Perceptions of an “Application Cap”: A Survey of Ophthalmology Residency Program Directors

Purpose: To determine residency program directors’ (PD) perceptions of the ophthalmology match process, particularly regarding their opinions on a potential "application cap" that would limit the number of programs to which an applicant can apply. Methods: An Association of University Professors of Ophthalmology (AUPO)-endorsed survey targeted U.S. PDs from the 2021 and 2022 cycles. A survey was initially distributed on 02/14/2023 with a single email reminder approximately 3 months later. All responses were anonymous and collected via a secure Qualtrics link. Results: Of the 45/121 PD respondents (37.2% response rate), 88.9% supported an application cap and suggested a median of 40 (interquartile range: 33.75-50) programs per applicant. Additionally, 93.3% agreed that applying to less programs will not disadvantage URiM candidates or hinder the goal of DEI in ophthalmology. PDs highlighted the following benefits of capping: sharper applicant focus, holistic reviews, and reduced costs. Concerns with capping included biases against international medical graduates and osteopathic applicants and fostering an anticompetitive attitude. Conclusion: The majority of PDs support an application cap. Such a move may reduce administrative and financial burden, while enabling a holistic application review. Whether through an application cap or other means, reducing the number of applications that programs receive is likely to benefit all parties.