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A Critical Disconnect: Residency Selection Factors Lack Correlation With Intern Performance
John C Burkhardt1, Kendra P Parekh2, Fiona E Gallahue3
1Assistant Professor, Departments of Emergency Medicine and Learning Health Sciences, University of Michigan Medical School.
Journal of Graduate Medical Education
|January 4, 2021
Summary
Emergency medicine residency selection factors show weak correlations with resident performance. Current application data may not consistently predict future clinical success in the specialty.
Area of Science:
- Medical Education
- Graduate Medical Education
- Emergency Medicine
Background:
- Emergency medicine (EM) residency programs seek optimal applicant selection processes.
- Identifying high-performing residents is crucial for specialty training.
Purpose of the Study:
- To assess the association between EM residency application data and resident performance using milestone assessments.
- To test the hypothesis that selection factors weakly correlate with milestone outcomes.
Main Methods:
- Secondary analysis of data from 5 EM residency programs (2013-2018).
- Multivariate linear regression models analyzed 23 core competencies.
- Factors included: gender, URM status, USMLE Steps 1 & 2 CK, AOA, grades, advanced degrees, SLOE, and rank list position.
Main Results:
- Most academic medical school performance metrics (USMLE Steps 1 & 2 CK, grades, AOA) were not associated with EM residency milestone performance.
- Isolated correlations were observed (e.g., surgical grades and wound care milestones), but overall associations were minimal.
- No consistent, meaningful correlations were found between common selection factors and resident milestones.
Conclusions:
- Current EM residency selection factors do not consistently predict resident performance.
- The existing selection process may not reliably identify future high-performing residents.
- Further research is needed to refine selection criteria for EM training.
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