We read with interest the viewpoint by Christophel and Levine.1 Although we agree with the problem, we suggest a different solution.
In a 2008 editorial entitled “Otolaryngology (Urban) Legend,”2 we addressed the alarming increase in the number of applications each medical student was submitting to obtain residency training in otolaryngology–head and neck surgery. The latest Electronic Residency Application Service (ERAS) data for our field show that the median number of applications per US graduate applicant rose from 40 in 2006 to 60 in 2014, an extraordinary increase considering that there are approximately 100 otolaryngology training programs.3 This tectonic shift in the application process has led to an increase in the average number of submitted applications per program from 159 in 2008 to 278 in 2014. For our program at The University of Chicago this year, we received 382 applications for 2 positions, leading to a 0.5% match rate. Although we can exult in our selectivity, we believe that the change to a central standard application process, along with ready availability of data such as these match rates, has created the conditions for a vicious cycle of increases in applications per applicant. How many of these 382 applicants had a genuine interest in our program? Are applicants simply responding to stress about matching in a competitive field by checking boxes on the Common Application form?
Naclerio RM, Pinto JM, Baroody FM. Drowning in Applications for Residency Training: A Program’s Perspective and Simple Solutions. JAMA Otolaryngol Head Neck Surg. 2014;140(8):695–696. doi:10.1001/jamaoto.2014.1127
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