Building trust in the transition to residency by ensuring fair competition and protecting future applicants: Why Thalamus sent an attorney’s letter to APGO

Dear colleagues in the medical education community,

Earlier today, Thalamus sent an attorney’s letter to the Association of Professors of Gynecology and Obstetrics (APGO). This letter challenged their decision to deny our organization the ability to exhibit at the CREOG & APGO Annual Meeting (CAAM) from February 28 to March 2, 2024. On behalf of Thalamus, I wanted to share why we made this decision.

On the surface, this may seem like an unconventional response to a denial to exhibit notification. Yet, it is our belief at Thalamus that this move by APGO is indicative of some chilling trends taking hold in the transition to residency. In line with one of Thalamus’ core values, “Bravery with Purpose,” our organization respectfully challenges the status quo for the good of the broader medical education community.

Since 2014, Thalamus has been a proud technology partner of the OBGYN specialty. The number of OBGYN programs using our software has grown consistently year-over-year.  Today, nearly 100% of OBGYN applicants schedule interviews with >50% of OBGYN residency programs through Thalamus. For years, CAAM has been an important forum for us to interact with the applicants and programs we serve, to understand their changing needs and to continue to innovate to serve them better.

So, what has dramatically changed?

As some of you may know, OBGYN recently announced its own specialty-wide application for the 2025 residency recruitment season, including announcing an interview management platform (still under development) that will be a direct competitor with our product. As technologists passionate about GME, we believe that competition is a good thing for growth and improvement.

As a mission-driven company born out of GME, we welcome software enhancements that best serve the needs of the community. But because of the above context, we strongly believe that APGO’s decision to keep Thalamus away from longstanding users of our software is a deeply anti-competitive move. This will stifle the innovation that serves the GME community by imposing a “choice” and selectively favoring one product over another.

This is an unprecedented move by APGO, and as far as we can tell, the first time this has happened at any GME-related conference. Thalamus has frequently and always respectfully exhibited in the presence of our competitors, including the proposed OBGYN collaborator. Competition spurs innovation, and it helps Thalamus become even better. We trust that our product speaks for itself.

What is more distressing is that the decision to exclude Thalamus from CAAM will have harmful implications for applicants and programs alike. We are now approximately seven months from the start of the next residency application season, and it’s unclear that the OBGYN application will be ready to meet the needs of the specialty, to train programs to use it, and/or to work out the bugs of a new technology, all in time for the upcoming 2025 season to open this summer. To date, we have not heard how the nearly 50% of OBGYN applicants that cross-apply into other specialties will manage multiple applications and avoid duplicate work. There has not even been a decision as to how fragmentation in this process will be able to support SOAP.  

Not surprisingly, Thalamus has received commitments from several OBGYN programs who have chosen to remain with us for the upcoming season.  And those programs deserve the opportunity to engage with us at CAAM as they have always done.

At Thalamus, we know first-hand the massive level of change management required to bring a specialty onto a new platform. In 2020, when Thalamus was offered complimentarily to OBGYN residency programs as part of a specialty-wide pilot, only a subset of the specialty participated in the first year. Many waited to make sure our product worked—and worked better than their existing platforms—before making the switch.

Historically, Thalamus has also been the primary technology supporter and data collaborator for the Recommended Standards for Obstetrics and Gynecology Residency Application and Interview Processes.  During the height of the COVID crisis, Thalamus provided OBGYN programs complimentary access to our premium add-ons, including Itinerary Wizard, Thalamus Video and Cortex, assisting the community scrambling in their transitions to virtual interviews and to promote specialty-wide adoption at the formal request of APGO. This includes acting as the major operational facilitator of every OBGYN common interview release date, since its inception in 2020. The 2024 recruitment season alone, 130 OBGYN programs–representing 47% of the specialty–used Thalamus to send out over 10,000 invitations on the common interview release day on October 24, 2023.  

Given this long-standing relationship, several OBGYN programs have confided in us that they have felt coerced into making an uninformed move to this new and untested application system. This pressure is antithetical to Thalamus’s own operational model. The key to our growth has been the trust that we’ve built with the communities we serve, we never force or coerce anyone to use our software, it is our goal to earn your trust in our products.

Notably, Thalamus has recently restructured as a public benefit corporation (PBC), which means that we are legally obligated to operate in a way that not only considers our financial bottom line, but the public benefit we provide to the GME and medical community. This is a major distinction between us and our private equity-backed competitors that are standard for-profit companies, whose primary obligations are to their investors alone.  Thalamus has never charged applicants for any of our services.

Last year, Thalamus initiated a historic strategic collaboration with the AAMC, making our platform free of charge for all specialties that use the ERAS application, including OBGYN. For us, the collaboration enabled us to realize a vision our founding team laid out six years earlier in the Journal of Graduate Medical Education (, where we identified the need for collaborative studies of GME interview software.

I believe the GME community may have been surprised by our collaboration, as two organizations that had competed for years were now working together to bring innovation to the transition to residency.  I am also aware of the community’s criticism of the AAMC, because I was a frequent and bold contributor to that conversation.  But as we finalized the collaboration, our two organizations were able to align on making this transition better for all members of the community. 

Since then, the AAMC has launched a fee-assistance program, lowered the pricing of ERAS applications, and saw the first drop in applications in over a decade, likely a result of the broader adoption of preference signals.  Thalamus saw a 75% opt-in rate across 6500+ residency and fellowship programs and sent out over 400K+ invitations for the ERAS 2024 recruitment season. 

Together, the AAMC and Thalamus are completing a streamlined API integration between My ERAS/ERAS PDWS and Thalamus Core, Cortex and Cerebellum.  Thalamus interview data will also be included complimentary in Residency Explorer to provide applicants a more complete picture of their competitiveness to specialties and programs.  There is a long way to go to improve this transition, but Thalamus is now rapidly innovating alongside our strategic collaborators at the AAMC. I’m proud of the progress that we’ve made in innovation, and toward data collaboration over fragmentation. This benefits the entire medical education community.

To our OBGYN applicants and program supporters, we wish you a successful 2024 CAAM conference. We are sorry we are unable share this conference with you. Know that regardless, we are excited to welcome you onto Thalamus for the upcoming season.  Since we won’t be able to be with you in San Antonio, our leaders, as well as our data and engineering teams will be holding an innovation summit at our headquarters instead, mapping out our next technological breakthrough that is sure to turn heads whether at a conference or not.

Hopefully next year at this time, we’ll be together to share, innovate, and yes, compete on a level playing field.


– Jason

Jason Reminick, MD, MBA, MS

CEO and Founder, Thalamus