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Khodadadi RB, Yetmar ZA, Domonoske CL, Razonable RR. Factors associated with infectious diseases fellowship academic success. MEDICAL EDUCATION ONLINE 2024; 29:2352953. [PMID: 38720561 PMCID: PMC11086035 DOI: 10.1080/10872981.2024.2352953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 05/05/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND A multitude of factors are considered in an infectious disease (ID) training program's meticulous selection process of ID fellows but their correlation to pre and in-fellowship academic success as well as post-fellowship academic success and short-term outcomes is poorly understood. Our goal was to investigate factors associated with subsequent academic success in fellowship as well as post-fellowship short-term outcomes. METHODS In 2022, we retrospectively analyzed deidentified academic records from 39 graduates of the Mayo Clinic Rochester ID Fellowship Program (1 July 2013- 30 June 2022). Data abstracted included demographics, degrees, honor society membership, visa/citizenship status, medical school, residency training program, United States Medical Licensure Exam (USMLE) scores, letters of recommendation, in-training examination (ITE) scores, fellowship track, academic rank, career choice, number of honors, awards, and abstracts/publications prior to fellowship, during training, and within 2 years of graduation. RESULTS Younger fellows had higher USMLE step 1 scores, pre and in-fellowship scholarly productivity, and higher ITE performance. Female fellows had significantly higher USMLE step 3 scores. Prior research experience translated to greater in-fellowship scholarly productivity. Higher USMLE scores were associated with higher ID ITE performance during multiple years of fellowship, but USMLE step 2 clinical knowledge and 3 scores were associated with higher pre and in-fellowship scholarly productivity and receiving an award during fellowship. The USMLE step 1 score did not correlate with fellowship performance beyond year 1 and 2 ITE scores. CONCLUSIONS Multiple aspects of a prospective fellow's application must be considered as part of a holistic review process for fellowship selection. USMLE step 2 CK and 3 scores may predict fellowship performance across multiple domains.
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Affiliation(s)
- Ryan B. Khodadadi
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, USA
| | - Zachary A. Yetmar
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, USA
| | - Cynthia L. Domonoske
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, USA
| | - Raymund R. Razonable
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, USA
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Yun JY, Ryu H, Kim JW, Yoon HB, Choi S, Park WB, Bae EJ, Yim JJ, Myung SJ. Subtyping of Performance Trajectory During Medical School, Medical Internship, and the First Year of Residency in Training Physicians: A Longitudinal Cohort Study. J Korean Med Sci 2024; 39:e239. [PMID: 39189712 PMCID: PMC11347187 DOI: 10.3346/jkms.2024.39.e239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 07/01/2024] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND Developmental trajectories of clinical skills in training physicians vary among tasks and show interindividual differences. This study examined the predictors of medical internship performance and residency entrance and found subtypes of performance trajectory in training physicians. METHODS This retrospective cohort study involved 888 training physicians who completed a medical internship between 2015 and 2019. After the internship, 627 physicians applied for residency training between 2016 and 2020. Finally, 160 of them completed their first-year residency in internal medicine, surgery, pediatrics, and psychiatry departments between 2016 and 2020. Pearson's correlation coefficients of internship performance and first year-residency performance (n = 160) were calculated. Latent profile analysis identified performance trajectory subtypes according to medical school grade point average (GPA), internship performance, English proficiency, and residency selection procedures. Multivariate logistic regression models of residency acceptance (n = 627) and performance in the top 30%/lower 10% in the first year of residency were also constructed. RESULTS Medical internship performance showed a significant positive correlation with the medical school GPA (r = 0.194) and the written score for the medical licensing examination (r = 0.125). Higher scores in the interview (adjusted odds ratio [aOR], 2.57) and written examination (aOR, 1.45) of residency selection procedures and higher medical internship performance (aOR, 1.19) were associated with a higher chance of residency acceptance. The latent profile analyses identified three training physician subgroups: average performance, consistently high performance (top 30%), and adaptation to changes (lowest 10%). Higher scores in the interview for residency selection (aOR, 1.35) and lower scores for medical internship performance (aOR, 0.79) were associated with a higher chance of performing in the top 30% or lowest 10% in the first year of residency, respectively. CONCLUSION Performance in the interview and medical internship predicted being among the top 30% and lowest 10% of performers in the first year of residency training, respectively. Individualized educational programs to enhance the prospect of trainees becoming high-functioning physicians are needed.
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Affiliation(s)
- Je-Yeon Yun
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
- Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Korea
| | - Hyunjin Ryu
- Office of Medical Education, Seoul National University College of Medicine, Seoul, Korea
| | - Ju Whi Kim
- Office of Medical Education, Seoul National University College of Medicine, Seoul, Korea
| | - Hyun Bae Yoon
- Office of Medical Education, Seoul National University College of Medicine, Seoul, Korea
| | - Seung Choi
- Department of Educational Psychology, College of Education, University of Texas at Austin, TX, USA
| | - Wan Beom Park
- Office of Medical Education, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Eun Jung Bae
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
- Department of Pediatrics, Seoul National University School of Medicine, Seoul, Korea
| | - Jae-Joon Yim
- Office of Medical Education, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sun Jung Myung
- Office of Medical Education, Seoul National University College of Medicine, Seoul, Korea.
