LO79: The variable landscape of resident selection: A study of Canadian Royal College emergency medicine training programs

Abstract

Introduction: Little is known about how Royal College emergency medicine (RCEM) residency programs are selecting their residents. This creates uncertainty regarding alignment between our current selection processes and known best practices and results in a process that is difficult to navigate for prospective candidates. We seek to describe the current selection processes of Canadian RCEM programs. Methods: An online survey was distributed to all RCEM program directors and assistant directors. The survey instrument included 22 questions consisting of both open-ended (free text) and closed-ended (Likert scale) elements. Questions sought qualitative and quantitative data from the following 6 domains; paper application, letters of reference, elective selection, interview, rank order, and selection process evaluation. Descriptive statistics were used. Results: We received responses from 13/14 programs for an aggregate response rate of 92.9%. A candidate's letter of reference was identified as the single most important item from the paper application (38.5%). Having a high level of familiarity with the applicant was considered to be the most important characteristic of a reference letter author (46.2%). Respondents found that providing a percentile rank of the applicant was useful when reviewing candidate reference letters. Once the interview stage is reached, 76.9% of programs stated that the interview was weighted at least as heavily as the paper application; 53.8% weighted the interview more heavily. Once final candidate scores are established for both the paper application and the interview, 100% of programs indicated that further adjustment is made to the rank order list. Only 1/13 programs reported ever having completed a formal evaluation of their selection process. Conclusion: The information gained from this study helps to characterize the landscape of the RCEM residency selection process. We identified significant heterogeneity between programs with respect to which application elements were most valued. Canadian emergency medicine residency programs should re-evaluate their selection processes to achieve improved consistency and better alignment with selection best practices.