A recently published article in The Journal of Bone and Joint Surgery, co-written by William Eward, MD, DVM; Frank H. Bassett III, MD, associate professor of Orthopaedic Surgery and director of the Residency Program at Duke; and Kevin A. Wu, MD, from the Icahn School of Medicine at Mount Sinai, is sparking meaningful conversations about the future of residency selection.
In the piece, “Rethinking Residency Selection: Beyond Test Scores,” Eward and Wu challenge the traditional reliance on standardized test scores and advocate for a more holistic review process that emphasizes qualities essential for patient care and team collaboration.
The article underscores that while objective metrics, such as board scores, have long dominated residency decisions, they often fail to capture critical attributes — such as empathy, resilience, and communication skills—that directly impact patient outcomes and the culture of healthcare teams. Eward argues that the shift to a pass/fail scoring system for USMLE Step 1 offers an opportunity to rethink how programs evaluate candidates.
“Residency programs should look beyond numbers,” said Eward. “Our goal is to select physicians who not only excel academically but also demonstrate the human qualities that define great doctors—compassion, adaptability, and integrity.”
Eward’s call for reform aligns with national efforts to reduce bias and improve equity in medical education. His perspective invites educators and program directors to consider innovative strategies for assessing applicants, including structured interviews, situational judgment tests, and evaluations of lived experiences.