Knowing Your
Applicants
J. Christian Barrett M.D.
Division of Hematology,
Oncology and Palliative
care
Road Map
 Approach
to Recruitment
 US Allopathic Graduates
 Osteopathic Graduates
 International Graduates
Critical Appraisal
 Appraise


your program goals and vision
What type of applicant are you trying to
attract?
What are the barriers to attracting the
applicants you desire?
Factors Influencing Applicants
 Geography/Location
 Reputation


Institutional
Program
 Board
pass rates—first time takers
 Resident’s happiness
 Current resident quality
 Post-graduation placement
Establishing a Strategy
 Recruitment
cannot just happen
 Actively develop a recruitment strategy


Highlighting strengths
Mitigating weaknesses
 Hard
to truly measure impact
Selecting Your Residents
 You
CANNOT control who comes to your
program
 You CAN control who you will not take
Screening the Applicants
 Task
varies by program size and volume
 Establish recruitment targets


Number of slots
Number of applicants per slot
 How
willing are you to not fill?
Interviewing
 Interview
fatigue
 What information are you getting/giving?

Are you able to
360-Evaluation
 How
are using your resources in your
selection process?

Valuable sources of information
 Know
your culture and your applicants
 Aligning feedback with your goals
GME Collision Point

US society physician shortage and GME
funding debated – 50% cuts vs. 15,000 resident
slot expansion





How to count other providers in calculations?
Do more doctors improve care, increase care,
increase health care costs, etc?
What type of doctors are we going to fall short?
Linking to performance measures of quality
The fiscal cliff?
GME Applicant Collision Point
 Medical
School Openings and Expansions
(MD and DO)

2015 is point where US medical students
exceed the number of existing GME slots
 1st
year students 2015 = 26,403
 1st year GME positions ~ 23,000

6,000 slots per year typically filled by IMG
GME Applicant Collision Point
 AMSA
position supports federal funding to
ensure only that there is a sufficient
number of positions for US medical
graduates
 What impact does that have on you
applicant pool?
US Allopathic Graduates
 The

Application
Interpreting the MSPE, Transcripts, and LOR
 Lake
Wobegon School of Medicine
 Make sure you are looking at the histograms
and any qualifying comment definitions
 Are comments in total or
“selected”/”representative”
 Extension/Remediation


Board Scores
AOA
Predictors of “Success”


USMLE Board scores
University of Michigan Radiology Program experience

ITE and Radiology Board Performance

Correlated with…




Honors in preclinical courses (Anatomy, Biochem, Pathology,
Pharmacology, and Physiology)
Honors in clerkships (Medicine, Pediatrics, and Surgery)
Boards Scores
Did not correlate with…



MSPE or LOR superlatives
Honors in clerkships (OB-Gyn and Radiology)
Medical school prestige (based on US News & World Reports rankings)


Students who excelled were excelled as residents regardless of medical
school prestige
None of the factors correlated with rotational performance
evaluations
Boyse et al. Academic Radiology 2002;9(4):437-445
Social Media
 Survey
with 12,000 program director
respondents in 22 specialties accredited
by ACGME

196 (16.3%) visit internet sites for additional
information
 74
(38.1%) has ranked an applicant lower as
result of information found
Board Scores
 Score
Migration
 Changes being considered
Board Scores
STEP I
Step II
COMLEX I
COMLEX II
Minimum
passing
188
196
400
400
Median
Score
224
500
500
First Time
Pass MD
94%
97%
First Time
Pass IMG
73%
82%
First Time
Pass DO
89%
93%
Perceptions and the IMG
 Factors




consistently shown to influence
Program reputation
Geographic location
Perceived current resident happiness
Perceived quality of current residents
 Study
set up to examine influence of the
number of IMGs
Perceptions and the IMG
 Medical

Part 1



Rank five hypothetical programs 1-5
Score each program 0-100 based on desirability
Part 2


student survey – 1994
Rate importance of 25 factors in influencing their
actual match ranking list on scale 1-6
Part 3

