Re-engineering the resident applicant selection process in ophthalmology: a literature review and recommendations for improvement.

Full Abstract

The current resident selection process for ophthalmology has undergone little change over the last several years and remains highly dependent on the traditional selection factors (i.e., grades, honors, letters of recommendation, and an interview). Unfortunately, these selection factors have not been shown to be consistently predictive of future resident performance. In addition, the Accreditation Council for Graduate Medical Education (ACGME) has mandated implementation of six new competencies in resident training in the USA and the current selection process does not directly recruit for these competencies. We propose an implementation strategy to re-engineer and improve the resident selection process in ophthalmology and potentially develop assessments that would be predictive of actual downstream resident performance that would encompass the ACGME related competencies. An intra-departmental Task Force for the ACGME Competencies reviewed a PubMed literature search regarding resident selection. A content expert (AGL) gleaned selected "good practices" from the literature review and summarized the results. Specific recommendations were reviewed for topicality to ophthalmology and where possible for feasibility, reliability, and validity. We summarize several good practices identified from the literature review and propose an implementation matrix for aligning the resident application process with the ACGME competencies that might include:
using a standardized and consolidated academic score for the cognitive domains; converting the letter of recommendation format into a letter of evaluation; standardizing the letters of evaluation, including the "Dean's letter"; using behavior specific interview techniques with standardized questions; and developing a specialty based consensus for the selection of traits specific to ophthalmology that might predict success. The resident selection process for ophthalmology might be improved by implementation of specific good practices from the literature. Ophthalmology should strive to develop applicant selection tools that might be useful for predicting residency performance and that would align with the ACGME competency mandate for tools to predict future performance as a physician.

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Author information

Author/s: Lee, Andrew G (AG); Golnik, Karl C (KC); Oetting, Thomas A (TA); Beaver, Hilary A (HA); Boldt, H Culver (HC); Olson, Richard (R); Greenlee, Emily (E); Abramoff, Michael D (MD); Johnson, A Tim (AT); Carter, Keith (K);

Affiliation: Department of Ophthalmology, University of Iowa Hospital and Clinics, Iowa City, Iowa 52242, USA. Andrew-lee(-atsign-)uiowa.edu

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: Survey of ophthalmology (Surv Ophthalmol), published in United States. (Language: eng)

Reference: -2008 Mar-Apr; vol 53 (issue 2) : pp 164-76

Dates: Created 2008/03/19; Completed 2008/04/24;

PMID: 18348881, status: MEDLINE (last retrieval date: 11/6/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Clinical Competence - standards
Competency-Based Education - standards
Education, Medical, Graduate - standards
Guidelines as Topic

Humans
Internship and Residency - organization & administration
Ophthalmology - education
School Admission Criteria

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