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Collins S, Baker EB. Resident Recruitment in a New Era. Int Anesthesiol Clin 2024; 62:35-46. [PMID: 38855840 DOI: 10.1097/aia.0000000000000447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
ABSTRACT This chapter focuses on resident recruitment and recent US National Resident Matching Program changes and the impact in the evaluation and ranking of applicants within the specialty of anesthesiology. Recruitment challenges are examined as well as program strategies and potential future directions. Also discussed are DEI initiatives within the recruitment process.
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Affiliation(s)
- Stephen Collins
- Department of Anesthesiology, University of Virginia Health, Charlottesville, Virginia
| | - E Brooke Baker
- Division of Regional Anesthesiology and Acute Pain Medicine, Department of Anesthesiology and Critical Care Medicine Chief, Faculty Affairs and DEI, Executive Physician for Claims Management, UNM Hospital System
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Sawang M, Dempster AMA, Cai S. The Art and Science of Securing an Anaesthesiology Training Job: A Survey of the Key Factors in Two Australian Tertiary Hospitals. Cureus 2024; 16:e58879. [PMID: 38800242 PMCID: PMC11116926 DOI: 10.7759/cureus.58879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2024] [Indexed: 05/29/2024] Open
Abstract
Background There is no specific formal guidance on what prospective trainees must focus on to secure an anaesthetic training position in Australia, and there is little in the literature to advise both applicants and their mentors. Method This study aims to ascertain the views of anaesthetic clinicians from two Australian tertiary referral hospitals on what they consider most important for selection. A paper-based survey was conducted at both hospitals across three groups, totalling 104 participants with a 100% response rate. Results The characteristics most agreed upon to be of at least some importance were clinical anaesthetic knowledge (98%, 102/104), teaching (95%, 99/104), basic science and courses (94%, 98/104), other critical care experience (93%, 97/104), and anaesthetic experience for more than six months (92%, 96/104). Of these, anaesthetic experience of greater than six months, non-anaesthetic critical care experience, and the completion of relevant courses were felt to be most important. Furthermore, good referee reports (95%, 99/104), especially those that come from anaesthetists (75%, 78/104) as well as having previous experience working in the institution applied to (88%, 92/104) were also seen as important factors. 'Non-technical' skills (40%, 42/104) were also regarded as an important factor, with immense competition for a few training positions (45%, 47/104) as the greatest barrier. When it came to selection, prevocational trainees consistently ranked the majority of criteria higher than accredited trainees or specialists. Conclusion This staff survey in two Australian hospitals has shed light on factors considered critical in securing an anaesthetic training position. It underscores the significance of clinical anaesthetic knowledge, basic science proficiency, and relevant critical care experience.
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Affiliation(s)
- Michael Sawang
- Department of Anaesthesiology, Prince of Wales Hospital, Sydney, AUS
| | | | - Steven Cai
- Department of Anaesthesiology, Prince of Wales Hospital, Sydney, AUS
- Medicine, University of New South Wales, Sydney, AUS
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Caretta-Weyer HA, Eva KW, Schumacher DJ, Yarris LM, Teunissen PW. Postgraduate Selection in Medical Education: A Scoping Review of Current Priorities and Values. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:S98-S107. [PMID: 37983402 DOI: 10.1097/acm.0000000000005365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
PURPOSE The process of screening and selecting trainees for postgraduate training has evolved significantly in recent years, yet remains a daunting task. Postgraduate training directors seek ways to feasibly and defensibly select candidates, which has resulted in an explosion of literature seeking to identify root causes for the problems observed in postgraduate selection and generate viable solutions. The authors therefore conducted a scoping review to analyze the problems and priorities presented within the postgraduate selection literature to explore practical implications and present a research agenda. METHOD Between May 2021 and February 2022, the authors searched PubMed, EMBASE, Web of Science, ERIC, and Google Scholar for English language literature published after 2000. Articles that described postgraduate selection were eligible for inclusion. 2,273 articles were ultimately eligible for inclusion. Thematic analysis was performed on a subset of 100 articles examining priorities and problems within postgraduate selection. Articles were sampled to ensure broad thematic and geographical variation across the breadth of articles that were eligible for inclusion. RESULTS Five distinct perspectives or value statements were identified in the thematic analysis: (1) Using available metrics to predict performance in postgraduate training; (2) identifying the best applicants via competitive comparison; (3) seeking alignment between applicant and program in the selection process; (4) ensuring diversity, mitigation of bias, and equity in the selection process; and (5) optimizing the logistics or mechanics of the selection process. CONCLUSIONS This review provides insight into the framing and value statements authors use to describe postgraduate selection within the literature. The identified value statements provide a window into the assumptions and subsequent implications of viewing postgraduate selection through each of these lenses. Future research must consider the outcomes and consequences of the value statement chosen and the impact on current and future approaches to postgraduate selection.
