Residency Postinterview Communications: More Harm Than Good?

T he National Resident Matching Program (NRMP) was designed to provide a fair, reproducible, and confidential means of matching medical students and graduate medical education programs. During the recruitment process, residency programs and applicants actively communicate with one another to gather information to make more informed decisions. When these communications occur after interviews, but before rank order lists are submitted, they are termed ‘‘postinterview communications.’’ To prevent abuse, the NRMP provides strict regulations regarding the content of these communications. Its official policy states, ‘‘Both applicants and programs may express their interest in each other; however, they shall not solicit verbal or written statements implying a commitment.’’ Additionally, neither party can suggest that his or her own rank order is contingent on promises from the other party (ie, the residency program promises to rank an applicant to match if the applicant promises to rank the program No. 1). Unfortunately, postinterview communications are frequently misleading, as applicants and training programs make false or ambiguous statements in order to garner some perceived benefit from the other party. Previously, the nature and prevalence of postinterview communications were presented from the perspective of the applicant. To address the alternative perspective, in 2014, we surveyed residency program directors in multiple specialties within our institution and nationally via specialty mailing lists about postinterview communications and the influence they have on the recruitment process. We achieved an overall response rate of 23.2% (268 of 1156), with 107 responses from pediatrics programs, 58 from diagnostic radiology, 45 from internal medicine, 26 from internal medicine–pediatrics, 17 from pathology, and 9 responses from other specialties (with 6 nonresponses). Communications From Applicants to Residency Programs