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OBJECTIVE: To investigate potential differences in new patient appointment wait times for otolaryngology care based on insurance types and explore factors influencing these wait times. STUDY DESIGN: A cross-sectional audit study, using a "mystery caller" approach, analyzed with a linear mixed Poisson model to adjust for confounding factors. SETTING: A total of 612 physicians across 49 states and the District of Columbia, representing 6 otolaryngology subspecialties, were included. METHODS: Otolaryngology physicians were contacted by mystery callers via telephone with scripted clinical vignettes as patients with either Medicaid or Blue Cross/Blue Shield (BCBS) insurance. Callers requested next available appointment. Wait times for new patient appointments were recorded and analyzed in R using a generalized linear mixed Poisson model. RESULTS: A total of 1183 of 1224 calls reached a representative. Medicaid patients waited 5.73% longer (P < .001) compared to BCBS patients (IRR: 1.06; confidence interval [CI]: 1.03-1.09; P < .001), with respective mean wait times of 36.8 days (SE ± 1.6) and 32.4 days (SE ± 1.6). Longer waiting times were also associated with physicians affiliated with universities (P = .001) and certain subspecialties, such as pediatric otolaryngology (P < .001) and neurotology (P = .008). Regional differences were also observed, with specific AAO-HNS regions showing shorter wait times. The model achieved a conditional R-squared value of 0.947. CONCLUSION: This study reveals disparities in wait times for otolaryngology care based on insurance type, with extended wait times for Medicaid beneficiaries. The findings highlight a potential access to care disparity, which begets the need for strategies that ensure equitable access to otolaryngology care and further research to understand the underlying reasons for these potential disparities.
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Acessibilidade aos Serviços de Saúde , Cobertura do Seguro , Otolaringologia , Humanos , Estados Unidos , Otolaringologia/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Estudos Transversais , Cobertura do Seguro/estatística & dados numéricos , Masculino , Feminino , Listas de Espera , Agendamento de Consultas , Medicaid/estatística & dados numéricosRESUMO
OBJECTIVE: The objective of this study was to understand applicant perspectives on in-person and virtual otolaryngology residency interviews. STUDY DESIGN: Survey study. SETTING: Otolaryngology residency applicants who were interviewed during 2022-2023. METHODS: Survey sent to all otolaryngology residency applicants who interviewed during the 2022-2023 interview season. RESULTS: A total of 499 applicants were surveyed with 150 responses (30%). Approximately 48.3% of respondents were offered an in-person interview with 78.9% accepting the offer. Of those who did not accept, reasons included not wanting to travel (21.1%) and time conflicts (15.5%). When comparing virtual versus in-person interviews, those who attended virtual interviews were more likely to disagree that they connected with residents (P = .02) and that they had an improved perspective of the program (P = .002). The majority of applicants agreed that virtual interviews are more inclusive and equitable than in-person interviews (70.4%). When asked which interview style applicants would prefer, 63.1% of applicants preferred an in-person interview when compared to virtual with a second look option (29.5%) and virtual (7.4%). Respondents who self-identified as being underrepresented in medicine were less likely to choose in-person as their preferred interview format (P = .01) and were more likely to decline an in-person interview offer due to monetary limitations (P = .04). CONCLUSIONS: Applicants indicated dissatisfaction with connecting with residents and improving their perspective of the program when in a virtual setting. Applicants felt that virtual interviews were more equitable, but that if the barriers to equity were lessened then they would prefer in-person interviews.
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Internato e Residência , Medicina , Otolaringologia , Humanos , Emoções , Cirurgia de Second-Look , Inquéritos e QuestionáriosAssuntos
Docentes de Medicina , Liderança , Otolaringologia , Feminino , Humanos , População Negra , Grupos MinoritáriosRESUMO
OBJECTIVE: To determine the effect of the initiation of COVID-19-related restrictions on the volume of surgical cases performed by otolaryngology trainees. STUDY DESIGN: Multi-institutional retrospective analysis of resident surgical case logs. SETTING: Accredited residency training programs in otolaryngology head and neck surgery. METHODS: Resident surgical case logs were combined from 6 residency training programs from different regions of the United States. Case volumes were compared between the calendar year before March 1, 2020, and the year afterward. Subgroup analyses were performed for the type of hospital (university, pediatric, veteran, county) and the key index cases by subspecialty. RESULTS: All 6 participating residency programs had a decrease in resident operative case volume. Surgical volume decreased from a mean of 6014 to 4161 (P < .05). There were decreases observed in key index cases in every subspecialty (P < .01), without statistical differences seen among subspecialties. There were decreases observed in every hospital type (university, pediatric, veteran, county) without statistical differences among types. Postgraduate year 5 residents were the most affected by volume reductions (51.6%), and postgraduate year 3 residents were the least affected (1.4%). CONCLUSION: In the year following initiation of COVID-19-related restrictions, there was a significant decrease in trainee surgical case volumes within residencies for otolaryngology-head and neck surgery. There were no statistical differences in the volume decreases seen at different institutions, among hospital types, or within various subspecialties.
