http://journals.lww.com/academicmedicine/Abstract/publishahead/A_Plea_to_Reassess_the_Role_of_United_States.98722.aspx An interesting read. I am fascinated to think about how residency applicants were picked 'back in the day'. I imagine that a PD would call up the local Dean's offices and get a list of candidates who would be invited to the club. Assuming they used the correct forks and dressed the part, they were offered positions at the end of lunch. Ha. Of course, the explosion of geographic mobility, the NRMP match and the general expansion of residency training over time changed all that. Plus, I only have ONE Dean's office phone number. As a PD, the amount of things I don't know about the applicants is so large that having something I do know makes it weigh more than it "should". Whenever Medical Schools get around to telling me the things I need to know (actual ability to care of patients, work on teams, integrate feedback, dedication/work ethic, intellectual and humanistic curiosity) and the ACGME stops making high-stakes tests part of *my* performance review, I'll be happy to return the 'good ol' days' of recruitment when ugly things like tests weren't so imperative.