Internal Medicine Residency Program Directors' Screening Practices and Perceptions About Recruitment Challenges.

Area of Science:

• Medical Education
• Residency Recruitment
• Graduate Medical Education

Background:

• Application inflation presents significant challenges for internal medicine residency programs.
• Program directors (PDs) face difficulties in efficiently screening a growing number of applications.

Purpose of the Study:

• To investigate the screening practices of internal medicine residency program directors.
• To understand PDs' perceptions of current recruitment challenges and application inflation.

Main Methods:

• A survey was distributed to 373 Alliance for Academic Internal Medicine member residency programs in March-May 2017.
• PDs rated the importance of inclusion/exclusion criteria, provided United States Medical Licensing Examination (USMLE) cutoff scores, and reported recruitment practice adjustments.
• Exploratory factor analysis was used to identify key decision-making factors for interview invitations.

Main Results:

• USMLE Step 2 Clinical Knowledge scores were frequently deemed
• very important
• by 57% of respondents.
• While USMLE scores are crucial, non-USMLE criteria were more often identified as the single most important (SMI) criterion (68%).
• Most programs (64%) adjusted recruitment practices due to increased applications, with strong interest in limiting applications per applicant (71%) and facilitating program signaling (66%).

Conclusions:

• Internal medicine PDs utilize USMLE scores heavily but also prioritize non-USMLE factors for screening.
• Residency programs are actively adapting recruitment strategies to address application volume.
• Potential solutions for application inflation, such as limiting applications and program signaling, are widely supported.