Specialized trainers can reliably evaluate and improve the pelvic examination skills of interns, and improvements are demonstrable three months after training. Further research is needed to ascertain whether training efficiency can be improved and to measure the impact of training on patient satisfaction and clinical outcomes.
The authors identify several components of the application for residency and fellowship recruitment that impede progress toward conducting holistic review in graduate medical education (GME). As well, important differences between undergraduate (UME) and graduate medical education (GME) recruitment are discussed. The authors call for inclusion of questions about family background and disadvantaged status in the GME application, which is a standard practice within applications for health professions. The second recommendation encourages a question about non-cognitive strengths. Many specialties have adopted standardized letters of recommendation (SLORs) or standardized letters of evaluation (SLOEs) that collect this information from letters writers. Programs and applicants would benefit from uniformity across specialties. The authors also call for a centralized, searchable database that provides applicants with each program's mission, educational goals, and alumni outcomes. To support this paradigm shift in GME recruitment, reinforced with new Accreditation Council for Graduate Medical Education standards in July 2019, a task force should provide theoretical, evidence-based reasoning, along with development of new tools.
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