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COVID-19 , Otolaringologia , Procedimentos de Cirurgia Plástica , Humanos , Criança , COVID-19/epidemiologia , Pandemias , Estudos RetrospectivosRESUMO
BACKGROUND: Evaluation and interpretation of the literature on obstructive sleep apnea (OSA) allows for consolidation and determination of the key factors important for clinical management of the adult OSA patient. Toward this goal, an international collaborative of multidisciplinary experts in sleep apnea evaluation and treatment have produced the International Consensus statement on Obstructive Sleep Apnea (ICS:OSA). METHODS: Using previously defined methodology, focal topics in OSA were assigned as literature review (LR), evidence-based review (EBR), or evidence-based review with recommendations (EBR-R) formats. Each topic incorporated the available and relevant evidence which was summarized and graded on study quality. Each topic and section underwent iterative review and the ICS:OSA was created and reviewed by all authors for consensus. RESULTS: The ICS:OSA addresses OSA syndrome definitions, pathophysiology, epidemiology, risk factors for disease, screening methods, diagnostic testing types, multiple treatment modalities, and effects of OSA treatment on multiple OSA-associated comorbidities. Specific focus on outcomes with positive airway pressure (PAP) and surgical treatments were evaluated. CONCLUSION: This review of the literature consolidates the available knowledge and identifies the limitations of the current evidence on OSA. This effort aims to create a resource for OSA evidence-based practice and identify future research needs. Knowledge gaps and research opportunities include improving the metrics of OSA disease, determining the optimal OSA screening paradigms, developing strategies for PAP adherence and longitudinal care, enhancing selection of PAP alternatives and surgery, understanding health risk outcomes, and translating evidence into individualized approaches to therapy.
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Apneia Obstrutiva do Sono , Adulto , Humanos , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/epidemiologia , Apneia Obstrutiva do Sono/terapia , Pressão Positiva Contínua nas Vias Aéreas/métodos , Polissonografia/métodos , Fatores de RiscoRESUMO
Diversity impacts performance of our teams, fosters innovation, and improves outcomes of our patients in otolaryngology head and neck surgery. In addition to the moral imperative, increasing the otolaryngology diversity workforce will decrease health care disparities while equity and justice can increase the culture humility to take care of an increasingly diverse patient population. To move toward justice, otolaryngology departments need to end biases in faculty hiring, development, research evaluations, and publication practices. The more intentional our efforts, the more benefit to our patients, providers, staff, learners, and society.
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Otolaringologia , Humanos , Recursos HumanosRESUMO
OBJECTIVES: With increasing restraints on resident's experiences in the operating room, with causes ranging from decreased time available to increasing operating room costs, focus has been placed on how to improve resident's education. The objectives of our study are to (1) determine barriers in education in the operating room, (2) identify effective learning and teaching strategies for residents in the operating room with a focus on the tonsillectomy procedure. METHODS: An online survey was sent to all otolaryngology residents and residency programs for which contact information was available from January 2016 to March 2016 with 139 respondents. The 12-question survey focused on information regarding limitations to learning how to perform tonsillectomies as well as difficulties with teaching the same procedure. Resident responses were separated based on PGY level, and analysis was performed using t-tests and Chi squared analysis. RESULTS: Common themes emerged from responses for both teaching and learning how to perform tonsillectomies. A significant limitation in learning the procedure was lack of visualization during the surgery (57% learning vs 60% teaching). For both learners and teachers, the monopolar cautery instrument was found to be the most preferred instrument to use during tonsillectomy (80% each). The majority of resident respondents (93%) felt that an instructional video would be beneficial for both learning and teaching the procedure. CONCLUSIONS: Significant limitations for learning and teaching in the operating room were identified for performing tonsillectomies. Future endeavors will focus on resolving these limitations to improve surgical education. EVIDENCE LEVEL: Level IV.
