Hern H Gene, Johnson Brian, Alter Harrison J, Wills Charlotte P, Snoey Eric R, Simon Barry C
Alameda Health System - Highland Hospital, Department of Emergency Medicine, Oakland, California.
West J Emerg Med. 2015 Mar;16(2):331-5. doi: 10.5811/westjem.2015.1.24462. Epub 2015 Feb 25.
Applicants to residency face a number of difficult questions during the interview process, one of which is when a program asks for a commitment to rank the program highly. The regulations governing the National Resident Matching Program (NRMP) match explicitly forbid any residency programs asking for a commitment.
We conducted a cross-sectional survey of applicants from U.S. medical schools to five specialties during the 2006-2007 interview season using the Electronic Residency Application Service of the Association of American Medical Colleges. Applicants were asked to recall being asked to provide any sort of commitment (verbal or otherwise) to rank a program highly. Surveys were sent after rank lists were submitted, but before match day. We analyzed data using descriptive statistics and logistic regression.
There were 7,028 unique responses out of 11,983 surveys sent for a response rate of 58.6%. Of those who identified their specialty (emergency medicine, internal medicine, obstetrics and gynecology [OBGYN], general surgery and orthopedics), there were 6,303 unique responders. Overall 19.6% (1380/7028) of all respondents were asked to commit to a program. Orthopedics had the highest overall prevalence at 28.9% (372/474), followed by OBGYN (23.7%; 180/759), general surgery (21.7%; 190/876), internal medicine (18.3%; 601/3278), and finally, emergency medicine (15.4%; 141/916). Of those responding, 38.4% stated such questions made them less likely to rank the program.
Applicants to residencies are being asked questions expressly forbidden by the NRMP. Among the five specialties surveyed, orthopedics and OBGYN had the highest incidence of this violation. Asking for a commitment makes applicants less likely to rank a program highly.
住院医师培训项目的申请者在面试过程中会面临一些难题，其中之一就是当某个项目要求他们承诺将该项目排在较高位置时。管理全国住院医师匹配项目（NRMP）匹配的规定明确禁止任何住院医师培训项目提出此类承诺要求。
我们在2006 - 2007年面试季期间，使用美国医学院协会的电子住院医师申请服务，对来自美国医学院的五个专业的申请者进行了横断面调查。申请者被要求回忆是否被要求对将某个项目排在较高位置做出任何形式的承诺（口头或其他方式）。调查问卷在排名列表提交后、匹配日之前发送。我们使用描述性统计和逻辑回归分析数据。
在发出的11,983份调查问卷中，有7,028份得到了有效回复，回复率为58.6%。在那些明确了自己专业（急诊医学、内科、妇产科[OBGYN]、普通外科和骨科）的人中，有6,303人做出了有效回复。总体而言，所有受访者中有19.6%（1380/7028）被要求对某个项目做出承诺。骨科的总体发生率最高，为28.9%（372/474），其次是妇产科（23.7%；180/759）、普通外科（21.7%；190/876）、内科（18.3%；601/3278），最后是急诊医学（15.4%；141/916）。在做出回复的人中，38.4%表示此类问题使他们将该项目排在较高位置的可能性降低。
住院医师培训项目的申请者正被问到NRMP明确禁止的问题。在所调查的五个专业中，骨科和妇产科这种违规行为的发生率最高。要求做出承诺会使申请者将该项目排在较高位置的可能性降低。