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Affiliation(s)
- Holly A Caretta-Weyer
- H.A. Caretta-Weyer is associate professor and associate residency director, Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California; ORCID: https://orcid.org/0000-0002-9783-5797
| | - Kevin W Eva
- K.W. Eva is associate director and senior scientist, Centre for Health Education Scholarship, and professor and director, educational research and scholarship, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; ORCID: http://orcid.org/0000-0002-8672-2500
| | - Daniel J Schumacher
- D.J. Schumacher is professor of pediatrics, Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center/University of Cincinnati College of Medicine, Cincinnati, Ohio; ORCID: http://orcid.org/0000-0001-5507-8452
| | - Lalena M Yarris
- L.M. Yarris is professor and vice chair of faculty development, Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon
| | - Pim W Teunissen
- P.W. Teunissen is professor of workplace learning in health care, School of Health Professions Education, and gynecologist, Department of Obstetrics & Gynecology, Maastricht University and Maastricht University Medical Center, Maastricht, the Netherlands; ORCID: https://orcid.org/0000-0002-0930-0048
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Khodadadi RB, Yetmar ZA, Domonoske CL, Razonable RR. Factors Associated with Infectious Diseases Fellowship Academic Success. RESEARCH SQUARE 2023:rs.3.rs-3140095. [PMID: 37546853 PMCID: PMC10402197 DOI: 10.21203/rs.3.rs-3140095/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
Background A multitude of factors are considered in an infectious diseases (ID) training program's meticulous selection process of ID fellows but their correlation to pre and in-fellowship academic success as well as post-fellowship academic success and short-term outcomes is poorly understood. Our goal was to investigate factors associated with subsequent academic success in fellowship as well as post-fellowship short-term outcomes. Methods In 2022, we retrospectively analyzed deidentified academic records from 39 graduates of the Mayo Clinic Rochester ID Fellowship Program (July 1, 2013- June 30, 2022). Data abstracted included demographics, degrees, honor society membership, visa/citizenship status, medical school, residency training program, United States Medical Licensure Exam (USMLE) scores, letters of recommendation, in-training examination (ITE) scores, fellowship track, academic rank, career choice, number of honors, awards, and abstracts/publications prior to fellowship, during training, and within 2 years of graduation. Results Younger fellows had higher USMLE step 1 scores, pre and in-fellowship scholarly productivity, and higher ITE performance. Female fellows had significantly higher USMLE step 3 scores. Prior research experience translated to greater in-fellowship scholarly productivity. Higher USMLE scores were associated with higher ID ITE performance during multiple years of fellowship, but USMLE step 2 clinical knowledge and 3 scores were associated with higher pre and in-fellowship scholarly productivity and receiving an award during fellowship. USMLE step 1 score did not correlate with fellowship performance beyond year 1 and 2 ITE scores. Conclusions Multiple aspects of a prospective fellow's application must be considered as part of a holistic reviewprocess for fellowship selection. USMLE step 2 CK and 3 scores may predict fellowship performance across multiple domains.
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Patzkowski MS, Hauser JM, Liu M, Herrera GF, Highland KB, Capener DC. Medical School Clinical Knowledge Exam Scores, Not Demographic or Other Factors, Associated With Residency In-Training Exam Performance. Mil Med 2023; 188:e388-e391. [PMID: 34363086 DOI: 10.1093/milmed/usab332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/08/2021] [Accepted: 07/30/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The anesthesiology in-training exam (ITE) is a 200-item multiple-choice assessment completed annually by physician residents. Because all matriculated U.S. Department of Defense (DoD) anesthesiology residents are "hired" by the DoD after residency graduation, it is important to ensure that ITE performance, as a proxy for core competencies achievement, is maximized. METHODS Graduated resident program files from 2013 to 2020 were queried for age, sex, matriculant status (medical student vs. other), medical school (Uniformed Services University vs. other), military service (Army vs. Air Force), preresidency military service (yes vs. no), U.S. Medical Licensing Exam (USMLE) Step 2 Clinical Knowledge (CK) score, and the American Board of Anesthesiologists ITE Score from the third clinical anesthesia year (CA-3 year). RESULTS For every 1-point increase in USMLE Step 2 CK true z-score, the CA-3 ITE z-score increased by 0.59 points. Age was not associated with CA-3 ITE z-score in any dataset regression. Categorical covariates of sex, application status, medical school, service, and preresidency military service were not significantly associated with CA-3 ITE z-score (all P >.05), as shown by estimated adjusted marginal means. The estimated adjusted grand mean of CA-3 ITE z-scores was 0.48 (standard error ± 0.14). CONCLUSION Resident physicians enter residency with varying degrees of past academic success, and it is important to develop early strategies to support them in acquiring the requisite knowledge base.
