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Published on: January 12, 2018
De-escalating the research arms race in the residency application process
John S Barbieri1, Jeremiah S Truel2, J Bryan Carmody3
1Department of Dermatology, Brigham & Women's Hospital, Boston, MA, United States.
Abstract:
The escalating pressure on medical students to produce research to gain a relative advantage during residency selection-described as a "research arms race"-has created unintended consequences for medical trainees and the broader academic community. Driven by the scarcity of residency positions and accelerated by changes in grading systems and honor societies, applicants increasingly pursue high volumes of publications and presentations, sometimes at the expense of research quality and potentially amplifying inequities. To address these concerns, the authors propose 5 actionable measures to shift the incentives driving the research arms race in residency selection with the goal of promoting a fairer and more authentic -residency application process: (1) limit the number of research entries allowed in the Electronic Residency Application Service (ERAS) application to emphasize quality over quantity; (2) revise research publication categories in the ERAS application to prevent double-counting and improve transparency; (3) revise the National Resident Matching Program Charting Outcomes tool to disaggregate types of research and report more comprehensive descriptive statistics; (4) encourage residency programs to transparently share their core values by clearly communicating the traits and experiences they most value; and (5) provide medical students with diverse opportunities to demonstrate their abilities and obtain mentorship and meaningful letters of recommendation. These changes could de-escalate the rising research productivity pressure and promote fairness and holistic review in the residency application process. Broad stakeholder engagement, buy-in, and collaboration-among -program directors, medical schools, specialty organizations, and medical education organizations-will be critical to successfully implement these recommendations. Without seeking to de-escalate the rising research productivity pressure, there is a risk of amplifying a destructive trend toward homogeneity, stifling the creativity and diverse interests of future physicians, and fundamentally undermining holistic review.
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