Internal Medicine Clerkship Directors' Roles and Experiences as Specialty Advisors: Results from a National Survey

Purpose Despite the high-stakes nature of the residency application process, data are lacking on the training, resources, and guidance provided by specialty-specific advisors. To establish best practices and improve the quality of specialty-specific advising in internal medicine (IM), the authors surveyed IM clerkship directors (CDs) about their roles and responsibilities as advisors. Method From September to December 2023, 140 IM CDs at U.S. medical schools with full or provisional Liaison Committee on Medical Education accreditation were surveyed. The survey was based on 22 questions regarding CDs' roles and experiences as advisors and an annual 8-question section on CD and medical school characteristics. Results Of the 140 CDs sent the survey, 116 (83.0%) responded. Two participants did not finish the entire survey but completed the section on which this study is based, leaving a total sample size of 118. The IM CDs advised a median of 12 students (interquartile range, 5-25; range, 0-50) per application cycle and performed a mean (SD) of 9.0 (4.0; range, 1-17) different advising responsibilities. Only 14 of the 118 participants (11.9%) received dedicated full-time equivalent time for advising. The CDs reported using a range of faculty development resources, but training provided by schools was limited; only 52 of 117 (44.4%) received education on best practices for advising. Of the 118 respondents, 75 (63.6%) reported not knowing whether their school provided resources for students underrepresented in medicine applying to residency. Finally, CDs noted a change in their advising, with 54 of 116 (46.6%) recommending that the average (i.e., middle-third) IM applicant apply to more programs compared with previous years. Conclusions The IM CDs provided essential insight into specialty-specific advisors' roles, resources, and advising practices. This study revealed opportunities to promote equitable advising, reduce application inflation, and optimize the training and support of specialty-specific advisors.