We want it to be easy.
We use the internet on a daily basis to search for information. We rejoice when the first website gives us clear access to what we seek; we become increasingly frustrated if we go in circles from one site to another without finding what we need. Imagine what it must be like for a final-year medical student trying to research residency programs. The format and the information that program websites contain is highly variable and often out of date. Program descriptions on the CaRMS website contain detailed text but are not easily searchable. Many students remain unaware of additional resources found on the CanPrePP website. It must be a very time-consuming process indeed!
It has long been acknowledged that applying to residency is an extremely stressful process. Reference Clark, Shah, Kolla, Marshall, Bryson and Nair1,Reference Delva2 Statistics about the number of available positions or student satisfaction with match results do not account for the time and effort that went into making choices and setting rank lists. The CaRMS match moved to virtual interviews in 2021 and visiting electives only resumed to a very limited extent in the fall of 2022, with full capacity not expected until the fall of 2023. 3 These changes resulting from the COVID-19 pandemic made it even harder for applicants to learn about programs and make choices; they increasingly rely more on virtual resources to gather information. Reference Niznick, Lun and Gotfrit4
Residency program websites can serve as an important source of information for students Reference Blissett, Law, Morra and Ginsburg5 and have been shown to influence applicants rank lists. Reference Boudreau, Das, George and Godzik6 However, the study by Tsai and colleagues in this issue of the Journal Reference Tsai, Wen and Tao7 confirms that wide variation exists in how programs use websites to showcase their strengths, curriculum, and resources. At a broad level, US program websites were found to be more comprehensive than Canadian websites. Some of this can be explained by the fact that Canadian resident salaries, vacation policies, and insurance plans are province-dependent, while benefits in the USA can be department- and institution-specific. Canadian programs may expect applicants to look elsewhere for this information as well as information on selection criteria, application process, and application dates.
Tsai and colleagues adapted their assessment tool from prior studies. Although it includes a broad range of criteria, most items are “all or none,” either present or absent on a given website. For example, the “neighbourhood” criterion was fulfilled if the website included at least one detail of the surrounding neighborhood, while “selection criteria” was fulfilled if the website included at least one method of how applicants will be evaluated (e.g., interview). It is possible that even websites graded as comprehensive by the assessment tool would still be found to be insufficiently helpful by students.
The assessment tool also did not weigh the relative importance of items, and the study did not attempt to identify what website information is of most interest to candidates. Prior studies have shown that applicants highly value information about faculty, residents, research opportunities, and curriculum. Reference Boudreau, Das, George and Godzik6,Reference Gaeta, Birkhahn, Lamont, Banga and Bove8 The CaRMS website provides a ranking of influences on first-choice program location. Top items include impression of town, leisure activity opportunities, collegiality between faculty and residents, support within program, diversity of training within a program, cultural diversity of the town/city, and level of responsibility given to residents (in addition to “non-modifiable” influences such as proximity to friends and family and employment prospects for partner). This is not the kind of information that is easy to convey with data or even a paragraph. This suggests that program websites need to look at innovative ways to showcase their city and their program.
Many programs introduced additional virtual resources during the COVID-19 pandemic. Reference Niznick, Lun and Gotfrit4 Virtual tours and open houses allow applicants to explore facilities and interact with faculty and current residents in addition to getting a better understanding of the program’s environment. Webinars and online information sessions give applicants opportunities to learn program highlights, curriculum details, research opportunities, and other aspects. These sessions often include question and answer forums where applicants can directly interact with program representatives and current residents. Reference Niznick, Lun and Gotfrit4 This virtual personal interaction can be highly influential when students rank programs. Reference Leppard, Nath and Cheung9 Social media utilization by residency programs has also increased. Reference Gaini, Patel, Khan, Singh and Love10 However, not all applicants may have social media accounts and individual posts can be influenced by personal bias. Programs would be wise to ensure that information presented on social media is also displayed objectively on their program websites.
What should programs do? Use the study by Tsai and colleagues and the data it provides as both an inspiration and a resource. Programs should practice “self-applying” and carefully critique their websites to identify areas for improvement. Can you find all the information? Can you find what you would want to know? Try as much as possible to make websites a “one-stop shop.” Use links judiciously but make sure they take one directly to the information sought.
Use videos or links to social media to provide more detailed and nuanced information about community, environment, and benefits. Use websites not only to inform students of upcoming virtual information sessions but to help them prepare for such sessions.
Providing critical program information that is easily accessible, consistently presented, and user-friendly will ultimately lead to a more efficient, effective, and inclusive application process.
Above all, make it easy. It is what you would want.
