Recruitment behavior and program directors: how ethical are their perspectives about the match process?

This study examined family practice residency directors' perspectives on the 1999 National Resident Matching Program (NRMP) process and identified directors' expectations for students' recruitment behavior. Subjects were the family practice residency program directors. A 22-item written questionnaire was mailed to each director. The questions related to the directors' perceptions of the following issues: applicants interviewing in more than one specialty, communication initiated by programs or applicants, commitments made to applicants and by applicants, ethical dilemmas faced by the program director, and the NRMP process itself. Descriptive statistics were reported. Only a few of the residency program directors (9.1%) felt that it was ethically wrong for an applicant to interview in more than one specialty. However, most program directors (83%) indicated that the knowledge of an applicant interviewing in more than one specialty had a "significant" negative or "some" negative effect on the applicant's rank order. Ninety-five percent of program directors indicated that they engage in follow-up communication with applicants following the formal interview. Almost all program directors (98%) reported that at least some applicants contact them following the formal interview to inform them that the program was a "high" or No. 1 rank-order choice. The majority of program directors (94%) felt that the NRMP process placed their program in the position of having to be dishonest with applicants to match their top choices. The results of the study indicate that the actions of many program directors and applicants may not be consistent with the written policies of the NRMP.