Residency Application Process (October 2018)

Residency interview season is upon us, with our four dates scheduled for the non-holiday Fridays in November (11/2, 11/9, 11/16 and 11/30).  It’s an exciting time for the department and program, but the selection process always weighs heavily on me.

I am increasingly impressed by the caliber of the applications we receive and genuinely wonder how I ever was fortunate enough to match into this specialty.  Attempting to select appropriate candidates from a large pool of exceptional individuals is truly somewhat arbitrary, but I thought I would share some insight into our process.  There are many different ways programs tackle this, so by no means are we a sterling example, but I hope transparency can stimulate some discussion on ways we can improve our system.  I’ll share a couple of thoughts for potential future directions in a later post.

This application cycle we received 388 applications.  We require all applicants to submit a secondary, short essay on “Why I want to come to UK” to attempt to limitedly differentiate those that are broadly applying versus those truly interested in our program.  The deadline for the secondary application is usually the middle of September.  At that point, I review each of the completed applications to get a gestalt of our applicant pool and distribute the applications to faculty volunteers.  They will then review the applications and whittle them down to a group of roughly 90-100.  Our faculty are free to ultimately utilize their own criteria when reviewing applicants, but are encouraged to complete a scoring sheet to frame the process.  Included in this evaluation are six sections:  Aggregate USMLE Scores, Clinical Performance, Academic and Research Accomplishments, Letters of Recommendation, Interest in our Program, and Outside Interests and Diversity Enhancement.

four people holding green check signs standing on the field photography
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Once I have the final group of applications from our faculty, I select 48 applicants to invite for an interview (12 applicants on each of the 4 days).  We also offer “alternate” status to an additional 20 applicants, who are able to pick up interview slots that either go unfilled or are dropped.  Because of the fluid nature of the interview acceptance process, we generally have 10 or more dropped slots between the invitation for interview (around October 1st) and the interviews themselves.  Hence, we consider both groups of 68 (48 invites + 20 alternates) as essentially the same:  applicants on paper that seem most appropriate for our program.  I then generate a list of the applicants and summative statistics (see below) for final faculty review prior to sending invites.  The goal of this final review is to ensure we have an equitable list of applicants that seem to fit our program priorities.

This final step – going from 100 to 68 – is the most difficult for me.  What differentiates each applicant at this point?  Are we being as fair as possible?  How can we know if applicant A is more or less likely to ultimately have interest in our program than applicant B?  These and so many other questions underlie the potential limitations and bias in this process.

How’d it look this year?  I’ve copied a table below of some of our statistics for the total group.  We determined gender based on the pronoun used in letters of recommendation, and Underrepresented Minority (URM) is self-identified.  A personal connection included a rotation at our program or other associations to the program/university.  For Mean USMLE, we took an average of Step 1 and 2 (if Step 2 was available), weighted for Step 1 scores:  [(Step 1 score *2)+(Step 2 score *1)] / 3).

GenderURMRegionPersonal ConnectionMean USMLE
M = 54%12%MW = 35%37%242 (Range 200-265)
F = 46% SA = 28%  
  SE = 18%  
  SW = 15%  
  W = 7%  
  NE = 1%  

So:  388 applicants trimmed to 68, 48 applicants will be interviewed, and 4 new residents welcomed into the program this coming January.  This is by no means an idealized system, and at the end of the day, both my biggest hope and concern is that we treat our program and all our applicants justly.

At any rate, let me know what you think – about the entire system or how we manage it at UK.  I’ll share some thoughts and data I’ve collected on potential changes to the process sometime soon.