Assessing the correlation between <scp>PhORCAS</scp> letters of recommendation and clinical aptitude among <scp>PGY1</scp> residency candidates

Abstract Introduction Despite an increasing number of unfilled pharmacy residency positions, discrepancies between candidate qualifications and program expectations persist, prompting a reevaluation of application and interview assessment methods. Objectives The primary objective of this study was to identify if key themes used within the Pharmacy Online Residency Centralized Application System letters of recommendation (LOR) correlate with how candidates perform on a clinical case administered during their residency interview. Methods This single‐center, retrospective study assessed the LOR of candidates interviewed for the post‐graduate year 1 (PGY1) pharmacy residency program at a large academic medical center from 2021 to 2024 over three interview cycles. A standardized clinical case was administered as part of the interview process and graded on an objective rubric by a consistent evaluator. Candidates' LOR were screened for 12 key themes and compared with their clinical case score. Baseline characteristics of letter writers and candidates were collected. Results This study included 107 PGY1 pharmacy candidate applications from 2021 to 2024. Of the 12 key themes, utilization of evidence‐based medicine, clinical judgment, positive peer comparison, independence, and strong baseline knowledge within the LOR had a statistically significant and positive correlation with clinical case scores. In a multivariate generalized linear regression model, evidence‐based medicine, independence, and strong baseline knowledge were found to have a significant and positive association with clinical case scores, irrespective of other key themes identified. Conclusion These data suggest that key themes identified may be useful when reviewing candidates' LORs to optimize the screening process to identify candidates that possess the clinical acumen required for the residency program. Further studies are warranted to validate the key themes found in this report.