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Pessoal de Educação , Internato e Residência , Tonsilectomia , Competência Clínica , Humanos , Aprendizagem , Salas CirúrgicasRESUMO
The Accreditation Council for Graduate Medical Education and the American Board of Otolaryngology-Head and Neck Surgery Milestones Project grew out of a continued need to document objective outcomes within resident education. Milestones 2.0 began its work in 2016, with an intent to resolve inconsistencies in the original milestones based on an iterative process. Milestones 2.0 retains the original 5 levels of achievement but includes a "not yet assessable" option as well. In addition, Milestones 2.0 has added harmonized milestones across all specialties. Each specialty has incorporated a supplemental guide with examples and resources to improve facility with the tool. There will be further refinement of the Milestones as new research emerges with the ultimate goal of providing programs and trainees with a reliable roadmap that can be used to direct and assess learning.
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Internato e Residência , Otolaringologia , Acreditação , Competência Clínica , Educação de Pós-Graduação em Medicina , Humanos , Estados UnidosRESUMO
The importance of diversity is well established and holds important implications for workplace and physician-patient relationships. Evaluation of diversity statistics within otolaryngology-head and neck surgery reveals areas of deficiency that may be improved with targeted proactive approaches. This article provides a general overview of diversity within otolaryngology, highlights key components of diversity initiatives, and provides strategies for implementation.
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Otolaringologia , Humanos , Relações Médico-PacienteRESUMO
Mentorship and sponsorship are critically important for otolaryngologists at all levels of their career. Mentorship is typically found within a long-term professional relationship and provides career advice and support. Sponsorship is a more transactional relationship that promotes the mentee for specific career advancement opportunities. Both help mentees achieve more in their careers and have higher career satisfaction. This article defines mentorship and sponsorship and the current state of these within otolaryngology. Strategies for being an effective mentor and mentee are listed. Mentorship needs among women and underrepresented minorities within otolaryngology are discussed.
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Tutoria , Mentores , Feminino , HumanosRESUMO
Purpose: Otolaryngologists are uniquely situated to provide sexual and gender minority (SGM) care, including gender-affirmation (voice/communication, facial surgery) and HIV/AIDS-related conditions. Yet, no research has characterized otolaryngology residency program directors' attitudes toward SGM-related curricula, nor opportunities for supporting training in SGM-related care. Methods: An anonymous cross-sectional e-mail survey was disseminated to 116 otolaryngology residency program directors in July-September 2019. Information collected included current/future curriculum in and attitudes toward SGM care, and program demographics. Data were categorical and analysis utilized chi-square test. Results: The 65 complete responses (56% rate) were nationally representative. Overall, 17% of programs include no SGM-related education. Subjective importance of SGM training ranged from not important at all (3%) to absolutely essential (11%), with mode of average importance (47%); this varied significantly by program geographic setting and population, and program size. The mean percentage of curriculum dedicated to SGM care was 1.0% for didactics and 0.7% for clinical. Curricula include HIV/AIDS-related conditions (58%), facial gender-affirming procedures (50%), culturally informed care (42%), changes with gender-affirming hormones (voice/communication: 48%, facial: 22%), and cancer in SGM patients (42%). Frequently reported barriers were insufficient experienced faculty (52%) and time (42%). Program directors deemed visiting expert lectures (66%), small-group discussion (39%), and online modules (27%) the best ways to incorporate SGM education. Conclusions: More than 80% of otolaryngology residency curricula in a representative national survey include SGM-related education, which represents a limited portion of total curriculum. These results highlight the opportunity for expert lectures and discussion-based and online tool development to facilitate standardized SGM education in otolaryngology residencies.
