성형외과 전공의 선발 인터뷰 중 금지된 질문의 사용빈도(Plast Reconstr Surg Glob Open. 2023)

성형외과 전공의 선발 인터뷰 중 금지된 질문의 사용빈도(Plast Reconstr Surg Glob Open. 2023)
Prevalence of Prohibited Questions during Plastic Surgery Residency Interviews

 

소개
INTRODUCTION

성형외과는 가장 경쟁이 치열한 레지던트 과정 중 하나이며, 이러한 추세는 최근 몇 년 동안 더욱 심해졌습니다.1,2 2020년과 2021년 지원 주기에서 미국 의대생 지원자의 30.1%가 통합 성형외과 포지션에 매칭에 실패했습니다. 이 수치는 2022년에는 38.4%(108명)로 증가했습니다.3-5 2022년 매칭 주기 동안 86개의 통합 성형외과 및 재건외과(PRS) 프로그램에서 제공하는 194개의 PGY-1 자리에 411명의 지원자가 있었습니다.6,7 2022년 전국 레지던트 매칭 프로그램(NRMP) 보고서에 따르면 281명(80%)의 지원자가 미국 의과대학에서 교육을 받았으며 이 그룹이 173개(89.2%) 자리를 확보했습니다.5 성형외과 합격자의 자격은 모든 전문과 중에서 가장 경쟁이 치열합니다.

• 미국 의과대학협회(AAMC)에 따르면 성형외과 1년차 통합 전공의의 USMLE 1단계와 2단계를 합한 점수(각각 247점, 253.2점)는 이비인후과 전공의(각각 247점, 254.4점)에 이어 두 번째로 높았으며,
• 성형외과 1년차 전공의의 평균 출판, 발표 및 초록 수(20편)는 신경외과(24편)에 이어 두 번째로 높았습니다. 6), 정형외과(13.9건) 및 이비인후과(13.7건)보다 45% 더 많습니다.8

따라서 성형외과 통합전형에 참여하는 것은 경쟁이 치열하며, 대부분의 지원자들은 성형외과 전문의가 되기 위해 각 면접을 필수적으로 고려합니다. 이처럼 경쟁이 치열한 상황에서 면접 과정의 공정성과 투명성은 무엇보다 중요합니다. 
Plastic surgery is one of the most competitive residencies, and this trend has only intensified in recent years.1,2 In the 2020 and 2021 application cycles, 30.1% of United States medical student applicants for integrated plastic surgery positions failed to match. This figure rose to 38.4% (108 applicants) in 2022.3–5 During the 2022 match cycle, there were 411 applicants for the 194 PGY-1 spots offered by 86 integrated plastic and reconstructive surgery (PRS) programs.6,7 Based on the 2022 National Resident Matching Program (NRMP) report, 281 (80%) applicants were educated in US medical schools, and this group secured 173 (89.2%) of the positions.5 The qualifications of successful candidates in plastic surgery are the most competitive of all specialties.

• According to the American Association of Medical Colleges (AAMC), the combined USMLE Step 1 and Step II for the first-year integrated plastic surgery residents (247 and 253.2, respectively) were second only to residents in otolaryngology (247 and 254.4, respectively),
• while the average number of publications, presentations, and abstracts of the first-year plastic surgery residents (20) was second only to neurosurgery (24.6) and 45% greater than orthopedic surgery (13.9) and otolaryngology (13.7).8 

Consequently, participation in the integrated plastic surgery match is highly competitive, and most applicants consider each interview essential to their prospect of becoming a plastic surgeon. In such a high-stakes setting, the fairness and transparency of the interview process are paramount.

다양한 의학 및 외과 전문과목에 대한 연구에 따르면 면접 과정에서 지원자에게 허용되지 않거나 잠재적으로 불법적인 질문을 하는 비율이 충격적으로 높은 것으로 나타났습니다(그림 1).9-13 비외과 및 외과 전문과목 지원자 약 11,000명을 대상으로 한 Hern 등의 연구에 따르면 응답자의 53.3%가 결혼 여부, 24%가 자녀, 13.8%가 육아 계획에 대해 질문을 받은 것으로 나타났습니다.8 다른 전문과목에서도 유사한 결과가 보고되었습니다.9

• -인종/민족, 성별, 성 정체성, 성적 지향, 나이, 장애, 종교, 정치적 견해, 가족 상태에 관한 채용 과정에서의 질문은 1964년 민권법 제7장에 의거하여 연방법을 명백히 위반하는 것입니다.14
• 마찬가지로, NRMP는 지원자와 프로그램 모두를 위한 행동 강령을 제공하며 연방법을 면밀히 준수하는 경향이 있습니다.15,16 이 가이드에는 "불법적인 질문 자제"라는 제목의 특정 섹션이 포함되어 있습니다.
• 또한, AAMC는 인구통계, 가족, 병력(군대, 체포, 전과), 기타 프로그램/전문과목 및 순위 계획 등 인터뷰 시 피해야 할 주제를 설명하는 "의료 인터뷰 수행 모범 사례"를 게시합니다(그림 2).17

Studies of various medical and surgical specialties have documented that the incidence of impermissible or potentially illegal questions asked to candidates during the interview process is shockingly high (Fig. 1).9–13 A study by Hern et al surveying nearly 11,000 applicants in both nonsurgical and surgical specialties revealed that 53.3% of respondents were asked about their marital status, 24% about children, and 13.8% about plans for child-rearing.8 Similar findings have been reported in other specialties.9–13 

• Questions during an employment process regarding race/ethnicity, sex, gender identity, sexual orientation, age, disability, religion, political views, and family status explicitly violate federal law under Title VII of the Civil Rights Act of 1964.14 
• Likewise, the NRMP offers Codes of Conduct for both applicants and programs that tend to closely follow the federal legislation.15,16 This guide contains a specific section entitled “Refrain From Asking Illegal Questions.”
• Moreover, the AAMC publishes “Best Practices for Conducting Medical Interviews” that spell out topics to avoid during an interview, including demographics, family, history (military, arrests, criminal convictions), and other programs/specialties and ranking plans (Fig. 2).17

 

이러한 명확한 가이드라인에도 불구하고, 지원자들은 계속해서 이러한 허용되지 않는 질문에 직면하고 있으며, 여기서 허용되지 않는 질문이란 AAMC/NRMP가 금지하는 모든 주제 및/또는 진술로 정의합니다. 지난 10년간의 이전 매칭 주기에 대한 연구에 따르면 성별 모두 유의미한 영향을 받았지만, 여성 응답자가 특히 결혼 여부, 가족 계획 및/또는 프로그램에 대한 헌신과 관련하여 허용되지 않는 질문을 받을 가능성이 더 높았습니다.10 불법은 아니지만 지원자의 특정 프로그램에 대한 헌신 또는 인터뷰에 관한 질문은 매칭 규정에 의해 금지되어 있지만, 연구에 따르면 여러 전문과목에서 위반이 만연한 것으로 나타났습니다.10 -13,18 따라서 이 연구의 목적은 세 가지입니다:

• PRS 레지던트 면접에서 허용되지 않는 질문과 불법적인 질문의 유행을 문서화하고,
• 발생하는 질문의 유형을 탐구하며,
• 프로세스의 공정성과 투명성을 개선하기 위해 이 문제에 대한 경각심을 불러일으키기 위한 것입니다.

