed the applicants' perspectives on an application or interview cap. We assessed the attitudes of surgical subspecialty applicants towards capping, which may be useful when considering innovations in residency selection. DESIGN/SETTING/PARTICIPANTS About 1841 applicants to the Johns Hopkins' ophthalmology, urology, plastic surgery, and orthopedic surgery residency programs from the 2022-2023 cycle were invited to respond to a 22-item questionnaire. Statistical analyses of aggregate data were conducted using R. RESULTS Of the 776/1841 (42%) responses, 288 (40%) were in support of an application cap, while 455 (63%) were in support of an interview cap. Specialty (p < 0.001), gender (p < 0.001), taking a gap year (p = 0.02), medical school region (p = 0.04), and number of interviews accepted off of a waitlist (p = 0.01) were all significantly associated with a difference in opinion regarding an application cap. Specialty (p < 0.001), USMLE Step 1 score (p = 0.004), number of interviews (p < 0.001), and number of programs ranked (p < 0.001) were all significantly associated with a difference in opinion regarding an interview cap. Of those applicants who were in support of the respective caps they believed that on average a cap should consist of 48.1 (16.1) applications and 16.0 (8.0) interviews. CONCLUSIONS Our findings highlight the desire for interview caps among the majority of applicants to surgical subspecialties and thus this innovation may be considered by other specialties in the era of virtual interviews.
Collapse
Affiliation(s)
- Shwetha Mudalegundi
- Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
| | - Marisa Clifton
- Department of Urology, Brady Urological Institute, Johns Hopkins University, Baltimore, Maryland
| | - Scott Lifchez
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Dawn LaPorte
- Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Saras Ramanathan
- Department of Ophthalmology, University of California San Francisco, San Francisco, California
| | - Ahmed H Sabit
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Fasika Woreta
- Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.
| |
Collapse
|
2
|
Beesley H, Pernar L, Kettoola Y, Hess D. The Association Between Virtual Interviewing and Geographical Distribution of Matched Residency Programs for General Surgery Applicants. JOURNAL OF SURGICAL EDUCATION 2023; 80:194-199. [PMID: 36241484 PMCID: PMC9554332 DOI: 10.1016/j.jsurg.2022.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 09/15/2022] [Accepted: 09/23/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Due to the COVID-19 pandemic, the Coalition for Physician Accountability's work group on Medical Students in the class of 2021 made the recommendation in May of 2020 that the upcoming residency recruitment cycle be conducted virtually. This flexibility may have allowed applicants to apply and interview at programs with less regard to geography, knowing that travel costs of interviewing would not be a factor. Alternatively, applicants who interviewed virtually could choose to remain in a close proximity to their home institutions where they likely have a greater comfort level and familiarity with the community both personally and professionally. We examine the distribution of applicants matched at general surgery residency programs in 2021 to those in 2020 to see if there was a change in geographic variability. DESIGN Retrospective review of general surgery residents SETTING: United States general surgery residency programs PARTICIPANTS: 2153 PGY1 categorical general surgery residents who were interviewed virtually and PGY2 categorical general surgery residents who interviewed in-person, who also attended residency programs and medical schools located in the continental United States with publicly accessible residency websites containing necessary biographical information. RESULTS A total of 2153 residents were included; 1124 in their PGY1 and 1029 in their PGY2. Average distance from attended medical school to matched program (634.2 vs 662.5), percentage of matched programs within 500 miles of attended medical school (57.3 vs 55.7), average price of flight, when available, from attended medical school to matched program (222.8 vs 230.4), and percentage of attended medical schools with non-stop flight to matched program (42.9 vs 42.9) did not significantly differ between PGY1 and PGY2 residents. CONCLUSIONS The decision to adopt virtual interviewing practices compared to previous in-person interviews did not significantly alter the geographical distribution of students' matched programs. The distance from medical school to the matched program, flight availability, and flight pricing remained comparable between residents interviewed in-person and residents interviewed virtually.
Collapse
Affiliation(s)
- Hassan Beesley
- Boston University School of Medicine, Boston, Massachusetts
| | - Luise Pernar
- Boston University School of Medicine, Boston, Massachusetts; Department of Surgery, Boston Medical Center, Boston, Massachusetts
| | | | - Donald Hess
- Boston University School of Medicine, Boston, Massachusetts; Department of Surgery, Boston Medical Center, Boston, Massachusetts.
