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The Early Result Acceptance Program (ERAP) in OB/GYN residency may lead to less preferred matches for many applicants and programs, increasing disparities for DOs and IMGs.

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Area of Science:

  • Medical Education
  • Residency Training
  • Graduate Medical Education

Background:

  • The transition to residency presents challenges for obstetrics and gynecology (OB/GYN) trainees.
  • An Early Result Acceptance Program (ERAP) has been proposed to ease this transition.
  • Data-driven analyses on ERAP's impact on residency transition are currently lacking.

Purpose of the Study:

  • To simulate the outcomes of the Early Result Acceptance Program (ERAP) in OB/GYN.
  • To compare simulated ERAP outcomes with historical National Resident Matching Program (NRMP) Match data.
  • To assess the effects of ERAP on residency match preferences and disparities.

Main Methods:

  • Utilized National Resident Matching Program (NRMP) data from 2014-2021.
  • Simulated ERAP outcomes using de-identified applicant and program rank order lists.
  • Compared simulated ERAP results with actual NRMP Match outcomes, including sensitivity analyses.

Main Results:

  • 14% of applicants received less preferred matches under ERAP, while only 8% received more preferred matches.
  • Less preferred matches disproportionately impacted DOs and international medical graduates (IMGs).
  • Significant numbers of applicants and programs reported mutual dissatisfaction with their matches.

Conclusions:

  • ERAP simulation indicates it fills most OB/GYN positions but results in numerous less preferred matches.
  • ERAP may exacerbate existing disparities for DOs and IMGs.
  • The program creates incentives for "gamesmanship" due to mutually dissatisfied pairs and challenges for couples.