Despite these clear guidelines, applicants continue to face these disallowed questions, which we define here as any topic and/or statement that AAMC/NRMP prohibits. Studies from prior match cycles over the last decade have revealed that while both genders were significantly affected, female respondents were more likely to receive an impermissible question, especially regarding marital status, family planning, and/or commitment to the program.10 Although not illegal, questions regarding an applicant’s commitment to a given program and/or interviews are prohibited by match rule, yet studies show violations are prevalent across numerous specialties.10–13,18 Thus, the purpose of this study is threefold:

• to document the prevalence of impermissible and illegal questions during PRS residency interviews,
• to explore the types of questions that arise, and
• to draw awareness to this matter in hopes of improving the fairness and transparency of the process.

방법
METHODS

기관 심의위원회의 승인을 받은 후, PRS 레지던트 면접 시 잠재적으로 불법적인 질문에 대한 16개 문항으로 구성된 익명 설문조사를 설계하여 REDCap에 배포했습니다(그림 1). 이 설문조사는 2022년 3월부터 2022년 6월까지 미국 내 한 통합 PRS 프로그램의 2022년 매칭 지원자(302명) 전원에게 발송되었습니다. 매칭 결과가 발표된 후(2022년 3월) 지원자들에게 일주일 간격으로 세 차례 이메일을 발송하여 27.8%의 응답률을 보였습니다. 이후 2022년 6월까지 2주 간격으로 세 차례의 리마인더 이메일이 발송되었습니다. 총 66일 동안 지속적으로 응답을 수집하여 최종 응답률 33.1%를 달성했습니다. 
After institutional review board approval, an anonymous 16-question survey on potentially illegal questions during the PRS residency interview was designed and distributed on REDCap (Fig. 1). From March 2022 to June 2022, this survey was sent to all match 2022 applicants (302 applicants) of one integrated PRS program in the United States. After match results were published (March 2022), three separate emails, spaced a week apart, were sent to applicants with a response rate of 27.8%. Three subsequent reminder emails were sent 2 weeks apart until June 2022. Responses were continuously collected for a total of 66 days, achieving a final response rate of 33.1%.

연구 데이터는 워싱턴 DC의 어린이 국립병원에서 호스팅하는 REDCap-Research 전자 데이터 캡처를 사용하여 수집 및 관리되었습니다.19,20 REDCap은 연구용 데이터 캡처를 지원하도록 설계된 안전한 웹 기반 소프트웨어 플랫폼으로, (1) 검증된 데이터 캡처를 위한 직관적인 인터페이스, (2) 데이터 조작 및 내보내기 절차를 추적하기 위한 감사 추적, (3) 공통 통계 패키지로 데이터를 원활하게 다운로드하기 위한 자동 내보내기 절차, (4) 데이터 통합 및 외부 소스와의 상호운용성을 위한 절차 등을 제공합니다. 설문조사 도구는 식별 가능한 정보와 연결되지 않았으며 모든 응답은 익명으로 처리되었습니다. 
Study data were collected and managed using REDCap—Research Electronic Data Capture, hosted at Children’s National Hospital of Washington, DC.19,20 REDCap is a secure, web-based software platform designed to support data capture for research studies, providing (1) an intuitive interface for validated data capture; (2) audit trails for tracking data manipulation and export procedures; (3) automated export procedures for seamless data downloads to common statistical packages; and (4) procedures for data integration and interoperability with external sources. The survey instrument was not linked to identifiable information; all responses were anonymous.

지원자들에게는 인구통계학적 정보, 면접 경험, 질문 또는 AAMC 가이드라인에 따라 불법으로 간주될 수 있는 의견에 대해 질문했습니다. 또한 응답자들에게 이러한 시나리오에서 어떤 반응을 보였는지, 부적절한 질문과 관련된 조치를 취하기로 결정했는지, 해당 프로그램의 순위가 영향을 받았는지에 대해서도 질문했습니다. 
The applicants were queried about the demographic information, interview experience, questions, or comments that would be considered illegal based on the AAMC guidelines. Additionally, respondents were asked about their responses in these scenarios, if they had decided to pursue actions related to inappropriate questions, and if their ranking of these programs was affected.

답변은 REDCap에 표로 작성되었으며, 데이터 평가는 Microsoft Excel 16.40(Microsoft Corporation, 워싱턴주 레드몬드)을 사용하여 수행되었습니다. 통계 분석은 Stata 소프트웨어, 버전 14.2 MP(Stata Corporation, College Station, Texas)를 사용하여 수행되었습니다. 설문조사 완료 시 성별, 인종, 연령에 따른 경향과 부적절한 질문의 유병률을 분석했습니다. 단변량 분석은 공변량 t 검정을, 연속형 데이터 비교는 윌콕슨-만-위트니 테스트를 사용하여 수행했으며, 범주형 변수는 카이제곱 검정을 사용하여 비교했습니다. 값은 연속형 변수의 경우 평균 ± SD 또는 사분위수 범위(IQR)를 포함한 중앙값으로, 범주형 변수의 경우 백분율을 포함한 빈도로 표시했습니다. P값이 0.05 미만이면 통계적으로 유의미한 것으로 간주했습니다. 성별, 연령, 인종/민족별로 계층화된 하위 그룹 분석의 경우, 큰 효과 크기를 감지할 수 있는 검정력이 80% 이상인 것으로 나타났습니다(Cohen's W = 0.5). 
Answers were tabulated into REDCap, and data evaluation was done using Microsoft Excel 16.40 (Microsoft Corporation, Redmond, WA). Statistical analysis was performed using Stata software, version 14.2 MP (Stata Corporation, College Station, Tex.). Trends between gender, ethnicity, or age at completing the survey and the prevalence of inappropriate questions were analyzed. Univariate analysis was performed using unpaired t test, and Wilcoxon-Mann-Whitney tests to compare continuous data, and categorical variables were compared using chi-square test. Values were expressed as mean ± SD or median with interquartile range (IQR) for the continuous variables and frequencies with percentages for the categorical variables. A P value less than 0.05 was considered to be statistically significant. For the subgroup analyses, stratified by gender, age, and race/ethnicity, we found greater than 80% of power to detect a large effect size (Cohen’s W = 0.5).