| |
Collapse
|
3
|
Shlobin NA, Graffeo CS, Dornbos DL, Mukherjee D, Sivakumar W, Johnson J. The Committee on Advanced Subspecialty Training-accredited postgraduate neurosurgery fellowship application experience: a national survey. J Neurosurg 2022; 138:1124-1131. [PMID: 36087313 DOI: 10.3171/2022.7.jns22544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 07/21/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The neurosurgery fellowship application process is heterogenous. Therefore, the authors conducted a survey of individuals graduating from Committee on Advanced Subspecialty Training (CAST)-accredited fellowships in the past 5 years to examine 1) experiences with the fellowship application process, 2) perspectives on the process, 3) reasons for pursuing a given subspecialty and fellowship, and 4) post-fellowship practices. METHODS A survey querying demographics, experiences with and perspectives on the fellowship application process, and factors contributing to the pursuit of a given fellowship was distributed to individuals who had graduated from CAST-accredited fellowships in the past 5 years. The survey response period was May 22, 2021-June 22, 2021. RESULTS Of 273 unique individuals who had graduated from CAST-accredited fellowships in the past 5 years, 65 (29.7%) were included in this analysis. The most common postgraduate year (PGY) during which respondents applied for fellowship positions was PGY5 (43.8%), whereas the most common training level at which respondents accepted a fellowship position was PGY6 (46.9%), with a large degree of variability for both (range PGY4-PGY7). Only 43.1% respondents reported an application deadline for their fellowship. A total of 77.4% respondents received 1-2 fellowship position offers, and 13.4% indicated that there was a match process. In total, 64.5% respondents indicated that the fellowship offer timeline was mostly or very asynchronous. The time frame for applicants to decline or accept a fellowship offer was heterogeneous and mismatched among institutions. Respondents agreed that a more standardized application timeline would be beneficial (median response "agree"), and 83.1% of respondents indicated that PGY5 or PGY6 was the appropriate time to interview for a fellowship. CONCLUSIONS Respondents reported heterogeneous experiences in applying for a fellowship, indicated that a standardized application timeline including interviews at PGY5 or PGY6 would be beneficial, and preferred streamlining the fellowship application process.
Collapse
Affiliation(s)
- Nathan A Shlobin
- 1Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | - David L Dornbos
- 3Department of Neurosurgery, University of Kentucky College of Medicine, Lexington, Kentucky
| | - Debraj Mukherjee
- 4Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Walavan Sivakumar
- 5Department of Neurosurgery, Pacific Neuroscience Institute, Los Angeles; and
| | - Jeremiah Johnson
- 6Department of Neurosurgery, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, California
| | | |
Collapse
|
4
|
Markle JC, Ahmed H, Pandya K, Parikh A, Bolok Y, Fehlman J, Aitharaju V, Bastian R, Dey S, Chalasani M, Chanamolu M, Pedersen K, Ganios N, Pham V, Mansur S, Law JC. Transparency in the Ophthalmology Residency Match: Background, Study, and Implications. Cureus 2021; 13:e19826. [PMID: 34963843 PMCID: PMC8702383 DOI: 10.7759/cureus.19826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2021] [Indexed: 11/05/2022] Open
Abstract
Background Medical students are applying to dramatically more ophthalmology residency programs than in the past, causing an increased administrative burden for programs and financial harm to students. This study considers the background of this situation and looks at how a lack of transparency surrounding potential residency match filters contributes. Furthermore, this study raises several potential solutions to this lack of transparency that may increase the functionality of the ophthalmology residency match. Objective The purpose of this study was to determine the availability and consistency of potential ophthalmology residency match filters through training program websites and the American Medical Association's (AMA) Residency & Fellowship Database (FREIDA). Methods This study was a cross-sectional observational study of ophthalmology residency program websites and AMA's FREIDA database entries. For 119 ophthalmology residency programs, five potential filters were evaluated for both availability and consistency on individual residency websites and FREIDA. These filters were: (1) whether a program required a minimum United States Medical Licensing Examination (USMLE) Step 1 score; (2) minimum number of letters of recommendation required; 3) whether a minimum USMLE Step 2 score was required; (4) if the program accepts the Comprehensive Osteopathic Medical Licensing Examination (COMLEX) sequence in lieu of the USMLE; and (5) ability of the residency to sponsor a visa (J-1, H-1B, or F-1). Each program's website and FREIDA entry were independently evaluated by two authors to increase validity, with a third author brought in to break the tie in case of a disagreement. Results Only two ophthalmology residency programs had information about all five filters both available and consistent on their website and FREIDA. Inter-reviewer reliability was 92.5%. Conclusions Information about potential filters used in the ophthalmology residency match is neither publicly available nor consistent. This lack of transparency may contribute to the phenomenon of medical students applying to dramatically more ophthalmology residency programs. A standardized database of these filters is needed to increase transparency to applicants, which may reduce the expenses of medical students and the workload of program directors.
