Residency Selection Criteria: What Medical Students Perceive as Important

Little is known about medical students' perceptions of which criteria are important in residency selection. Student knowledge of this process may affect their education and their ability to obtain the residency of their choice.

To determine the perceived importance among medical students of various selection criteria for residency.

Medical students at three institutions were asked to rate the importance of various residency selection criteria using a web-based survey instrument.

Sixteen residency selection criteria were included in the survey.

The overall response rate was 49.2%. Criteria perceived as extremely important by the majority of students were the interview (80.6%), grades in third and fourth year courses in their chosen specialty (73.3%), letters of recommendation excluding the Dean's letter (65.3%), and grades in third and fourth year clerkships (55.9%). USMLE Step 1 score (46.7%) was viewed as extremely important by many students. Moderately important: grades in fourth year electives not in their chosen specialty (57.3%), medical school's reputation (50.5%), number of honor grades (49.0%), USMLE Step 2 score (42.3%), and Dean's letter (41.1%). Mildly/not important: grades in the first and second years (56.8%), academic awards (55.2%), extracurricular activities (52.6%), research (50.9%), class rank (49.3%), and AOA (46.5%). Students in the clinical years of training were more likely to place importance on honors grades (p=0.04) and AOA (p=0.009) and were less likely to place importance on grades in fourth year electives not in their chosen specialty (p˂0.0001), scores on USMLE Step 1 (p=0.0003), USMLE Step 2 (p˂0.0001), and Dean's letter (p˂0.0001).

Misperceptions about which criteria are important in residency selection are common among medical students. Many overestimate the importance of subjective criteria while undervaluing objective criteria.