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ASTRO Blog

February 2022

Best Practices for Residency Applicant Review and Selection

By Rachel B. Jimenez, MD;1 Curtiland Deville, Jr., MD;2 Chelsea C. Pinnix, MD, PhD;3 and Iris C. Gibbs, MD4

When embarking on the residency selection process for your training program, it is important to recognize that attracting applicants with relevant attributes and experiences is vital for shoring up the strength of our specialty while meeting the needs of an increasingly diverse patient population. A holistic review, applied at all stages of the selection process, can be an effective way to ensure that qualified applicants are not overlooked. Below, we provide some do’s and don’ts to consider during each phase of the recruitment season, followed by additional resources for context and further reading.

Do’s

  1. Be consistent:
    • Use standardized questions across all interviewees to promote fairness and uniformity in an interview setting.
    • Identify the most important skills and attributes of desirable applicants in advance of the residency selection process.
    • Consider which skills and attributes are trainable or acquirable through your training program (e.g., research skills) and which are not trainable and constitute proficiencies expected upon entry (e.g., empathy, communication skills).
    • Generate a rubric of selection criteria. Circulate the rubric among members of the selection committee for their feedback and encourage use of the rubric in all phases of the selection process from screening and interviews to final selection.
  2. Promote awareness:
    • Provide implicit bias training for all members of the residency selection process to promote awareness and mitigate the effects of unconscious bias.
    • Educate the committee about local, institutional and national representation trends and strategies to enhance diversity and inclusion.
  3. Encourage multiple perspectives:
    • Form a diverse residency selection committee (ethnicity/race, sexual orientation, gender identity, religion, academic level, position focus) that offers broad and multi-faceted perspectives on the applicant pool.
    • Foster an environment of open communication that allows members of the selection committee to offer their opinions in a safe and respectful manner.
  4. Context matters:
    • When evaluating the strengths/weaknesses of an applicant’s experiences (e.g., strength of prior research experience or prestige of a letter writer), consider the opportunities available to that applicant in their given training environment and if they have made the most of the opportunities to which they reasonably have access. Reward distance traveled.

Don'ts

  1. Avoid inappropriate questions:
    • Do not inquire about an applicant’s racial or ethnic identity, marital status, sexual orientation, gender identity, age or parental status.  At times, a candidate may voluntarily share this information so you may simply acknowledge it and move on to the next question. It is not a good practice to ask follow-up questions, even if it is volunteered by the applicant. Similarly, avoid commenting on someone’s physical appearance or inquiring about where else the applicant applied or where they plan to rank your program. This information should have no bearing on the applicant’s candidacy as a resident physician.
  2. Don’t anchor:
    • Avoid focusing on a single strength or weakness in a candidate’s application. If an applicant meets screening criteria for an interview, despite fewer strengths in one domain or because of a particular accomplishment, avoid drawing upon that same item for subsequent considerations of their candidacy.
  3. Diversity is not a quota:
    • Resist the pitfalls of “checking a box.” Invest in individuals and be inclusive.

For additional reading:

Best Practices for Conducting Residency Program Interviews
Diversity Trends by Sex and Underrepresented in Medicine Status Among U.S. Radiation and Medical Oncology Faculty Over 5 Decades
Impact of Holistic Review on Student Interview Pool Diversity
Linguistic Biases in Letters of Recommendation for Radiation Oncology Residency Applicants from 2015 to 2019
Potential Implications of the New USMLE Step 1 Pass/Fail Format for Diversity Within Radiation Oncology


Affiliations:

1. Assistant Professor and Associate Residency Program Director, Harvard Radiation Oncology Program; President, Association for Program Directors in Radiation Oncology
2. Associate Professor of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University; ASTRO Board Representative Ex-officio, Health Equity, Diversity and Inclusion.
3. Associate Professor and Residency Program Director, The University of Texas MD Anderson Cancer Center; Vice-president, Association for Program Directors in Radiation Oncology
4. Professor of Radiation Oncology and Associate Dean of MD Admissions, Stanford Medicine; former Director of Education and Residency Program Director, Stanford Department of Radiation Oncology

Posted: February 9, 2022 | 1 comments