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首页> 外文期刊>The Journal of Graduate Medical Education >Viewpoint From 2 Undergraduate Medical Education Deans The Residency Application Process: Working Well, Needs Fixing, or Broken Beyond Repair?
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Viewpoint From 2 Undergraduate Medical Education Deans The Residency Application Process: Working Well, Needs Fixing, or Broken Beyond Repair?

机译：来自2位本科医学教育院长的观点居留申请流程：是否运作良好，需要修复或超出维修范围？

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The experience of current medical students applying for US residencies The residency application process, which includes not just the basic application components but away electives, negotiating for interviews, garnering faculty support, and managing postinterview communication, is protracted, is expensive, and often lacks transparency.1 The process has become more challenging for medical students and program directors because of the increased number of applicants and applications. Students are stressed by the timeline of residency interviewing, the difficulty in finding out information about residency programs, the perceived increase in competitiveness of the Match, and the time and expense that these processes entail. Having all aspects of the application ready by September 15, when residency programs start accessing applications through the Electronic Residency Application Service (ERAS), can be a daunting task, even for students at schools that complete the core clinical year earlier than the end of year 3. Furthermore, programs in specialties like orthopedic surgery and emergency medicine expect students to do electives at institutions away from their own schools. Some students applying to orthopedic surgery residency may do 3 away rotations at different programs. This is a lot to accomplish in a short amount of time; there may be limited opportunity for students to carefully consider and reflect on their chosen specialty and the specific program choices. Applying for residency occupies a substantial portion of the fourth year of medical school, which potentially prevents students from using the year more productively. This may also discourage schools from initiating experiences and curricula that can maximally prepare for the challenges of residency, especially in a way relevant to a student's chosen field.1 Students also have voiced concern over difficulty finding information about programs. Some services, like the American Medical Association's FREIDA Online, are good sources for finding programs by region. Doximity has taken this a step further by rating programs using data like board pass rates, but it also uses reputation, which is of questionable merit.2 Websites for programs are highly variable and may not be updated regularly. Students therefore rely heavily on mentors and advisers, who can be immensely helpful, but who also may have limited knowledge of programs beyond a regional scope. Students may use online resources like The Student Doctor Network,3 where the information can be current but may not be accurate. Collectively, this results in an information imbalance in which students may have difficulty narrowing the lists of programs to which they are applying, since it is challenging to assess the strengths of a program or whether it is the right fit prior to an interview. On a logistical level, students have reported that obtaining a date and time for an interview can be extremely difficult, even when they receive an invitation from a program. Some students have found that interview slots fill up quickly, within seconds, despite prompt responses to invitations. Some programs, especially those in more competitive fields, offer only a handful of interview dates, which may conflict with those of other programs. Some students hear nothing back from certain programs they have applied to, and may be unsure whether to interpret this as a rejection or as being placed on a waiting list for an interview. This leads to a dilemma about how to communicate with programs or whether to request advisers to advocate on their behalf. The whole enterprise can be very expensive for students. In addition to the fees for ERAS and the National Resident Matching Program (NRMP), students have to pay for travel and accommodations, which can be substantial. These expenses are not typically covered by federal loan programs, and thus students may need to take out nongovernmental loans. This adds to the level of indebtedness that is alre
机译：当前医学生申请美国居留的经验居留申请过程不仅冗长，昂贵而且通常缺乏透明度，该过程不仅包括基本申请内容，还包括选修课，面试谈判，获得教职人员支持以及管理面试后沟通。 .1由于申请人和申请数量的增加，该过程对医学生和项目主管而言更具挑战性。居住面试的时间表，难以找到有关居住计划的信息，比赛的竞争力明显提高以及这些过程所需的时间和费用给学生们带来了压力。在9月15日之前准备好所有方面的申请，当居留计划开始通过电子居留权申请服务（ERAS）访问申请时，即使对于在年底之前完成核心临床学年的学校学生来说，也是一项艰巨的任务。 3.此外，骨科手术和急诊医学等专业计划要求学生在远离自己学校的学校进行选修课。一些申请骨科手术住院医师的学生可能会在不同的课程中进行3次轮换。在短时间内可以完成很多工作;学生可能很少有机会仔细考虑并反思他们选择的专业和特定课程的选择。申请居住权占医学院四年级的很大一部分，这有可能使学生无法更有效地利用这一年。这也可能使学校不愿开办能够最大程度地应对居住挑战的经验和课程，特别是在与学生选择的领域相关的方式上。1学生还对难以找到有关课程信息表示担忧。某些服务，例如美国医学会的FREIDA Online，是按地区查找计划的良好来源。 Doximity通过使用诸如董事会通过率之类的数据对程序进行评级，进一步迈出了一步，但是它也使用了声誉，这是值得怀疑的。2程序的网站变化很大，并且可能不会定期更新。因此，学生在很大程度上依赖导师和顾问，他们可以提供极大的帮助，但对区域范围以外的课程知识也可能有限。学生可以使用“学生医生网络” 3之类的在线资源，其中的信息可能是最新的，但可能并不准确。总体而言，这导致信息不平衡，其中学生可能难以缩小他们正在申请的课程列表，因为在进行面试之前评估课程的优势或是否合适是一项挑战。在后勤方面，学生们报告说，即使他们收到计划的邀请，也很难获得面试的日期和时间。一些学生发现，尽管对邀请做出了迅速反应，但面试时间却在几秒钟之内迅速填满。有些程序，特别是竞争激烈的程序，仅提供少数面试日期，这可能与其他程序的面试日期冲突。一些学生从他们申请的某些程序中听不到任何回音，并且可能不确定是将其解释为拒绝还是被列入面试等待名单。这导致在如何与程序进行通信或是否要求顾问代表他们倡导方面陷入困境。整个企业对学生而言可能是非常昂贵的。除了ERAS和国家居民匹配计划（NRMP）的费用外，学生还必须支付交通和住宿的费用，这笔费用可能很大。这些费用通常不包括在联邦贷款计划中，因此学生可能需要获得非政府贷款。这增加了负债的程度

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