Bandiera Glen, Abrahams Caroline, Ruetalo Mariela, Hanson Mark D, Nickell Leslie, Spadafora Salvatore
G. Bandiera is associate dean, Postgraduate Medical Education, University of Toronto, and chief of emergency medicine, St. Michael's Hospital, Toronto, Ontario, Canada. C. Abrahams is director of policy and analysis, Postgraduate Medical Education Office, University of Toronto, Toronto, Ontario, Canada. M. Ruetalo is a research officer, Postgraduate Medical Education Office, University of Toronto, Toronto, Ontario, Canada. M.D. Hanson is associate dean, Undergraduate Medical Education Admissions and Student Finances, University of Toronto, Toronto, Ontario, Canada. L. Nickell is associate dean, Undergraduate Health Professions Students Affairs, University of Toronto, Toronto, Ontario, Canada. S. Spadafora is vice dean, Postgraduate Medical Education, University of Toronto, Toronto, Ontario, Canada.
Acad Med. 2015 Dec;90(12):1594-601. doi: 10.1097/ACM.0000000000000954.
Medical education institutions have a social mandate to produce a diverse physician workforce that meets the public's needs. Recent reports have framed the admission process outcome of undergraduate and postgraduate medical education (UGME and PGME) programs as a key determinant of the collective contributions graduating cohorts will make to society, creating a sense of urgency around the issue of who gets accepted. The need for evidence-informed residency application and selection processes is growing because of the increasing size and diversity of the applicant pool and the need for equity, fairness, social accountability, and health human resource planning. The selection literature, however, is dominated by a UGME focus and emphasizes determination of desirable qualities of future physicians and selection instrument reliability and validity. Gaps remain regarding PGME selection, particularly the creation of specialty-specific selection criteria, suitable outcome measures, and reliable selection systems.In this Perspective, the authors describe the University of Toronto's centralized approach to defining system-level best practices for residency application and selection. Over the 2012-2013 academic year, the Best Practices in Application and Selection working group reviewed relevant literature and reports, consulted content experts, surveyed local practices, and conducted iterative stakeholder consultations on draft recommendations. Strong agreement arose around the resulting 13 principles and 24 best practices, which had either empirical support or face validity. These recommendations, which are shared in this article, have been adopted by the university's PGME advisory committee and will inform a national initiative to improve trainees' transition from UGME to PGME in Canada.
医学教育机构肩负着一项社会使命，即培养出能够满足公众需求的多元化医生队伍。最近的报告将本科和研究生医学教育（UGME和PGME）项目的录取过程结果视为毕业生群体对社会做出集体贡献的关键决定因素，这使得关于谁能被录取的问题变得紧迫起来。由于申请人池规模不断扩大且日益多样化，以及对公平、公正、社会问责和卫生人力资源规划的需求，基于证据的住院医师申请和选拔过程的需求也在增加。然而，选拔文献主要关注UGME，强调确定未来医生的理想品质以及选拔工具的可靠性和有效性。在PGME选拔方面仍存在差距，特别是在制定特定专业的选拔标准、合适的结果衡量指标和可靠的选拔系统方面。在这篇观点文章中，作者描述了多伦多大学为住院医师申请和选拔定义系统层面最佳实践的集中方法。在2012 - 2013学年，申请与选拔最佳实践工作组审查了相关文献和报告，咨询了内容专家，调查了当地做法，并就建议草案进行了反复的利益相关者协商。围绕由此产生的13项原则和24项最佳实践达成了强烈共识，这些原则和实践要么有实证支持，要么具有表面效度。本文分享的这些建议已被该大学的PGME咨询委员会采纳，并将为加拿大一项旨在改善学员从UGME向PGME过渡的全国性倡议提供参考。
