Stillman MD, Miller KH, Ziegler CH, Upadhyay A, Mitchell CK. Program Characteristics Influencing Allopathic Students’ Residency Selection. J Am Osteopath Assoc 2016;116(4):214-226. doi: 10.7556/jaoa.2016.046.
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Context: Medical students must consider many overt variables when entering the National Resident Matching Program. However, changes with the single graduate medical education accreditation system have caused a gap in knowledge about more subtle considerations, including what, if any, influence the presence of osteopathic physician (ie, DO) and international medical graduate (IMG) house officers has on allopathic students’ residency program preferences. Program directors and selection committee members may assume students’ implicit bias without substantiating evidence.
Objective: To reexamine which program characteristics affect US-trained allopathic medical students’ residency selection, and to determine whether the presence of DO and IMG house officers affects the program choices of allopathic medical students.
Methods: Fourth-year medical students from 4 allopathic medical schools completed an online survey. The Pearson χ2 statistic was used to compare demographic and program-specific traits that influence ranking decisions and to determine whether school type (private vs public), valuing a residency program’s prestige, or interest in a competitive specialty dictated results. Qualitative data were analyzed using the Pandit variation of the Glaser and Strauss constant comparison.
Results: Surveys were completed by 323 of 577 students (56%). Students from private vs public institutions were more likely to value a program’s prestige (160 [93%] vs 99 [72%]; P<.001) and research opportunities (114 [66%] vs 57 [42%]; P<.001), and they were less likely to consider their prospects of being accepted (98 [57%] vs 111 [81%]; P<.001). A total of 33 (10%) and 52 (16%) students reported that the presence of DO or IMG trainees, respectively, would influence their final residency selection, and these percentages were largely unchanged among students interested in programs’ prestige or in entering a competitive specialty. Open-ended comments were generally optimistic about diversification of the physician workforce, and 4 of the 709 student comments expressed cynicism or hostility to the presence of DOs or IMGs.
Conclusion: Both overt and subtle variables influence students’ perceptions of residency programs in the United States, but the presence of DO and IMG house officers seems relevant to a small percentage of them.
This Medical Education theme issue introduces a new collaboration between the JAOA and the American Association of Colleges of Osteopathic Medicine (AACOM) to recruit, peer review, edit, and distribute articles through the JAOA on osteopathic medical education research and other scholarly issues related to medical education.
a Fourteen students did not identify which institution they attended and thus were omitted from this table. Not all respondents completed each survey item.
b P value reflects Pearson x2.
a The survey comprised 12 questions on a 5-point Likert scale with scores defined by responses as follows: 1, strongly disagree; 2, disagree; 3, neutral; 4, agree; and 5, strongly agree.
b Fourteen students did not provide the institution they attended; thus frequency and percentages of program-specific traits with type of school are based on n=309. Moreover, 1 student did not respond to the question related to prestige of residency programs.
a Data are given as No. (%) unless otherwise indicated.
b Fourteen students did not respond to what institution they attended, hence the sample size of students for private and public schools is n=309. Frequency and percentages of program specific traits with type of school are based on n=309. Moreover, 1 student did not respond to the question related to prestige and reputation of residency programs.
c P value reflects Pearson χ2.
Abbreviations: DOs, osteopathic physicians; IMGs, international medical graduates.
Abbreviations: DOs, osteopathic physicians; IMGs, international medical graduates
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