AMBULATORY PEDIATRICS Volume 5, Number 4 216 Copyright  2005 by Ambulatory Pediatric Association July–August 2005 The Impact of the Interview in Pediatric Residency Selection Wendy Sue Swanson MD; Mary Catherine Harris MD; Christina Master, MD; Paul R. Gallagher, MA; Anthony E. Mauro, LSW, MBA; Stephen Ludwig, MD Objective.—To better understand the impact of USMLE scores and interview scores on the National Resident Match- ing Program (NRMP) rank of applicants to the residency program at The Children’s Hospital of Philadelphia. Methodology.—We evaluated 935 applicants’ files from 2000, 2001, and 2002. For each candidate, one interviewer had access to the full application, while the other interviewer was blinded to USMLE scores and grades. Interview scores were generated by both interviewers. Statistical analysis was performed to evaluate relationships between USMLE scores, interview scores, and NRMP rank list number. Results.—There were a wide range of USMLE scores among candidates who interviewed (range 181 to 269, 227.7  17.1, M  standard deviation). USMLE scores were weakly correlated to nonblinded interview scores (r =-0.17), final committee scores (r =-0.26), and NRMP ranking (r =-0.21): P  .0005. Blinded interviews did not correlate with USMLE scores. Both nonblinded and blinded interviews had stronger correlations with NRMP rank list number (r = 0.49, P  .0005 and r = 0.36, P  .0005, respectively). The nonblinded interview accounted for 20.6% of variance in the NRMP rank list order. Conclusions.—Interview scores were the most important variable for candidate ranking on the NRMP list. Further- more, when interviewers had access to board scores, there was a modest correlation to performance on the USMLE. While interviews may reflect a candidate’s personality, they may not effectively measure desired characteristics when access to academic markers is unrestricted. We suggest incorporating blinded interviews into the selection process to give candidates a better opportunity to display communication skills, emotional stability, and ‘‘fit’’ for the program. KEY WORDS: board scores; interviews, residency selection Ambulatory Pediatrics 2005;5:216 220 T he selection of candidates for competitive residen- cy training programs is an extremely important process. In a profession dependent on interpersonal and communication skills, the on-site interview is an es- sential part of this evaluation and should be an effective means of measuring information not presented elsewhere in a candidate’s application. During the recruitment pro- cess, candidates travel to the program’s hospital, receive tours of the facility, and participate in a number of inter- views with faculty and residents. These interviews, often two or more, can ‘‘make or break’’ a prospective resi- dent’s candidacy. Studies have shown that the interviews are the most important factor in the program director’s final decision in ranking candidates. 1–3 As the interview day itself is the most time-consuming part of the selection process for program directors and students alike, it should serve a transparent purpose of providing a window into the unique qualifications of each candidate. In light of From the Division of General Pediatrics (Drs Swanson and Mas- ter, Mr Mauro, and Dr Ludwig), Division of Neonatology (Dr Har- ris), and Division of Biostatistics (Mr Gallagher), Department of Pediatrics, The Children’s Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, Pa. Address correspondence to Mary Catherine Harris, MD, Division of Neonatology, The Children’s Hospital of Philadelphia, 34 St and Civic Center Blvd, Philadelphia, PA 19104 (e-mail: harrism@ email.CHOP.edu). Received for publication August 23, 2004; accepted April 7, 2005. this, it would behoove residency programs to evaluate the interview process and its impact on candidates’ rank num- ber for the National Resident Matching Program (NRMP) list. One of the known biases in candidate ranking is the use of USMLE scores for selection. The National Board of Medical Examiners (NBME; now USMLE) scores are a convenient measure used for comparison when screen- ing large numbers of applicants. Some residency program directors feel that the score ‘‘levels the playing field’’ across medical schools because of the standardized nature of the exam. 4,5 However, despite the fact that USMLE scores have not been shown to predict ‘‘better’’ clinical performance, they are often used as a screening tool dur- ing the initial review to determine interview invitations. 6,7 The use of USMLE board scores, albeit widespread, may create unintended bias in candidate evaluation and selec- tion. To select the ‘‘best-fit’’ residents for a training program while placing heavy value on the interview, programs must understand the factors that contribute to interview scoring and their ultimate influence on final ranking. The purpose of this study is to contribute to the common goal of making residency selection more effective in compre- hensively assessing an applicant’s true skill set. We will examine how USMLE scores and other academic markers affect scoring in the interview, compare the results of in- terviews blinded and nonblinded from academic markers, and correlate interview scores with final ranking on the NRMP match list.