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Affiliation(s)
- Michael S Patzkowski
- Department of Anesthesia, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA
| | - Joshua M Hauser
- Department of Anesthesia, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA
| | - Mark Liu
- Department of Anesthesia, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA
| | - Germaine F Herrera
- Defense and Veterans Center for Integrative Pain Management, Department of Anesthesiology, Uniformed Services University, Bethesda, MD 20814, USA.,Henry M. Jackson Foundation Inc, Rockville, MD 20852, USA
| | - Krista B Highland
- Defense and Veterans Center for Integrative Pain Management, Department of Anesthesiology, Uniformed Services University, Bethesda, MD 20814, USA.,Henry M. Jackson Foundation Inc, Rockville, MD 20852, USA
| | - Dale C Capener
- Department of Anesthesia, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA
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Jewell C, Kraut A, Miller D, Ray K, Werley E, Schnapp B. Metrics of Resident Achievement for Defining Program Aims. West J Emerg Med 2022; 23:1-8. [PMID: 35060852 PMCID: PMC8782131 DOI: 10.5811/westjem.2021.12.53554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 12/06/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction Resident achievement data is a powerful but underutilized means of program evaluation, allowing programs to empirically measure whether they are meeting their program aims, facilitate refinement of curricula and improve resident recruitment efforts. The goal was to provide an overview of available metrics of resident achievement and how these metrics can be used to inform program aims. Methods A literature search was performed using PubMed and Google Scholar between May and November of 2020. Publications were eligible for inclusion if they discussed or assessed “excellence” or “success” during residency training. A narrative review structure was chosen due to the intention to provide an examination of the literature on available resident achievement metrics. Results 57 publications met inclusion criteria and were included in the review. Metrics of excellence were grouped into larger categories, including success defined by program factors, academics, national competencies, employer factors, and possible new metrics. Conclusions Programs can best evaluate whether they are meeting their program aims by creating a list of important resident-level metrics based on their stated goals and values using one or more of the published definitions as a foundation. Each program must define which metrics align best with their individual program aims and mission.
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Affiliation(s)
- Corlin Jewell
- University of Wisconsin School of Medicine and Public Health, BerbeeWalsh Department of Emergency Medicine, Madison, Wisconsin
| | - Aaron Kraut
- University of Wisconsin School of Medicine and Public Health, BerbeeWalsh Department of Emergency Medicine, Madison, Wisconsin
| | - Danielle Miller
- University of Colorado School of Medicine, Department of Emergency Medicine, Aurora, Colorado
| | - Kaitlin Ray
- University of Wisconsin School of Medicine and Public Health, BerbeeWalsh Department of Emergency Medicine, Madison, Wisconsin
| | - Elizabeth Werley
- PennState College of Medicine, Department of Emergency Medicine, Hershey, Pennsylvania
| | - Bejamin Schnapp
- University of Wisconsin School of Medicine and Public Health, BerbeeWalsh Department of Emergency Medicine, Madison, Wisconsin
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Panda N, Bahdila D, Abdullah A, Ghosh AJ, Lee SY, Feldman WB. Association Between USMLE Step 1 Scores and In-Training Examination Performance: A Meta-Analysis. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:1742-1754. [PMID: 34323860 DOI: 10.1097/acm.0000000000004227] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE On February 12, 2020, the sponsors of the United States Medical Licensing Examination announced that Step 1 will transition to pass/fail scoring in 2022. Step 1 performance has historically carried substantial weight in the evaluation of residency applicants and as a predictor of subsequent subject-specific medical knowledge. Using a systematic review and meta-analysis, the authors sought to determine the association between Step 1 scores and in-training examination (ITE) performance, which is often used to assess knowledge acquisition during residency. METHOD The authors systematically searched Medline, EMBASE, and Web of Science for observational studies published from 1992 through May 10, 2020. Observational studies reporting associations between Step 1 and ITE scores, regardless of medical or surgical specialty, were eligible for inclusion. Pairs of researchers screened all studies, evaluated quality assessment using a modified Newcastle-Ottawa Scale, and extracted data in a standardized fashion. The primary endpoint was the correlation of Step 1 and ITE scores. RESULTS Of 1,432 observational studies identified, 49 were systematically reviewed and 37 were included in the meta-analysis. Overall study quality was low to moderate. The pooled estimate of the correlation coefficient was 0.42 (95% confidence interval [CI]: 0.36, 0.48; P < .001), suggesting a weak-to-moderate positive correlation between Step 1 and ITE scores. The random-effects meta-regression found the association between Step 1 and ITE scores was weaker for surgical (versus medical) specialties (beta -0.25 [95% CI: -0.41, -0.09; P = .003]) and fellowship (versus residency) training programs (beta -0.25 [95% CI: -0.47, -0.03; P = .030]). CONCLUSIONS The authors identified a weak-to-moderate positive correlation between Step 1 and ITE scores based on a meta-analysis of low-to-moderate quality observational data. With Step 1 scoring transitioning to pass/fail, the undergraduate and graduate medical education communities should continue to develop better tools for evaluating medical students.
