Residency directors' responses to the concept of a proposed electronic residency application service

In 1992, the Executive Council of the Association of American Medical Colleges (AAMC) recommended that the feasibility of the proposed Electronic Residency Application Service (ERAS) be investigated. This action was based on concerns that the current system was inefficient, costly, and disruptive to students, medical schools, and residency programs. The purpose of this study was to explore residency directors' opinions about the benefits and barriers to the introduction of such a system.

All directors from family practice and obstetrics-gynecology residency programs were surveyed in early 1993. Three forced-choice and three open-ended questions elicited opinions concerning benefits and potential barriers to the implementation of ERAS. T-tests and chi-square tests for independence were used to examine differences for continuous and categorical variables.

Overall, 544 residency directors (81%) responded to the questionnaire: 339 (86%) in family practice, and 205 (75%) in obstetrics-gynecology. Eighty percent of the respondents in family practice and 75% of those in obstetrics-gynecology were in favor of the initiation of ERAS. Perceived benefits included increased "efficiency," "simplicity," "standardization," and "completeness." Concerns included "technical problems," "loss of flexibility," "lack of a personal touch," "costs," and "lack of security."

It is appropriate for the AAMC to take the lead in investigating the computerization of this important process. It is essential, however, to gather data from all three consumers of this potentially valuable service as an important step in the project's development.