Monday, August 28, 2017

The match for larygology fellowships

In The Laryngoscope"

Perceptions of the laryngology Match: A survey of program directors and recent trainees

Eric J. Formeister, Mark S. Courey and Katherine C. Yung
Version of Record online: 7 AUG 2017 | DOI: 10.1002/lary.26761

"The Match for laryngology fellowship training was instituted for the 2012/2013 application cycle on a voluntary basis and has been operational since. Twenty-three laryngology fellowship programs are now participating in the Match for the 2017/2018 application cycle.
"the Match was created to allow applicants the opportunity to review all programs they were interested in prior to feeling pressure to select a program. This early selection pressure has been referred to as “early and exploding offers” by Niederle and Roth, who cite this as the principal motivating factor that influenced the adoption of a gastroenterology fellowship Match.[2] It also allows program directors time to interview more applicants while mitigating the pressure to provide early offers to the most desirable candidates. In a free-market system without a Match, these pressures tend to create earlier and earlier applicant selection. A match with uniform deadlines allow interview seasons to begin later in the course of a residency program, theoretically increasing the number of interested applicants.[1]
"42% of pre-Match trainees interviewed prior to their PGY4 year, compared to 22% in the post-Match cohort. There were statistically significant differences between the number of programs applied to, interview offers received, and interviews attended between the pre-2012 and post-2012 cohort. Trainees in the post-Match cohort applied to, on average, 6.9 programs, received interview offers at 6.5 programs, and attended 5.3 interviews, compared to an average number of 4.2 applications, 3.3 interview offers, and 3.5 interviews attended in those applying prior to institution of the Match
"Our results indicate that both applicants and program directors believe that the Match is a positive development for laryngology. However, fellowship directors appear to be more guarded in their support, as evidenced by only one-third agreeing or strongly agreeing that the Match improves their ability to procure the best fellows. Perhaps this is due to cases in which there has been internal selection of excellent candidates via the Match who would have been selected regardless of whether or not a Match program existed. This is supported by the free-text response from one anonymous fellowship director, who stated that a distinct disadvantage of the Match is an inability to internally select a candidate early and then mentor them in laryngology during residency. It is also noteworthy that trainees who applied before adoption of the Match were significantly more likely to support the notion that the Match is a positive development for the specialty (89%), versus only 56% of those who applied after the Match agreeing with this statement. This difference could be reflective of the reported frustrations that accompany the Match process (e.g., more interviews demanding more time and money from applicant to maximize their perceived chances of matching), compared to the theoretical benefits perceived by those earlier trainees who did not apply via this standardized process.

Undoubtedly, a laryngology Match increases the consumption of time, resources, and cost for both fellowship directors and candidates, as the average number of applicants interviewed at each program from pre-Match to post-Match doubled from approximately three to approximately six, and the number of programs applied to, interview offers received, and interviews attended by applicants all increased significantly compared to prior to the Match. Although there is an obvious advantage inherent in the ability to sample more programs (72% of applicants cite this as an advantage) or to interview more applicants (55% of program directors report this as an advantage) prior to deciding, the Match does have the potential to unnecessarily inflate the number of applications and interviews at each program. This is especially true in the case of internally selected candidates, where applying via the Match essentially becomes a formality."

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