Relationship Between Postinterview Correspondence From Residency Program Applicants and Subsequent Applicant Match Outcomes

摘要

What was known Studies show postinterview communication from applicants may affect their placement on the program's National Resident Matching Program (NRMP) rank order list.;What is new Study finds that postinterview correspondence by applicants was not associated with position on the rank order list.;Limitations Single-program, single-specialty study limits generalizability.;Bottom line Correspondence does not benefit the applicant and can lead to misleading statements.;Introduction Communication between residency programs and applicants after interviews is common during the residency match process. In separate surveys, 86% of applicants reported being contacted by residency programs after their interview,1 and 54% to 97% of applicants sent correspondence to programs after interviews.2–4 In the context of increasing competition for residency positions, it is important to understand the effect of communication on applicants and programs. The influence of correspondence on applicants has been assessed in several surveys. In a recent multicenter survey of 564 students who participated in the 2010 Match, most reported that postinterview communication was stressful but that it also helped with their ranking decisions.1 Surveys of students applying to pediatrics, surgery, emergency medicine, and internal medicine programs have consistently demonstrated that communication from programs has led applicants to modify their rank order lists.2,5–7 Data on the effects of postinterview correspondence on residency programs is limited and conflicting. In 1 study, 57% of applicants responded that programs encouraged them to stay in touch if they were interested in matching with the program,5 suggesting program directors may be influenced by postinterview communication. However, in surveys administered by the National Resident Matching Program (NRMP), program directors indicated that postinterview contact from candidates had limited importance in determining rank order when compared with applicant characteristics.8,9 To resolve the conflict and to expand the findings beyond subjective surveys, we tested the hypothesis that written postinterview correspondence from applicants to a residency program improved the applicant's position on the residency program's rank order list.;Methods Kaiser Permanente's Oakland Internal Medicine Residency is a university-affiliated, community-based program with 40 residents. The program receives more than 1000 applications per year. Interview offers are extended to applicants based on review of their Electronic Residency Application Service file. During the 2009–2010 and 2010–2011 recruitment seasons, we analyzed applicant characteristics and collected all written correspondence (e-mails or letters) from applicants to the program after their interview. Applicant Characteristics The following applicant data were included in this study: program type applied to (preliminary or categorical internal medicine); sex; past or current residency in Northern California (as an indicator of interest in the program for geographic reasons); type of graduating medical school (allopathic, osteopathic, or international); medical school rank in the U.S. News & World Report for the Match year10; Alpha Omega Alpha (AOA) honor society membership; United States Medical Licensing Examination (USMLE) Step 1 score (dichotomized as < 220 and ≥ 220); and core internal medicine clerkship grade. Applicants were also categorized based on whether they completed a prior rotation at the program, returned for a second look during the interview season, or participated in the couples match.;Results Applicant Characteristics A total of 470 applicants (354 categorical and 116 preliminary) interviewed at the program during the 2009–2010 and 2010–2011 recruitment seasons. Characteristics of the group included the following: 56.6% women; 8.5% AOA members; 32.7% attended medical schools ranked in the top 20 by U.S. News & World Report11; 20% rec