Postgraduate Selection in Medical Education: A Scoping Review of Current Priorities and Values

Abstract

Purpose: The process of screening and selecting trainees for postgraduate training has evolved significantly in recent years, yet remains a daunting task. Postgraduate training directors seek ways to feasibly and defensibly select candidates, which has resulted in an explosion of literature seeking to identify root causes for the problems observed in postgraduate selection and generate viable solutions. The authors therefore conducted a scoping review to analyze the problems and priorities presented within the postgraduate selection literature in order to explore practical implications and present a research agenda. Method: Between May 2021 and February 2022, the authors searched PubMed, EMBASE, Web of Science, ERIC, and Google Scholar for English language literature published after 2000. Articles that described postgraduate selection were eligible for inclusion. 2,273 articles were ultimately eligible for inclusion. Thematic analysis was performed on a subset of 100 articles examining priorities and problems within postgraduate selection. Articles were sampled to ensure broad thematic and geographical variation across the breadth of articles that were eligible for inclusion. Results: Five distinct perspectives or value statements were identified in the thematic analysis: (1) Utilizing available metrics to predict performance in postgraduate training; (2) Identifying the best applicants via competitive comparison; (3) Seeking alignment between applicant and program in the selection process; (4) Ensuring diversity, mitigation of bias, and equity in the selection process; and (5) Optimizing the logistics or mechanics of the selection process. Conclusions: This review provides insight into the framing and value statements authors use to describe postgraduate selection within the literature. The identified value statements provide a window into the assumptions and subsequent implications of viewing postgraduate selection through each of these lenses. Future research must consider the outcomes and consequences of the value statement chosen and the impact on current and future approaches to postgraduate selection.

Reading between the lines: exploring the unwritten rules of letters of recommendation in the Canadian resident selection process

“…Resident selection is a high stakes process that has received considerable attention in recent years, 1 including discussion of the fairness and effectiveness of the methods used to make decisions. 2,3 Letters of recommendation (LORs) are commonly used in the resident selection process, but they have come under increasing criticism for the variability in how they are written and assessed; [4][5][6][7] the presence of gender and other biases; 8,9 and their inability to discriminate well between applicants.…”