Identifying and Promoting Best Practices in Residency Application and Selection in a Complex Academic Health Network.
Medical education institutions have a social mandate to produce a diverse physician workforce that meets the public's needs. Recent reports have framed the admission process outcome of undergraduate and postgraduate medical education (UGME and PGME) programs as a key determinant of the collective contributions graduating cohorts will make to society, creating a sense of urgency around the issue of who gets accepted. The need for evidence-informed residency application and selection processes is growing because of the increasing size and diversity of the applicant pool and the need for equity, fairness, social accountability, and health human resource planning. The selection literature, however, is dominated by a UGME focus and emphasizes determination of desirable qualities of future physicians and selection instrument reliability and validity. Gaps remain regarding PGME selection, particularly the creation of specialty-specific selection criteria, suitable outcome measures, and reliable selection systems.In this Perspective, the authors describe the University of Toronto's centralized approach to defining system-level best practices for residency application and selection. Over the 2012-2013 academic year, the Best Practices in Application and Selection working group reviewed relevant literature and reports, consulted content experts, surveyed local practices, and conducted iterative stakeholder consultations on draft recommendations. Strong agreement arose around the resulting 13 principles and 24 best practices, which had either empirical support or face validity. These recommendations, which are shared in this article, have been adopted by the university's PGME advisory committee and will inform a national initiative to improve trainees' transition from UGME to PGME in Canada.
G. Bandiera is associate dean, Postgraduate Medical Education, University of Toronto, and chief of emergency medicine, St. Michael's Hospital, Toronto, Ontario, Canada. C. Abrahams is director of policy and analysis, Postgraduate Medical Education Office, University of Toronto, Toronto, Ontario, Canada. M. Ruetalo is a research officer, Postgraduate Medical Education Office, University of Toronto, Toronto, Ontario, Canada. M.D. Hanson is associate dean, Undergraduate Medical Education Admissions and Student Finances, University of Toronto, Toronto, Ontario, Canada. L. Nickell is associate dean, Undergraduate Health Professions Students Affairs, University of Toronto, Toronto, Ontario, Canada. S. Spadafora is vice dean, Postgraduate Medical Education, University of Toronto, Toronto, Ontario, Canada.
Glen
G
Bandiera
Caroline
C
Abrahams
Mariela
M
Ruetalo
Mark D
MD
Hanson
Leslie
L
Nickell
Salvatore
S
Spadafora
D002321:Career Choice; D002983:Clinical Competence; D004503:Education, Medical, Graduate / Q000458:organization & administration; D004504:Education, Medical, Undergraduate / Q000458:organization & administration*; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration; D007586:Job Application; D007588:Job Satisfaction; D010560:Personnel Selection; D014481:United States