What do applicants look for when selecting internal medicine residency programs? A comparison of rating scale and open-ended responses.

OBJECTIVE

To develop reliable scale measures of factors most important to applicants when they select internal medicine residencies and to assess their validity by comparing scores from these measures with responses to open-ended questions.

DESIGN

All 353 applicants ranked by the University of North Carolina at Chapel Hill (UNC-CH) for the 1988 National Residency Match Program received a questionnaire after submitting their match lists. First, they listed the three most important factors considered in ranking residency programs and starred the single most important factor out of the three. Then, they rated 41 items on a five-point Likert scale ranging from 1 (not important) to 5 (extremely important).

SETTING

Categorical internal medicine residency program at an academic medical center.

MEASUREMENTS AND MAIN RESULTS

315 (88%) applicants responded to the survey. Three reliable scales, Interpersonal Issues (7 items, alpha = 0.78), Reputation (5 items, alpha = 0.77), and Work Issues (11 items, alpha = 0.89), were developed using exploratory factor analysis of applicants' responses to the 41 items. Applicants felt interpersonal issues were very important (mean score = 4.2 +/- 0.5), academic reputation was important (3.3 +/- 0.8), and work issues were less important (2.8 +/- 0.7). The differences between these scores were significant (F = 3.76, p < 0.05). The ratings for the top five items not in these scales also indicated that education and location were very important. These results were corroborated by applicants' responses to the open-ended request to list the three most important factors in ranking residencies.

CONCLUSION

These findings suggest that work issues are important, but greater emphasis is placed on interpersonal issues, education, location, and a program's reputation when applicants select residency programs. Furthermore, this study provides evidence supporting the reliability and validity of the three scales.