결과
RESULTS

지원자 특성은 표 1에 나와 있습니다. 설문조사에 참여한 302명의 지원자 중 100명(33.1%)이 설문조사 요청을 완료했습니다. 대부분의 응답자는 지원 주기 동안 10회 이상의 면접을 받았습니다. 지원자의 대다수(78%)가 허용되지 않는 질문/시나리오를 경험했으며, 이러한 질문이 하나 이상 포함된 면접을 평균 3.6회(SD 3.79) 진행했습니다(그림 3 및 4). 이러한 질문이 가장 많이 등장한 카테고리는 인터뷰 숫자/랭킹(42%)이었으며, 결혼 여부(33%), 경력 균형(25%), 인종/민족(22%)이 그 뒤를 이었습니다. (성형외과 지원자에게 보낸 설문조사 예시가 표시된 설문조사, 보충 디지털 콘텐츠 1을 참조하세요. ) 이러한 질문/시나리오 중 상당수가 부적절하다고 생각했지만(25.6%), 지원자의 42.3%는 이러한 질문/시나리오의 적절성에 대해 잘 모르겠다/중립적이라고 느꼈습니다(표 2). 나머지 25명의 응답자(32.1%)는 면접 토론의 맥락을 고려할 때 해당 질문이 적절했다고 답했습니다. 8명의 지원자(10.3%)는 이러한 시나리오에서 답변을 거부했으며, 답변한 지원자 중 85.7%는 진실하게 답변했습니다. 이러한 불법 가능성이 있는 시나리오에 대해 불만을 제기하거나 신고한 지원자는 없었습니다. 응답자들이 꼽은 가장 일반적인 이유로는 기관의 보복이나 직급에 대한 부정적인 영향에 대한 두려움(30.9%)이 가장 많았고, 실익이 없어서(16.2%)가 그 뒤를 이었습니다. 마지막으로 응답자의 30%는 자신의 경험이 직급 목록에 영향을 미쳤다고 답했습니다.

Applicant characteristics are illustrated in Table 1. One hundred of the 302 applicants who were surveyed (33.1%) completed the survey request. Most respondents had received more than 10 interviews for the application cycle. The majority (78%) of applicants experienced an impermissible question/scenario with an average of 3.6 (SD 3.79) interviews that included at least one of these questions (Figs. 3 and 4). The most prevalent categories of these questions were number/ranking interviews (42%), followed by marital status (33%), career balance (25%), and race/ethnicity (22%). (See survey, Supplemental Digital Content 1, which displays the example survey sent to plastic surgery applicants. https://links.lww.com/PRSGO/C580.) Although many of these questions/scenarios were seen as inappropriate (25.6%), 42.3% of applicants felt unsure/neutral about the appropriateness of the statements (Table 2). The other 25 respondents (32.1%) found that these questions were appropriate given the context of the interview discussion. Eight applicants (10.3%) refused to respond in these scenarios, and of those who did answer, 85.7% answered truthfully. No applicant submitted a complaint or reported these potentially illegal scenarios. The most common reasons cited by the respondents included fear of retribution or negative impact on their ranking by the institution (30.9%), followed by lack of benefit (16.2%). Lastly, 30% of respondents said their experience influenced their rank list.

 

 

 

연령대, 성별, 인종/민족과 가장 많이 발생한 불법 질문 범주, 진실성, 순위 결정의 연관성을 조사하기 위해 추가 분석을 수행했습니다. 

• 연령대와 불법 질문, 진실성, 순위 결정 범주 간에 통계적으로 유의미한 연관성은 발견되지 않았습니다(표 3). 
• 성별에 대한 분석 결과, 이러한 유형의 시나리오를 접하는 것이 여성의 순위 결정에 유의미한 영향을 미치는 것으로 나타났습니다(여성 43.4% 대 남성 13.3%, P = 0.001)(표 4). 
• 인종/민족에 대한 분석 결과 흑인, 아시아계, 히스패닉/라틴계 지원자가 자신의 인종/민족과 관련된 질문을 통계적으로 더 많이 받은 것으로 나타났습니다. (표 5).

Additional analyses were performed to examine the association of age group, gender, and race/ethnicity, with the most prevalent categories of illegal questions, truthfulness, and ranking decision.

• There were no statistically significant associations between different age groups and categories of illegal questions, truthfulness, or ranking decision (Table 3).
• Regarding gender, our analysis found that encountering these types of scenarios significantly influenced the rank list for females (43.4% women versus 13.3% men, P = 0.001) (Table 4).
• Analysis on race/ethnicity revealed that Black, Asian, and Hispanic/Latino applicants had statistically more questions that pertained to their race/ethnicity. (Table 5).

 

 

