Current Communication Practices Between Obstetrics and Gynecology Residency Applicants and Program Directors
Authors: Morgan Helen Kang , Winkel Abigail Ford , George Karen , Strand Eric , Banks Erika , Byrne Fiona , Marzano David , Hammoud Maya M. 
Published: October 2022

Importance

In order to equitably improve the residency application process, it is essential to understand the problems we need to address.

Objective

To determine how obstetrics and gynecology (OBGYN) applicants and faculty communicate applicants’ interest to residency programs, and how program directors report being influenced by these communications.

Design, Setting, and Participants

This survey study was conducted with email surveys of OBGYN application stakeholders in 2022. Included participants were OBGYN applicants, clerkship directors, and residency program directors in medical education associations’ email listservs.

Exposures

Surveys sent by the American Association of Medical Colleges, Association of Professors of Gynecology and Obstetrics, and Council on Resident Education in Obstetrics and Gynecology.

Main Outcomes and Measures

Whether applicants themselves, or faculty on their behalf, communicated to residency programs, and the influence program directors reported placing on these communications for their decision-making. Descriptive statistics and χ2 tests were used to analyze differences.

Results

A total of 726 of 2781 applicants (26.1%), 79 of 249 (31.7%) clerkship directors, and 200 of 280 (71.4%) programs responded to the surveys and were included in the analysis. The self-reported racial and ethnic demographics of the 726 applicant respondents were 86 Asian (11.8%), 54 Black (7.4%), 41 Latinx (5.6%), 1 Native Hawaiian or Pacific Islander (0.1%), 369 White (52.2%), 45 with multiple racial identities (6.2%), and 91 (12.5%) did not indicate race and 17 (2.3%) preferred not to answer. The majority of applicants (590 [82.9%]) sent communications at some point in the application process. Applicants who identified as White (336 [88.7%]) or Asian (75 [87.2%]) were more likely than those who identified as Black (40 [74.1%]) or Latinx (33 [80.5%]) to reach out to programs (P = .02). There were also differences in type of medical school, with 377 of 427 MD applicants (88.3%), 109 of 125 DO applicants (87.2%), and 67 of 87 International Medical Graduate applicants (77.7%) reporting sending communications (P = .02). Approximately one-third (254 applicants [35.7%]) had faculty reach out to programs on their behalf. White (152 [40.1%]) and Asian (37 [43.0%]) applicants were more likely to have faculty reach out compared with Black (6 [11.1%]) and Latinx (12 [29.3%]) applicants (P = .01). Program directors reported that preinterview communications from faculty they knew (64 [32.2%]) and other program directors (25 [12.6%]) strongly influenced their decisions, and otherwise rarely reported that communications strongly influenced their decisions.

Conclusions and Relevance

The current state of communications may increase inequities in residency application processes; differences between faculty communications for applicants from different racial and ethnic backgrounds are particularly concerning given that program directors are more likely to weigh communications from faculty in their decision-making. A centralized, equitable means for applicants to signal their interest to programs is urgently needed.