“Fit” Has a Broader Meaning: Recognizing the Utility of Person–Environment Fit Theory in Residency Recruitment and Selection

I read the article entitled “The F Word: How ‘Fit' Threatens the Validity of Resident Recruitment” with great interest.¹  Notably, the authors present “fit” as a nebulous term that is used to convey a gestalt impression, conceivably serving as a proxy for unconscious bias and a threat to diversity. To mitigate these risks, they propose that terms, such as “fit,” must have a clear and shared meaning.¹  Fortunately, to meet the challenge of this recommendation, we can diversify our own perspectives by incorporating well-established concepts from industrial and organizational (I/O) psychology.²  I/O psychology is a recognized division of the American Psychological Association and is characterized by the scientific study of human behavior in organizations. Personnel psychology is a dedicated subfield that primarily deals with the recruitment, selection, and retention of personnel, in addition to the study of workplace culture and interpersonal relationships.² 

Beginning in the 1990s, applications of person–environment fit (P–E fit) theory, which refers to the alignment between characteristics of individuals and those of their job and workplace, became more explicit. One of the key articles in this movement is “Person–Environment Fit in the Selection Process” by Werbel and Gilliland.³  In their work, the authors proposed an expanded model of fit in personnel selection, which incorporates person–job, person–organization, and person–workgroup fit (figure). The descriptions that Werbel and Gilliland provided resonate with the recommendations by Shappell and Schnapp¹  to reduce the potential negative effects that may arise from terms like “fit.” For example, person–organization fit is defined as the congruence of values, needs, and goals between an individual and organization.³  In their box, Shappell and Schnapp suggested that residency programs establish a clear brand identity, which includes clarifying values and goals.¹  Then, if fostering self-starters is considered meaningful to the program, they can decide to preferentially rank applicants who have demonstrated an ability to create and develop new initiatives. Furthermore, Shappell and Schnapp proposed that when “fit creeps into the discussion” that the conversation be directed away from this word.¹  However, instead of being fearful of this terminology, we should consider embracing it based on a broader understanding of its meaning. A different approach could be taken, in which a member of the selection committee states, “Based on the work we have done to identify our residency program's core values and goals, I believe that this applicant aligns better from the perspective of person–organization fit compared to this applicant.” Therefore, the framework of P–E fit offers the exact “deliberate language” that Shappell and Schnapp were seeking.

Over the past decade, there has been a growing intradisciplinary collaboration between I/O psychology and the medical community.⁴  While the majority of these efforts have existed overseas, we are starting to see the positive impact of similar relationships in graduate medical education in the United States.⁵  By merging the contextual experience of our residency programs with the selection science expertise of I/O psychologists, we have the opportunity to engage in theory-driven studies that can ultimately promote diversity through a broader understanding of what it means to “fit.”