Reply to the Editorial Commentaries on Association of Residents' Medical School Reputation and Urology Residency Program Ranking.

Abstract

Listen

Translate article

You have accessUrology PracticeEditorial1 Mar 2023Reply to the Editorial Commentaries on Association of Residents’ Medical School Reputation and Urology Residency Program Ranking Sagar R. Patel, Jenna N. Bates, Wesley A. Mayer, and Jennifer M. Taylor Sagar R. PatelSagar R. Patel Scott Department of Urology, Baylor College of Medicine, Houston, Texas More articles by this author , Jenna N. BatesJenna N. Bates Scott Department of Urology, Baylor College of Medicine, Houston, Texas More articles by this author , Wesley A. MayerWesley A. Mayer Scott Department of Urology, Baylor College of Medicine, Houston, Texas More articles by this author , and Jennifer M. TaylorJennifer M. Taylor *Correspondence: Scott Department of Urology, Baylor College of Medicine, 7200 Cambridge St, Suite 10B, Houston, TX 77030 telephone: 713-798-7670; E-mail Address: [email protected] https://orcid.org/0000-0001-8595-8805 Scott Department of Urology, Baylor College of Medicine, Houston, Texas More articles by this author View All Author Informationhttps://doi.org/10.1097/UPJ.0000000000000381AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail We greatly appreciate the editorial comments by Drs Margolin, Parikh and Thompson, and Kraft, each of which highlighted important challenges and opportunities surrounding the review process.1 Identifying strong urology applicants is challenging due to the lack of standardization across medical student evaluation, application review, and interview structures. Historically, an applicant’s match results were largely attributed to performance on board exams and clerkship grades. However, as noted by Drs Parikh and Thompson,1 standardized medical exam performance (eg, USMLE [United States Medical Licensing Examination]) fails to correlate with the clinical and surgical performance of urology residents.2 As board exams and medical schools transition to pass/fail systems, it is becoming increasingly difficult to differentiate applicants based on traditional metrics. Indeed, the Society of Academic Urologists convened a task force to address the assessment of residency applicants in the era of a binary USMLE score and decreasing prevalence of grades and Alpha Omega Alpha designations. Although residency programs strive to select “successful” residents, the meaning of “success” varies greatly among individuals and programs. Some programs may strive to produce physician-scientists, while others may aim to graduate clinical leaders to practice in underserved communities. Naturally the culture and goals of individual residency programs influence their evaluation criteria. However, the ACGME (Accreditation Council for Graduate Medical Education) sets requirements that aim to accomplish a high standard of training in all programs in terms of professionalism, surgical aptitude, clinical knowledge, delivery of care, and scholarly collaboration. As suggested by Drs Parikh and Thompson, a standardized structured interview process may allow programs to better evaluate an applicant’s alignment with their unique mission and culture.1 Our program has been conducting standardized structured interviews for over 15 years, and we have found it provides us with a better comparative evaluation of applicants. Principles of holistic review facilitate “individualized” consideration of an applicant’s capabilities with endorsement and guidelines now available from multiple academic medicine organizations, including the Association of American Medical Colleges, Electronic Residency Application Service, ACGME, and Fellow of the American College of Surgeons.3 With the availability of innovations in medical education (eg, letter of recommendation templates,4 standardized video interviews,5 and preference signaling), we encourage programs to develop a “learnable” selection process through real-time feedback from their own microenvironment to identify their own metrics for success. These inclusive methods may reduce the influence of an applicant’s medical school ranking in favor of what might be more relevant and meaningful attributes.