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Affiliation(s)
- Nikhil Panda
- N. Panda is a clinical fellow of surgery, Massachusetts General Hospital and Harvard Medical School, and a postdoctoral researcher, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Dania Bahdila
- D. Bahdila is a doctoral candidate, Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, and Department of Preventive Dental Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abeer Abdullah
- A. Abdullah is a doctoral candidate, Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, and Department of Preventive Dental Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Auyon J Ghosh
- A.J. Ghosh is a clinical fellow of medicine and postdoctoral researcher, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Sun Yeop Lee
- S.Y. Lee is research assistant, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - William B Feldman
- W.B. Feldman is associate physician and research fellow, Division of Pulmonary and Critical Care Medicine and the Program On Regulation, Therapeutics, And Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
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Gudgel BM, Melson AT, Dvorak J, Ding K, Siatkowski RM. Correlation of Ophthalmology Residency Application Characteristics with Subsequent Performance in Residency. JOURNAL OF ACADEMIC OPHTHALMOLOGY 2021. [DOI: 10.1055/s-0041-1733932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Abstract
Purpose Only from reviewing applications, it is difficult to identify which applicants will be successful ophthalmology residents. The change of the USMLE Step 1 scoring to “Pass/Fail” removes another quantitative metric. We aimed to identify application attributes correlated with successful residency performance. This study also used artificial intelligence (AI) to evaluate letters of recommendation (LOR), the Dean's letter (MSPE), and personal statement (PS).
Design Retrospective analysis of application characteristics versus residency performance was conducted.
Participants Residents who graduated from the Dean McGee Eye Institute/University of Oklahoma Ophthalmology residency from 2004 to 2019 were included in this study.
Methods Thirty-four attributes were recorded from each application. Residents were subjectively ranked into tertiles and top and bottom deciles based on residency performance by faculty present during their training. The Ophthalmic Knowledge Assessment Program (OKAP) examination scores were used as an objective performance metric. Analysis was performed to identify associations between application attributes and tertile/decile ranking. Additional analysis used AI and natural language processing to evaluate applicant LORs, MSPE, and PS.
Main Outcome Measures Characteristics from residency applications that correlate with resident performance were the primary outcome of this study.
Results Fifty-five residents and 21 faculty members were included. A grade of “A” or “Honors” in the obstetrics/gynecology (OB/GYN) clerkship and the presence of a home ophthalmology department were associated with ranking in the top tertile but not the top decile. Mean core clerkship grades, medical school ranking in the top 25 U.S. News and World Report (USNWR) primary care rankings, and postgraduate year (PGY)-2 and PGY-3 OKAP scores were predictive of being ranked in both the top tertile and the top decile. USMLE scores, alpha-omega-alpha (AOA) status, and number of publications did not correlate with subjective resident performance. AI analysis of LORs, MSPE, and PS did not identify any text features that correlated with resident performance.
Conclusions Many metrics traditionally felt to be predictive of residency success (USMLE scores, AOA status, and research) did not predict resident success in our study. We did confirm the importance of core clerkship grades and medical school ranking. Objective measures of success such as PGY-2 and PGY-3 OKAP scores were associated with high subjective ranking.
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Affiliation(s)
- Brett M. Gudgel
- University of Oklahoma Health Science Center, Oklahoma City, Oklahoma
| | - Andrew T. Melson
- University of Oklahoma Health Science Center, Oklahoma City, Oklahoma
| | - Justin Dvorak
- University of Oklahoma Health Science Center, Oklahoma City, Oklahoma
| | - Kai Ding
- University of Oklahoma Health Science Center, Oklahoma City, Oklahoma
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Ie SR, Ratcliffe JL, Rubio C, Zhang KS, Shaver K, Musick DW. Utilization of a New Customizable Scoring Tool to Recruit and Select Pulmonary/Critical Care Fellows. Cureus 2021; 13:e15396. [PMID: 34249546 PMCID: PMC8253231 DOI: 10.7759/cureus.15396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2021] [Indexed: 11/05/2022] Open
Abstract
Background: Finding the ideal candidate for a residency/fellowship program has always been difficult. Finding the “perfect” match has always been the ultimate goal. However, many factors affect obtaining that “perfect” match. In the past, we would have each attending physician review around 20 to 50 Electronic Residency Application Service (ERAS) applications and rank them into three categories: high, middle, or low. Depending on their ranking, the applicant would be invited for an interview. After the interview, the applicants’ files (ERAS and interview) would be reviewed and ranked by the faculty as a group. This was time-consuming and fraught with too much subjectivity and minimal objectivity. We, therefore, sought to find a way to assess and rank applicants in a more objective and less time-consuming manner. By creating a customizable scoring tool, we were able to screen applicants to our pulmonary/critical care fellowship program in an efficient and a more objective manner. Objectives: A customizable scoring tool was developed weighting components in the ERAS and interview process, allowing residency/fellowship programs to create a final rank list consistent with the programs’ desired applicants. Methods: Two hundred and sixty pulmonary/critical care fellowship applications were reviewed from 2013 to 2018. In 2018, we used our new scoring rubric to create a rank list and rescore previous applicants. The traditional and new lists were compared to the final rank list submitted to the National Residency Matching Program (NRMP) for 2018. We wanted to ascertain which scoring method correlated best with the final rank list submitted to the NRMP. We obtained feedback from eight faculty members who had reviewed applicants with both scoring tools. Results: The novel customizable scoring tool positively correlated with the final rank list submitted to the NRMP (r= 0.86). The novel tool showed a better correlation to the final rank list than the traditional method. Faculties (6/6, 100%) responded positively to the new tool. Conclusions: Our new customizable tool has allowed us to create a final rank list that is efficient and more focused on our faculty’s desired applicants. We hope to assess and compare the quality of applicants matched through this scoring system and the traditional method by using faculty evaluations, milestones, and test scores.
