In a recent medical education twitter chat, other medical
educators and I were discussing success being tied to previous experience
playing a team sport. It stemmed from
this article, which suggested that success in residency (otolaryngology) may be more likely
if one played a team sport earlier. This
is a fascinating observation, and one that I hadn’t thought of when interviewing applicants. Others commented that there may be bias since
in early schooling, boys are more likely to be members of team sports than
girls.
It is interesting that residency program directors really
struggle with trying to find the magic bullet that will determine success. What does “success” really mean? For program directors, I suppose it could
mean having a resident who performed very well clinically, who was not a rabble
rouser and thus “caused no trouble”, and who received excellent evaluations throughout
training. It could mean impeccable
surgical outcomes for procedurally-related fields (although there are other
factors besides a resident involvement in surgery that might affect surgical
outcomes). It could also mean getting a
job and starting a practice after residency, or securing a fellowship after
residency training. I really don’t think
there is ONE thing that defines this success.
There may be success on a test (such as passing a board
examination): that has been studied. The
old adage: “past performance predicts future performance” is true with regards
to tests, in my opinion. How this
translates for programs directors is that those students who performed well on
USMLE Step 1 and/or Step 2 are more likely to pass the board examinations after
residency. While this is only one aspect
of “being a doctor” (using competency language, it would be the competency of medical
knowledge), residency programs are indeed being evaluated on this measure of
board pass rate.
There may be success regarding professionalism. Some might
take the reverse approach. When one is
unprofessional, what factors predict that unprofessional behavior? This has been studied by Dr. M Papadakis, and basically, past “unprofessional” behavior
in medical school predicts future disciplinary action by state medical boards.
There may be success in securing a match position. Many educators have published on this, such
as this from plastic surgery.
There may be success in other domains as well. Here is a description that uses a surgical aptitude test. Here is another study looking at the utility of letters of recommendation to predict success.
I have heard many references over the years that medicine is
a “team sport”. No one takes care of a
patient by only herself/himself. We
really need a team to help patients optimize their health. I believe that the field of geriatrics models
this very well, and has described training on working in multidisciplinary teams. The importance of teams in medicine has also been outlined for patient-centered medical homes, such that teamwork
competencies need to be defined.
One of my mentors (a female) has mentioned “I love seeing applicants
who were Eagle Scouts”. I have heard
others who get excited seeing certain extracurricular activities, such as
volunteerism, on a written application. Like
others, I certainly enjoy reading some things on an application more than
others, but I really haven’t found any one thing that predicts success.
To me, it is not just the application that is important. The
application gets you in the door [for the job interview], but the interview
gets you the job. As for defining success: well, we in medical education have a long way to go before we are able to pinpoint that one down.
Very nice article. My friend was an Eagle Scout, went to Princeton and excelled from there. What is success and how do we determine it.. Excellent topic for discussion and further study.
ReplyDeleteKind regards,
-Brett