How we select our residents--a survey of selection criteria in general surgery residents

Introduction: The future of general surgery depends on the quality of the resident trainees, and successful resident selection is a factor that is important in the process of high-quality surgical education.

Methods: A 36-question survey regarding resident selection and the interview process was sent to surgical program directors, department chairs, and associate program directors across the United States and Canada.

Results: In all, 262 valid replies were received (65%), of which 83% were program directors. University hospital programs accounted for 49% of the completed surveys. The mean yearly applicant number per residency program was 571. Most programs indicated that they strictly adhere to their selection criteria (82%). The screening selection is made by the program director in 62%. Only 31% of programs show their selection criteria on their web page. United States Medical Licensing Examination (USMLE) Step 1 is the single most important factor in screening criteria (37%), followed by USLME Step 2 (24%). A total of 96% of all programs have female residents, 66% have non-Liaison Committee on Medical Education graduates, and 38% have Doctor of Osteopathy (DO) residents. Final selection is made by the program director in 49%. Although research experience is considered in selection criteria (80%), only 46% of programs offer research opportunities to their residents and only 13% require 1-year of research. On a Likert 5-point scale, the interview is by far the most important factor (4.69), followed by Step 1 score (4.21), and letters of recommendation (4.02).

Conclusions: Even though all general surgery programs have a wide range of screening/selection criteria, USLME Step 1 is the single most important factor for preliminary screening, and the interview is the most important factor in determining the final selection. The final selection is relatively subjective and based on a combination of interview, USLME scores, research experience, and personal judgment.