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OBJECTIVE: To evaluate the efficacy of a web-based training module for teaching interpretation of laryngeal stroboscopy in a cohort of otolaryngology residents. STUDY DESIGN: Randomized controlled trial. SETTING: Academic tertiary center. SUBJECTS AND METHODS: Residents from three training programs were invited to complete an assessment consisting of a survey and five stroboscopic exams. Subsequently, participants were randomized to receive teaching materials in the form of (1) a handout (HO) or (2) a multimedia module (MM) and asked to complete a post-training assessment. Responses were compared to responses provided by three fellowship-trained laryngologists. RESULTS: Thirty-five of 47 invited residents (74.4%) completed both assessments. Overall mean postassessment scores were 64.3% ± 7.0, with the MM group (67.0% ± 7.6, n = 17) scoring higher (P = 0.03) than the HO (61.6% ± 5.4, n = 18) cohort. Postassessment scores did not differ by postgraduate year (P = 0.75) or institution (P = 0.17). Paired analysis demonstrated an overall mean improvement of 7.4% in the handout (HO) cohort (P = 0.03) and 10.3% in the MM cohort (P = 0.0006). Subset analysis demonstrated higher scores for the MM cohort for perceptual voice evaluation (HO = 68.8% ± 11.0; MM = 77.3% ± 10.6, P = 0.03) and stroboscopy-specific items (HO = 55.5% ± 8.2; MM = 61.9% ± 10.8, P = 0.06). On a five-point Likert scale, residents reported improved confidence in stroboscopy interpretation (P < 0.0001), irrespective of cohort (P = 0.62). Residents rated the MM (median = 5) more favorably as a teaching tool compared to the HO (median = 4, P = 0.001). CONCLUSION: Use of both the written HO and MM module improved scores and confidence in interpreting laryngeal stroboscopy. The MM was more effective in perceptual voice evaluation and stroboscopy-specific items. The MM was also rated more favorably by residents and may be an ideal adjunct modality for teaching stroboscopy.
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Internato e Residência , Estudos de Coortes , Escolaridade , Humanos , Multimídia , EstroboscopiaRESUMO
Local anesthesia is commonly used for head and neck procedures. Many anesthetic agents are available, with differing properties that can alter their durations of action and lengths of time to onset. These agents can be used acutely for laceration repair or as adjuncts to intravenous sedation. Local and regional anesthetic agents can also be used for chronic conditions. Several local anesthetic blocks are available. Local anesthesia has the potential for complications, ranging from issues with injection process, such as a broken needle, to reactions of the anesthetic agent. Some populations are more at risk for certain reactions to anesthesia.
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Anestesia por Condução/métodos , Anestésicos Locais/administração & dosagem , Cabeça/cirurgia , Pescoço/cirurgia , Humanos , Bloqueio NervosoRESUMO
OBJECTIVE: (1) Understand attitudes of otolaryngology residency applicants regarding gender and racial diversity within programs. (2) Examine how program diversity affects applicant decisions during the residency match. (3) Compare the importance of racial and ethnic program diversity among applicants. STUDY DESIGN: Web-based survey distributed in February and March 2019. SETTING: Tertiary care university setting. SUBJECTS AND METHODS: An anonymous web-based survey was distributed to 418 applicants in the 2019 otolaryngology match. Respondents were queried about the importance of program diversity and its effects on the match process. Ratings were based on a scale of 1 to 5 (with 5 being extremely important or significant effect). RESULTS: The response rate was 35%; 53% of responders were male; and 59% were white, 25% Asian, 6% black, and 6% Hispanic/Latino. Applicants rated the importance of having female faculty and residents as 4.1 (SD = 1.1) and 4.2 (SD = 1.1), respectively. Applicants rated the importance of having diverse faculty and residents as 3.9 (SD = 1.1) and 4 (SD = 1.2). Overall, 7.6% of applicants canceled interviews due to a lack of female residents and 5.5% due to a lack of female faculty; furthermore, 5.5% of applicants canceled interviews due to a lack of diverse residents and 4.9% due to a lack of diverse faculty. Female and nonwhite applicants prioritized females and diversity within programs more so than male and white applicants. CONCLUSIONS: Although residency applicants felt that program diversity was important, this did not significantly affect decision making during the match process, likely due to the competitive nature of the match. Women and nonwhite applicants prioritized program diversity more than white male applicants.
