Association for Surgical Education
Is match ethics an oxymoron?

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Abstract

Background: Graduate medical education has undergone economic and structural changes—changes that have placed increasing pressure on medical students and programs to match effectively. This study documents the experiences, perceptions, and ethical dilemmas of medical students with the 1998 match process.

Methods: Surveyed were 437 senior students from three medical schools. Students were questioned about: interviewing practices, communication with programs, commitments made, ethical dilemmas faced, and the match process itself. Data were analyzed using Student’s t test, the chi-square test, and descriptive statistics.

Results: In all, 314 (72%) students responded. Programs expect postinterview communication from students (57%). Students perceive that programs are making “informal” commitments (43%), lying to them (33%), and encouraging their unethical behavior in order to match (21%). Ethical dilemmas are related to requests for informal commitments.

Conclusions: The NRMP’s ruling that denounces prematch commitments is being broken by students and programs alike, resulting in the promotion of unprofessional behavior and gamesmanship.

Section snippets

Methods

The subjects for this study were senior students participating in the 1998 NRMP from the University of Kentucky, Michigan State University, and the University of Minnesota (N = 437). The students were asked to complete a 22-item written questionnaire; 13 questions were close-ended, 8 questions were partially close-ended to allow for comment, and one question was open-ended. Questions related to students’ perceptions of: interviewing in more than one specialty, communication initiated by

Results

A total of 314 students responded to the survey for a 72% response rate. The first research question addressed students’ interviewing practices. Fifty-seven percent (57%) of students indicated they had interviewed for positions in primary care (family practice, internal medicine, med-peds, and pediatrics), 38% interviewed in specialty fields, and 5% interviewed for both primary care and specialty positions. The primary reasons for students interviewing in more than one specialty were indecision

Comments

A review of the Association of American Medical Colleges curriculum directory reveals increasing emphasis on primary care in medical school curricula.5 This change in emphasis has enhanced students’ early exposure to primary care as well as their interest in these fields. This emphasis on primary care may limit a student’s exposure to specialty rotations early in their clinical training, and thus diminish their exposure to fields that they may wish to pursue for a career. Concurrently, the

References (9)

  • National Resident Matching Program Handbook for Institutions and Program Directors. 1998 Match. Washington, DC,...
  • National Resident Matching Program NRMP Data. Washington, DC: ; April...
  • Rules and Regulations. Federal Register. May 12,...
  • National Resident Matching Program NRMP Data. Washington, DC: April...
There are more references available in the full text version of this article.

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