Incorporating Holistic Review in Recruitment in a Physical Medicine and Rehabilitation Residency Program

Abstract

Traditional residency recruitment practices are vulnerable to unconscious biases, inequity, lack of diversity, and have limited ability to predict future clinical competency. Holistic review and evidence-based strategies, such as structured interviews and situational judgment tests, can mitigate these limitations. A physical medicine and rehabilitation residency program restructured its residency recruitment process using holistic review principles and evidence-based strategies during the 2020-2021 academic year. A subcommittee developed a weighted screening rubric based on Association of American Medical Colleges core competencies and semistructured interview questions targeting specific domains. Formal implicit bias training was provided. Screening scores determined interview invitations. Applicants participated in three different domain-focused semistructured interviews. Screening and interview scores were combined to form the program rank list. A postinterview anonymous questionnaire was sent to interviewees to obtain feedback. Four hundred eighty-nine applicants were screened (82 interview invitations, 80 interviewed, 8 matched). The respondents to the postinterview questionnaire found that interviews evaluated them objectively (90%) and improved their impression of the program (90%). The program's match was consistent with previous matches. Interviewed applicants represented a racially diverse group. Most questionnaire respondents had a positive impression of the interview process. This article demonstrates incorporating holistic review into residency recruitment and provides specific resources to aid other institutions pursuing similar goals.