Letters to the Editor
To the Editor:
After a one-year study and some controversy, the Association of American Medical Colleges (AAMC), in concert with several academic emergency medicine groups, announced that all 2017–2018 emergency medicine residency applicants will be required to complete a standardized video interview (SVI) as part of an “operational pilot program.”1
This operational pilot being required of emergency medicine applicants presents an ethical concern. While the academic emergency medicine community believes that programs need to “use the tool within their selection processes in order to properly assess its viability,”2 this program remains an operational pilot, with continued research planned.1–3 Whether any of these planned studies have undergone institutional review board (IRB) review and whether study participants are volunteers or provide informed consent is unclear.
This “operational pilot” fails to meet a standard of “normal educational practices,” and each participant’s responses could quite clearly be “damaging to the subjects’ financial standing, employability, or reputation.”4 Since there is a question as to the pilot’s status as research, an IRB—not the investigators, nor the AAMC itself—must determine what safeguards for participants should be implemented. Medical students are considered a vulnerable population and should be afforded extra protections from risk.5 The fact that the use of the AAMC’s Electronic Residency Application Service is essentially required to apply to emergency medicine residency makes this mandatory participation in research unethical. Even the coercion implied by calling participation mandatory should be of concern.
As a researcher myself, I support the continued research into the SVI, and I believe that some future version of it will be helpful to stakeholders. Methods beyond board scores and class rank are needed for evaluating applicants; however, we, as ethical educators and members of an academic medicine community, should be ashamed that we are guising this research as a “pilot” to avoid the appropriate protections afforded to participants and to evade the duty we have to protect our students.
Joshua J. Davis, MD
Emergency medicine resident, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania; Joshua.Davis@jefferson.edu.
5. Council for International Organization of Medical Sciences. International Ethical Guidelines for Biomedical Research Involving Human Subjects. 2002.Geneva, Switzerland: Council for International Organization of Medical Sciences.