Chanchlani1 raises important concerns about the residency match. I empathize with the frustration that many students have regarding the “lack of a clear rubric on how (residency programs) select candidates”; most programs base their decisions on “some combination of factors such as personal statement, reference letters and interview, the weight of these components is unknown and applicants do not know how eventual matches are made.”1 The confusion and anxiety regarding the practices employed may be related to the fact that resident selection committees must now make decisions based on little or no useful data.
A recent meta-analysis on the topic identified that the best predictors of physician performance are objective measures such as medical school grades and standardized examination scores.2 Reference letters, interviews, dean’s letters, personal letters and research experience were all found to have weak or no association with subsequent physician performance.2 Canadian medical schools now provide little or no objective data to resident selection committees — only 3 of 17 institutions provide any objective data regarding academic performance.3
Residency selection committees must now base their decisions on data points that have little or no utility regarding which students become the best physicians. They must sort through the large number of subjective data points that are variably presented in a nonstandardized format by the 17 Canadian medical schools.3 It’s no wonder that students are confused regarding how they should be measured during the match — programs are too! It’s time for Canadian medical schools to make an evidence-based decision and start reporting objective measures of academic performance. Maybe then, students can focus on learning medicine, rather than worrying about getting the “best” research project, elective or reference letter to secure them a residency position.