American Council of Academic Plastic Surgeons
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Predictors of Applicant Success to Integrated Plastic Surgery Residency
Megan M. Perez, BS1; Sofia Aronson, MD1; Noopur Gangopadhyay, MD2; Arun K. Gosain, MD2
1Division of Plastic & Reconstructive Surgery, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA 2 Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA

Background: Integrated plastic surgery residency programs are among the most competitive residency programs in the medical student match. We performed an objective review of the parameters used by program directors to match prospective residents, and resident performance based on these selection parameters.
Methods: Recent literature and the NMRP 2018 program directors survey were reviewed to determine the correlations between traditional applicant evaluation criteria and resident success, most often measured by subjective faculty evaluations, with an emphasis on the following selection criteria: 1) USMLE scores, 2) clerkship performance/AOA, 3) research, 4) medical school reputation, 5) letters of recommendation, 6) visiting student rotations, and 7) interview performance.
Results: Based on the program director survey, the most highly ranked factors in the decision to interview applicants were Step 1, AOA, and research. After interview completion, subjective components such as interpersonal skills and letters of recommendation became more important. No direct relationship between Step 1 and resident performance is established, though it has been shown that Step 2CK and third-year clerkship grades are predictors of surgical intern success. The number and quality of research publications appears less important as long as the applicant has published at least once. Medical students from the top 40 medical schools are likely to match at highly ranked programs, though this does not correlate with better performance. Letters of recommendation are heavily weighted despite evidence they are vulnerable to inconsistent interpretation. Visiting rotations and interviews are the highest ranked selection criteria as they allow opportunities to assess personal traits of an applicant, and thus differentiate amongst an otherwise academically homogenous population. Program directors who emphasized subjective criteria reported greater satisfaction with the selection process than those who emphasized academic qualifications, but only half felt that interview performance predicted resident performance.
Conclusion: Of the 7 components of the residency selection process reviewed, most do not show strong correlation with future resident performance. Reassessment of these criteria is warranted, particularly in light of upcoming changes in reporting of USMLE scores.

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