Impact of Medical Student Disciplinary Actions on the United States National Resident Match

Introduction: Each year, the United States National Resident Matching Program describes the relative importance of a number of factors in the residency match for each speciality. However, the impact of disciplinary actions taken by a school when a student fails to meet certain expectations is not specifically evaluated but may have a major impact on a physician’s future performance. Methods: This study used electronic surveys sent to deans of medical education and residency program directors (PDs) to assess the way disciplinary actions are used at US allopathic medical schools, and the perceived implications of those actions on the residency match. Results: Thirty-three deans and 158 PDs participated (response rates of 26% and 22%, respectively). The median percentage of students put on probation each year as a function of class size was 3.3% (interquartile range [IQR] 2% to 6%). Three institutions reported putting greater than 10% of their students on probation each year and one institution reported putting 22% of their students on probation each year. A student's risk of failing to match was thought to be very or extremely likely (to deans and PDs, respectively) if there was a history of failed coursework (18.8% and 41.2%, p = 0.017), academic probation (34.4% and 67.1%, p = 0.009), or professionalism probation (78.1% and 83.9%, p = 0.016). The differences between each of the above types of disciplinary action’s impact on the likelihood of interviewing (p < 0.001) and risk of failure to match (p < 0.001) were also significant among both groups. Conclusion: Significant variability exists in the use and reporting of disciplinary actions at US medical schools. A history of these adverse actions, even if successfully remediated, was thought to negatively impact a student’s likelihood to interview and match. Greater standardization in the use and reporting of disciplinary actions would be appropriate to ensure equitable treatment of students nationwide.