We thank Signer and Curtin as well as Goyal and colleagues for their engagement on the National Residency Match Program’s (NRMP’s) rules and ethical norms. The excellent points raised by Signer and Curtin indicate a need for clarification on several issues discussed in our original Invited Commentary.
First, our call for a ban on postinterview communication was not intended to preclude a student’s simple factual questions about a program. Questions of fact directed to program staff could be allowed while prohibiting other communications, which work against a student’s right to rank his or her preferences free of manipulation. Second, Signer and Curtin claim that “the NRMP created an online form . . . that allows applicants to anonymously report alleged program violations.” The NRMP reporting form must be emailed by the student to the NRMP. Although the form allows the option of confidentiality, this process is not anonymous since the sender’s email address is visible to the recipient. Third, the authors correctly point out that “Neither the [NRMP] agreement nor the code prohibits either party from volunteering ranking information. . . .” We would contend that the expectation of some program directors (PDs) that students will voluntarily declare their rank preference defeats the core purpose of the NRMP process.
The letter by Goyal and colleagues raises another excellent point about the common practice of preinterview day dinners. Although we do not advocate for banning such dinners, we suggest that all program staff involved receive training to avoid inappropriate questioning of candidates.
Since publishing our Invited Commentary, additional progress has been made to assure integrity in residency interviews. In the field of obstetrics and gynecology (OB/GYN), the Council on Resident Education in Obstetrics and Gynecology and the Association of Professors of Gynecology and Obstetrics1 have recommended adding more structure to the process. They proposed limiting the number of interview invitations to available slots to avoid time-pressured decisions by students, standardizing the window of time to respond to an interview offer, and setting a uniform deadline to inform applicants of whether they are to be interviewed. This is a clear indication that OB/GYN residency PDs recognize that there are problems with the current interview process. We encourage further discussion about reforms of the Match, both within specialties and at the national level.
Sonia N. Chimienti, MD
Associate professor of medicine, vice provost for student life and enrollment, and associate dean for student affairs, School of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.
Deborah M. DeMarco, MD
Professor of medicine, senior associate dean for clinical affairs, and associate dean for graduate medical education, School of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.
Terence R. Flotte, MD
Professor of pediatrics, Celia and Isaac Haidak Professor, executive deputy chancellor, provost, and dean, School of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts; firstname.lastname@example.org.
Michael F. Collins, MD
Professor of quantitative health sciences, professor of medicine, and chancellor, University of Massachusetts Medical School, and senior vice president for the health sciences, University of Massachusetts, Worcester, Massachusetts.
1. Council on Resident Education in Obstetrics and Gynecology. Developing Standards for the Ob-Gyn Application and Interview Process. 2019.Washington, DC: American College of Obstetricians and Gynecologists.