Medical Education  |   April 2016
Program Characteristics Influencing Allopathic Students’ Residency Selection
Author Notes
  • From the Department of Neurosurgery and Internal Medicine (Dr Stillman), the Department of Graduate Medical Education (Drs Hughes Miller and Ziegler), and the Department of Medicine (Dr Mitchell) at University of Louisville School of Medicine in Kentucky and Boston University School of Medicine in Massachusetts (Dr Upadhyay). 
  •  *Address correspondence to Michael D. Stillman, MD, 1959 NE Pacific St, BB 932, Seattle, WA 98195-0001. E-mail: michael.stillman1972@gmail.com
     
Article Information
Medical Education / Graduate Medical Education
Medical Education   |   April 2016
Program Characteristics Influencing Allopathic Students’ Residency Selection
The Journal of the American Osteopathic Association, April 2016, Vol. 116, 214-226. doi:10.7556/jaoa.2016.046
The Journal of the American Osteopathic Association, April 2016, Vol. 116, 214-226. doi:10.7556/jaoa.2016.046
Web of Science® Times Cited: 2
Abstract

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.

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