Using a Consensus-Driven Approach to Incorporate Holistic Review Into an Internal Medicine Residency Program

Area of Science:

• Medical Education
• Residency Admissions
• Holistic Review

Background:

• Residency programs face challenges implementing holistic review despite growing interest.
• Holistic review aims to consider a broader range of applicant qualifications beyond traditional metrics.

Purpose of the Study:

• To integrate holistic review into an internal medicine residency program.
• To assess the feasibility and acceptability of this new admissions process.

Main Methods:

• A consensus-driven process identified 10 highly valued applicant attributes.
• The residency program updated its ranking algorithm and screening criteria to incorporate these attributes.
• Stakeholder surveys assessed time requirements and compared new vs. prior ranking systems.

Main Results:

• Ten prioritized attributes included leadership, community service, and grit.
• 32% of matched residents demonstrated exceptional achievement in these attributes.
• 16% of matched residents would have ranked lower without holistic review points; review added 3.8 minutes per application.

Conclusions:

• Holistic review was successfully implemented in residency admissions via a consensus-driven approach.
• The process demonstrated favorable feasibility and acceptability.
• Current application materials may limit the full potential of holistic review.