To (1) summarize strategies proposed in the recent otolaryngology–head and neck surgery (OTO-HNS) literature for improving the residency application and selection process, (2) evaluate the effects of recently implemented changes to the OTO-HNS match, and (3) discuss recommendations for future changes to the OTO-HNS residency application and selection process.
Data Sources
PubMed, Medline Ovid database, and article reference lists.
Review Methods
A structured literature search was performed to identify current English language articles relating to the objectives of this study using the aforementioned data sources, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines. The search was limited to submissions published between January 1, 2015, and January 1, 2020.
Conclusions
Numerous proposals have been made for improving the otolaryngology residency application and selection process and addressing the competitive nature of the Match. These proposals include but are not limited to mandating a secondary essay, implementing consortia and early match processes, using a signaling system, conducting regional and web-based interviews, offering early engagement with interest groups, instituting a hard cap on applications, increasing costs of applying, counseling self-restraint to prospective applicants, and creating application filters.
Implications for Practice
As the volume of literature surrounding the OTO-HNS Match continues to increase, this review aims to provide a summary of past proposals and serve as a guide for possible future innovations. We propose 3 initiatives that may improve the residency application and selection process for both program and resident, with minimal impact to the current National Resident Matching Program (NRMP) Match structure.
SalehiPPBenitoDMichaelidesE. A novel approach to the national resident matching program: the Star System. JAMA Otolaryngol Head Neck Surg. 2018;144(5):397-398.
2.
HauserLJGebhardGMBlumhagenRCarlsonNECabrera-MufflyC. Applicant characteristics associated with successful matching into otolaryngology. Laryngoscope. 2017;127(5):1052-1057.
3.
Cabrera-MufflyCChangCWDPuscasL. Current interview trail metrics in the otolaryngology match. Otolaryngol Head Neck Surg. 2017;156(6):1097-1103.
4.
KozinEDSethiRKLehmannA, et al. Analysis of an online match discussion board: improving the otolaryngology–head and neck surgery match. Otolaryngol Head Neck Surg. 2015;152(3):458-464.
5.
MooreEJPriceDLVan AbelKMCarlsonML. Still under the microscope: can a surgical aptitude test predict otolaryngology resident performance?Laryngoscope. 2015;125(2):E57-E61.
6.
WongBJ. Reforming the match process: early decision plans and the case for a consortia match. JAMA Otolaryngol Head Neck Surg. 2016;142(8):727-728.
7.
BoweSNLauryAMGrayST. Improving otolaryngology residency selection using principles from personnel psychology. Otolaryngol Head Neck Surg. 2017;156(6):981-984.
8.
BoweSNLauryAMGrayST. Associations between otolaryngology applicant characteristics and future performance in residency or practice: a systematic review. Otolaryngol Head Neck Surg. 2017;156(6):1011-1017.
9.
MasoodMMStephensonEDFarquharDR, et al. Surgical simulation and applicant perception in otolaryngology residency interviews. Laryngoscope. 2018;128(11):2503-2507.
10.
WardMPingreeCLauryAMBoweSN. Applicant perspectives on the otolaryngology residency application process. JAMA Otolaryngol Head Neck Surg. 2017;143(8):782-787.
11.
BoweSNSchmalbachCELauryAM. The state of the otolaryngology match: a review of applicant trends, “impossible” qualifications, and implications. Otolaryngol Head Neck Surg. 2017;156(6):985-990.
12.
ChangCWErhardtBF. Rising residency applications: how high will it go?Otolaryngol Head Neck Surg. 2015;153(5):702-705.
13.
NaclerioRMPintoJMBaroodyFM. Drowning in applications for residency training: a program’s perspective and simple solutions. JAMA Otolaryngol Head Neck Surg. 2014;140(8):695-696.
14.
KramerS. Is the program-specific paragraph responsible for declining application numbers? A commentary. Otolaryngol Head Neck Surg. 2018;158(2):215-216.
15.
ChangCWD. Match 2017: blindsided or fumbled?Otolaryngol Head Neck Surg. 2018;158(4):594-597.
16.
ChangCWDGraySTMalekzadehS, et al. Cultivating and recruiting future otolaryngology residents: shaping the tributary. Otolaryngol Head Neck Surg. 2019;160(1):8-10.
17.
National Resident Matching Program. Results and data: 2013 Main Residency Match®. In: The Match. National Resident Matching Program; 2013.
18.
National Resident Matching Program. Results and data: 2014 Main Residency Match®. In: The Match. National Resident Matching Program; 2014.
19.