토론
DISCUSSION

허용되지 않거나 불법일 가능성이 있는 질문을 받았다는 지원자의 보고는 새로운 발견이 아닙니다. Ciesielski-Carlucci 등의 연구에 따르면 레지던트 지원자의 절반 이상이 면접 중 질문이 "부적절하거나 불편하거나 차별적일 가능성이 있다."21 비뇨기과, 응급의학과, 피부과, 방사선 종양학과에 대한 후속 연구에서도 비슷한 결과가 나왔습니다.12,13,22,23 Hern 등은 2012~2013년 레지던트 면접 주기에서 19개 전문과목을 조사한 결과 응답자의 65.9%가 적어도 한 가지 이상의 잠재적 불법 질문을 받았다고 답했으며 외과 지원자의 82%가 그러한 질문을 받았다고 답했습니다.9,10 이러한 초기 연구에서는 행동 강령과 허용 가능한 면접 절차의 정의가 필요했습니다. 그러나 현재 프로그램에서 쉽게 이용할 수 있는 다양한 리소스(2016년과 2021년에 업데이트됨)가 있음에도 불구하고, 본 연구에서 발견된 성형외과 면접 과정에서 허용되지 않거나 불법적인 질문의 높은 유병률은 이러한 우려가 면접 및 매칭 과정의 무결성을 계속 위협하고 있음을 강조합니다. 
Applicants reporting potentially impermissible or potentially illegal questions is not a novel discovery. A study by Ciesielski-Carlucci et al revealed that more than half of residency applicants identified questions asked during interviews as “inappropriate, uncomfortable, or possibly discriminatory.”21 Subsequent studies have been carried out specific to urology, emergency medicine, dermatology, and radiation oncology yielding similar results.12,13,22,23 Hern et al examined 19 specialties in the 2012–2013 residency interview cycle and found that 65.9% of respondents reported receiving at least one potentially illegal question, and 82% of surgical applicants were asked such questions.9,10 These earlier studies called for a code of conduct and a definition of acceptable interview procedures. Yet, despite the wide range of resources now readily available to programs (updated in 2016 and 2021), the high prevalence of impermissible or illegal questions during the plastic surgery interview process found in the present study highlights that these concerns continue to jeopardize the integrity of the interview and match process.

Here are some examples of inappropriate questions in a U.S. residency matching interview for the categories you mentioned: Ranking interviews: Where else have you interviewed? How would you rank this program compared to others? What is your top choice for residency? Marital status: Are you married? Do you have a significant other or plan to have one during residency? What does your spouse/partner think of our program? Race: What is your ethnicity or race? Were you born in the United States? What's your native language? Asking these types of questions during an interview is inappropriate and can violate ethical standards and anti-discrimination laws. Interviewers should focus on the applicant's qualifications, skills, and ability to perform the duties required in the residency program.

PRS 매칭 지원자가 보고한 가장 일반적인 두 가지 허용되지 않는 질문은 지원자의 직급 목록(42%)과 결혼 여부(33%)에 대한 논의와 관련된 것이었습니다. 2016년에 Hern 등은 일부 전문 분야의 응답자 중 30% 이상이 계급 목록 및 프로그램에 대한 헌신과 관련된 불법적인 질문을 받았다고 보고했습니다. 이들은 이러한 질문이 "다른 질문과 같은 방식으로 잠재적으로 불법적인 것은 아니다."라고 지적한다. 10 이러한 성격의 질문은 레지던트 면접에 특화되어 있으며 민권법이 보호하지 않기 때문에 덜 금지적으로 느껴진다고 지적했습니다. 이는 불법적인 질문을 경험한 응답자의 42%가 해당 질문이 직급과 관련된 질문이었다고 답한 연구 결과에서 나타난 높은 유병률을 설명할 수 있습니다.

• 2010년 피부과 지원자 설문조사에서 응답자의 90%가 다른 프로그램의 면접에 대해 질문을 받았으며, 32%는 프로그램 순위를 공개해야 한다는 압박감을 느꼈다고 답했습니다.13
• 2017년 방사선 종양학과 지원자 202명의 응답을 조사한 Sura 등은 비슷한 결과를 발견했습니다: 불법적인 질문의 47%는 다른 프로그램의 면접에 관한 것이었고, 12%는 순위 의도에 관한 것이었습니다.11
• 마찬가지로, 세베스타 등은 2017년 매칭 주기(NRMP가 아닌 AUA가 관리)에서 비뇨기과 지원자 141명의 응답을 보고했는데, 85%가 적어도 한 번의 면접에서 불법적인 질문을 받았으며, 지원자의 48%가 순위 목록에 대한 질문을 받았고, 허용되지 않는 질문을 받았다고 보고한 모든 지원자는 다른 면접 장소나 참석 면접 횟수에 대해 질문받았습니다.12

The two most common impermissible questions reported by applicants to the PRS match were related to discussions of the applicant’s rank list (42%) and marital status (33%). In 2016, Hern et al. found that over 30% of respondents in some specialties reported illegal questions related to rank lists and commitment to programs. They astutely pointed out that these are “not potentially illegal in the same way as other questions.”10 Questions of this nature are specific to residency interviews and somehow feel less prohibitive, as civil rights laws do not protect them. This may explain the high prevalence shown in our study, where 42% of those who experienced an illegal question reported the questions were rank-related.

• In 2010, Sbicca et al found that 90% of respondents to a dermatology applicant survey were asked about interviews at other programs, whereas 32% felt pressured to reveal how they intended to rank programs.13 
• While examining the responses of 202 radiation oncology applicants in 2017, Sura et al revealed similar findings: 47% of illegal questions were regarding interviews at other programs, wheras 12% were specific to rank intention.11 
• Similarly, Sebesta et al reported 141 responses by urology applicants in the 2017 match cycle (governed by AUA, not NRMP); 85% reported an illegal question during at least one interview, 48% of applicants were asked about rank lists, and all who reported impermissible questions were asked about other interview locations or the number of interviews attended.12 

이러한 질문은 지원자에게 딜레마를 야기할 수 있는데, 면접 횟수가 많다고 답하면 특정 프로그램에 관심이 적다는 의미로 오해될 수 있고, 반대로 적은 횟수를 답하면 덜 바람직한 지원자처럼 보일 수 있기 때문입니다. 이러한 질문은 법적 위반에 해당하지 않지만, NRMP 웹사이트(2021년 8월 업데이트)에는 다른 프로그램에 대한 프로그램별 문의 및/또는 지원자의 순위 계획이 경기 참가 계약 위반에 해당한다고 명시되어 있습니다.24
These questions can create a dilemma for applicants given that admitting to a high number of interviews may be misinterpreted to mean that they have little interest in attending that specific program, whereas reporting a lower number may give the appearance that they are a less desirable candidate. Although these questions do not constitute a legal infraction, the NRMP website (updated August 2021) clearly states that inquiries by programs regarding other programs and/or how the applicant plans to rank them are a violation of the Match Participation Agreement.24

반면, 결혼 여부 또는 출산/가족 계획에 관한 질문은 종종 주법에 의해, 더 나아가 연방법에 의해 금지되어 있습니다.14 이러한 유형의 질문에 대한 본 연구 결과는 일반적으로 다른 전문 분야에서 발표된 연구 결과와 일치했습니다.9-13,22 그러나 이러한 질문이 여성 지원자에게 더 자주 묻는 것으로 나타난 선행 연구와 달리,9,10 본 연구에서는 성별 차이가 드러나지 않았습니다. 