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Affiliation(s)
- Susanti R Ie
- Pulmonary and Critical Care Medicine, Carilion Clinic, Roanoke, USA
| | | | - Catalina Rubio
- Medicine, Liberty University College of Osteopathic Medicine, Lynchburg, USA
| | - Kermit S Zhang
- Internal Medicine, Virginia Tech Carilion School of Medicine, Roanoke, USA
| | | | - David W Musick
- Educational Evaluation and Policy Studies, Virginia Tech Carilion School of Medicine, Roanoke, USA
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Markham TH, de Haan JB, Guzman-Reyes S, Brollier LD, Campbell AN, Pivalizza EG. Potential Harm of Elimination of Score Reporting for the United States Medical Licensing Examination Step 1 Examination to Anesthesiology Residency Selection. Anesth Analg 2021; 132:275-279. [PMID: 33031347 DOI: 10.1213/ane.0000000000005235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Travis H Markham
- From the Department of Anesthesiology, UTHealth McGovern Medical School, Houston, Texas
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13
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Cortes-Penfield NW, Khazanchi R, Talmon G. Educational and Personal Opportunity Costs of Medical Student Preparation for the United States Medical Licensing Examination Step 1 Exam: A Single-Center Study. Cureus 2020; 12:e10938. [PMID: 33194500 PMCID: PMC7660126 DOI: 10.7759/cureus.10938] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Purpose To assess the degree to which medical students choose to disengage from their regular preclinical curriculum and extracurricular activities in order to focus on United States Medical Licensing Examination (USMLE) Step 1 exam preparation, as well as learner-perceived effects of Step 1 preparation on their physical, social, and mental health. Method Online survey of medical students who have taken the USMLE Step 1 exam at a single large Midwestern academic medical center. Results The response rate was 54%. Students often reported absenteeism from a variety of preclinical curricular activities, including lectures (44%) and didactics focusing on medical ethics (37%), clinical skills (28%), and encounters with actual and standardized patients (9%) in order to study for USMLE Step 1. Many students also forewent extracurricular opportunities including research (53%), elective patient care opportunities (45%), community service (39%), and healthcare advocacy experiences (38%) in order to study for USMLE Step 1. Majorities of students identified Step 1 preparation as a cause of burnout (79%) or significant anxiety or depression (61%), for which nearly a third sought mental healthcare; students also reported Step 1 preparation as a cause of engaging in dangerous behaviors such as illicit prescription stimulant use as well as driving or providing patient care while impaired by fatigue. In narrative comments, students frequently described Step 1 to be a barrier to their development into effective clinicians, the traditional medical school curriculum to be a barrier to performance on Step 1, or both. Conclusions Medical students often prioritize Step 1 exam preparation over engaging with the standard preclinical curriculum, extracurricular opportunities, and activities to promote wellbeing. These findings have implications for the emphasis residency program directors place on single high-stakes standardized exams in the resident recruitment process.
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Affiliation(s)
| | - Rohan Khazanchi
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, USA.,School of Public Health, University of Minnesota, Minneapolis, USA
| | - Geoffery Talmon
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, USA
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Application Factors Associated With Clinical Performance During Pediatric Internship. Acad Pediatr 2020; 20:1007-1012. [PMID: 32268217 DOI: 10.1016/j.acap.2020.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 03/25/2020] [Accepted: 03/26/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Our goal was to identify aspects of residency applications predictive of subsequent performance during pediatric internship. METHODS We conducted a retrospective cohort study of graduates of US medical schools who began pediatric internship in a large pediatric residency program in the summers of 2013 to 2017. The primary outcome was the weighted average of subjects' Accreditation Council for Graduate Medical Education pediatric Milestone scores at the end of pediatric internship. To determine factors independently associated with performance, we conducted multivariate linear mixed-effects models controlling for match year and Milestone grading committee as random effects and the following application factors as fixed effects: letter of recommendation strength, clerkship grades, medical school reputation, master's or PhD degrees, gender, US Medical Licensing Examination Step 1 score, Alpha Omega Alpha membership, private medical school, and interview score. RESULTS Our study population included 195 interns. In multivariate analyses, the aspects of applications significantly associated with composite Milestone scores at the end of internship were letter of recommendation strength (estimate 0.09, 95% confidence intervals [CI]: 0.04, 0.15), numbers of clerkship honors (est. 0.05, 95% CI: 0.01-0.09), medical school ranking (est. 0.04, 95% CI: 0.08-0.01), having a master's degree (est. 0.19, 95% CI: 0.03-0.36), and not having a PhD (est. 0.14, 95% CI: 0.02-0.26). Overall, the final model explained 18% of the variance in milestone scoring. CONCLUSIONS Letter of recommendation strength, clerkship grades, medical school ranking, and having obtained a Master's degree were significantly associated with higher clinical performance during pediatric internship.
