{"id":2669,"date":"2019-08-20T14:58:09","date_gmt":"2019-08-20T18:58:09","guid":{"rendered":"https:\/\/blogs.nejm.org\/general-medicine\/?p=2669"},"modified":"2019-08-22T14:58:08","modified_gmt":"2019-08-22T18:58:08","slug":"bias-in-the-residency-ranking-process","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2019\/08\/bias-in-the-residency-ranking-process\/","title":{"rendered":"Bias in the Residency Ranking Process"},"content":{"rendered":"
\"Scott<\/a>

Scott Hippe, MD, is a Chief Resident at Family Residency of Idaho in Boise.<\/p><\/div>\n

\u201cCan we please try to be objective about this!\u201d <\/em>I said these words to myself over and over during this year\u2019s interview season as we formulated our residency rank list. At my institution, the residents and faculty have equal sway in forming the rank list. The chief resident facilitates the resident half of the process. As the hours wore on during our last meeting, the discussion gradually deviated from assessing the applicants\u2019 clinical potential. The focus shifted to peripheral elements of character: \u201c[Applicant] is just really cool and I want them to be my friend,\u201d and similar arguments. I was concerned.<\/p>\n

One\u2019s ability to get along with other residents is important. However, it isn\u2019t the only factor to consider when ranking residency applicants. You want a clinically solid incoming class who know their stuff and can keep up with the rigors of residency. Trying to move away from haphazard character judgments, I focused on applicants\u2019 board scores and clerkship grades. Consider a situation where applicants \u201cA\u201d and \u201cB\u201d were equally liked by resident interviewers and were similarly involved in extracurriculars. The fair thing to do would be to use their \u201cstats\u201d to sort out who deserved to be ranked higher. Right? And then I started thinking about those criteria.<\/p>\n

I realize that the Insights<\/em> blog is read by individuals of many different backgrounds and at varying stages of medical training. Depending on who you are, the ensuing comments might be controversial or maybe they are old news. The first, potentially obvious observation: Objective measures aren\u2019t perfect at predicting real-life clinical ability.<\/p>\n

\u201cObjective\u201d measures aren’t the be-all, end-all to ranking<\/h2>\n