Emergency medicine residency director perceptions of the resident selection process

OBJECTIVE: To assess perceptions of emergency medicine (EM) program directors (PDs) of the resident selection process. METHODS: PDs of 120 EM residencies were mailed a 22 question survey immediately following the 1999 match. (Applicants interviewing in more than one specialty and post-interview communications were areas of interest). Non-respondents received a second mailing. RESULTS: Ninety-eight (81. 7%) completed surveys were returned. Five PDs felt that interviewing in more than one specialty was ethically wrong, while most felt multi-specialty interviews were a system byproduct (42%) or that there was nothing wrong (41%). Eighty-one percent of PDs felt the applicant's rank order would be negatively affected if the applicant disclosed interviewing in >1 specialty. Forty-seven percent of PDs (always or frequently) told applicants to keep in touch if interested in the program. However, 88% of PDs were skeptical or did not believe an applicant's communicated intent to rank the program 'high,' nor did this communication influence an applicant's rank order (75%). Forty-two percent of PDs reported informal commitments by applicants. PDs frequently felt lied to by applicants (always (4%), frequently (42%), sometimes (42%)). Applicants often ask how the program intends to rank them. Highly ranked applicants receive positive responses from 61% of PDs vs. 33% of PDs who give negative responses to low ranked applicants. Ten percent of PDs offer residency positions outside of the match. CONCLUSIONS: Applicants who interview in >1 specialty are viewed negatively by PDs. Post-interview communications by applicants are viewed with skepticism. Gamesmanship is practiced commonly during the resident selection process.