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The Effort and Cost of the Pediatric Surgery Match Process: Are We Interviewing Too Many Candidates?

Saturday, October 20, 2012: 7:30 AM
Versailles Ballroom (Hilton Riverside)
Keith A. Thatch, M.D.1, Saleem Islam2, Kenneth Azarow3, Mike K. Chen4, Cynthia D. Downard, M.D., M.M.Sc.5, Craig W. Lillehei, MD6, Pramod S. Puligandla, MD, MSc7, Marleta Reynolds, MD8, John H.T. Waldhausen, MD9, Keith T. Oldham, MD10, Max R. Langham, MD, FAAP11 and Ronald Hirschl1, (1)Pediatric Surgery, University of Michigan, Ann Arbor, MI, (2)Department of Surgery, Section of Pediatric Surgery, University of Florida, Gainesville, FL, (3)Children's of Omaha, (4)Pediatric Surgery, Children's Hospital of Alabama, University of Alabama at Birmingham, Birmingham, AL, (5)Pediatric Surgery, University of Louisville, Louisville, KY, (6)Department of Surgery, Children's Hospital Boston, Harvard Medical School, Boston, MA, (7)Montreal Children's Hospital, (8)Surgery, Children's Memorial Hospital, Chicago, IL, (9)Department of General and Thoracic Surgery, Seattle Children's Hospital, Seattle, WA, (10)Pediatric Surgery, Medical College of Wisconsin, Children's Hospital of Wisconsin, Milwaukee, WI, (11)Surgery, University of Tennessee, Memphis, TN

Purpose: Over the last two decades, the annual number of Pediatric Surgery training programs in the match has doubled from ~20 to 43.  Previous studies have demonstrated that this growth has resulted in considerable cost and effort for candidates as well as General Surgery/Pediatric Surgery programs.  We believe that there is a need to adapt to these increases and adjust the match process.

Methods: A survey of all pediatric surgery training program directors with regard to their last three matches and interview practices was conducted.  Specifically, we inquired about the rank at which each program matched in 2008, 2009, and 2010, and how many candidates were invited and actually interviewed for the 2011 match.  Finally, we asked each program director to estimate the minimum number of residents they needed to interview for an effective match.

Results: We received responses from 100% of the program directors with regard to the match in 2008 and 2009, and 93% in 2010. The median rank at which each program matched was 3 in 2008, 4 in 2009, and 2 in 2010(see graph).  84% of programs matched within their top five choices and the lowest rank matched for any year was 12.  For the 2011 match, programs varied significantly in the number of interview invitations with a median of 33(range: 14-47).  Actual interviews involved a median of 30 candidates per program(range: 10-42) even though the collective opinion of the responding program directors was that the median minimum number of candidates required to be interviewed was 20(range: 10-35).

Conclusion: These data suggest that Pediatric Surgery training programs interview an excess number of candidates given their eventual match rank and the opinion of the program directors.  We propose that programs evaluate mechanisms designed to reduce the number of interviews in order to limit the cost and effort associated with the match.