Association Between Internal Medicine Residency Applicant Characteristics and Performance on ACGME Milestones During Intern Year

Background Residency programs apply varying criteria to the resident selection process. However, it is unclear which applicant characteristics reflect preparedness for residency. Objective We determined the applicant characteristics associated with first-year performance in internal medicine residency as assessed by performance on Accreditation Council for Graduate Medical Education (ACGME) Milestones. Methods We examined the association between applicant characteristics and performance on ACGME Milestones during intern year for individuals entering Northwestern University’s internal medicine residency between 2013 and 2018. We used bivariate analysis and a multivariable linear regression model to determine the association between individual factors and Milestone performance. Results Of 203 eligible residents, 198 (98%) were included in the final sample. One hundred fourteen residents (58%) were female, and 116 residents (59%) were White. Mean Step 1 and Step 2 CK scores were 245.5 (SD 12.0) and 258 (SD 10.8) respectively. Step 1 scores, Alpha Omega Alpha membership, medicine clerkship grades, and interview scores were not associated with Milestone performance in the bivariate analysis and were not included in the multivariable model. In the multivariable model, overall clerkship grades, ranking of the medical school, and year entering residency were significantly associated with Milestone performance (P ≤ .04). Conclusions Most traditional metrics used in residency selection were not associated with early performance on ACGME Milestones during internal medicine residency.