Abstract
BACKGROUND: Residency program prestige is an important variable medical students consider when creating their rank list. Doximity Residency Navigator is a ranking system that previous reports have shown significantly influences medical student application decisions. Doximity's use of peer nomination as a central component of its methodology for determining program rank has drawn criticism for its lack of objectivity. Doximity has not published information regarding how peer nomination and more objective measures are statistically weighted in reputation calculation. OBJECTIVE: This study assesses whether a strong negative correlation exists between residency program size and Doximity ranking. METHODS: A cross-sectional study of Doximity residency rankings from the 2018-2019 academic year was conducted. Data extracted from Doximity included program rank, size, and age. Data were additionally collected from the Blue Ridge Institute for Medical Research, National Institutes of Health, funding in 2018 and the US News & World Report Best Medical Schools 2019-2020. A multivariable linear regression model was used that included Doximity ranking as the outcome variable and residency program size as the predictor variable with adjustment for the aforementioned variables. RESULTS: Sixteen of the 28 specialties on Doximity were included in the analysis, representing 3388 unique residency programs. After adjustment for covariates, residency program size was a significant predictor of Doximity ranking (β = -1.84; 95% CI -2.01 to -1.66, P < .001). CONCLUSIONS: These findings support the critique that the Doximity reputation ranking system may favor larger residency programs. More transparency for Doximity reputation ranking algorithm is warranted.