National Resident Matching Program. Results and data: 2015 Main Residency Match®. In: The Match. National Resident Matching Program; 2015.
20.
National Resident Matching Program. Results and data: 2016 Main Residency Match®. In: The Match.National Resident Matching Program; 2016.
21.
National Resident Matching Program. Results and data: 2017 Main Residency Match®. In: The Match. National Resident Matching Program; 2017.
22.
National Resident Matching Program. Results and data: 2018 Main Residency Match®. In: The Match. National Resident Matching Program; 2018.
23.
National Resident Matching Program. Results and data: 2019 Main Residency Match®. In: The Match. National Resident Matching Program; 2019.
24.
MoherDLiberatiATetzlaffJAltmanDG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol. 2009;62(10):1006-1012.
25.
StepanKOKaulVFRaquibAR, et al. An evaluation of the program-specific paragraph in the otolaryngology residency application. Laryngoscope. 2018;128(11):2508-2513.
26.
PuscasLEsclamadoR. Use of a secondary essay in the residency application process. JAMA Otolaryngol Head Neck Surg. 2015;141(7):591-592.
27.
NaplesJGCanfarottaMTabtabaiRSparksDParhamKFalconeT. Otolaryngology interest groups: a potential solution to the residency match crisis. Laryngoscope Investig Otolaryngol. 2019;4(1):24-29.
28.
GraboyesEMGoebelJA. Reforming the otolaryngology–head and neck surgery match: should we embrace a consortia match?JAMA Otolaryngol Head Neck Surg. 2016;142(8):728-730.
29.
SataloffRT. The otolaryngology residency application problem. Ear Nose Throat J. 2017;96(3):91-93.
30.
AppelbaumNPLeeNAmendolaMDodsonKKaplanB. Surgical resident burnout and job satisfaction: the role of workplace climate and perceived support. J Surg Res. 2019;234:20-25.
31.
LeeAHLiaoRYoungP, et al. Otolaryngology residency interviewing dates and practices: what should an applicant expect?Laryngoscope. 2019;129(10):2280-2285.
32.
LeeAHYoungPLiaoRYiPHRehDBestSR. I dream of Gini: quantifying inequality in otolaryngology residency interviews. Laryngoscope. 2019;129(3):627-633.
33.
Kay-RivestEVarmaNScottGM, et al. Securing an OTL-HNS residency: how competitive is it? Comparing medical student perceptions to actual Canadian statistics. J Otolaryngol Head Neck Surg. 2017;46(1):16.
34.
Cabrera-MufflyCSheederJAbazaM. State of otolaryngology match: has competition increased since the “early” match?Otolaryngol Head Neck Surg. 2015;152(5):838-842.
35.
JohnsonAPSviderPFFolbeAJ, et al. An evaluation of geographic trends in the otolaryngology residency match: home is where the heart is. JAMA Otolaryngol Head Neck Surg. 2015;141(5):424-428.
36.
ChristophelJJLevinePA. Too much of a good thing. JAMA Otolaryngol Head Neck Surg. 2014;140(4):291-292.
37.
PolaccoMALallyJWallsAHarroldLRMalekzadehSChenEY. Digging into debt: the financial burden associated with the otolaryngology match. Otolaryngol Head Neck Surg. 2017;156(6):1091-1096.
38.
BaroodyFMPintoJMNaclerioRM. Otolaryngology (urban) legend: the more programs to which you apply, the better the chances of matching. Arch Otolaryngol Head Neck Surg. 2008;134(10):1038.
39.
WhippleMELawABBlyRA. A computer simulation model to analyze the application process for competitive residency programs. J Grad Med Educ. 2019;11(1):30-35.
40.
KaplanABRiedyKNGrundfastKM. Increasing competitiveness for an otolaryngology residency: where we are and concerns about the future. Otolaryngol Head Neck Surg. 2015;153(5):699-701.
41.
SchwanJAbazaMCabrera-MufflyC. How should unmatched otolaryngology applicants proceed?Laryngoscope. 2015;125(10):2291-2294.
42.
VillwockJABoweSNDunleavyDOvertonBRSharmaSAbazaMM. Adding long-term value to the residency selection and assessment process. Laryngoscope. 2020;130(1):65-68.
43.
VillwockJAHamillCSSaleKASykesKJ. Beyond the USMLE: the STAR algorithm for initial residency applicant screening and interview selection. J Surg Res. 2019;235:447-452.
44.
KimpleAJMcClurgSWDel SignoreAGTomoumMOLinFCSeniorBA. Standardized letters of recommendation and successful match into otolaryngology. Laryngoscope. 2016;126(5):1071-1076.