• Sbicca 등은 2009년 매치에서 피부과 지원자 78명(44%)이 결혼 여부에 대한 질문을 받았고, 33명(19%)이 현재 자녀가 있거나 자녀를 가질 계획이 있는지 물었다고 보고했습니다.13 
• 비뇨기과 지원자 데이터에 따르면 55%가 결혼 여부와 현재/미래 자녀 계획 등 개인 생활에 대한 질문을 받았습니다.12 
• Sura 등은 결혼 여부 질문이 30%의 빈도로 나타났다고 발표했습니다. 자녀 양육 계획은 방사선 종양학 지원자의 6%가 보고했습니다. 
• 이와 대조적으로 Hern 등은 외과 및 비외과 전문의 지원자 11,000명을 대상으로 실시한 설문조사에서 응답자의 53.3%가 결혼 여부에 관한 질문을, 24%가 자녀에 관한 질문을, 13.8%가 자녀 양육 계획에 관한 질문을 받았다고 밝혔습니다.9,11 
• 본 연구에 따르면 지원자의 33%가 결혼 여부에 관한 질문을 받은 반면, 약 16%는 가족 계획에 관한 질문을 받았다고 답했습니다. 

In contrast, questions regarding marital status or childbearing/family plans are often proscribed by the state and, more tangentially, by federal laws.14 Our results for these types of questions were generally consistent with findings published in other specialties.9–13,22 However, unlike prior studies, which found these questions were more frequently asked to female applicants,9,10 our study did not reveal a gender difference.

• Sbicca et al reported 78 (44%) dermatology applicants being asked about marital status, and 33 (19%) asked if they either currently had children, or intended to have children, in the 2009 Match.13 
• Urology applicant data showed that 55% were asked questions about personal life, including marital status and current/future plans for children.12 
• Sura et al revealed that marital status questions appeared 30% of the time. Child-rearing plans were reported by 6% of radiation oncology applicants.
• In contrast, Hern et al revealed that 53.3% of respondents reported illegal questions on marital status, 24% regarding children, and 13.8% being asked about plans for child rearing in a survey sent to 11,000 applicants of both surgical and nonsurgical specialties.9,11 
• Our study found that 33% of applicants reported receiving a question about marital status, whereas about 16% were questioned about family planning.

질문의 의도와 관계없이, 매칭이 되지 않은 지원자는 해당 질문에 대한 답변이 자신을 차별하는 데 사용되었는지 여부에 대해 법적으로 이의를 제기할 수 있습니다. 결혼 여부에 따른 고용 차별은 연방법에 의해 직접적으로 보호되지는 않지만,25 많은 주에서 이러한 관행을 금지하는 법률을 제정했으며,26-30 이러한 질문이 1964년 민권법 제 7조에 의해 금지된 은밀한 형태의 성차별이라는 이론에 따라 고용주를 고소하는 소송 사례도 있습니다.14

Regardless of the questions’ intent, an applicant who fails to match could legally challenge whether their answer to such a question was used to discriminate against them. Although employment discrimination based on marital status is not directly protected under federal law,25 many states have enacted laws that prohibit this practice,26–30 and there are examples of litigants suing employers on the theory that these questions are a covert form of gender discrimination, which is prohibited under Title VII of the Civil Rights Act of 1964.14

또한 타이틀 7은 인종, 나이, 종교, 성적 지향에 따른 고용 차별을 금지하고 있으며, 설문조사에서 지원자의 22%, 4%, 2%, 1%가 각각 이러한 차별을 경험했다고 응답했습니다. 설문조사에서 인종 및 민족적 소수 집단(흑인, 아시아계, 히스패닉/라틴계)에 속한 지원자의 50%가 자신의 인종/민족과 관련된 질문을 받은 반면, 백인 및 두 가지 이상의 인종으로 분류된 공동 지원자는 이보다 훨씬 적은 비율(각각 9%, 8%)로 질문을 받은 것으로 나타났습니다. 이러한 질문의 의도와 상관없이 지원자는 차별을 위한 질문이었는지 여부에 대해 법적으로 이의를 제기할 수 있으므로 프로그램에서는 이러한 주제에 대한 질문을 자제해야 합니다. 본 연구에서 연령에 관한 질문은 드물었으며(4%), 1967년 고용 연령 차별 금지법에 따른 연방의 고용 차별 보호는 40세 이상의 개인에게만 적용됩니다(더 젊은 사람에게 적용될 수 있는 주별 법률이 있음).31 마지막으로, 한 지원자가 장애에 대한 질문을 받았다고 보고했습니다. 1990년 미국 장애인법은 장애인에 대한 고용 차별을 금지하고 있지만, 합리적인 직장 내 편의 제공에도 불구하고 채용 예정자가 필수 기능을 수행하지 못할 수 있는 경우는 허용하고 있습니다.32

Title VII also prevents employment discrimination based on race, age, religion, and sexual orientation, which were reported by 22%, 4%, 2%, and 1% of applicants in our survey, respectively. In our study, 50% of applicants belonging to racially and ethnically minoritized groups (Black, Asian, and Hispanic/Latino) were asked questions that pertained to their race/ethnicity versus co-applicants identified as White and two or more races, who were asked in a significantly lesser degree (9% and 8%, respectively). Regardless of the intention of these questions, programs should refrain from inquiring about this topic, as applicants could legally challenge whether their question was used to discriminate against them. Questions regarding age in our study were rare (4%), and federal protection against employment discrimination under the Age Discrimination in Employment Act of 1967 is only applicable to individuals 40 years of age or older (although there are state-specific laws that may apply to younger persons).31 Lastly, one applicant reported being asked about a disability. Although the Americans with Disabilities Act of 1990 prohibits employment discrimination against individuals with disabilities, there are allowances where a prospective employee may be unable to perform essential functions despite reasonable workplace accommodations.32

또한 이러한 금지 질문이 지원자에게 미치는 영향과 인상도 조사했습니다. 그 결과, 금지된 질문을 받은 응답자의 30%가 순위 목록 순서에 영향을 받았으며, 통계적으로 유의미한 성별 차이(여성의 순위 목록이 변경된 비율은 43.4%, 남성의 경우 13.3%)가 나타났습니다(표 4). 

