Why not remove subjectivity from the residency admissions process?

[Erica Lewinski]

I'm still puzzled by this bizarre nepotism that results as a practical consequence of the subjective criteria followed in the medical resident admission process, despite having the remarkably structured and methodical USMLE process in place.

Why not use the USMLE scores (and US Citizenship of course) primarily as the basis for admissions? that removes subjectivity and its harmful consequences, not to mention the mess
in which this ERAS/Scramble matching process currently finds itself in.

Doesn't any one feel any (action-inducing-) pain for the financial strain of having to apply at 30 bucks a pop to zillions of places? And, having to live a dog's life in the week of the scramble, with a dozen rented fax-machines, all sounding busy signals simultaneously and all the wrinkled CVs? And after all this, having to face the interviewing committee, who lands-up giving that position to their resident's wife there anyway (despite she having barely 75 and 76 percentile scores in the USMLE). Aren't these pieces all adding-up, to create a mockery of a system, of an otherwise excellent intellectual profession, that has some high-quality labor force in it?

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[Cameron]

I'm certain you'll get a host of replies, but I'll add my two cents... I think the underlying flaw in your argument is that there is no valid objective measure that would satisfy everyone. You're also assuming that a high USMLE score automatically equals a higher-quality applicant and doctor -- I don't necessarily believe that and I'm sure there are a number of people here who would be willing to argue back and forth regarding the issue.. Academic qualifications are important, but not everything.
Since there is no single objective measure, we're left with being evaulated based on a number of objective and, yes, subjective qualifications and traits. I am actually glad that we have subjective criteria. From an applicant's perspective, many programs look the same objectively (on paper) but when you visit you get a different subjective feel for each one. The same is true for those deciding which applicants to rank highly. Is it always fair? No, but nobody ever said it was.

 

[Idiopathic]

Even the people with outstanding USMLE scores would probably not want to be judged on that stat alone. Everybody wants a chance to have their more 'personal' info help make the decision, I believe.

 

[Mongo]

I think this person might be onto something

 

[minime]

The score that you make on the USMLE has nothing to do with how well you will practice medicine. It says nothing about who you are and your personality, which really is just as important or more important as how many factoids you know.
Even the makers of the USMLE say that it is really just a test to make sure that everyone has the same basic knowledge. It was never meant to really "grade" how well you are going to be a doc. ie it was really meant to be P/F.

 

[Erica Lewinski]

The score that you make on the USMLE has nothing to do with how well you will practice medicine. It says nothing about who you are and your personality, which really is just as important or more important as how many factoids you know.
Even the makers of the USMLE say that it is really just a test to make sure that everyone has the same basic knowledge. It was never meant to really "grade" how well you are going to be a doc. ie it was really meant to be P/F.

I agree in the context of the perspective taken here. However, one of the complaints heard from PDs etc. is that, they are very busy generally; so, why not make easy on themselves a bit, when 90%+ people are eventually gonna go and find something somewhere. Afterall, to some extent, any human-MD-resident-to-be is pliable and moldable to behave properly and effectively as per the norms set by a program and its executive leaders.

 

[carrigallen]

The same rules are true for hiring an employee: would you want to hire someone without talking with them personally first?

As far as connections go, it is the same as the workplace. If I already know an applicant, then that means I will feel more secure in my decision to choose them. Even if you only know the person who is recommending them, it is a more secure decision.

 

[azzarah]

I agree that this process has got to become a little less subjective. I am curious though...why did you insist on US citizenship in your post?

 

[DeLaughterDO]

The score that you make on the USMLE has nothing to do with how well you will practice medicine. It says nothing about who you are and your personality, which really is just as important or more important as how many factoids you know.
Even the makers of the USMLE say that it is really just a test to make sure that everyone has the same basic knowledge. It was never meant to really "grade" how well you are going to be a doc. ie it was really meant to be P/F.

I agree with the above - as far as using the USMLE as a sole decision factor for who gets admission and who does not. Would you also propose the MCAT/GRE/LSAT as the sole criteria for admission to medical/graduate/law school?

Also, the purpose of the interview (at least partly) is to get a feel for the applicant - to find out if they would "fit" in the program at hand. It also gives the applicant a chance to learn more about the progam - take a tour, talk to the residents, nurses, other ancillary staff, department staff, etc - and hopefully make an informed decision whether that program is right for them. There is much to learn that is not presented on a program's web-site.

jd

 

[Jaded Soul]

The bottom line is, you are more than just your board score.

 

[bigfrank]

Hey there all,

Of course we are more than our board scores. Taking subjectivity out of the whole process is like asking a "liberal" to look at Kerry's voting record objectively -- not gonna happen.

 

[BigSkyDreams]

Howdy,

They have to live with you for 3 to 5 years and should check to make sure you are at least compatible with the team.

Did you ever see The Apprentice? If we followed your rules, we could be stuck with a bunch of Omarosas. Now that is the strongest argument for nepotism yet.

Subjectivism protects programs from taking people that may, in the long run, hurt the program. (i.e. leaving or creating a malignant culture) IMHO, it is better to hand pick your team than have it dictated to you by 350 questions.

 

[IntrinsicFactor]

Yep, we're in the world where personality and interpersonal skills matter. I think programs (and applicants!) should get to choose their best fit.

 

[BlackPuma]

your board score is not going to be an indicator how hard you work, how passionate you are with your patients, or that you give a freakin crap about the field or are just in it for the money...

 

[Strongman]

your board score is not going to be an indicator how hard you work, how passionate you are with your patients, or that you give a freakin crap about the field or are just in it for the money...

Hence, radiology and derm. The people in my class that have matched in these 2 fields HAVE worked their tushes off, but have admitted to the lack of care or passion for patient care. Much moreso radiology than derm. Its funny what people will admit to/confess once they've matched at the med school competition/ residency interviews are all over.