45.
TangALHowardJJMSinghE, et al. Are standardized letters of recommendation in residency applications correlated with objective data?J Med Educ Curric Dev. 2019;6:2382120519893976.
46.
YoungVN. Letters of recommendation: association with interviewers’ perceptions and preferences. Otolaryngol Head Neck Surg. 2017;156(6):1108-1113.
47.
BayrakSBVillwockJAVillwockMRChiuAGSykesKJ. Using word clouds to re-envision letters of recommendation for residency applicants. Laryngoscope. 2019;129(9):2026-2030.
48.
KominskyAHBrysonPCBenningerMSTierneyWS. Variability of ratings in the otolaryngology standardized letter of recommendation. Otolaryngol Head Neck Surg. 2016;154(2):287-293.
49.
FriedmanRFangCHHasbunJ, et al. Use of standardized letters of recommendation for otolaryngology head and neck surgery residency and the impact of gender. Laryngoscope. 2017;127(12):2738-2745.
50.
HuACGuJTWongBJF. Objective measures and the standardized letter of recommendation in the otolaryngology residency match. Laryngoscope. 2020;130(3):603-608.
51.
AAMC. April Residency Data—Avg. Applications per Applicant by Specialty. AAMC; 2020.
52.
BoweSNSchmalbachCELauryAM. Regarding “Is the program-specific paragraph responsible for declining application numbers? A commentary.”Otolaryngol Head Neck Surg. 2018;158(6):1150-1151.
53.
BernsteinJ. Not the last word: want to match in an orthopaedic surgery residency? Send a rose to the program director. Clin Orthop Relat Res. 2017;475(12):2845-2849.
54.
ColesPKushnirANiederleM. Preference signaling in matching markets. Am Econ J Microecon. 2013;5(2):99-134.
55.
SalehiPPSalehiPMichaelidesE. Preference signaling in the National Resident Matching Program: reply. JAMA Otolaryngol Head Neck Surg. 2018;144(10):951-952.
56.
ChenJXDengFGrayST. Preference signaling in the National Resident Matching Program. JAMA Otolaryngol Head Neck Surg. 2018;144(10):951.
57.
GebhardGMHauserLJDallyMJWeitzenkampDACabrera-MufflyC. Do otolaryngology residency applicants relocate for training?Laryngoscope. 2016;126(4):829-833.
58.
SalehiPPAzizzadehBLeeYH. Preference signaling for competitive residency programs in the NRMP. J Grad Med Educ. 2019;11(6):733-734.
59.
AzizzadehKHamdanUSSalehiPP. Effect of coronavirus disease 2019 and pandemics on global surgical outreach [published online July2, 2020]. JAMA Otolaryngol Head Neck Surg.
60.
SalehiPPJohnsonABRubinsteinBPahlavanNAzizzadehBHamdanUS. A guide to developing safety protocols for international craniofacial outreach programs during the COVID-19 era [published online July17, 2020]. J Craniofac Surg.
61.
SalehiPPAzizzadehB. The roles and challenges of facial plastic surgeons in pandemics. Facial Plast Surg Aesthet Med. 2020;22(3):160-161.
62.
National Resident Matching Program. Results and Data: 2017 Main Residency Match®. National Resident Matching Program; 2017.
63.
SviderPFGuptaAJohnsonAP, et al. Evaluation of otolaryngology residency program websites. JAMA Otolaryngol Head Neck Surg. 2014;140(10):956-960.
64.
Lu-MyersYMyersCG. Incorporating interpersonal skills into otolaryngology resident selection and training. Otolaryngol Head Neck Surg. 2018;158(1):21-23.
65.
JardineDHoaglandBPerezAGesslerE. Evaluation of surgical dexterity during the interview day: another factor for consideration. J Grad Med Educ. 2015;7(2):234-237.
SalehiPPAzizzadehBLeeYH. Pass/fail scoring of USMLE Step 1 and the need for residency selection reform. Otolaryngol Head Neck Surg. Published online August25, 2020. doi:10.1177/0194599820951166
70.
KalyoussefEDhandaAKPaskhoverB. Implications of change to USMLE Step 1 scoring for otolaryngology residency programs [published online July7, 2020]. Otolaryngol Head Neck Surg.
71.
ChangCW. Gift horse. JAMA Otolaryngol Head Neck Surg. 2014;140(7):677-678.
72.
Molina BurbanoFYaoABurishN, et al. Solving congestion in the plastic surgery match: a game theory analysis. Plast Reconstr Surg. 2019;143(2):634-639.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