• 이번 연구 결과와 유사하게 4학년 의대생을 대상으로 NRMP 위반에 대해 조사한 2021년 연구에서는 응답자 433명 중 60.3%가 다른 면접 장소에 대한 질문을 받았으며, 이들 중 53%가 프로그램에 대해 부정적인 인상을 남겼고, 22.6%는 위반한 프로그램의 순위를 높게 평가하지 않거나 매우 낮게 평가했습니다. 흥미롭게도 이 연구에서 대부분의 규정 위반은 프로그램 디렉터가 저지른 것으로 밝혀졌습니다.33 우리는 프로그램 디렉터가 필요한 변화를 주도하고 지속시킬 수 있는 가장 좋은 위치에 있다는 이 연구 저자들의 제안을 지지합니다.

Our study also explored the effect and impression these impermissible questions had on applicants. Results demonstrated that receiving a forbidden question influenced the rank lists order of 30% of respondents with a statistically significant gender difference: rank lists of women were altered 43.4% of the time versus 13.3% for men (Table 4).

• Similar to our findings, a 2021 study surveying fourth-year medical students regarding NRMP violations revealed that 60.3% of the 433 respondents were asked about locations of other interviews; 53% of these applicants were left with a negative impression of the program, with 22.6% being less to much less likely to rank the violating programs highly. Interestingly, most match violations in this study were found to be committed by program directors.33 We support the proposal of the authors of this study that program directors are best poised to initiate and perpetuate necessary change.

조사 결과의 또 다른 중요한 발견은 많은 지원자들이 무엇이 허용되지 않거나 불법적인 질문인지 아닌지에 대한 불완전한 정보를 가지고 있다는 점입니다. 이 연구에 참여한 많은 응답자는 명백히 허용되지 않거나 불법적인 일부 유형의 질문의 적절성에 대해 "구분하기 어렵다"거나 "중립적"이라고 느낀다고 말했습니다. 이는 지원자와 프로그램 참가자가 모병원과 AAMC/NRMP에서 설명한 면접 가이드라인을 검토해야 할 필요성을 더욱 강조합니다. 일반적으로 면접관은 레지던트/수련의로 근무할 수 있는 능력과 명백한 관련이 없는 질문은 피해야 하며, 답변이 근본적이거나 근본적인 직무 관련 필요성이 있는 질문에만 집중해야 합니다. 질문의 경계가 불확실한 경우에도 고용기회균등위원회와 같은 규제 기관에서는 차별 청구 여부를 결정할 때 질문의 의도와 정보 사용 방식을 중요한 측면으로 고려합니다.
Another important finding of our investigation was that many applicants had imperfect information about what did or did not constitute an impermissible or illegal line of questioning. Many respondents to this study stated that it was “hard to tell” or felt “neutral” about the appropriateness of some types of clearly impermissible or illegal questions. This further highlights the need for applicants and program participants to review interview guidelines outlined by their parent hospital and by the AAMC/NRMP. In general, interviewers should avoid questions that have no obvious bearing on a resident’s ability to serve as a resident/trainee and stick to questions for which the answer has some fundamental or underlying job-related necessity. Even when the boundaries of a question are uncertain, regulatory bodies like the Equal Employment Opportunity Commission consider the intent of questioning and how the information is used as critical aspects when determining whether to pursue a claim for discrimination.

이러한 질문에 대해 신청자가 직접 법적 조치를 취하는 경우는 드물지만, NRMP 신청자 위반 신고 시스템을 통해 신청자는 프로그램 조사 및 제재를 초래할 수 있는 위반 사항을 신고할 수 있습니다. 이 시스템은 심각한 프로그램 강압에 대한 신고가 접수되고 위반이 확인된 후 2017년에 도입되었으며, 위반이 확인된 경우 종종 NRMP 등록, 순위 및 결과(R3) 시스템에서 경기 위반자로 1~3년 플래그가 표시됩니다.34 플래그가 없더라도 이전 연구에서는 지원자들이 이러한 불법적인 질문을 한 프로그램을 부정적으로 인식하고 순위를 매기는 데 미치는 영향에 대해 주의를 환기했습니다.18 2019년 NRMP 회장/최고경영자 및 최고정책책임자가 발표한 기사에서는 이러한 제재 조치로 지원자 및 의과대학 관계자가 R3 시스템을 통해 2년 또는 3년의 '플래그'를 볼 수 있다고 명시하고 있습니다.34 위반 프로그램에 의한 후속 위반이 드물었기 때문에 이러한 제재가 효과적이라는 것을 발견했습니다. 일부 레지던트 지원자가 인종이나 장애로 인해 낮은 순위를 받았다고 주장하는 사례가 조사되어 기각되기도 했습니다.35-37 그러나 이러한 신고의 유병률과 처분에 관한 최근 데이터는 부족합니다. 연구 결과에 따르면 많은 지원자가 이 제도의 익명성을 모르거나 신뢰하지 않는 것으로 나타났습니다. 면접 중 허용되지 않은 질문을 받았다고 답한 응답자 중 위반 사항을 신고한 응답자는 단 한 명도 없었으며, 그 이유로는 약 1/3이 보복/순위 하락에 대한 두려움(30.9%)을 꼽았고 다른 응답자는 "신고할 가치가 없다"(16.2%)고 답해 거의 절반(47.1%)이 익명 위반 신고 양식이 있다는 사실을 모르고 있는 것으로 나타났습니다.
Although direct legal action by an applicant for such questions is rare, the NRMP Applicant Violation Report system allows applicants to report violations that can result in program investigation and sanctions. This system was put in place in 2017 following reports of significant program coercion and confirmed violations often resulting in a 1-to-3-year flag as a match violator in the NRMP Registration, Ranking, and Results (R3) system.34 Even without a flag, prior studies have called attention to the influence on how applicants negatively perceive and rank programs that asked these illegal questions.18 An article published by the NRMP president/chief executive officer and chief policy officer in 2019 specifies that such sanctions may entail a 2-or 3-year “flag” visible to applicants and medical school officials through the R3 system.34 They have found these sanctions were effective, as subsequent breaches by violating programs were rare. Some residency applicant claims of lower ranking due to their race or a disability have been investigated and dismissed;35–37 however, there is a paucity of recent data regarding the prevalence and disposition of such reports. Our study findings suggest that many applicants either do not know of, or trust the anonymity of the system. Of all respondents who reported being asked an impermissible question during an interview, not a single respondent reported a violation, with nearly one-third citing fear of retribution/lower ranking (30.9%) and others selecting that doing so was “not worth it” (16.2%) This suggests that nearly half (47.1%) are unaware of the anonymous violation reporting form available (https://www.nrmp.org/wp-content/uploads/2021/12/Violations-Report-Form-for-Applicants.pdf).