Collapse
Affiliation(s)
- Jonathan C Markle
- School of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Harris Ahmed
- Department of Ophthalmology, Loma Linda University Medical Center, Loma Linda, USA
| | - Kishan Pandya
- School of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Ankur Parikh
- Department of Ophthalmology, University of Cincinnati Medical Center, Cincinnati, USA
| | - Youstina Bolok
- School of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Jared Fehlman
- School of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Varun Aitharaju
- School of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Riley Bastian
- School of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Shreya Dey
- School of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Meghana Chalasani
- School of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Meghana Chanamolu
- School of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Karina Pedersen
- School of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Natalie Ganios
- School of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Vincent Pham
- School of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Shabnam Mansur
- School of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Janice C Law
- Department of Ophthalmology, Vanderbilt University Medical Center, Nashville, USA
| |
Collapse
|
5
|
Antono B, Willis J, Phillips RL, Bazemore A, Westfall JM. The Price of Fear: An Ethical Dilemma Underscored in a Virtual Residency Interview Season. J Grad Med Educ 2021; 13:316-320. [PMID: 34178252 PMCID: PMC8207909 DOI: 10.4300/jgme-d-20-01411.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Brian Antono
- At the time of writing, Brian Antono, MD, MPH, was a Health Policy Fellow, Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Department of Family Medicine, Georgetown University School of Medicine, and is now Medical Instructor, Department of Family Medicine and Community Health, Duke University
| | - Joel Willis
- At the time of writing, Joel Willis, DO, PA, MA, MPhil, was a Health Policy Fellow, The Center for Professionalism and Value in Health Care and American Board of Family Medicine, and is now Assistant Professor, Division of Family Medicine, George Washington University Medical Faculty Associates
| | - Robert L. Phillips
- Robert L. Phillips Jr, MD, MSPH, is Executive Director, The Center for Professionalism and Value in Health Care and American Board of Family Medicine
| | - Andrew Bazemore
- Andrew Bazemore, MD, MPH, is Senior Vice President of Research & Policy, American Board of Family Medicine, and Co-Director, Center for Professionalism and Value in Health Care
| | - John M. Westfall
- John M. Westfall, MD, MPH, is Director, Robert Graham Center for Policy Studies in Family Medicine and Primary Care
| |
Collapse
|
6
|
Zastrow RK, Burk-Rafel J, London DA. Systems-Level Reforms to the US Resident Selection Process: A Scoping Review. J Grad Med Educ 2021; 13:355-370. [PMID: 34178261 PMCID: PMC8207920 DOI: 10.4300/jgme-d-20-01381.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 01/18/2021] [Accepted: 02/18/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Calls to reform the US resident selection process are growing, given increasing competition and inefficiencies of the current system. Though numerous reforms have been proposed, they have not been comprehensively cataloged. OBJECTIVE This scoping review was conducted to characterize and categorize literature proposing systems-level reforms to the resident selection process. METHODS Following Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, searches of Embase, MEDLINE, Scopus, and Web of Science databases were performed for references published from January 2005 to February 2020. Articles were included if they proposed reforms that were applicable or generalizable to all applicants, medical schools, or residency programs. An inductive approach to qualitative content analysis was used to generate codes and higher-order categories. RESULTS Of 10 407 unique references screened, 116 met our inclusion criteria. Qualitative analysis generated 34 codes that were grouped into 14 categories according to the broad stages of resident selection: application submission, application review, interviews, and the Match. The most commonly proposed reforms were implementation of an application cap (n = 28), creation of a standardized program database (n = 21), utilization of standardized letters of evaluation (n = 20), and pre-interview screening (n = 13). CONCLUSIONS This scoping review collated and categorized proposed reforms to the resident selection process, developing a common language and framework to facilitate national conversations and change.
Collapse
Affiliation(s)
- Ryley K. Zastrow
- Ryley K. Zastrow, BS, is a Fourth-Year Medical Student, Department of Medical Education, Icahn School of Medicine at Mount Sinai
| | - Jesse Burk-Rafel
- Jesse Burk-Rafel, MD, MRes, is Assistant Professor, Department of Internal Medicine, and Assistant Director of UME-GME Innovation, Institute for Innovations in Medical Education, NYU Grossman School of Medicine
| | - Daniel A. London
- At the time of writing, Daniel A. London, MD, MS, was an Orthopaedic Surgery Resident, Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, and is currently a Hand Surgery Fellow, Mary S. Stern Hand Surgery Fellowship, TriHealth
| |
Collapse
|
7
|
Salari S, Deng F. A Stepping Stone Toward Necessary Change: How the New USMLE Step 1 Scoring System Could Affect the Residency Application Process. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2020; 95:1312-1314. [PMID: 32404607 DOI: 10.1097/acm.0000000000003501] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Score reporting for the United States Medical Licensing Examination Step 1 will change from a 3-digit number to pass/fail as soon as January 1, 2022. The shift is meant to prevent residency program directors from using Step 1 scores to select applicants for interviews, a purpose for which the exam was not designed. Using Step 1 scores in this way also has put undue stress on medical students applying to residency. However, the score reporting change represents only one stepping stone toward an improved transition from undergraduate to graduate medical education. To enable a more reliable and holistic review of applicants, residency program directors and medical school administrators must promote other standardized evaluation tools and address the hypercompetitive and frenzied state of the residency application process. For example, medical schools should provide program directors with assessments of students' fit and readiness for residency that are not burdensome to understand and compare. In addition, residency programs should implement "traffic rules" to improve the interview process for applicants. These changes will significantly mitigate the burden on all stakeholders. As residents who recently experienced this transition, the authors of this Invited Commentary argue that now is the opportune time to redefine selection criteria and reemphasize the characteristics that truly matter in training competent future physicians.
