Preparing for Residency

How ob-gyn is transforming the residency-interview process

Timothy M. Smith , Contributing News Writer

For many U.S. residency programs, the interview-application process has become unwieldy and inefficient. Fourth-year medical students are applying to more programs than ever, and residency programs often do not notify applicants of their application status. Some residency programs go so far as to offer interviews when they do not have open interview spots.

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A project led by the Association of Professors of Gynecology and Obstetrics (APGO) and funded by the AMA Reimagining Residency initiative is transforming the transition from undergraduate to graduate medical education by revamping how ob-gyn residency programs conduct their interview-application processes.

The project—called “Right Resident, Right Program, Ready Day One”—has been working with the 280-plus ob-gyn residency programs and other stakeholders across the U.S. to set new standards for the specialty’s residency-selection process to reduce the number of applications being submitted, better match applicants with residency programs and boost learner preparedness for residency.

The goal of the project is “to make sure that applicants actually find the right program for them,” said Maya Hammoud, MD, during a recent AMA Insight Network webinar.

Among other benefits, members of the AMA Health System Program have access to the AMA Insight Network’s Quality, Safety and Equity community. This virtual forum provides an opportunity for like-minded leaders from across the country to hear more examples of how leading health systems are finding innovative ways to address health care inequities in their communities.

Dr. Hammoud, who directs the Center for Education in the ob-gyn department at University of Michigan Medical School, was the principal investigator on the project and the president of APGO at the time of the grant.

Before launching the effort in 2019, Dr. Hammoud and her colleagues realized that if applicants do not get the number of interviews they feel they deserve, “they start applying randomly to a lot of programs where programs might not look at them,” she said. “So we wanted to make sure that applicants do not waste their money.”

Working with residency programs and national associations, such as the Council on Resident Education in Obstetrics and Gynecology, which is part of the American College of Obstetricians and Gynecologists, APGO put together a new set of standards for communicating with interview applicants. Those new standards for 2025 include:

  • Setting a final application deadline of Sept. 25.
  • Releasing interview offers Oct. 29.
  • Limiting interview-invitation slots to the number of interview slots available.
  • Allowing a minimum of 48 hours for applicants to accept interview offers.
  • Beginning interviews no later than Nov. 1.
  • Informing applicants of their final status no later than Nov. 27. 

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APGO also developed a standardized letter of evaluation—similar to the one long used by emergency medicine residency programs.

“The main difference between our letter and their letter,” Dr. Hammoud said, “is that their standardized letter had been normative. Our letter is criterion-based.”

The goal, instead, has been to look at each applicant individually.

“There's a lot of data collected on the current letters that shows that there's bias and that the letter is probably more reflective of the person who writes it, rather than the person that they're writing it about,” she said. “This standardized letter has actually shown a lot of promise in terms of reducing that bias.”

But evaluation is a two-way street.

“Any initiative that we do within our specialty, we study it, and we collect evidence,” Dr. Hammoud said, noting that she and her colleagues make a point of publishing the project’s results. One of their concerns was that adopting a single interview offer date could cause interview hoarding.

“We actually showed that a single interview offer date mitigates over-interviewing,” she said.

The webinar also explored how the project used signaling to trim the number of applications submitted, how virtual interviews have improved equity and how readiness curriculum and coaching might boost first-year residents’ readiness.

Beginning with the 2024–2025 application cycle, a new application—dubbed the Residency Centralized Application Service—will replace the Electronic Residency Application Service (ERAS) for those applying to train in ob-gyn residency programs. Learn more about the new ob-gyn physician residency application.