본 연구에는 몇 가지 한계가 있습니다. 첫 번째는 단일 기관의 지원자로부터 데이터를 수집했기 때문에 해당 기관에 지원하지 않은 2022년 성형수술 지원자 중 14%(49명)의 경험이 누락되었다는 점입니다(NRMP에 보고된 총 351명의 지원자 중). 국가 데이터를 확보하기 위해 노력했지만 확보할 수 없었습니다. 또한 설문조사 응답률은 33.1%로 이전 연구에 비해 상대적으로 낮았습니다. 둘째, 지원자의 회상 편향을 제한하기 위해 3월에 설문조사를 배포했지만, 인터뷰가 12월부터 2월에 걸쳐 진행되었기 때문에 회상 편향이 발생할 가능성이 있습니다. 또한 부정적인 경험이 있는 지원자들이 응답할 가능성이 높기 때문에 더 많은 응답을 수집했을 가능성도 있습니다. 또한 응답자가 이 주기의 평균 지원자보다 면접 횟수가 많거나 적은지 여부는 명확히 알 수 없습니다. 인터뷰 횟수가 많은 지원자가 설문조사에 응답할 가능성이 더 높을 수 있으며, 이는 혼란을 야기할 수 있지만, 인구통계학적 정보와 관계없이 단일 PRS 프로그램의 모든 지원자에게 설문조사를 전송하여 선택 편향을 최소화했습니다. 회상 편향을 줄이기 위해 지원자들에게 면접에서 특정 유형의 질문을 경험한 적이 있는지를 물었고, 각 면접에 대해 개별 사례를 집계하지 않았습니다. 이 데이터 수집 방법은 Hern 등의 연구에서 사용된 방법을 모방한 것입니다.9 따라서 두 번의 면접 중 하나에서 특정 유형의 부적절하거나 허용되지 않는 질문(예: 종교)을 받은 지원자는 15번의 면접 중 하나에서 같은 유형의 질문을 받은 지원자와 동일하게 카운트됩니다. 이러한 응답 그룹화는 특정 지원자가 허용되지 않는 질문을 받을 가능성이 더 높은지(전체 면접 대비 비율로) 파악하는 데 도움이 될 수 있는 보다 세분화된 통계 조사를 크게 제한합니다. 또한, 설문지의 익명 형식으로 인해 어떤 프로그램에서 어떤 면접관이 허용되지 않는 질문을 했는지도 알 수 없었습니다. 따라서 특정 프로그램의 특정 면접관에게 이러한 질문의 빈도가 집중되고 일부 지원자가 다른 지원자보다 부적절한 질문을 받을 가능성이 훨씬 더 높을 수 있습니다. 이번 조사 결과를 고려할 때 보다 자세한 분석이 필요하지만, 정확한 데이터를 확보하기 위해서는 지원자의 전향적인 보고가 필요할 수 있습니다. 또 다른 잠재적 한계는 이 연구를 위해 분석된 연도에는 모든 면접이 가상으로 진행되었다는 점입니다. 이는 이전의 대면 면접과는 완전히 다른 경험을 제공했을 수 있습니다. 화상 회의를 통해 기록될 가능성이 있기 때문에 직접 대면하거나 전통적인 사전 인터뷰 모임에서 이루어지는 보다 솔직한 토론이 제한되었을 수 있습니다. 이 연구에서는 대조군이 없었으며 같은 해의 비외과 전문과목과 비교하지 않았습니다.
Our study has several limitations. The first is that our data were collected from applicants of a single institution; thus, we are missing the experiences of 14% (49) of applicants from the 2022 plastic surgery match who did not apply to this institution (of the 351 applicants total reported by NRMP). While we attempted to obtain national data, we were unable to do so. Furthermore, our survey response rate was relatively low at 33.1% versus prior studies. Second, we distributed the survey in March to limit applicant recall bias; however, with interviews spanning from December to February, recall bias may be likely. It is also possible that we captured more responses from those with negative experiences as they were more likely to respond. Furthermore, we cannot elucidate if respondents had more or fewer interviews than average applicants of this cycle. Perhaps applicants with more interviews were more likely to respond to our survey, which could be confounding; however, we minimized selection bias by sending the survey to all applicants of a single PRS program regardless of any demographic information. To reduce recall bias, the applicants were asked if they had experienced certain types of questions in any interview and not to count each separate instance for each interview they received. This method of data collection was fashioned after that used in the study of Hern et al.9 Thus, an applicant who was asked a certain type of inappropriate or impermissible question (eg, religion) in one of two interviews would be counted the same as an applicant who was asked the same type of question in one of fifteen interviews. This grouping of responses greatly limits a more granular statistical inquiry, which would have been helpful to determine if certain candidates are more likely (as a percentage of their total interviews) to be asked impermissible questions. Moreover, the anonymous format of the questionnaire also did not allow at which programs and by which interviewers the impermissible questions were asked. Thus, it is possible that the frequency of these questions clusters in certain interviewers at specific programs and that a small subset of applicants are far more likely to be asked inappropriate questions than other candidates. Given our findings, a more detailed analysis is warranted, but this may require prospective reporting by applicants to ensure accurate data. Another potential limitation is that in the year analyzed for this study, all interviews were conducted virtually. This may have provided an entirely different experience than prior in-person interviews. The potential to be recorded over videoconferencing may have limited the more candid discussions held in person or at the traditional preinterview gatherings. In this study, we did not have a control group or compare with a nonsurgical specialty of the same year.

