Fixing the Match: A Survey of Resident Behaviors

Background: The authors studied residency applicant attitudes toward rank list creation, communication with programs, and the impact of these factors on their performance in the Match. Methods: An anonymous, 26-question, multiple-choice, online survey was distributed to the program coordinators of every Accreditation Council for Graduate Medical Education-accredited program participating in the National Resident Matching Program for whom e-mail addresses were available. The survey addressed five areas: (1) demographics and interview characteristics, (2) preinterview and interview factors, (3) postinterview contact, (4) importance of various factors in rank list creation, and (5) Match outcome. Survey responses were analyzed with Microsoft Excel. Results: A total of 1179 responses were received. It was not possible to calculate a response rate, because the number of residents receiving the survey was not known. The majority of respondents (78 percent) reported postinterview contact with a program. A large portion of respondents (42 percent) considered such contact to be important in the creation of their rank lists. Half of all respondents admitted to exaggerating their interest in a program during or after an interview. The majority of respondents (87.5 percent) received no assistance in covering the costs of second-look visits to programs. Conclusions: Applicants may be modifying their rank lists in response to post-interview contact from programs; furthermore, they usually have no assistance in paying for the cost of second looks. To level the playing field for students and programs alike, the authors propose that the National Resident Matching Program modify residency interview rules to (1) disallow any postinterview contact between programs and students, and (2) disallow second looks.