title: Securing an OTL-HNS residency: how competitive is it? Comparing medical student perceptions to actual Canadian statistics.
abstract: BACKGROUND
  The residency match is an important event in an aspiring physician's career. Otolaryngology - Head and Neck Surgery (OTL-HNS) is a surgical specialty that has enjoyed high numbers of applicants to its residency programs. However, recent trends in Canada show a decline in first-choice applicants to several surgical fields. Factors thought to influence a medical student's choice include role models, career opportunities and work-life balance. The notion of perceived competitiveness is a factor that has not yet been explored. This study sought to compare competitiveness of OTL-HNS, as perceived by Canadian medical students to residency match statistics published yearly by CaRMS (Canadian Residency Matching Service), with the hope of informing future decisions of surgical residency programs.
  
  
  METHODS
  An electronic survey was created and distributed to all medical students enrolled in the 17 Canadian medical schools. After gathering demographic information, students were asked to rank what they perceived to be the five most competitive disciplines offered by CaRMS. They were also asked to rank surgical specialties from most to least competitive. Publically available data from CaRMS was then collected and analyzed to determine actual competitiveness of admissions to Canadian OTL-HNS residency programs.
  
  
  RESULTS
  1194 students, from first to fourth year of medical school, completed the survey. CaRMS statistics over the period from 2008 to 2014 demonstrated that the five most competitive specialties were Plastic Surgery, Dermatology, Ophthalmology, Emergency Medicine and OTL-HNS. Among surgical disciplines, OTL-HNS was third most competitive, where on average 72% of students match to their first-choice discipline. When students were questioned, 35% ranked OTL-HNS amongst the top five most competitive. On the other hand 72%, 74% and 80% recognized Opthalmology, Dermatology and Plastic Surgery as being among the five most competitive, respectively. We found that fourth-year medical students were significantly more knowledgeable about the competitiveness of both OTL-HNS and Plastic Surgery compared to first-year students (p < 0.01).
  
  
  CONCLUSIONS
  Overall, Canadian medical students may underestimate the competitiveness of OTL-HNS. Furthermore, competitiveness would appear to be a concept that resonates with medical students during the match process.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Canada. emily.kay-rivest@mail.mcgill.ca.
authors.forename: E
authors.identifier: http://orcid.org/0000-0002-4085-4532
authors.initials: E
authors.lastname: Kay-Rivest
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Canada.
authors.forename: N
authors.initials: N
authors.lastname: Varma
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Western University, London, Canada.
authors.forename: G M
authors.initials: GM
authors.lastname: Scott
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Canada.
authors.forename: J J
authors.initials: JJ
authors.lastname: Manoukian
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Université de Montréal, Montréal, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Desrosiers
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of Ottawa, Ottawa, Canada.
authors.forename: J P
authors.initials: JP
authors.lastname: Vaccani
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Canada.|Center for Medical Education, McGill University, Montreal, Canada.
authors.forename: L H P
authors.initials: LH
authors.lastname: Nguyen
mesh_terms: D000328:Adult; D002170:Canada; D002321:Career Choice; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D010036:Otolaryngology / Q000193:education*; D010465:Perception; D013337:Students, Medical; D011795:Surveys and Questionnaires
keywords: Competitiveness; Medical education; Residency match