Unraveling the medical residency selection game

Lokke M. Gennissen*, Karen M. Stegers-Jager, Jacqueline de Graaf, Cornelia R.M.G. Fluit, Matthijs de Hoog

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

10 Citations (Scopus)
22 Downloads (Pure)


The diversity of modern society is often not represented in the medical workforce. This might be partly due to selection practices. We need to better understand decision-making processes by selection committees in order to improve selection procedures with regard to diversity. This paper reports on a qualitative study with a socio-constructivist perspective conducted in 2015 that explored how residency selection decision-making occurred within four specialties in two regions in the Netherlands. Data included transcripts of the decision-making meetings and of one-on-one interviews with committee members before and after the group decision-making meetings. Candidates struggled to portray themselves favorably as they had to balance playing by the rules and being authentic; between fitting in and standing out. Although admissions committees had a welcoming stance to diversity, their practices were unintentionally preventing them from hiring underrepresented minority (URM) candidates. While negotiating admissions is difficult for all candidates, it is presumably even more complicated for URM candidates. This seems to be having a negative influence on attaining workforce diversity. Current beliefs, which make committees mistakenly feel they are acting fairly, might actually justify biased practices. Awareness of the role of committee members in these processes is an essential first step.

Original languageEnglish
Pages (from-to)237-252
Number of pages16
JournalAdvances in Health Sciences Education
Issue number1
Early online date1 Sept 2020
Publication statusPublished - Mar 2021

Bibliographical note

Funding Information:
The research program is funded by the Dutch Ministry of Health, Welfare and Sports—Project: Dedicated Schakeljaar. The funding body had no influence on the design of the study and collection, analysis, and interpretation of data and writing of the manuscript. Acknowledgements

Publisher Copyright:
© 2020, The Author(s).


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