Limitations
This study is not without its limitations. Primarily, as this is an observational study in which the associations and trends presented do not necessarily imply causality. Further, due to the survey components of our study, there is risk of recall bias, non-response bias, and sampling bias. As with all survey-based research, there is potential self-selection bias among respondents. Likewise, although our sample size is robust, our data only represent 19% of PGY-1/PGY-2 otolaryngology residents, thus our findings may not be generalizable to the entire otolaryngology resident population. In addition, only otolaryngology residents were contacted, thus our survey distribution method did not directly capture responses from residents who considered otolaryngology but ultimately pursued another specialty, but instead used otolaryngology residents’ impressions of what factors impacted those medical school classmates’ decisions. For these reasons, future studies that more comprehensively assess the factors and perceptions impacting applicants’ decisions are needed.