To the Editor:
We read with great interest Chimienti and colleagues’ Invited Commentary1 on the current violation of National Residency Match Program (NRMP) rules and ethical norms by students, faculty members, and program directors (PDs) and the resulting negative effect on the NRMP ranking process. This problem has been documented previously by Santen and colleagues2 and others. We applaud the authors for providing their thoughts and support their proposal to eliminate any postresidency interview correspondence, including thank you letters. We also agree with the authors that applicants might not feel comfortable sharing their personal information with the interviewers and could tend to be dishonest, fearing that this information might affect their ranking. Substantial discussion among PDs is needed to develop approaches to address this problem.
We should include informal activities, such as the preinterview day dinners hosted for the applicants. Residency programs consider this interaction with senior or chief residents as “social hours” or “informal dinner” and encourage attendance. Candidates are more likely to share personal information during these events. As informal and friendly gatherings, the information candidates reveal there does not necessary violate the NRMP rules, but is frequently shared with program administrators. When programs use this information in ranking candidates, this clearly violates NRMP rules. Moreover, some of this information could be very personal, such as an applicant’s age, marital status, country of origin, and spousal occupation,3 which, if used, is considered a workplace discrimination under The U.S. Equal Employment Opportunity Commission.4
Although many residents and faculty are not fully aware of acceptable versus unacceptable questions, some interviewers likely ask these questions despite awareness.5 PDs need to develop postinterview/match anonymous activities or surveys to find if any of the interviewers are involved in such practices. Programs directors should be aware that such information should not be used for candidate selection, which can be difficult, especially in smaller programs. Residency programs and medical societies should develop educational activities to educate both the interviewers and candidates regarding these inappropriate practices in the residency recruiting process.
Hemant Goyal, MD
Gastroenterology fellow, Department of Medicine, The Wright Center for Graduate Medical Education, Scranton, Pennsylvania; firstname.lastname@example.org.
David C. Parish, MD, MPH
Section chief, Division of General Internal Medicine, and professor of medicine, Mercer University School of Medicine, Macon, Georgia.
Edwin W. Grimsley, MD
Senior associate dean and professor of medicine, Mercer University School of Medicine, Macon, Georgia.
1. Chimienti SN, DeMarco DM, Flotte TR, Collins MF. Assuring integrity in the Residency Match Process. Acad Med. 2019;94:321–323.
2. Santen SA, Davis KR, Brady DW, Hemphill RR. Potentially discriminatory questions during residency interviews: Frequency and effects on residents’ ranking of programs in the national resident matching program. J Grad Med Educ. 2010;2:336–340.
3. Singla U, Goyal H, Devereaux R, Parish DC. Are you married? The prevalence of potentially inappropriate and illegal questions during residency interviews. Paper presented at: The Annual Meeting of the American College of Physicians Georgia Chapter; October 22, 2016; Braselton, GA.
4. U.S. Equal Employment Opportunity Commission. Employees & job applicants. https://www.eeoc.gov/employees
. Accessed September 19, 2019.
5. Hern HG Jr, Alter HJ, Wills CP, Snoey ER, Simon BC. How prevalent are potentially illegal questions during residency interviews? Acad Med. 2013;88:1116–1121.