Subject: We’ve done it! The Holy Grail of Residency Recruitment!

Dear Team,

I can hardly believe I’m typing these words, but after countless late nights, we’ve finally cracked the code! We’ve discovered a completely foolproof artificial intelligence method to select the perfect residency applicants. Imagine this: no more midnight calls about professionalism lapses, no more painful remediation meetings, no more eye-rolling as we read the same cookie-cutter personal statements claiming applicants were “detectives” and “born to be internists.” Our algorithm ensures 100% predictive accuracy!

Should we publish immediately and revolutionize residency selection worldwide, or keep our genius under wraps

ABSTRACT

Background The emigration of highly skilled physicians, or “brain drain,” from lower- to higher-income countries poses major health care system challenges, yet data on Middle East radiology residents are limited.

Objective To examine the emigration and retention patterns of radiology residents graduating from a large academic institution in Lebanon.

Methods We retrospectively examined graduates of the internationally accredited radiology residency program at the American University of Beirut Medical Center, Lebanon, from 2004 to 2024. Data were collected from departmental records and alumni databases by 2 investigators, supplemented by public sources to corroborate information. For each graduate, we collected sex, nationality, year of graduation, current country of practice, current professional position, and subspecialty training. Descriptive statistics were used to calculate frequencies and percentages, and to examine trends in emigration over time.

Results Fifty of the 60 total included radiology graduates (83.3%) left Lebanon post-residency, with most (42 of 60, 70.0%) relocating to the United States. This pattern intensified in recent years, increasing from 55.6% (5 of 9) emigration among the 2004-2008 cohort to 93.3% (14 of 15) and 100% (16 of 16) among the 2017-2020 and 2021-2024 cohorts, respectively. As of 2025, only 10 graduates (16.7%) remained in Lebanon.

Conclusions From 2004 to 2024, 83.3% of radiology residency graduates from a major academic program in Lebanon emigrated, with the emigration rate reaching 100% in the most recent cohorts. Most graduates relocated to the United States, and all non-Lebanese graduates also emigrated after completing their training.

Rouge on the Lips of Silence

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ABSTRACT

Background There remains limited understanding of effective strategies to increase diversity, equity, and inclusion within residency programs—highlighting the need for a comprehensive review of current interventions.

Objective To synthesize literature regarding interventions to increase the representation of populations underrepresented in medicine (URiM) within US residency programs.

Methods A scoping review of studies published from January 2000 to July 2023 was conducted. Data were extracted from PubMed, Embase, Cochrane Library, and Scopus. URiM was defined by race, ethnicity, and gender. Studies were included if an intervention was implemented by a graduate medical education residency program but were excluded if they did not describe a defined intervention or if they were published outside of the United States. Study interventions were categorized into 5 areas: applicant factors, selection measures, application screening, interviews, and post-interview communication.

Results Initial search captured 2683 titles and abstracts; 257 full-text articles were reviewed, with 27 eligible articles meeting inclusion criteria. Eligible articles were categorized as: applicant–12 (44%), selection–8 (30%), screening–17 (63%), interview–8 (30%), and post-interview–4 (15%). Many articles addressed multiple interventions that positively impacted URiM composition, making it difficult to isolate the effect of individual interventions. Common, effective interventions included holistic reviews, clerkships, and standardized interviews.

Conclusions This review demonstrates that interventions aimed at increasing diversity in residency programs vary in their approaches, but consistent evaluation and evidence of effectiveness are lacking from the current literature.

ABSTRACT

Background The topic of social determinants of health (SDH) is increasingly being integrated into medical education, yet there remains a lack of synthesized knowledge regarding how simulation is used to teach SDH in residency training.

Objective To identify the extent and capacity in which simulation is being used to teach medical residents about SDH.

Methods A scoping review was performed in 2023. A search using PubMed, Web of Science, Scopus, and Ovid was performed using keywords related to SDH, simulation, and residency training. The subsequent results were then analyzed to see if they fit the inclusion criteria of being related to SDH, having occurred during residency training, and having used simulation in the curriculum. One researcher (N.T.) reviewed every article, and a second researcher (T.S.) verified a portion of the articles.

Results Sixteen studies met the inclusion criteria. The most used simulation method was patient-based scenarios (7 studies), followed by scenario-based learning, such as poverty simulations (5 studies). Financial instability was the most frequently addressed topic, appearing in 7 studies. Common themes drawn from the studies include a positive learner perception of using simulation to teach SDH (7 studies), perceived increase in resident knowledge of how to address patients’ social needs (6 studies), improved ability to identify social risks (4 studies), a better understanding of SDH topics (4 studies), and enhanced knowledge of community resources (4 studies).

Conclusions Simulation can provide various scenarios to learn about SDH in residency, and it is looked favorably upon by learners.