Purpose  The AAMC has promoted holistic review as a best practice in residency recruitment. The goal is to create an alternate set of metrics to evaluate applicants, while looking beyond scores at more meaningful attributes that align with program values to diversify the pool of candidates interviewed and selected (Holistic Review.” AAMC, <a href="http://www.aamc.org/services/member-capacity-building/holistic-review.;Jones">www.aamc.org/services/member-capacity-building/holistic-review.;Jones</a> et al. in Acad Med 96:176–181, 2021). Currently, there is no standardized set of rules or metrics mandated by the AAMC or ACGME to guide residency programs in this process. Our aim was to evaluate how the implementation of holistic review affected the diversity (race, gender, ethnicity, and geographic origin) of applicants selected for interview and match at our institution. Methods We examined the application cycles between 2017 and 2021 to determine whether changes in the recruitment process influenced the diversity of interviewed and matched applicants after holistic review was implemented. Changes included implementing structured interviews in 2019 and semi-structured interviews, redacted/blinded screening, and a revised scoring rubric in 2020. Tracked variables included pre-interview scores, interview scores, and match status stratified by sex, minority status, URiM status, and degree type (MD vs. DO) within application years. Results Recruitment changes resulted in a higher percentage of URiM applicants being invited for interview, an increase in the proportion of matched female applicants, and interview invites to applicants applying from more diverse regions and states after holistic review was implemented. A notable challenge to holistic review implementation included significant additional time required in the application review process. Conclusion Implementation of holistic review demonstrated increased minority, URiM and geographic diversity of applicants interviewed. We maintained and increased proportions of URiM and minority residents in our program respectively. Future implementation strategies should continue to update branding and marketing to highlight program growth and strengths, increase workforce to screen, interview and select applicants and continue to mitigate bias— particularly in the rank list meeting. In the era following a ban on affirmative action, holistic review strategies, including blinded screening, may allow continued diversification of the surgical workforce in ways that look beyond race.

Radical implementation of holistic review for general surgery residency recruitment: an institutional 4-year review and lessons learned

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2025年7月10日

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Garima G. Sinha,
Jonathan A. McKenzie,
Tania K. Arora

摘要

Purpose

The AAMC has promoted holistic review as a best practice in residency recruitment. The goal is to create an alternate set of metrics to evaluate applicants, while looking beyond scores at more meaningful attributes that align with program values to diversify the pool of candidates interviewed and selected (Holistic Review.” AAMC, www.aamc.org/services/member-capacity-building/holistic-review.;Jones et al. in Acad Med 96:176–181, 2021). Currently, there is no standardized set of rules or metrics mandated by the AAMC or ACGME to guide residency programs in this process. Our aim was to evaluate how the implementation of holistic review affected the diversity (race, gender, ethnicity, and geographic origin) of applicants selected for interview and match at our institution.

Methods

We examined the application cycles between 2017 and 2021 to determine whether changes in the recruitment process influenced the diversity of interviewed and matched applicants after holistic review was implemented. Changes included implementing structured interviews in 2019 and semi-structured interviews, redacted/blinded screening, and a revised scoring rubric in 2020. Tracked variables included pre-interview scores, interview scores, and match status stratified by sex, minority status, URiM status, and degree type (MD vs. DO) within application years.

Results

Recruitment changes resulted in a higher percentage of URiM applicants being invited for interview, an increase in the proportion of matched female applicants, and interview invites to applicants applying from more diverse regions and states after holistic review was implemented. A notable challenge to holistic review implementation included significant additional time required in the application review process.

Conclusion

Implementation of holistic review demonstrated increased minority, URiM and geographic diversity of applicants interviewed. We maintained and increased proportions of URiM and minority residents in our program respectively. Future implementation strategies should continue to update branding and marketing to highlight program growth and strengths, increase workforce to screen, interview and select applicants and continue to mitigate bias— particularly in the rank list meeting. In the era following a ban on affirmative action, holistic review strategies, including blinded screening, may allow continued diversification of the surgical workforce in ways that look beyond race.