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Demystifying research in medical education: a novel framework, resources, and ethical challenges. Int Anesthesiol Clin 2020; 58:46-51. [PMID: 32804874 DOI: 10.1097/aia.0000000000000289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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16
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Cullen MW, Klarich KW, Oxentenko AS, Halvorsen AJ, Beckman TJ. Characteristics of internal medicine residents who successfully match into cardiology fellowships. BMC MEDICAL EDUCATION 2020; 20:238. [PMID: 32723355 PMCID: PMC7385967 DOI: 10.1186/s12909-020-02154-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 07/15/2020] [Indexed: 05/30/2023]
Abstract
BACKGROUND The unique traits of residents who matriculate into subspecialty fellowships are poorly understood. We sought to identify characteristics of internal medicine (IM) residents who match into cardiovascular (CV) fellowships. METHODS We conducted a retrospective cohort study of 8 classes of IM residents who matriculated into residency from 2007 to 2014. The primary outcome was successful match to a CV fellowship within 1 year of completing IM residency. Independent variables included residents' licensing exam scores, research publications, medical school reputation, Alpha Omega Alpha (AOA) membership, declaration of intent to pursue CV in the residency application personal statement, clinical evaluation scores, mini-clinical evaluation exercise scores, in-training examination (ITE) performance, and exposure to CV during residency. RESULTS Of the 339 included residents (59% male; mean age 27) from 120 medical schools, 73 (22%) matched to CV fellowship. At the time of residency application, 104 (31%) had ≥1 publication, 38 (11%) declared intention to pursue CV in their residency application personal statement, and 104 (31%) were members of AOA. Prior to fellowship application, 111 (33%) completed a CV elective rotation. At the completion of residency training, 108 (32%) had ≥3 publications. In an adjusted logistic regression analysis, declaration of intention to pursue CV (OR 6.4, 99% CI 1.7-23.4; p < 0.001), completion of a CV elective (OR 7.3, 99% CI 2.8-19.0; p < 0.001), score on the CV portion of the PGY-2 ITE (OR 1.05, 99% CI 1.02-1.08; p < 0.001), and publication of ≥3 manuscripts (OR 4.7, 99% CI 1.1-20.5; p = 0.007) were positively associated with matching to a CV fellowship. Overall PGY-2 ITE score was negatively associated (OR 0.93, 99% CI 0.90-0.97; p < 0.001) with matching to a CV fellowship. CONCLUSIONS Residents' matriculation into CV fellowships was associated with declaration of CV career intent, completion of a CV elective rotation, CV medical knowledge, and research publications during residency. These findings may be useful when advising residents about pursuing careers in CV. They may also help residents understand factors associated with a successful match to a CV fellowship. The negative association between matching into CV fellowship and overall ITE score may indicate excessive subspecialty focus during IM residency.
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Affiliation(s)
- Michael W. Cullen
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota USA
| | - Kyle W. Klarich
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota USA
| | - Amy S. Oxentenko
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Scottsdale, Arizona USA
| | - Andrew J. Halvorsen
- Internal Medicine Residency, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota USA
| | - Thomas J. Beckman
- Division of General Internal Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota USA
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Swails JL, Aibana O, Stoll BJ. Reporting of the Medical Licensing Examination-Reply. JAMA 2020; 323:187. [PMID: 31935024 DOI: 10.1001/jama.2019.18184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Jennifer L Swails
- Department of Internal Medicine, McGovern Medical School at UT Health, Houston, Texas
| | - Omowunmi Aibana
- Department of Internal Medicine, McGovern Medical School at UT Health, Houston, Texas
| | - Barbara J Stoll
- Medical Sciences, McGovern Medical School at UT Health, Houston, Texas
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18
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Everett GD, Isea L. Reporting of the Medical Licensing Examination. JAMA 2020; 323:185-186. [PMID: 31935021 DOI: 10.1001/jama.2019.18181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
| | - Luis Isea
- Internal Medicine, AdventHealth Orlando, Orlando, Florida
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19
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Selecting anesthesiology residency candidates-Beyond the numbers. J Clin Anesth 2019; 41:38-39. [PMID: 28802600 DOI: 10.1016/j.jclinane.2017.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 05/06/2017] [Indexed: 11/23/2022]
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20
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Aslet M, Paton LW, Gale T, Tiffin PA. Evaluating the recruitment process into UK anaesthesia core training: a national data linkage study of doctors' performance at selection and subsequent postgraduate training. Postgrad Med J 2019; 96:14-20. [PMID: 31341040 DOI: 10.1136/postgradmedj-2019-136390] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 05/20/2019] [Accepted: 07/09/2019] [Indexed: 11/04/2022]
Abstract
PURPOSE OF THE STUDY To explore which factors increase the likelihood of being deemed appointable to core anaesthesia training in the UK and whether those factors subsequently predict performance in postgraduate training. STUDY DESIGN Observational study linking UK medical specialty recruitment data with postgraduate educational performance, as measured by Annual Review of Competence Progression (ARCP) outcomes. Data were available for 2782 trainee doctors recruited to anaesthesia core training from 2012 to 2016 with at least one subsequent ARCP outcome. RESULTS Both higher interview and shortlisting scores were independent and statistically significant (p≤0.001) predictors of more satisfactory ARCP outcomes, even after controlling for the influence of postgraduate exam failure. It was noted that a number of background variables (eg, age at application) were independently associated with the odds of being deemed appointable at recruitment. Of these, increasing age and experience were also negative predictors of subsequent ARCP rating. These influences became statistically non-significant once ARCP outcomes associated with exam failure were excluded. CONCLUSIONS The predictors of 'appointability' largely also predict subsequent performance in postgraduate training, as indicated by ARCP ratings. This provides evidence for the validity of the selection process. Our results also suggest that greater weight could be applied to shortlisting scores within the overall process of ranking applicants for posts.
