Changes in otolaryngology application requirements and match outcomes: Are we doing any better?

ObjectivesOtolaryngology-specific requirements were piloted to minimize applicant and program burdens. We investigated the impact of introducing and then removing these requirements on Match outcomes.Methods2014-2021 National Resident Matching Program (R) data were examined. The primary outcome was the impact of Otolaryngology Resident Talent Assessment (ORTA; prematch 2017, postmatch 2019) and Program-Specific Paragraph (PSP; implemented 2016, optional 2018) on applicant numbers and match rates. Secondary survey analysis assessed candidate perceptions of PSP/ORTA.ResultsApplicant numbers declined significantly during PSP/ORTA (18.9%; p = 0.001). With the optional PSP and postmatch ORTA, applicant numbers increased significantly (39.0%; p = 0.002). Examined individually, mandatory PSP was associated with a significant decline in applicants (p = 0.007), whereas postmatch ORTA was associated with significant increases in applicants (p = 0.010). ORTA and PSP negatively impacted the decision to apply to otolaryngology in 59.8% and 51.3% of applicants, respectively. Conversely, match rate success improved significantly from 74.8% to 91.2% during PSP/ORTA (p = 0.014), followed by a significant decline to 73.1% after PSP was made optional and ORTA moved to postmatch (p = 0.002).ConclusionsORTA and PSP correlated with decreased applicant numbers and increased match rate success. As programs seek ways to remove barriers to applying to otolaryngology, the potential consequences of an increasing pool of unmatched candidates must also be considered. The Program-Specific Paragraph (PSP) and Otolaryngology Resident Talent Assessment (ORTA) were added with good intent-so candidates could convey serious intentions to specific programs (via the PSP) and for programs to identify excellent, "best-fit" future residents (via the ORTA). While PSP and ORTA have been suggested to contribute to declining applicant numbers, the implications of these interventions have not been thoroughly investigated. We evaluated the impact of introducing and then removing these requirements on Match outcomes from 2014 to 2021. We found that applicant numbers declined significantly (18.9%) and match rate success increased significantly (16.4%) during PSP/ORTA. When PSP was made optional and ORTA was moved to postmatch, applicant numbers and match rates returned to baseline. ORTA and PSP negatively impacted the decision to apply to otolaryngology in 59.8% and 51.3% of applicants, respectively. Any new Match interventions must involve a combination of application/selection process reform and pregraduate curriculum development. Additional application requirements must be instituted strategically and with careful consideration for the implications on applicant numbers and match rate success.