10 Reasons We Need to Rethink How We Select Medical Students

Everyone wants to be part of a high performance team. Some experience it in the Armed Forces. Some are part of championship sports teams. Some are lucky enough to have experienced it at some part of their careers. Most won't, and, instead, will be cogs in the wheel, grinding away, day after day, part of the 87% who are disengaged. Failed recruits, burned out and angry workers, and frustrated or harmed customers/patients are the results.

The primary thing that converts a startup to a successful scale up are high performing teams and their leaders. Unfortunately, we seem to have lost sight of the importance of how much people make a difference, instead we’re too busy being mesmerized by strategy, technology, and whether something is “disruptive” or not or how much investors think a company is worth.

The problem plagues the medical school application process, where untrained faculty interviewers ask irrelevant or gotcha questions and applicants tap dance their way through the interviews, to a background soundtrack of, "What is s/he thinking?"

Here are 10 reasons we need to rewire how we hire:

1. The MCATs are not predictive of long-term performance as a doctor.

2. Existing selection techniques continue to result in under-representation of minorities and teams that are not diverse psychologically, demographically, or racially. In addition, after training and graduation, we expect them to assume roles for which they are not "hard wired," like leadership and entrepreneurship.

3. The present interview process is time-consuming and expensive.

4. There is no correlation with performance in a job interview and eventual performance on the job.

5. Personality typing is not predictive of career success or job satisfaction.

6. Few applicants have an adequate job preview.

7. A wrong hire can have dire consequences when one resident is part of a three-person team that year.

8. It is almost impossible to fire a resident after the first year without significant repercussions.

9. Grumpy, angry, dissatisfied doctors hurt patients more than happy doctors.

10. There is a persistent GME funding bottleneck that particularly affects foreign medical graduates interested in doing residencies in the US; only about 50% of which eventually match. If trends continue, more and more medical students will not match. Will they sue their medical schools? Should undergraduates be made to sign "truth in lending" statements informing them that there is a small but definite chance they may not be able to get a residency?

Picking the right person for the right job is the keystone of building high performance teams. We all know that getting the right people on the bus is key. The challenge is how to select those we pick to step on board and which seats to offer them.