459 - Factors that influence rank decisions for applicants to a categorical pediatric residency program.

Publication Number: 459.4946

Reena Tam, University of Utah School of Medicine, Salt Lake City, UT, United States; Meghan O'Connor, University of Utah School of Medicine, Salt Lake City, UT, United States; Joni Hemond, University of Utah School of Medicine, Salt Lake City, UT, United States; Ashley N. Boyington, University of Utah, Salt Lake City, UT, United States

Background: During residency recruitment, applicants consider many factors when ranking programs. Identifying those factors and to what degree they influence applicants when ranking programs is important to improving recruitment efforts particularly now, considering the 5% drop in fill rate for pediatric residency programs in 2024. We sought to understand which aspects of our program and interview day were viewed positively or negatively by applicants during their rank consideration process.

Objective: To identify factors that influence rank decisions amongst categorical pediatric residency applicants at a single program.

Design/Methods: This cohort study compared 4 ERAS seasons (2021 to 2024); all were virtual. Applicants were surveyed anonymously after rank list submission and before match day using JotForm. Questions used Likert scale responses to indicate the degree a factor influenced applicant's rank decision as well as free text comments. Descriptive analysis was used to quantify responses and qualitative analysis was applied to comments to identify themes.

Results: Over the study period, 232 applicants responded (26.5%). The top 3 factors that influenced applicants to rank the program higher were: 1. X+Y scheduling, 2. interactions with program staff, and 3. approachability of residents and faculty. The top 3 factors that influenced a lower rank were: 1. geographic location, 2. diversity of patient population, and 3. diversity of residents, staff, leadership, and faculty.

Comments regarding location identified limitations in training opportunities due to state laws starting in season 2023. Comments indicated that restrictive legislation, such as gender-affirming care, would impact their ability to learn the skills needed to practice pediatrics.

Conclusion(s): Contextualizing the factors that influence decision-making amongst applicants is important for residency program recruitment. Staff interactions with applicants and the approachability of residents and faculty in making applicants feel welcome is important, arguing that programs should prepare personnel to foster a positive recruitment experience. X+Y scheduling was the most positive influencer suggesting a program’s approach to scheduling should be discussed during recruitment. The concerns about location and diversity provide evidence that rankings are influenced by local contexts that are external to the residency program itself. Next steps include adding survey question(s) about specific state laws and developing recruitment strategies to thoughtfully address applicant concerns related to geographic location and diversity.

Top 3 factors influencing rank decision