AUA 2018: The National Resident Matching Program Code of Conduct: What Is The Degree Of Compliance During The Urology Match Process?

San Francisco, CA USA ( Elisabeth Sebesta, MD, a clinical urologist from New York, NY, presented on a study that assessed the frequency and type of violations to NRMP Code of Conduct and Urology Match “guidelines to programs” statement during the Urology Match process in conjunction with the applicants’ perception of these violations.

In 1952, the National Resident Matching Program (NRMP) was created in the United States to provide matching services to residency programs across the nation. A code of conduct was created by the NRMP to facilitate equality by ensuring that faculty did not ask any “illegal”/coercive questions, which include but are not limited to questions regarding age, gender, religion, sexual orientation, family status, and programs applicant has applied to. The code of conduct also states faculty are not able to solicit post-interview communication or require second-look visits or imply involvement in the decision making process. The Urology Residency Match, separate from the NRMP and overseen by the AUA, also has a “guideline to programs” section that states there should be no ranking of applicants as first on [their] list prior to match and no verbal post-interview contact.

In the study, 285 senior medical students from the 2017 Urology Match were included. All applicants were sent electronic surveys, which consisted of 21 questions pertaining to post-interview communication, second-look visits, “illegal”/coercive questions, and perceived impact of these violations. Responses were compared based on gender.

It was found that of the 166 applicants who responded to the survey, 58% received follow-up communication, which mainly consisted of a “Thank You” note. However, 13% reported unsolicited phone calls from faculty explaining interest in the applicant, a direct violation of the Urology Match guidelines section. From the applicant perspective, 46% reported receiving communication of any kind from a program positively affected that program’s rank, but nearly 20% felt mislead due to thoughts that they had a higher chance of matching based on contact from the program. Second-look visits were also reported in 30% of survey responses and 60% of those reported that it positively affected the program’s ranking. Furthermore, female applicants were significantly more likely to be asked “illegal”/coercive questions than their male counterparts.

In conclusion, a high portion of applicants experienced violations of the NRMP Code of Conduct and/or the Urology Match guidelines to the program. While it is still unclear what roles the NRMP Code of Conduct plays in the Urology match, this study lays the groundwork for improving fairness in the residency match process.

Presented by: Elisabeth Sebesta, MD

Written by: Whitney Zhang, Department of Urology, University of California-Irvine at the 2018 AUA Annual Meeting - May 18 - 21, 2018 – San Francisco, CA USA