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Atitude do Pessoal de Saúde , Etnicidade , Internato e Residência , Otolaringologia/educação , Seleção de Pessoal , Adulto , Colorado , Tomada de Decisões , Feminino , Humanos , Masculino , Fatores Sexuais , Inquéritos e QuestionáriosRESUMO
OBJECTIVES: To evaluate otolaryngology residents' level of confidence and understanding in interpreting laryngeal stroboscopy. METHODS: Otolaryngology residents from three residency programs with fellowship-trained laryngologists on faculty were invited to participate. An assessment consisting of a survey and five stroboscopic exams was administered. Each exam consisted of questions on perceptual voice evaluation, laryngoscopic findings, and stroboscopic findings. Scores were compared to answers provided by three fellowship-trained laryngologists. RESULTS: Thirty-eight of 47 invited residents (80.8%) enrolled in the study. On a five-point likert scale, residents reported low confidence (medianâ¯=â¯2, rangeâ¯=â¯1-4) in interpreting stroboscopy, regardless of training program (Pâ¯=â¯0.81). Mean assessment scores were 56.5% ± 11.9, with scores in perceptual voice evaluationâ¯=â¯68.5% ± 10.6; laryngoscopyâ¯=â¯70.2% ± 12.8; and stroboscopyâ¯=â¯45.3% ± 17.8. Residents performed worse on stroboscopy questions compared to laryngoscopy questions (P < 0.0001). There was a significant difference in scores by postgraduate year (Pâ¯=â¯0.03), but not by institution (Pâ¯=â¯0.34). A moderately positive correlation between reported level of confidence and overall scores (ρâ¯=â¯.47, Pâ¯=â¯0.003) was demonstrated. CONCLUSIONS: Despite didactic and clinical exposure, residents report low confidence in interpreting stroboscopy and scored lower on stroboscopy-specific questions compared to other assessment items. Additional resources and learning opportunities are needed to improve resident confidence and comprehension of stroboscopy.
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Educação de Pós-Graduação em Medicina , Internato e Residência , Laringoscopia/educação , Otorrinolaringologistas/educação , Otolaringologia/educação , Estroboscopia , Distúrbios da Voz/diagnóstico , Competência Clínica , Compreensão , Escolaridade , Humanos , Valor Preditivo dos Testes , Estados Unidos , Distúrbios da Voz/fisiopatologia , Qualidade da VozRESUMO
Rates of burnout, mental illness, and suicide are disproportionately elevated among physicians, and surgical specialists, including otolaryngologists, are at even higher risk for professional burnout. These trends have been identified at both the trainee and attending level. To combat resident burnout, the Accreditation Council for Graduate Medical Education (ACGME) Council of Review Committee Residents (CRCR) designed the Back to Bedside Initiative, the goals of which are to foster meaning in the learning environment and to help trainees to engage more deeply with patients. Two funded Back to Bedside proposals involve otolaryngology training programs. Herein, we discuss these 2 approaches in an effort to foster additional novel resident wellness initiatives and awareness thereof across our subspecialty.
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Esgotamento Profissional/prevenção & controle , Esgotamento Profissional/psicologia , Promoção da Saúde/métodos , Internato e Residência , Otorrinolaringologistas/educação , Otorrinolaringologistas/psicologia , Grupos Focais , Humanos , Relações Médico-Paciente , Conselhos de Especialidade Profissional , Estados UnidosRESUMO
OBJECTIVES/HYPOTHESIS: The purpose of this study was to evaluate fellowship program directors' perceptions of incoming clinical fellows' preparedness for subspecialty training and to thereby identify strengths and shortcomings in otolaryngology training programs' ability to prepare residents for fellowship. STUDY DESIGN: Validated e-mail survey. METHODS: Two hundred eleven otolaryngology subspecialty fellowship program directors and faculty directly involved with training fellows were contacted. A validated survey by the American College of Surgeons was modified and distributed to otolaryngology fellowship faculty in six otolaryngology subspecialties. The 59-item survey employed a five-response Likert scale tailored to each subspecialty. Responses were collected between November 2016 and January 2017. RESULTS: One hundred ten otolaryngology faculty responded to the survey (52%). Respondents had worked with fellows for a mean of 12 years (standard deviation = 8). Respondents felt fellows were competent in the areas of professionalism, clinical evaluation, and management. Pediatric faculty were more likely to disagree about fellows' independence in the operating room (P = .004) and during call (P = .002) compared to other specialties. Laryngology and facial plastic and reconstructive surgery faculty felt more neutral about anatomy recognition (P = .008), tissue manipulation (P = .002), and use of energy sources (e.g., cautery, lasers) (P < .001). Fellows in all subspecialties were felt to be least prepared in research and academic interest. CONCLUSIONS: Faculty involved in fellowship training feel that fellows are well-prepared overall upon entering fellowship. Residency programs may benefit from providing more experience with facial plastic reconstructive surgery, laryngology, and pediatrics. Regardless of specialty, residents could benefit from increased training in research design, data analysis, and basic statistics. LEVEL OF EVIDENCE: NA Laryngoscope, E280-E286, 2018.
