Unraveling the medical residency selection game
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Unraveling the medical residency selection game Lokke M. Gennissen1 · Karen M. Stegers‑Jager1 · Jacqueline de Graaf2,3 · Cornelia R. M. G. Fluit4 · Matthijs de Hoog1,5 Received: 13 July 2018 / Accepted: 13 July 2020 © The Author(s) 2020
Abstract The diversity of modern society is often not represented in the medical workforce. This might be partly due to selection practices. We need to better understand decision-making processes by selection committees in order to improve selection procedures with regard to diversity. This paper reports on a qualitative study with a socio-constructivist perspective conducted in 2015 that explored how residency selection decision-making occurred within four specialties in two regions in the Netherlands. Data included transcripts of the decision-making meetings and of one-on-one interviews with committee members before and after the group decision-making meetings. Candidates struggled to portray themselves favorably as they had to balance playing by the rules and being authentic; between fitting in and standing out. Although admissions committees had a welcoming stance to diversity, their practices were unintentionally preventing them from hiring underrepresented minority (URM) candidates. While negotiating admissions is difficult for all candidates, it is presumably even more complicated for URM candidates. This seems to be having a negative influence on attaining workforce diversity. Current beliefs, which make committees mistakenly feel they are acting fairly, might actually justify biased practices. Awareness of the role of committee members in these processes is an essential first step. Keywords Diversity · Residency selection · Specialty training · Post-graduate medical education · Qualitative research
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s1045 9-020-09982-x) contains supplementary material, which is available to authorized users. * Lokke M. Gennissen [email protected] 1
Institute of Medical Education Research Rotterdam (iMERR), Room Ae‑227, Erasmus MC, Postbus 2040, 3000 CA Rotterdam, The Netherlands
2
Radboud UMC, Nijmegen, The Netherlands
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Department of Internal Medicine at Radboud UMC, Nijmegen, The Netherlands
4
Center on Research in Learning and Education, Radboud University Medical Center Health Academy, Nijmegen, The Netherlands
5
Department of Pediatrics at Erasmus MC, Rotterdam, The Netherlands
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Introduction The increasing sociocultural diversity in Western society is underrepresented in the medical workforce (Leyerzapf and Abma 2012; Verdonk and Janczukowicz 2018), partly because we seem to lose medical graduates with a sociocultural diverse background, i.e. underrepresented minorities (URM) in the transition to residency (Leyerzapf and Abma 2012). This is unfortunate in light of the increasing demand for culturally sensitive care (Saha et al. 2008; Goldsmith 2000; U.S. Department of Health Human Services 2006; Verdonk and Janczukowi
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