Understanding the Holistic Review Tool

About Holistic Review

Holistic review is an approach to evaluating residency applicants that considers multiple dimensions of a candidate’s background, experiences, attributes, competencies, and academic preparation together, rather than relying too heavily on any single factor alone. The goal is to support a more complete understanding of each applicant and help programs identify individuals whose strengths and experiences align with their mission, goals, and values. 

The ResidencyCAS holistic review tool is designed to support that broader process. It's one of many tools and review inputs programs may use as they evaluate candidates, alongside faculty judgment, existing review practices, and other application materials. 

How the ResidencyCAS Holistic Review Tool Works 

The ResidencyCAS holistic review tool is designed to assist programs in conducting a more comprehensive review of applications by considering multiple dimensions of an applicant’s profile, rather than focusing disproportionately on one or two factors such as grades or test scores. It helps programs identify individuals whose unique combination of strengths align with that program’s mission, goals, and values. The holistic review tool is not a generative AI system and does not analyze personal statements, letters of recommendation, or other free-text responses. Instead, it uses structured application data and official supporting materials as part of a broader review process. 

The holistic review tool is meant to support review, not replace it. Programs may use it to help prioritize applications for review, add context to their decisions, or surface applicants who might otherwise be overlooked when relying on a single metric, but it remains just one of many tools and review metrics programs may use to evaluate candidates. 

The tool is research-based, and its approach is designed to be understandable to programs rather than functioning as a black box. Programs are able to use it as part of a broader review process with visibility into the factors it incorporates.

Programs Can Choose What Matters Most

A central feature of the ResidencyCAS holistic review tool is that each program chooses how to weigh the different components used in the tool. There is no single ResidencyCAS-wide weighting or standard formula; instead, programs can adjust the relative emphasis on broad areas of the application, so the tool reflects what they value most. 

Because that weighting is set by each program, the tool is not a national ranking of applicants and is not directly comparable across programs. The holistic review tool will surface applicants for each program most aligned with how that program has chosen to weigh the components of the application it considers important. 

Information That Can Be Considered

The holistic review tool may take into account several broad areas of the application, using data elements that come directly from what applicants submit and from official supplementary materials. It does not create new content, use generative AI, rewrite application materials, or guess at information that is not provided; instead, it uses existing, structured information to support a more complete review of each candidate. 

At a high level, these areas can include: 

• Academics: academics may include items such as licensing exam performance, advanced degrees earned, and related indicators of medical knowledge and progress drawn from quantitative components of structured evaluations, such as a specialty’s standardized letter of evaluation (SLOE). 
• Professional and service experiences: experiences may include areas such as clinical or patient care experience, work experience, community service, advocacy, research, teaching, and other meaningful roles applicants describe in their applications. 
• Achievements and scholarly activity: achievements may include examples such as publications, presentations, leadership roles, honors, or other accomplishments that show how applicants have contributed to their academic or professional communities. 
• Background and lived experience: some programs may consider information that provides context for a candidate’s journey, such as indicators of socioeconomic background, first-generation status, or other lived experiences that help the program understand an applicant’s path and potential contribution to the learning environment. 
• Values and Competencies: this area reflects how applicants’ experiences and structured evaluations speak to qualities such as personal growth, resilience, interpersonal and communication skills, teamwork and leadership, professionalism, innovation and critical thinking, and organizational or time management strengths, using structured application data such as experience classifications, tags, and standardized evaluation components rather than subjective interpretation of narrative responses. 

The goal is not to infer information from indirect signals or to count words in essays, but to use real, structured information that applicants and official sources provide to form a more complete view of each candidate. Because every program sets its own priorities, different programs may emphasize these broad areas differently. 

Transparency and Use 

This tool is based on data science, not generative AI. It does not create new content, guess at missing facts, manipulate applicant information, or place invented details in front of reviewers; instead, it uses existing application data and official materials to help programs review applicants more holistically. The tool uses structured application data and official supporting materials. It does not interpret, summarize, or score narrative responses. 

The tool is also designed to be explainable and transparent to programs. Unlike black-box systems that make it difficult to understand how results are generated, the ResidencyCAS approach is intended to be understandable, and programs are given visibility into how to use it as part of their broader review process. 

Key Takeaways for Applicants

For applicants, the most important points to understand are: 

• The holistic review tool is one tool programs may use to support their review; it does not by itself determine interview or selection decisions. Decisions are made by the individuals reviewing the applications and by the program leadership. It's best to think of the holistic review tool as a “decision support tool.” 
• Each program sets its own weights of the broad application components used in holistic review, so what matters most may differ from one program to another. The tool is intended to reflect how an applicant compares within a specific program’s applicant pool, based on information that applicant has provided and what that program values. 
• Because the weights and detailed configuration of the holistic review tool are determined by each individual program, applicants are best served by presenting a genuine, accurate, and complete picture of their academic record, experiences, and accomplishments, trusting that programs will use the holistic review tool and their own review processes to evaluate that information thoughtfully.