Collapse
Affiliation(s)
- Salomeh Salari
- S. Salari is a first-year resident, Department of Obstetrics and Gynecology, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Francis Deng
- F. Deng is a third-year resident, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
| |
Collapse
|
8
|
Christiansen SM, Osher JM, Riemann CD. Association of Mentor-to-Program Contact and Applicant Rank Disclosure With Vitreoretinal Fellowship Applicant's Final Match Outcome in 2016 and 2017. JAMA Ophthalmol 2018; 136:642-647. [PMID: 29710103 DOI: 10.1001/jamaophthalmol.2018.1107] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Communication between applicants, mentors, and training programs is common before the residency and fellowship match. Few studies have examined the association of prematch communication on final match outcomes. Objectives To report various characteristics of the vitreoretinal surgery fellowship match and to examine the association of mentor-to-program communication and applicant disclosure of their number 1 ranking with the probability of matching number 1. Design, Setting, and Participants In this cross-sectional study of the 2016 and 2017 vitreoretinal surgery fellowship matches, an online survey examined (1) number of applications submitted, (2) number of programs ranked, (3) rank order of final match, (4) total application and interview-related costs, (5) mentor-to-program contact, (6) applicant disclosure of number 1 ranking, and (7) mentor disclosure of number 1 ranking. A link to an anonymous online survey was sent to 198 matched fellows (105 fellows from the 2016 match and 93 from the 2017 match). Main Outcomes and Measures Survey responses regarding the vitreoretinal surgery fellowship application process. Results The survey was sent to 198 matched fellowship applicants, and 152 (77%) completed the survey. Of the 105 matched applicants in 2016, 21 (20%) were women. Of the 93 matched applicants in 2017, 24 (26%) were women. Matched applicants applied to a mean (SD) of 34 (17) programs (range, 1-85) and ranked a mean (SD) of 12 (4) programs (range, 1-27). Of 152 applicants, 66 (43%) matched at their number 1 ranked program, 23 (15%) matched number 2, and 21 (14%) matched number 3. The mean (SD) total cost was $5500 ($2776) (range, $500-$13 500). Two-sided χ2 testing found no association (odds ratio, 0.70; 95% CI, 0.34-1.4; P = .33) between mentor-to-program contact and the probability of applicants matching at their number 1 ranked program. Matched applicants who revealed their number 1 ranking either personally or via a mentor matched at a program ranked lower (more desirable) on their rank list (mean match ranking, 2.8) compared with those who did not reveal their number 1 ranking (mean match ranking, 4.2; 95% CI, 0.2-2.5; P = .01). Applicant disclosure of their intention to rank a program number 1, either personally or via a mentor, was associated with matching number 1 (odds ratio, 2.6; range, 1.1-6.0; P = .03). Conclusions and Relevance Vitreoretinal fellowship applicants who disclosed their number 1 ranking, either personally or via a mentor, were associated with improved match outcomes compared with their cohorts who did not make such disclosures.
Collapse
Affiliation(s)
- Steven M Christiansen
- Cincinnati Eye Institute, Cincinnati, Ohio.,Department of Ophthalmology, University of Cincinnati, Cincinnati, Ohio
| | - James M Osher
- Cincinnati Eye Institute, Cincinnati, Ohio.,Department of Ophthalmology, University of Cincinnati, Cincinnati, Ohio
| | - Christopher D Riemann
- Cincinnati Eye Institute, Cincinnati, Ohio.,Department of Ophthalmology, University of Cincinnati, Cincinnati, Ohio
| |
Collapse
|
9
|
Hosadurg N. Residency Applications: Overcoming Redundancy With Disclosure. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2018; 93:676. [PMID: 29443710 DOI: 10.1097/acm.0000000000002172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Nisha Hosadurg
- Postgraduate year 1 resident, Department of Internal Medicine, Tufts Medical Center, Boston, Massachusetts; ; ORCID: http://orcid.org/0000-0001-8669-3132
| |
Collapse
|