Rank 12 factors 1-12 in order of importance to
their actual selection process
Perceptions and the IMG
 702

students from 18 medical schools
Part 1
 Rank

Randomly assigned characteristics




five hypothetical programs 1-5
Salary and benefits, geography, program size, etc
1/3 of students received information regarding
the number of IMG in each program
1/3 of students received information regarding
the reputation of each program
1/3 of students received no information
regarding IMGs or reputation
Perceptions and the IMG
Ranking
Program
(%IMG)
Without
IMG
With
IMG
Ranking
Rank
Change
Without
IMG
With
IMG
Rating
Change
B(90%)
2.5
3.5
-1.0
72
54
-18
D(44%)
1.9
1.8
+0.1
80
79
-1
C(35%)
4.7
4.4
+0.3
30
32
+2
E(26%)
3.0
2.9
+0.1
62
64
+2
A(3%)
3.0
2.4
+0.6
61
71
+10
• A and D University-based programs
• BDCEA Board pass rates (85%/100%/5%/70%/50%)
International Graduates:
Are They All the Same?
 Quality


variation
Teaching quality of institution
Quality of the clinical training
 Graduation

Dates
US medical experience of equivalent
 Observership
vs. clinical experience
 Will this requirement evolve?
 Board
scores—Timing of examination
Developing a List
 Personal
Experience
 Reputation
 Colleagues



Intra-institutional Peers
Specialty society/PD peers
Contacts at the school
QS World University Rankings

Ireland



Trinity College Dublin
University of Glasgow
Royal College of Surgeons

Singapore

Japan

Australia






National University of Singapore (NUS)
University of Tokyo
University of Melbourne
University of Sydney
University of Queensland
Germany

Ruprecht-Karls-Univeritat Heidelburg

Korea

New Zealand



Seoul National University
University of Otago
The University of Auckland
My Personal Experience
 Middle


East
American University of Beirut
Weill-Cornell-Qatar
 Peru


National University of San Marcos
Cayetano Heridia University
Medical Schools in India
















All India Institute of Medical Sciences, New Delhi
Christian Medical College, Vellore
Armed Forces Medical College, Pune
JIPMER, Pondicherry
Maulana Azad Medical College, Delhi
University College of Medical Science and Research Centre, New Delhi
Kasturba Medical College, Manipal
Grant Medical College, Mumbai
Seth GS Medical College, Mumbai
Lady Hardinge Medical College, New Delhi
Royal College of Medical Science and Research Centre, New Delhi
St. John’s Medical College, Bangalore
Madras Medical College, Chennai
Osmania Medical College, Hyperabad
Bangalore Medical College, Bangalore
BJ Medical School (MJMC), Ahmedabad
Indian Grading Scales
 As
with the US, hard to compare
 Look at

Minimum passing score
 Numbers

can appear low (%)
Distinction/First Class score (A equivalent)
 Second
Class ~ same as B+
Americans Abroad
 Poland


Univ. of Warsaw
Jagiellonian university medical college
6
year program offered to HS graduates
Americans Abroad
 Caribbean


Saint George’s University
American University of the Caribbean
 48


schools excluding Cuba
23 (48%) founded since 2000
32 “offshore”
 21
(66%) founded since 2000
Fifth Pathway
4
years Intl. school  1 year US clinical
work without degree  Step III eligible
 Issued through December 31, 2009
 Last accepted December 31, 2016

Afterwards, must seek ECFMG certification
Partnerships—
One Size Does Not Fit All?
 Duke-National

University Singapore
Inaugural class June 2007  July 2011
 Dubai
and Harvard
 University of Queensland SOM and
Oschner Health System
 Weill Cornell-Qatar

Inaugural class June 2002  July 2008
Accreditation


Commission on Higher Education of the
Middle States Association of Colleges and
Schools
Council on Higher Education for Public Health
(CEPH)




First outside of North America
Commission for Collegiate Nursing Education
Joint Commission International
AOA Honor Society
Aculturalization
 Are
you able and ready to handle IMG
aculturalization?
 Is aculturalization a two-way street?
ACGME-I
 Why?




Improve physician training/education as
means to improve health care delivery
standards
Diminishing opportunities potentially
looming
Size limitations prohibitive to set up own
GME accreditation systems with rigorous
peer review as in USA
Physician retention in countries
ACGME-I
 Currently
3 accredited programs
(Singapore)



National Healthcare Group Program
National University Health System Program
Singapore Health Services Pte Ltd Program
 Contracts



Signed
Qatar
UAE
Oman (negotiations ongoing)
Making your Match List
 Check
NRMP first to be certain no prior
match violations