Zastrow Ryley K, Burk-Rafel Jesse, London Daniel A
is a Fourth-Year Medical Student, Department of Medical Education, Icahn School of Medicine at Mount Sinai.
is Assistant Professor, Department of Internal Medicine, and Assistant Director of UME-GME Innovation, Institute for Innovations in Medical Education, NYU Grossman School of Medicine.
J Grad Med Educ. 2021 Jun;13(3):355-370. doi: 10.4300/JGME-D-20-01381.1. Epub 2021 Jun 14.
Calls to reform the US resident selection process are growing, given increasing competition and inefficiencies of the current system. Though numerous reforms have been proposed, they have not been comprehensively cataloged.
This scoping review was conducted to characterize and categorize literature proposing systems-level reforms to the resident selection process.
Following Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, searches of Embase, MEDLINE, Scopus, and Web of Science databases were performed for references published from January 2005 to February 2020. Articles were included if they proposed reforms that were applicable or generalizable to all applicants, medical schools, or residency programs. An inductive approach to qualitative content analysis was used to generate codes and higher-order categories.
Of 10 407 unique references screened, 116 met our inclusion criteria. Qualitative analysis generated 34 codes that were grouped into 14 categories according to the broad stages of resident selection: application submission, application review, interviews, and the Match. The most commonly proposed reforms were implementation of an application cap (n = 28), creation of a standardized program database (n = 21), utilization of standardized letters of evaluation (n = 20), and pre-interview screening (n = 13).
This scoping review collated and categorized proposed reforms to the resident selection process, developing a common language and framework to facilitate national conversations and change.
鉴于当前美国住院医师选拔系统竞争日益激烈且效率低下，要求改革该选拔过程的呼声越来越高。尽管已经提出了众多改革建议，但尚未对其进行全面梳理。
开展此项范围综述，以描述和分类针对住院医师选拔过程提出的系统层面改革的文献。
遵循系统评价和Meta分析扩展版范围综述（PRISMA-ScR）指南，对Embase、MEDLINE、Scopus和科学网数据库进行检索，查找2005年1月至2020年2月发表的参考文献。若文章提出的改革适用于或可推广至所有申请人、医学院校或住院医师培训项目，则纳入研究。采用归纳法进行定性内容分析，以生成编码和高阶类别。
在筛选的10407篇独特参考文献中，116篇符合纳入标准。定性分析产生了34个编码，根据住院医师选拔的大致阶段分为14类：申请提交、申请审核、面试和配对。最常提出的改革措施包括实施申请上限（n = 28）、创建标准化项目数据库（n = 21）、使用标准化推荐信（n = 20）和面试前筛选（n = 13）。
此项范围综述整理并分类了针对住院医师选拔过程提出的改革建议，形成了一种通用语言和框架，以促进全国性的讨论和变革。
