Exploring the Predictive Value of National Residency Matching Program (NRMP) Rank in Residency Outcomes

To examine the relationship between the National Residency Matching Program (NRMP) rank list position and otolaryngology residency performance.

Five consecutive graduating classes at a single institution's otolaryngology residency training program (2021-2025) were evaluated (n = 18) using their complete 5-year data. Correlation coefficients were calculated to assess the relationship between NRMP rank and in-service exam scores, research productivity, total case logs, milestone evaluations, selection as Administrative Chief Resident, receipt of teaching awards, and post residency position. Milestone evaluations were based on faculty ratings across all 7 core competencies on a 1- to 7-point scale, with an average score calculated for each resident. Spearman's rho was used to evaluate correlations between NRMP rank and both in-service scores and milestone evaluations. Chi-square tests were conducted to assess associations between NRMP rank and categorical outcomes, including selection as Administrative Chief Resident, receipt of the teaching award, and post residency position.

The average NRMP rank of the residents was 8.778 (range: 1-26). There was a significant correlation between higher NRMP rank and higher milestone evaluations (ρ = -.544, P = .020). However, no significant correlations between NRMP rank and in-service exam scores, research productivity, total case logs, selection as Administrative Chief Resident, receipt of the teaching award, or post residency position were found.

Our results suggest that better-ranked residents receive higher milestone evaluation scores. However, NRMP rank alone may not reliably predict performance on in-service exam scores, chief resident selection, receipt of teaching awards, or position after residency training.