결론
CONCLUSIONS

성형외과 레지던트 면접에서 지원자에게 묻는 질문의 내용에 중점을 두었음에도 불구하고, 부적절하고 허용되지 않는, 그리고 그 정도는 덜하지만 솔직히 위법적인 질문이 여전히 빈번하게 등장하고 있습니다. 이번 조사 결과는 고의성이 있거나 지원자가 기술적으로 허용되지 않는 질문을 그렇게 생각한다는 것을 의미하지는 않습니다. 실제로 지원자의 32.1%는 기술적으로 허용되지 않는 질문을 "적절하다"고 해석했습니다. 그러나 선의의 발언이라도 오해와 조사의 빌미가 될 수 있고 소송의 대상이 될 수 있으므로 모호한 질문이나 진술은 피하는 것이 면접 과정의 무결성을 가장 잘 보장할 수 있는 방법입니다. 이전에 제안된 개선 방안에는 순위 목록 제출 전에 검토할 경기 정책 동영상과 면접관용 NRMP 온라인 교육 모듈 개발이 포함되어 있습니다.11,13 이러한 개선 방안이 불법 또는 허용되지 않는 질문을 폐지하는 목표를 달성하는 데 도움이 될 수 있다는 데 동의하지만, 이는 NRMP/AAMC가 주도해야 할 것입니다.
Despite the emphasis placed on the content of what is asked of applicants during plastic surgery residency interviews, inappropriate, impermissible, and to a lesser degree, frankly, illegal questions still surface with frequency. Our findings do not imply malintent or that applicants view questions that are technically impermissible as such. In fact, 32.1% of applicants interpreted technically impermissible questions as “appropriate.” However, the integrity of the interviewing process is best ensured if any ambiguous questions or statements be avoided, because even well-intentioned comments can lend to misinterpretation and investigation and possibly be subject to litigation. Prior suggestions for improvement have included developing both match policy videos to be reviewed before rank list submission and NRMP online training modules for interviewers.11,13 While we agree that these may assist in achieving the goal of abolishing illegal or impermissible questions, they would have to be led by the NRMP/AAMC.

현재 어떤 수준에서도 가이드라인 검토가 의무화되어 있지 않으므로, 성형외과 수련 프로그램에 면접 과정의 무결성을 보장하기 위한 안전장치를 마련할 것을 제안합니다. 여기에는 다음이 포함됩니다:
As the review of guidelines is not currently mandatory at any level, we suggest that plastic surgery training programs institute safeguards to ensure the integrity of the interview process. These include:

1. 면접 과정에 관여하는 모든 사람은 AAMC "의료 면접 수행 모범 사례" 섹션 2,17 "교수진을 위한 실무 가이드" 및 프로그램용 NRMP 경기 행동 강령을 읽었음을 서명합니다. 여기에는 총 7페이지로 구성되어 있으며, 면접관이라면 누구나 10분 이내에 완료할 수 있습니다.38
2. 지원자에게 자신의 권리를 알려야 하며, 모든 면접 소개 시 불법적인 주제에 대해 간략하게 검토해야 합니다.
3. 각 면접에서 위반 사항을 신고할 수 있는 익명 링크를 제공해야 합니다. 
4. Sura 등이 제안한 것과 같이 면접 대상자에 의한 연례 부서별 사내 감사 실시.11

1. All persons involved with the interview process sign off on having read the AAMC “Best Practices for Conducting Medical Interviews” Section 2,17 “A Practical Guide for Faculty” and the NRMP Match Code of Conduct for Programs. These contain in total seven pages of reading that should take any interviewer less than 10 minutes to complete.38
2. Applicants should be made aware of their rights, and illegal topics should be reviewed briefly at every interview introduction.
3. An anonymous link to report a violation should be provided at each interview. Link here: https://www.nrmp.org/wp-content/uploads/2021/12/Violations-Report-Form-for-Applicants.pdf
4. Annual departmental in-house audits by interviewees, like those suggested by Sura et al.11

향후 연구에서는 성형외과 매칭 과정에서 허용되지 않는 질문의 유병률에 대한 프로그램 및 지원자 교육 및 감독 강화의 효과에 초점을 맞춰야 합니다.
Future studies should focus on the effect of the increased program and applicant education and oversight on the prevalence of impermissible questions in the plastic surgery match process.

 

 

https://www.nrmp.org/intro-to-the-match/the-match-agreement/match-codes-of-conduct/

NRMP-Match-Code-of-Conduct_Schools_Final.pdf

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NRMP-Match-Codes-of-Conduct_Applicants_Final.pdf

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NRMP-Match-Code-of-Conduct_Programs_Final.pdf

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The NRMP has created the Match Codes of Conduct below to serve as guides for all Match participants throughout the application, interview, matching, and onboarding processes.

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Plast Reconstr Surg Glob Open. 2023 Jun 13;11(6):e5018. doi: 10.1097/GOX.0000000000005018. eCollection 2023 Jun.

Prevalence of Prohibited Questions during Plastic Surgery Residency Interviews

Ashley E Rogers 1, Esperanza Mantilla-Rivas 1, Daniela Duarte-Bateman 1, Monica Manrique 1, Jennifer L McGrath 1, Md Sohel Rana 2, Albert K Oh 1, Lisa R David 3, Jeffrey E Janis 4, Gary F Rogers 1

Affiliations collapse

Affiliations

1From the Division of Plastic and Reconstructive Surgery, Children's National Hospital, Washington, D.C.

2Joseph E. Roberts, Jr. Center for Surgical Care, Children's National Hospital, Washington, D.C.

3Department of Plastic and Reconstructive Surgery Wake Forest Baptist Medical Center Winston Salem, N.C.

4Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.

PMID: 37325372

PMCID: PMC10263253

DOI: 10.1097/GOX.0000000000005018

Free PMC article

Abstract

Despite rules set forth by the National Resident Matching Program and American Association of Medical Colleges (AAMC), prohibited questions during the residency interview process are well documented. This study describes the prevalence of these encounters by surveying residency applicants to integrated plastic and reconstructive surgery (PRS) programs for the 2022 match cycle.

Methods: An anonymous 16-question REDCap survey was distributed to 2022 cycle applicants of a single PRS program. The applicants were queried about demographic information, interview experience, and questions deemed illegal by the AAMC/NRMP guidelines.

Results: One hundred survey responses were attained for a 33.1% response rate. The majority of respondents were aged 26-30 (76%), women (53%), and white (53%); 33% received 15+ interviews for the application cycle. Seventy-eight percent of respondents reported being asked a prohibited question during at least one interview, with the most common "illegal" question categories being number/ranking of interviews (42%), marital status (33%), career balance (25%), and race/ethnicity (22%). Only 25.6% of applicants considered the subject matter inappropriate, whereas 42.3% were unsure. Although no applicant took action to report the potentially illegal scenarios, 30% said that their experiences influenced their rank list.

Conclusions: Our survey study revealed that prohibited interview questions in PRS residency interviews are common. Permissible lines of questioning and discussion between programs and applicants during residency interviews have been defined by AAMC. Institutions should provide guidance and training to all participants. Applicants should be made aware of and empowered to utilize available anonymous reporting tools.

Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.