How Some Specialties Are Getting Innovative with Medical Residency Recruitment

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Professional and interpersonal skills are essential in a medical career but aren’t easily evaluated via standard applications or even interviews. In 2020, Michael Cullen, PhD, senior director of assessment, evaluation, and research in graduate medical education at the University of Minnesota Medical School in Minneapolis, along with a team of researchers, developed a 45-minute, online situational judgement test (SJT) designed to measure conscientiousness, integrity, accountability, teamwork, stress tolerance, aspiring to excellence, and patient-centered care as they would present in the residency setting (Teach Learn Med. 2020;32:508-521). In the test, the applicant is presented with situations they’re likely to encounter as a resident or fellow and then given lists of possible responses and/or actions, each of which must be rated on a scale of 1 to 7 (“completely ineffective” to “highly effective”). The SJT is automatically scored, requiring no input from faculty, and comes with a development report for matched trainees, which can be used for setting professionalism goals for trainees.

Applicants in dozens of residency and fellowship programs in psychiatry and other specialties took part in the SJT pilot. In their study paper, researchers concluded that the tests “show promise as a method for assessing noncognitive attributes in residency program applicants.” Dr. Cullen cited the SJT as another tool that could be used to achieve a more holistic review of candidates without adding the need for faculty input.

The Future of Recruitment

As the number of residency applicants continues to rise, medical education leaders are working on additional ways to improve and refine the recruitment process. Dr. Hammoud and her colleagues are working with the AMA on a proposed system alignment check index system that would help students pinpoint programs to which they are most aligned. Programs would apply “weights” in six key aspects of their offerings and applicants would use that information to self-evaluate their suitability. “It’s kind of like a dating app,” said Dr. Hammoud, “but because the applicant is self-evaluating, it’s to their advantage to be accurate. No one else sees it but them.”

Dr. Rosman would like to see continued collaboration between specialties to address the challenges of the application process. “Many of the pain points are similar across specialties,” she emphasized. “Working together, we can come up with innovative ways to solve problems within the current system.”

To encourage development of a system where applicants could apply to far fewer programs and reviewers could be more thoughtful, Dr. Thorne supports greater transparency among programs regarding their selection criteria and the attributes they value most highly. “Applicants may benefit from seeing data about their likelihood of matching at a limited number of programs they identify ahead of the process as their preferred destination,” he said. “This may support a cap on applications in the future.” 

Linda Kossoff is a freelance medical writer based in California.