We Wear Suits and Lie to Each Other

Objective The residency match process is stressful and costly for fourth-year medical students with significant personal and professional implications. We hypothesize that students use impression management (IM) tactics such as conforming to the perceived expectations of program directors and interviewers and to improve their chances of matching. Design After institutional review board approval, a piloted survey tool was administered to fourth-year medical students at 17 schools. Questions were divided into interviewing behavior categories—slight image creation (embellishing and tailoring), extensive image creation (constructing, inventing, and borrowing), image protection (omitting), and ingratiation (opinion conforming). Descriptive statistics are presented as percentages. Data were analyzed using chi-square test, Fischer exact test, and Bonferroni-adjusted p values where appropriate with statistical significance set at p < 0.05. Setting Allopathic medical schools in the United States. Participants Fourth-year medical students in the United States. Results The response rate was 21.3%. Respondents were equally male (49.7%)/female (50.3%), primarily 25 to 27-year old (65.9%) and located in the midwest (78.8%). Most attended public medical schools (73.1%). Statistically significant findings are presented in the Tables. Conclusions Fourth-year medical students feel the need, and in some instances, actually engage in IM tactics. This study demonstrates that IM tactics are used, and vary by interviewee characteristics. Program directors’ awareness of IM tactics may help improving the quality of residency interviews and therefore select more suitable candidates.