Letters to the Editor
To the Editor:
Choosing and securing a residency position is a high-stakes, stressful process. With programs receiving increasing numbers of applications,1 there is mounting pressure for applicants to distinguish themselves. While the ratio of available residency positions to U.S. seniors applying for positions has been trending upward (most recently 1.61 positions per applicant), it is noteworthy that the ratio for all applicants, including U.S. MD and DO seniors and international medical graduates, is 0.81 positions per applicant (and the ratio is even lower for more competitive specialties).2 This pressure may be fomented by sites like Student Doctor Network where better-credentialed candidates share their Match information.3 The intensified environment during Match season may lead some to resort to fraud or deception to secure a position. Prior reports of such professionalism breaches include exaggeration on the application,4 plagiarized personal statements,5 and misrepresentation of published work.6 We urge residency programs to be aware of these risks and take steps to mitigate them.
Our program recently experienced a case of deception in which someone outside the Match posed as an applicant by e-mail and requested that his application be withdrawn from consideration. We complied, and the applicant matched somewhere else. To our knowledge, and the National Resident Matching Program’s,7 this scenario is rare. Match-related professionalism breaches are mostly performed by applicants, not third parties, but our experience illustrates that programs should be aware of this type of fraud in addition to the more prevalent types.
This case and those cited above highlight the responsibility of programs to be vigilant and evaluate professionalism closely during the interview process. Preserving the integrity of the recruitment process and the Match is a shared responsibility. We encourage programs to leave applicant withdrawals to the Electronic Residency Application Service algorithm, rather than risk removing acceptable applicants.
Kathleen Crapanzano, MD, MACM
Associate professor of clinical psychiatry, Department of Psychiatry, Louisiana State University Health Sciences Center, and program director, LSU-Our Lady of the Lake Psychiatry Residency program, Baton Rouge, Louisiana; Kcrap1@lsuhsc.ed; ORCID: https://orcid.org/0000-0002-6182-4973.
Bilal Ahmad, MD
Third-year resident, LSU-Our Lady of the Lake Psychiatry Residency program, Baton Rouge, Louisiana.
1. Gruppuso PA, Adashi EY. Residency placement fever: Is it time for a reevaluation? Acad Med. 2017;92:923–926.
2. National Resident Matching Program. Results and Data: 2018 Main Residency Match. 2018.Washington, DC: National Resident Matching Program.
3. Sura K, Wilson LD, Grills IS. Comparison of self-reported data on student doctor network to objective data of the National Resident Matching Program. J Am Coll Radiol. 2017;14:1594–1597.
4. Young TA. Teaching medical students to lie. The disturbing contradiction: Medical ideals and the resident-selection process. CMAJ. 1997;156:219–222.
5. Segal S, Gelfand BJ, Hurwitz S, et al. Plagiarism in residency application essays. Ann Intern Med. 2010;153:112–120.
6. Kistka HM, Nayeri A, Wang L, Dow J, Chandrasekhar R, Chambless LB. Publication misrepresentation among neurosurgery residency applicants: An increasing problem. J Neurosurg. 2016;124:193–198.
7. Anderson A; Director for Match policy, National Resident Matching Program. Personal communication with K. Crapanzano and B. Ahmad by e-mail, June 1, 2018.