“The End Game”- Students’ perspectives of the National Residency Matching Program: A focus group study

Background The evolving match process has resulted in increasing pressures on medical students, residency programs, and medical schools. These pressures have led to calls for reform of the National Residency Matching Program (NRMP). Large amounts of data regarding strategic ways to apply to residencies are available, but students may not trust the data enough to make such an important decision. In order to understand student experiences during the NRMP, qualitative studies are needed. Method Video-recorded focus groups were conducted with students who participated in the 2017 NRMP at a large Midwestern medical school. Recordings were independently analyzed using a conventional content analysis approach, developing categories which were reviewed by all members of the research team. Results Five focus groups were completed with 24 volunteers within weeks of match results. Categories were identified and supporting quotes included. These categories included information regarding the selection of programs, accepting and scheduling interviews, and the interview experience. Participants indicated that they accept all interviews and then subsequently canceled them, regardless of the impact on fellow students or residency programs. Participants also provided recommendations for programs, but were reluctant to suggest major changes to the NRMP. Discussion The match is a high-stakes experience in which the “over-apply, overaccept” strategy is dominant. Students recognize that they are investing excessive time and resources, but will not leave anything to chance. This study illuminates the areas of concern and perspectives of the NRMP from the student point-of-view. Further qualitative studies are needed to investigate this further.