Conclusion
With recent changes in the USMLE Step 1 scoring system from numerical scores to pass/fail, programs may be compelled to seek new ways to differentiate applicants. However, programs must bear in mind the consequence(s) of deterring applicants when implementing any new requirement(s) for residency applications. Our study suggests that the PSP and ORTA are perceived as barriers to applying to otolaryngology and were associated with significant declines in applicant numbers and increases in match rate success. Optional PSP and post-match ORTA conversely led to significant increases in applications and decreases in match rate success. Methods affecting application numbers should be applied strategically and with careful consideration. Though perceived barriers to otolaryngology applications may risk losing high quality candidates, are we really doing any better with increasing pools of unmatched applicants year after year?