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      Emergency Medicine Residency Applicants’ Perceptions about Being Contacted after Interview Day

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          Abstract

          Objective

          We sought to characterize the experiences and preferences of applicants to emergency medicine (EM) residency programs about being contacted by programs after their interview day but before the rank list submission deadline.

          Methods

          This cross-sectional study surveyed all applicants to an academic EM residency during the 2006–2007 interview cycle. Participation was anonymous and voluntary. We used a Web-based survey software program to administer the survey in February 2007, after rank lists were submitted. Two additional invitations to participate were sent over the next month. The instrument contained multiple-choice and free-text items. This study was submitted to our Institutional Review Board and was exempt from formal review.

          Results

          240/706 (34%) of applicants completed the survey. 89% (214/240) of respondents reported being contacted by a residency program after their interview but before rank lists were due. Of those contacted, 91% report being contacted by e-mail; 67% by mail; and 55% by phone. 51% of subjects reported that being contacted changed the order of their rank list in at least one case. A majority of contacted applicants felt “happy” (58%) or “excited” (56%) about being contacted, but significant numbers reported feeling “put on the spot” (21%) or “uncomfortable” (17%).A majority felt that it is appropriate for programs to contact applicants after interview day but before the rank lists are submitted, but 39% of contacted subjects responded that contact by phone is either “always inappropriate” or “usually inappropriate.” Regarding perceptions regarding the rules of the match, 80% (165/206) of respondents felt it was appropriate to tell programs where they would be ranked, and 41% (85/206) felt it was appropriate for programs to notify applicants of their place on the program’s rank list.

          Conclusion

          Most EM residency applicants report being contacted by programs after the interview day but before rank lists are submitted. Although applicants feel this practice is appropriate in general, over a third of subjects feel that contact by phone is inappropriate. These findings suggest that residency programs can expect a majority of their applicants to be contacted after an interview at another program, and shed light on how applicants perceive this practice.

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          Most cited references10

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          General surgery program directors' perceptions of the match.

          To identify expectations of general surgery program directors (PDs) for recruitment behavior, and to document the experiences, perceptions, and ethical dilemmas they experienced with the 1998 National Resident Matching Program (NRMP).Two hundred sixty-five general surgery PDs were asked to complete a 30-item written questionnaire. Questions inquired about PD perceptions of students' interviewing practices, how communication with applicants is conducted and interpreted, and overall perceptions of the match.A total of 77.7% of PDs responded. A total of 44% of PDs found nothing wrong with students interviewing in multiple specialties and conceded legitimate reasons for doing so; yet, 75% of PDs felt this practice negatively affected students' rank order. A total of 46.6% of programs told students to keep in touch to be ranked; only 8.7% of PDs believed students' stated interest, and 76.6% of PDs said these affirmations had no effect on students' rank. A total of 36.5% of PDs felt students made informal commitments to them, and 90.4% felt students at least sometimes lied to them. A total of 51.7% of PDs felt the match was a reasonable process that needed no changes.As long as the stakes are high and there are no repercussions for unethical behaviors and practices during residency recruitment, gamesmanship will continue to be the accepted culture.
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            Professionalism and the match: a pediatric residency program's postinterview no-call policy and its impact on applicants.

            The National Residency Matching Program allows match participants to recruit each other and try to influence future ranking decisions in their favor, but it also states that participants "must not make statements implying commitment." The National Residency Matching Program cautions against statements such as, "We plan to rank you very highly on our list," because they can be misinterpreted as an informal commitment. To avoid issues around miscommunication, the University of Washington Pediatric Residency Program instituted a postinterview no-call policy with applicants. The purpose of this study was to determine this policy's impact on applicants. A Web-based, anonymous survey was sent after the National Residency Matching Program deadline for submitting rank lists but before match day to applicants who interviewed at our program from 2003 to 2006. Applicants were asked whether our program's position on their rank list would have been influenced more favorably, less favorably, or not at all had they received a telephone call from our program. The survey response rate was 53% (n = 468). A total of 10.3% (n = 48) of the applicants to our program would have been favorably influenced by a telephone call after their interview. Significantly more applicants reported that a recruiting call from our program would have caused them to rank our program more favorably in 2006 (17.2%) than in 2003-2005 combined (8.4%). We identified a vulnerable applicant population whose rank lists are potentially influenced by questionable postinterview communication from residency programs. To protect the integrity and fairness of the match, we call for more explicit guidelines regarding postinterview communication with applicants.
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              Is match ethics an oxymoron?

              Graduate medical education has undergone economic and structural changes-changes that have placed increasing pressure on medical students and programs to match effectively. This study documents the experiences, perceptions, and ethical dilemmas of medical students with the 1998 match process. Surveyed were 437 senior students from three medical schools. Students were questioned about: interviewing practices, communication with programs, commitments made, ethical dilemmas faced, and the match process itself. Data were analyzed using Student's t test, the chi-square test, and descriptive statistics. In all, 314 (72%) students responded. Programs expect postinterview communication from students (57%). Students perceive that programs are making "informal" commitments (43%), lying to them (33%), and encouraging their unethical behavior in order to match (21%). Ethical dilemmas are related to requests for informal commitments. The NRMP's ruling that denounces prematch commitments is being broken by students and programs alike, resulting in the promotion of unprofessional behavior and gamesmanship.
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                Author and article information

                Journal
                West J Emerg Med
                WestJEM
                Western Journal of Emergency Medicine
                Department of Emergency Medicine, University of California, Irvine School of Medicine
                1936-900X
                1936-9018
                December 2010
                : 11
                : 5
                : 474-478
                Affiliations
                Oregon Health and Science University, Department of Emergency Medicine, Portland, OR
                Author notes
                Address for Correspondence: Lalena M. Yarris, MD, MCR, Department of Emergency Medicine, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Mail Code CDW-EM, Portland, OR 97239. Email yarrisl@ 123456ohsu.edu

                Supervising Section Editor: Michael Epter, DO

                Article
                wjem11_5p474
                3027442
                21293769
                06f1e70b-f161-48b2-8b7d-2012532ca72a
                Copyright © 2010 the authors.

                This is an Open Access article distributed under the terms of the Creative Commons Non-Commercial Attribution License, which permits its use in any digital medium, provided the original work is properly cited and not altered. For details, please refer to http://creativecommons.org/licenses/by-nc-nd/3.0/. Authors grant Western Journal of Emergency Medicine a nonexclusive license to publish the manuscript.

                History
                : 2 October 2009
                : 16 February 2010
                : 20 March 2010
                Categories
                Education/Academic Medicine
                Original Research

                Emergency medicine & Trauma
                Emergency medicine & Trauma

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