Crane J T, Ferraro C M
Department of Emergency Medicine, University of Illinois at Chicago 60612, USA.
Acad Emerg Med. 2000 Jan;7(1):54-60. doi: 10.1111/j.1553-2712.2000.tb01892.x.
To determine the criteria used by emergency medicine (EM) residency selection committees to select their residents, to determine whether there is a consensus among residency programs, to inform programs of areas of possible inconsistency, and to better educate applicants pursuing careers in EM.
A questionnaire consisting of 20 items based on the current Electronic Residency Application Service (ERAS) guidelines was mailed to the program directors of all 118 EM residencies in existence in February 1998. The program directors were instructed to rank each item on a five-point scale (5 = most important, 1 = least important) as to its importance in the selection of residents. Followup was done in the form of e-mail and facsimile.
The overall response rate was 79.7%, with 94 of 118 programs responding. Items ranking as most important (4.0-5.0) in the selection process included: EM rotation grade (mean +/- SD = 4.79 +/- 0.50), interview (4.62 +/- 0.63), clinical grades (4.36 +/- 0.70), and recommendations (4.11 +/- 0.85). Moderate emphasis (3.0-4.0) was placed on: elective done at program director's institution (3.75 +/- 1.25), U.S. Medical Licensing Examination (USMLE) step II (3.34 +/- 0.93), interest expressed in program director's institution (3.30 +/- 1.19), USMLE step I (3.28 +/- 0.86), and awards/achievements (3.16 +/- 0.88). Less emphasis (<3.0) was placed on Alpha Omega Alpha Honor Society (AOA) status (3.01 +/- 1.09), medical school attended (3.00 +/- 0.85), extracurricular activities (2.99 +/- 0.87), basic science grades (2.88 +/- 0.93), publications (2.87 +/- 0.99), and personal statement (2.75 +/- 0.96). Items most agreed upon by respondents (lowest standard deviation, SD) included EM rotation grade (SD 0.50), interview (SD 0.63), and clinical grades (SD 0.70). Of the 94 respondents, 37 (39.4%) replied they had minimum requirements for USMLE step I (195.11 +/- 13.10), while 30 (31.9%) replied they had minimum requirements for USMLE step II (194.27 +/- 14.96). Open-ended responses to "other" were related to personal characteristics, career/goals, and medical school performance.
The selection criteria with the highest mean values as reported by the program directors were EM rotation grade, interview, clinical grades, and recommendations. Criteria showing the most consistency (lowest SD) included EM rotation grade, interview, and clinical grades. Results are compared with those from previous multispecialty studies.
确定急诊医学(EM)住院医师选拔委员会用于选拔住院医师的标准,确定住院医师培训项目之间是否存在共识,告知各项目可能存在不一致的领域,并更好地教育追求急诊医学职业的申请者。
根据当前的电子住院医师申请服务(ERAS)指南编制了一份包含20个项目的问卷,于1998年2月邮寄给当时所有118个急诊医学住院医师培训项目的项目主任。要求项目主任就每个项目在选拔住院医师时的重要性,按照五分制(5 = 最重要,1 = 最不重要)进行排名。通过电子邮件和传真的形式进行了跟进。
总体回复率为79.7%,118个项目中有94个项目回复。在选拔过程中被列为最重要(4.0 - 5.0)的项目包括:急诊医学轮转成绩(均值±标准差 = 4.79 ± 0.50)、面试(4.62 ± 0.63)、临床成绩(4.36 ± 0.70)和推荐信(4.11 ± 0.85)。中等重视程度(3.0 - 4.0)的项目有:在项目主任所在机构完成的选修课(3.75 ± 1.25)、美国医学执照考试(USMLE)第二步(3.34 ± 0.93)、对项目主任所在机构表达的兴趣(3.30 ± 1.19)、USMLE第一步(3.28 ± 0.86)以及奖项/成就(3.16 ± 0.88)。较少受到重视(<3.0)的项目包括阿尔法欧米伽阿尔法荣誉学会(AOA)身份(3.01 ± 1.09)、就读医学院校(3.00 ± 0.85)、课外活动(2.99 ± 0.87)、基础科学成绩(2.88 ± 0.93)、发表文章(2.87 ± 0.99)以及个人陈述(2.75 ± 0.96)。受访者最一致认同的项目(标准差最低)包括急诊医学轮转成绩(标准差0.50)、面试(标准差0.63)和临床成绩(标准差0.70)。在94名受访者中,37名(39.4%)回复称他们对USMLE第一步有最低要求(195.11 ± 13.10),而30名(31.9%)回复称他们对USMLE第二步有最低要求(194.27 ± 14.96)。对“其他”问题的开放式回复涉及个人特质、职业/目标和医学院校表现。
项目主任报告的均值最高的选拔标准是急诊医学轮转成绩、面试、临床成绩和推荐信。显示出最大一致性(最低标准差)的标准包括急诊医学轮转成绩、面试和临床成绩。将结果与之前多专业研究的结果进行了比较。