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Knowing Your Applicants

Knowing Your Applicants. J. Christian Barrett M.D. Division of Hematology, Oncology and Palliative care. Road Map. Approach to Recruitment US Allopathic Graduates Osteopathic Graduates International Graduates. Critical Appraisal. Appraise your program goals and vision

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Knowing Your Applicants

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  1. Knowing Your Applicants J. Christian Barrett M.D. Division of Hematology, Oncology and Palliative care

  2. Road Map • Approach to Recruitment • US Allopathic Graduates • Osteopathic Graduates • International Graduates

  3. Critical Appraisal • Appraise your program goals and vision • What type of applicant are you trying to attract? • What are the barriers to attracting the applicants you desire?

  4. Factors Influencing Applicants • Geography/Location • Reputation • Institutional • Program • Board pass rates—first time takers • Resident’s happiness • Current resident quality • Post-graduation placement

  5. Establishing a Strategy • Recruitment cannot just happen • Actively develop a recruitment strategy • Highlighting strengths • Mitigating weaknesses • Hard to truly measure impact

  6. Selecting Your Residents • You CANNOT control who comes to your program • You CAN control who you will not take

  7. Screening the Applicants • Task varies by program size and volume • Establish recruitment targets • Number of slots • Number of applicants per slot • How willing are you to not fill?

  8. Interviewing • Interview fatigue • What information are you getting/giving? • Are you able to

  9. 360-Evaluation • How are using your resources in your selection process? • Valuable sources of information • Know your culture and your applicants • Aligning feedback with your goals

  10. GME Collision Point • US society physician shortage and GME funding debated – 50% cuts vs. 15,000 resident slot expansion • How to count other providers in calculations? • Do more doctors improve care, increase care, increase health care costs, etc? • What type of doctors are we going to fall short? • Linking to performance measures of quality • The fiscal cliff?

  11. GME Applicant Collision Point • Medical School Openings and Expansions (MD and DO) • 2015 is point where US medical students exceed the number of existing GME slots • 1st year students 2015 = 26,403 • 1st year GME positions ~ 23,000 • 6,000 slots per year typically filled by IMG

  12. GME Applicant Collision Point • AMSA position supports federal funding to ensure only that there is a sufficient number of positions for US medical graduates • What impact does that have on you applicant pool?

  13. US Allopathic Graduates • The Application • Interpreting the MSPE, Transcripts, and LOR • Lake Wobegon School of Medicine • Make sure you are looking at the histograms and any qualifying comment definitions • Are comments in total or “selected”/”representative” • Extension/Remediation • Board Scores • AOA

  14. Predictors of “Success” • USMLE Board scores • University of Michigan Radiology Program experience • ITE and Radiology Board Performance • Correlated with… • Honors in preclinical courses (Anatomy, Biochem, Pathology, Pharmacology, and Physiology) • Honors in clerkships (Medicine, Pediatrics, and Surgery) • Boards Scores • Did not correlate with… • MSPE or LOR superlatives • Honors in clerkships (OB-Gyn and Radiology) • Medical school prestige (based on US News & World Reports rankings) • Students who excelled were excelled as residents regardless of medical school prestige • None of the factors correlated with rotational performance evaluations Boyse et al. Academic Radiology 2002;9(4):437-445

  15. Social Media • Survey with 12,000 program director respondents in 22 specialties accredited by ACGME • 196 (16.3%) visit internet sites for additional information • 74 (38.1%) has ranked an applicant lower as result of information found

  16. Board Scores • Score Migration • Changes being considered

  17. Board Scores

  18. Perceptions and the IMG • Factors consistently shown to influence • Program reputation • Geographic location • Perceived current resident happiness • Perceived quality of current residents • Study set up to examine influence of the number of IMGs

  19. Perceptions and the IMG • Medical student survey – 1994 • Part 1 • Rank five hypothetical programs 1-5 • Score each program 0-100 based on desirability • Part 2 • Rate importance of 25 factors in influencing their actual match ranking list on scale 1-6 • Part 3 • Rank 12 factors 1-12 in order of importance to their actual selection process

