Readiness for Residency: A Survey to Evaluate Undergraduate Medical Education Programs

Health professions programs continue to search for meaningful and efficient ways to evaluate the quality of education they provide and support ongoing program improvement. Despite flaws inherent in self-assessment, recent research suggests that aggregated self-assessments reliably rank aspects of competence attained during preclerkship MD training. Given the novelty of those observations, the purpose of this study was to test their generalizability by evaluating an MD program as a whole.

The Readiness for Residency Survey (RfR) was developed and aligned with the published Readiness for Clerkship Survey (RfC), but focused on the competencies expected to be achieved at graduation. The RfC and RfR were administered electronically four months after the start of clerkship and six months after the start of residency, respectively. Generalizability and decision studies examined the extent to which specific competencies were achieved relative to one another.

The reliability of scores assigned by a single resident was G = 0.32. However, a reliability of G = 0.80 could be obtained by averaging over as few as nine residents. Whereas highly rated competencies in the RfC resided within the CanMEDS domains of professional, communicator, and collaborator, five additional medical expert competencies emerged as strengths when the program was evaluated after completion by residents.

Aggregated resident self-assessments obtained using the RfR reliably differentiate aspects of competence attained over four years of undergraduate training. The RfR and RfC together can be used as evaluation tools to identify areas of strength and weakness in an undergraduate medical education program.