title: Selection criteria for internal medicine residency applicants and professionalism ratings during internship.
abstract: OBJECTIVE
  To determine whether standardized admissions data in residents' Electronic Residency Application Service (ERAS) submissions were associated with multisource assessments of professionalism during internship.
  
  
  METHODS
  ERAS applications for all internal medicine interns (N=191) at Mayo Clinic entering training between July 1, 2005, and July 1, 2008, were reviewed by 6 raters. Extracted data included United States Medical Licensing Examination scores, medicine clerkship grades, class rank, Alpha Omega Alpha membership, advanced degrees, awards, volunteer activities, research experiences, first author publications, career choice, and red flags in performance evaluations. Medical school reputation was quantified using U.S. News & World Report rankings. Strength of comparative statements in recommendation letters (0 = no comparative statement, 1 = equal to peers, 2 = top 20%, 3 = top 10% or "best") were also recorded. Validated multisource professionalism scores (5-point scales) were obtained for each intern. Associations between application variables and professionalism scores were examined using linear regression.
  
  
  RESULTS
  The mean ± SD (minimum-maximum) professionalism score was 4.09 ± 0.31 (2.13-4.56). In multivariate analysis, professionalism scores were positively associated with mean strength of comparative statements in recommendation letters (β = 0.13; P = .002). No other associations between ERAS application variables and professionalism scores were found.
  
  
  CONCLUSIONS
  Comparative statements in recommendation letters for internal medicine residency applicants were associated with professionalism scores during internship. Other variables traditionally examined when selecting residents were not associated with professionalism. These findings suggest that faculty physicians' direct observations, as reflected in letters of recommendation, are useful indicators of what constitutes a best student. Residency selection committees should scrutinize applicants' letters for strongly favorable comparative statements.
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Cullen
authors.forename: Darcy A
authors.initials: DA
authors.lastname: Reed
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Halvorsen
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Wittich
authors.forename: Lisa M Baumann
authors.initials: LM
authors.lastname: Kreuziger
authors.forename: Mira T
authors.initials: MT
authors.lastname: Keddis
authors.forename: Furman S
authors.initials: FS
authors.lastname: McDonald
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Beckman
mesh_terms: D000328:Adult; D002983:Clinical Competence; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D016014:Linear Models; D008297:Male; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012570:School Admission Criteria; D014481:United States