What Predicts “Problem” Residents

When I was putting together my residency application I often thought “Which aspect of my application is most important to program directors?” While I still do not know the answer to that question, I did read a study that demonstrated what program directors should look at. A study by Brenner et al. in 2010 published in Academic Medicine explored what aspects of the residency application correlated most with residents that had “major” and “minor” problems during residency. Surprisingly (or not), USMLE scores, failed courses, letters of recommendation and interviews did not correlate with likelihood of problems during residency. What did correlate was any negative comment in the dean letter. Interestingly but again not surprisingly the amount of negative comments correlated with the amount of problems a resident was expected to have in residency. Of course there are limitations to this study including that only one program in one specialty (psychiatry) was assessed. Furthermore, post residency issues were not assessed. For example, perhaps patients with lower USMLE scores had worse patient outcomes post residency (although I doubt it).

What are the implications of such a study?

For one, it stresses the importance of keeping the MSPE as neutral as possible. And finally perhaps there could be less emphasis placed on getting a 260 on step 1 and hitting a number on a test and more emphasis on being enthusiastic, eager to learn and professional during clinical clerkships.

  1. Brenner, Adam M., Samuel Mathai, Satyam Jain, and Paul C. Mohl. “Can We Predict “Problem Residents”?” Academic Medicine7 (2010): 1147-151. Web.

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