After your medical residency interviews: Communication guidelines


With Match Day just around the corner, a new study suggests that “sensible” regulations governing how communication is handled after interviews during the match process could lead to more authentic dialogue, ensure ethical behavior and promote a positive Match experience for medical students and residency programs alike in future years.

National Resident Matching Program (NRMP) policy already restricts communication. For example, it allows applicants and programs to express interest in one another but not to solicit verbal or written statements implying a commitment. The NRMP also prohibits either side from saying their rank order depends on a promise from the other side—“you rank me No. 1, and I’ll rank you No. 1.”

5 recommendations to make the post-interview process positive

But a recent perspective published in the Journal of Graduate Medical Education advocates that residency programs could take five steps to make the post-interview process a better experience for future residents and program leaders. Physician authors from Duke University Medical Center recommend that residency programs:

  • Set clear expectations for applicants on interview day about what are considered appropriate forms of post-interview communications.
  • Limit post-interview communications to objective information.
  • Provide a point person to handle all post-interview communications.
  • Consider logging all post-interview communications to safeguard ethical standards. If additional oversight is needed, communications could be forced to pass through a messaging service on the NRMP website.
  • Initiate dialogue on a national level within specialties to create specialty-specific consensus guidelines. The authors note that needs vary among specialties.

The authors made these recommendations after surveying 268 diverse residency programs nationwide about the communication they had with applicants after interviews. The study concluded both sides felt misled by communications.

Study authors noted that previous studies have shown that up to 94 percent of applicants send communications to program leaders after an interview, often believing their communications will improve their ranking. But just 5.2 percent of program directors who participated in the study published in February said that they always or usually move up applicants on their rank order lists after the applicant promises to rank their program No. 1.

Preventing unproductive communications

With no mechanism in place to stop an applicant from telling multiple programs they have ranked a program No. 1, 52.6 percent of program directors surveyed reported that at least once a year they have one or more applicants say they are ranking the residency program No. 1 when the applicant has actually given the program a different ranking.

And authors note that medical students may easily interpret any positive language from a residency program as a promise to be ranked to match. Previous studies have shown up to 33 percent of applicants have reported they were misled by a communication from a residency program leader, and 8.3 percent of applicants who responded to one survey said a residency program directly asked them how their program would be ranked.

Yet the new survey showed that 64.6 percent of programs reported that they never share any information with applicants about their likelihood to match, “signifying a disconnect between the reporting on either side,” study authors said.

The study noted that banning all communication would be the “simplest solution” to prevent communication concerns. In fact, nearly 46 percent of survey respondents favored that approach. But, authors noted, it also would be the most impractical way to change the system because residency programs and applicants spend up to seven years together. Authors said “it is important to make sure that all questions and doubts are addressed up front before a binding commitment is made.”

Instead, the authors encouraged “residency program directors in all specialties to talk with their colleagues and propose sensible regulations for post-interview communications” to ensure a productive and ethical exchange for everyone involved.