Ethical implications of swapping residency interview dates for monetary compensation

Dermatology residency applications have become increasingly competitive, with more applicants applying each year against a relatively fixed number of residency positions. The implementation of tiered preference signaling, although ideal for applicants to express genuine interest in programs, has effectively reduced the number of applications per candidate and increased the value of each interview opportunity. With limited interviews distributed across select dates, scheduling conflicts inevitably arise each cycle, prompting applicants to coordinate with one another to swap interview dates. Of concern, there have been reports of medical student dermatology residency applicants seeking monetary compensation in exchange for their desired slot. We outline these ethical considerations and propose strategies to reduce incentives for monetized interview swaps.