title: Documentation of quality improvement exposure by internal medicine residency applicants.
abstract: BACKGROUND
  Quality improvement (QI) has become an essential component of medical care in the United States. In residency programs, QI is a focus area of the Clinical Learning Environment Review visits conducted by the Accreditation Council for Graduate Medical Education. The readiness of applicants to internal medicine residency to engage in QI on day one is unknown.
  
  
  OBJECTIVE
  To document the reporting of QI training or experience in residency applications.
  
  
  METHODS
  Electronic Residency Application Service applications to a single internal medicine program were reviewed individually looking for reported QI involvement or actual projects in the curriculum vitae (CVs), personal statements (PSs), and letters of recommendation (LORs). CVs were also reviewed for evidence of education in QI such as completion of Institute for Healthcare Improvement (IHI) modules.
  
  
  RESULTS
  Of 204 candidates shortlisted for interview, seven had QI items on their CVs, including one basic IHI certificate. Three discussed their QI work in their PSs, and four had recommendation letters describing their involvement in QI. One applicant had both CV and LOR evidence, so that 13 (6%) documented QI engagement.
  
  
  CONCLUSIONS
  Practice of or instruction in QI is rarely mentioned in application documents of prospective internal medicine interns.
authors.affiliation: Department of Internal Medicine, The Guthrie Clinic, Sayre, PA, USA; VKolade@gmail.com.
authors.forename: Victor O
authors.initials: VO
authors.lastname: Kolade
authors.affiliation: Department of Biostatistics, Boston University, Boston, MA, USA.
authors.forename: Anuradha
authors.initials: A
authors.lastname: Sethi
keywords: graduate medical education; internal medicine; internship and residency; quality improvement