Selection factors among international medical graduates and psychiatric residency performance

Objective: The authors examine the association between the selection factors used in a psychiatric residency program and subsequent clinical and academic performance among international medical graduate (IMG) candidates. Methods: The authors completed a retrospective review of application files and residency evaluations of 50 IMG residents who completed the 4-year psychiatry training in a universityaffiliated program from July 1994 through June 2004. Results: United States Medical Licensing Examination (USMLE) Step 1 and personal interview appear associated with residents' performance determined by the program director's ranking. Standardized examinations before (USMLE Step 1 and 2) and during the residency (PRITE) were significantly correlated (USMLE 1, r=0.37; USMLE 2, r=0.40, p<0.003). Personal interview scores and psychotherapy treatment session evaluations were also significantly associated (r=0.38, p<0.003). Conclusion: Further research is necessary to determine predictive factors related to psychiatric residents' performance, especially among IMGs. Adjusting current selection criteria may result in better outcomes for training programs and future psychiatrists.