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Affiliation(s)
- Margaret Aslet
- Department of Health Sciences, University of York, York, North Yorkshire, UK
| | - Lewis W Paton
- Department of Health Sciences, University of York, York, North Yorkshire, UK
| | - Thomas Gale
- Faculty of Medicine and Dentistry, University of Plymouth, Plymouth, Devon, UK
| | - Paul A Tiffin
- Department of Health Sciences, University of York, York, North Yorkshire, UK .,Health Professions Education Unit, Hull York Medical School, York, UK
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de Haan JB, Markham T, Ghebremichael S. Considerations of a Resident Recruitment Committee on the USMLE Step 1 Examination. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:922-923. [PMID: 31241567 DOI: 10.1097/acm.0000000000002721] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Johanna Blair de Haan
- Assistant professor, Department of Anesthesiology, McGovern Medical School at UTHealth, Houston, Texas; . Assistant professor, Department of Anesthesiology, McGovern Medical School at UTHealth, Houston, Texas. Assistant professor, Department of Anesthesiology, McGovern Medical School at UTHealth, Houston, Texas
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22
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Chen DR, Priest KC. In Reply to de Haan et al. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:923. [PMID: 31241568 DOI: 10.1097/acm.0000000000002759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- David R Chen
- Fourth-year medical student, University of Washington School of Medicine, Seattle, Washington; ; @davidroychen; ORCID: http://orcid.org/0000-0002-5711-8689. Fifth-year MD/PhD student, Oregon Health & Science University, Portland, Oregon; @kelseycpriest; ORCID: http://orcid.org/0000-0003-3929-8177
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Favier RP, Vernooij JCM, Jonker FH, Bok HGJ. Inter-Rater Reliability of Grading Undergraduate Portfolios in Veterinary Medical Education. JOURNAL OF VETERINARY MEDICAL EDUCATION 2019; 46:415-422. [PMID: 30920333 DOI: 10.3138/jvme.0917-128r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The reliability of high-stakes assessment of portfolios containing an aggregation of quantitative and qualitative data based on programmatic assessment is under debate, especially when multiple assessors are involved. In this study carried out at the Faculty of Veterinary Medicine, Utrecht University, the Netherlands, two independent assessors graded the portfolios of students in their second year of the 3-year clinical phase. The similarity of grades (i.e., equal grades) and the level of the grades were studied to estimate inter-rater reliability, taking into account the potential effects of the assessor's background (i.e., originating from a clinical or non-clinical department) and student's cohort group, gender, and chosen master track (Companion Animal Health, Equine Health, or Farm Animal/Public Health). Whereas the similarity between the two grades increased from 58% in the first year the grading system was introduced to around 80% afterwards, the grade level was lower over the next 3 years. The assessor's background had a minor effect on the proportion of similar grades, as well as on grading level. The assessor intraclass correlation was low (i.e., all assessors scored with a similar grading pattern [same range of grades]). The grades awarded to female students were higher but more often dissimilar. We conclude that the grading system was well implemented and has a high inter-rater reliability.
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Affiliation(s)
- Robert P Favier
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University
| | - Johannes C M Vernooij
- Biostatistician, and Teacher in Methodology and Statistics, Department of Farm Animal Health, Faculty of Veterinary Medicine, Utrecht University
| | - F Herman Jonker
- Chair of the Portfolio Evaluation Committee, and Teacher in Reproduction, Department of Farm Animal Health, Faculty of Veterinary Medicine
| | - Harold G J Bok
- Centre for Quality Improvement in Veterinary Education, Faculty of Veterinary Medicine, 3508 TC Utrecht University
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