Formal Career Goal Advising Program for Otolaryngology, the UNC Experience

Abstract

Career goal advising (CGA) is critical to medical student success in the increasingly competitive field of otolaryngology. Otolaryngology is underrepresented in the preclinical curriculum; therefore, early exposure and guidance are limited. At the University of North Carolina (UNC), a formal CGA program was created in 2018 to provide direct access to faculty mentorship. Advisors provide early exposure to otolaryngology, advise the interest group, and meet regularly with students throughout medical school training. All participating students were surveyed. Since inception, the match rate of students applying to otolaryngology from UNC has been 95%. The majority of these students matched at top 25 residency programs. Students reported high satisfaction with access, responsiveness to concerns, preparedness for the match, and confidence in specialty choice. Our program offers a sustainable response to the challenge of exposure and competitiveness in otolaryngology and may provide a template for medical schools to improve faculty mentorship within otolaryngology.

Career goal advising (CGA) is critical to medical student success in the increasingly competitive field of otolaryngology. Increasing applicant numbers with limited spots have created a match rate of 71.2% in the 2024 to 2025 cycle. ¹ Otolaryngology is known to be underrepresented in early medical school curriculums; and therefore, early access to guidance and mentorship within the specialty are limited. ² , ³ , ⁴ , ⁵ Students without the benefit of otolaryngology‐specific advising early in their academic career look to navigate medical school and the match process without the appropriate tools to succeed.

Most advising structures are informal and rely on chance interactions or introductions to build meaningful relationships with faculty and residents. Programs with structured advising and otolaryngology‐specific mentoring have shown improvements in clinical preparedness and match rates. ⁶ At the University of North Carolina (UNC), a CGA program for otolaryngology was established to improve satisfaction and confidence with specialty choice, facilitate match preparedness and guidance throughout the residency application process, and improve access to faculty mentorship and research opportunities.

Methods

In collaboration with the UNC School of Medicine, the Department of Otolaryngology‐Head and Neck Surgery established a formal CGA program in 2018. This research was reviewed and deemed exempt by the UNC Institutional Review Board (IRB #22‐0234).

CGAs review recent otolaryngology match statistics and applicant data (eg, clinical grades, step scores, activities, and research productivity) in order to offer evidence‐based guidance. CGAs also carry forward recommendations from the Society of University Otolaryngologists (SUO), program director surveys, and historical experience.

The program provides many opportunities to increase student exposure to otolaryngology during the preclinical years. CGAs deliver a series of career exploration lectures, first in the fall focusing on introducing the field, residency requirements, faculty research, and facilitate student involvement in research for preclinical students. A CGA also advises the otolaryngology interest group, which offers simulation labs, shadowing opportunities, and match panels. In the third year, lectures focus on life as an otolaryngology resident as well as granular match statistics and considerations regarding leaves of absence for research or other degrees.

For students pursuing otolaryngology, CGAs assist with specialty decision‐making and course scheduling. Before match season, students meet with a CGA to review the application timeline and critical time points for suggested check‐ins (Figure 1). Throughout the process, CGAs provide personalized mentorship on away rotations, letters of recommendation, personal statements, application and interview preparation, overall competitiveness, and signaling, with availability for additional meetings as needed.

Figure 1.

Suggested meeting timeline. This timeline starts the second semester of the third year of medical school through March of the last year of medical school. LOR, letters of recommendation; PS, personal statement.

Anonymous surveys (Supplemental Figure S1, available online) were distributed to all UNC School of Medicine graduates who applied into otolaryngology from 2018 to 2024. Due to the small sample size, higher‐level analyses, such as multivariate analysis, were not feasible with this dataset.

Results

Since the inception of the formal CGA program, the match rate for UNC students into otolaryngology residency is 95% (20/21). Of the 21 students who applied, 57% (12/21) matched into a top 25 program based on the annual Doximity report versus 43% (9/21) based on US News and World Rank report. ⁷ , ⁸ Of 21 students, 62% male and 38% female, 15 responded to the survey. Based on our feedback survey, the majority of students “strongly agreed” or “agreed” that they had access to a CGA, that advisors were responsive to concerns, and that the CGA program improved exposure to otolaryngology (Figure 2). The majority of the students also “strongly agreed” or “agreed” that access to an advisor helped them prepare for the match and that they were confident in their specialty choice and were satisfied with support during the interview/Match process (Figure 3). A majority of students felt prepared for the Match and felt that CGAs helped them successfully match; though only 8/15 (53%) believed formal advising increased their competitiveness in the Match, 3/15 (20%) had neutral thoughts, and 2/15 (13%) disagreed. Despite this, otolaryngology applicants from UNC from 2018 to 2025 boast a match rate of 95%. Based on the student's rank list, 73% of students who responded matched into their top 25%. UNC students reported an average of 9.3 total presentations (ranging from 1 to 20) and an average of 7.3 total publications (range 4‐14).

Figure 2.

Career goal advising survey results.

Figure 3.

Career goal advising survey results continued.

Discussion

While many factors influence the match process, our formal CGA system may have contributed to UNC's highly successful match rate into otolaryngology. Though student‐specific variables (publications, Alpha Omega Alpha, board scores) and institutional factors (national medical school ranking) play a significant role especially in a student's competitiveness and success in the match, students reported high satisfaction with the program. ¹ , ⁹ , ¹⁰ , ¹¹ , ¹² Advisors were accessible, responsive, and helped students prepare for the match. Students also felt confident in their specialty choice and had increased exposure to the field.

Compared to national data from Texas STAR (Seeking Transparency in Application to Residency), our students reported equal presentations (9.3v. 9.3) and higher average publications with 7.3 publications versus 5.5. ¹⁰ Multiple factors (dual degrees, research years) determine the number of publications and presentations a student has; and while we are unable to conclude that our advising program leads to more publications and presentations, it is generally accepted that early faculty mentorship leads to more research opportunities.

While other institutions have reported increased satisfaction with structured advising programs, we are the first to describe a unique longitudinal CGA program for students pursuing a career in otolaryngology. ¹³ , ¹⁴ Given the increasing competitiveness in our field, early and personalized guidance is critical and has proven valuable. Our program not only supports students academically but also fosters informed specialty decision‐making and professional development.

Future directions will focus on enhancing early exposure to otolaryngology, increasing student confidence in specialty choice, and adapting to evolving match requirements.

Conclusions

CGA programs offer a sustainable response to the challenge of limited exposure to and increasing competitiveness in otolaryngology. Offering essential early and direct access to a CGA leads to high satisfaction with match preparedness, and may compliment standard advising programs for students applying into competitive specialties.

Author Contributions

Makayla R. Matthews, BS, analysis, writing, editing; Todd H. Lambert, MD, author, analysis, presentation of research; Robert A. Buckmire, MD, design, analysis, author; Rupali N. Shah, MD, design, analysis, author; Christine E. DeMason, MD, design, analysis, author.

Disclosures

Competing interests

None.

Funding source

None.

Supporting information

Supplemental Figure 1: Career Goal Advising Survey.