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Educação de Pós-Graduação em Medicina/métodos , Docentes de Medicina/psicologia , Bolsas de Estudo , Internato e Residência/métodos , Otolaringologia/educação , Competência Clínica , Humanos , Avaliação de Programas e Projetos de Saúde , Inquéritos e Questionários , Estados UnidosRESUMO
OBJECTIVES/HYPOTHESIS: The objectives of this study were to summarize externship experiences among recent graduates and current residents in otolaryngology residency programs and determine whether externships affect the match process. STUDY DESIGN: Cross-sectional survey. METHODS: A survey was distributed to otolaryngology residents in allopathic US residency programs and otolaryngology graduates from the past 5 years (2011-2015). There were 2,141 surveys distributed. RESULTS: There were 654 subjects who responded, for a 30.5% response rate. Most respondents were residents (n = 438, 67%). Of the residents, 85.6% had completed at least one externship compared to 75.9% of graduates (P = .002). The most common reasons for selecting a particular externship were geographic location (74.2%) and program reputation (71.1%), whereas the most common reason for not completing an externship was being advised not to (59.1%). Furthermore, 82.6% of respondents received at least one interview from their externships, 90% went to those interviews, and 89.1% reported that externship experiences affected their rank list. Respondents had a 32.7% match rate to the externship residency program if it was ranked versus a 48.8% match rate if the program was ranked first. Respondents who matched at the externship residency program matched higher on their rank list (P < .001). Of the respondents, 90.7% found externships to be valuable, and 74.5% recommended completing one. CONCLUSIONS: Externships are beneficial because they influence the rank list of applicants and are viewed as valuable experiences. Completing an externship is advisable for the experience, but applicants should weigh the benefits versus the possible risk of being judged more harshly during a month-long rotation. LEVEL OF EVIDENCE: NA Laryngoscope, 127:2242-2246, 2017.
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Educação de Pós-Graduação em Medicina/métodos , Internato e Residência/métodos , Otolaringologia/educação , Seleção de Pessoal , Estudos Transversais , Feminino , Humanos , Masculino , Inquéritos e QuestionáriosRESUMO
Inpatient rounding is an agelong tradition in the field of medicine. Among recent changes in health care, rounding is understudied as an area of research. The purpose of this study was to assess current methods of inpatient rounding in otolaryngology residency programs and assess satisfaction with current practices. Survey questions were designed by members of the resident committee of the Society of University Otolaryngologists. Surveys were sent to all 450 members, and we obtained a 32% response rate. Sixty-four percent of attendings perform bedside rounds; 44% of subjects reported that attending physicians participate in rounds at least once a week; and 21% reported daily participation. When asked if attending participation in rounding is adequate, attendings did not have a strong opinion (mean = 3.8). There is a paucity of research on inpatient rounding, and future studies should examine specific practices with the goal of maximizing patient safety and resident education.
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Otolaringologia/educação , Padrões de Prática Médica/estatística & dados numéricos , Visitas de Preceptoria , Educação de Pós-Graduação em Medicina , Humanos , Internato e Residência , Satisfação no Emprego , Corpo Clínico Hospitalar , Inquéritos e Questionários , Estados UnidosRESUMO
Objectives To identify how applicants to otolaryngology residency determine how to apply to, interview with, and rank programs on the interview trail and to determine the extent of the financial burden of the otolaryngology interview trail. Study Design Web-based survey distributed in March and April 2016. Setting Otolaryngology residency applicants throughout the United States. Subjects and Methods Applicants to otolaryngology residency during the 2016 match cycle and current otolaryngology residents were surveyed. Results Median number of applications, interview offers, interviews attended, and programs ranked was not different during the 2016 match and the previous 5 match years. The most important factor affecting the number of applications was the need to apply widely to ensure sufficient interview offers. The most common reason for declining an interview offer was scheduling conflict. Applicants during the 2016 match spent a median of $5400 applying and interviewing for otolaryngology residency. Conclusions Median number of applications, interview offers, interviews attended, and programs ranked has not changed. The most cited reason for applying to many programs was to increase the chances of matching, but this is not statistically likely to increase match success. We advocate for continued attempts to make the otolaryngology match process more transparent for both applicants and resident selection committees, but recognize that applicants are likely to continue to overapply for otolaryngology residency positions.