A Simulation of the Effect of Interview Caps on the National Resident Matching Program Match in Otolaryngology

Concerns regarding interview hoarding in the Match process have led to calls for a cap on the number of interviews an applicant can accept. However, no study has examined the effects of interview caps on applicants or a specialty. The authors created a simulation otolaryngology Match to analyze the effects of interview caps. The simulation included 120 residency programs, 360 positions, and 570 applicants (each assigned a competitiveness weighted value). Programs created interview lists (subject to 4 different interview cap conditions: no, 16, 12, and 8 cap) using weighted random selection and the competitiveness weighted values. Programs then selected 3 interviewees to fill their positions via weighted random selection using the competitiveness weighted values. Data analysis explored the effects of interview caps on individual applicants' probability of matching, the probability of matching with a certain number of interviews, and the average matched applicant competitiveness rank using one-way analysis of variance. The introduction of interview caps caused interviews to be distributed more equally among applicants. The 12-interview cap caused the applicants in the 100th competitiveness percentile to see their probability of matching fall from 99.3% to 67.2% (P <.001). Applicants with ≥ 12 interviews had a probability of matching of 94.4% when there was no cap, compared to 76.9% with a 12-interview cap (P <.001). The average competitiveness rank of matched applicants fell from 191 with no cap to 245 with a 12-interview cap (P <.001). Interview caps in the otolaryngology Match may create major distortions in the probability of matching, leading to much lower chances of matching for more competitive applicants, lower probabilities of matching with certain numbers of interviews, and a decreased average competitiveness of matched applicants.