  20. Perceptions and the IMG • 702 students from 18 medical schools • Part 1 • Rank five hypothetical programs 1-5 • Randomly assigned characteristics • Salary and benefits, geography, program size, etc • 1/3 of students received information regarding the number of IMG in each program • 1/3 of students received information regarding the reputation of each program • 1/3 of students received no information regarding IMGs or reputation

  21. Perceptions and the IMG • A and D University-based programs • BDCEA Board pass rates (85%/100%/5%/70%/50%)

  22. International Graduates:Are They All the Same? • Quality variation • Teaching quality of institution • Quality of the clinical training • Graduation Dates • US medical experience of equivalent • Observership vs. clinical experience • Will this requirement evolve? • Board scores—Timing of examination

  23. Developing a List • Personal Experience • Reputation • Colleagues • Intra-institutional Peers • Specialty society/PD peers • Contacts at the school

  24. QS World University Rankings • Ireland • Trinity College Dublin • University of Glasgow • Royal College of Surgeons • Singapore • National University of Singapore (NUS) • Japan • University of Tokyo • Australia • University of Melbourne • University of Sydney • University of Queensland • Germany • Ruprecht-Karls-UniveritatHeidelburg • Korea • Seoul National University • New Zealand • University of Otago • The University of Auckland

  25. My Personal Experience • Middle East • American University of Beirut • Weill-Cornell-Qatar • Peru • National University of San Marcos • CayetanoHeridia University

  26. Medical Schools in India • All India Institute of Medical Sciences, New Delhi • Christian Medical College, Vellore • Armed Forces Medical College, Pune • JIPMER, Pondicherry • Maulana Azad Medical College, Delhi • University College of Medical Science and Research Centre, New Delhi • Kasturba Medical College, Manipal • Grant Medical College, Mumbai • Seth GS Medical College, Mumbai • Lady Hardinge Medical College, New Delhi • Royal College of Medical Science and Research Centre, New Delhi • St. John’s Medical College, Bangalore • Madras Medical College, Chennai • Osmania Medical College, Hyperabad • Bangalore Medical College, Bangalore • BJ Medical School (MJMC), Ahmedabad

  27. Indian Grading Scales • As with the US, hard to compare • Look at • Minimum passing score • Numbers can appear low (%) • Distinction/First Class score (A equivalent) • Second Class ~ same as B+

  28. Americans Abroad • Poland • Univ. of Warsaw • Jagiellonianuniversity medical college • 6 year program offered to HS graduates

  29. Americans Abroad • Caribbean • Saint George’s University • American University of the Caribbean • 48 schools excluding Cuba • 23 (48%) founded since 2000 • 32 “offshore” • 21 (66%) founded since 2000

  30. Fifth Pathway • 4 years Intl. school  1 year US clinical work without degree  Step III eligible • Issued through December 31, 2009 • Last accepted December 31, 2016 • Afterwards, must seek ECFMG certification

  31. Partnerships—One Size Does Not Fit All? • Duke-National University Singapore • Inaugural class June 2007  July 2011 • Dubai and Harvard • University of Queensland SOM and Oschner Health System • Weill Cornell-Qatar • Inaugural class June 2002  July 2008

  32. Accreditation • Commission on Higher Education of the Middle States Association of Colleges and Schools • Council on Higher Education for Public Health (CEPH) • First outside of North America • Commission for Collegiate Nursing Education • Joint Commission International • AOA Honor Society

  33. Aculturalization • Are you able and ready to handle IMG aculturalization? • Is aculturalization a two-way street?

  34. ACGME-I • Why? • Improve physician training/education as means to improve health care delivery standards • Diminishing opportunities potentially looming • Size limitations prohibitive to set up own GME accreditation systems with rigorous peer review as in USA • Physician retention in countries

  35. ACGME-I • Currently 3 accredited programs (Singapore) • National Healthcare Group Program • National University Health System Program • Singapore Health Services Pte Ltd Program • Contracts Signed • Qatar • UAE • Oman (negotiations ongoing)

  36. Making your Match List • Check NRMP first to be certain no prior match violations

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