The Use of a Surgery-Specific Written Examination in the Selection Process of Surgical Residents

OBJECTIVE: Selection of surgical residents is a difficult task, and program directors are interested in identifying the best candidates. Among the qualities being sought after is the ability to acquire surgical knowledge, and eventually do well on their board examinations. During the interview process, many programs use results from the United States Medical Licensing Exam (USMLE) to identify residents they think will do well academically. The purpose of this study was to evaluate a different method of identifying such residents, through the use of a surgery-specific written exam (SSWE). DESIGN: A retrospective review of residents in our program between 2004 and 2012 was done. A 50-question SSWE was designed and administered to candidates on the day of their interview. Scores on the SSWE and the USMLE were compared with results on the American Board of Surgery In-Training Exam (ABSITE). Correlation coefficients were calculated and compared. SETTING: Community based General Surgery residency program. PARTICIPANTS: Resident applicants. RESULTS: Forty-three residents had scores available from the SSWE, USMLE Part 1 (USMLE-1), and Part 2 (USMLE-2). There were ABSITE scores available for 38 in postgraduate year (PGY) 1. USMLE-1 had a statistically significant correlation (r = 0.327, p = 0.045) with the ABSITE score in PGY-1 (ABSITE-1), while with USMLE-2 had slightly less correlation (r = 0.314, p = 0.055) with ABSITE-1. However, the SSWE had a much stronger correlation (r = 0.656, p < 0.001) than either of them. CONCLUSIONS: An SSWE is a good method to identify residents who will later do well on the ABSITE. It is a better method than using the more general USMLE. Since the AB-SITE has been shown to correlate with performance on board examinations, residency programs interested in identifying candidates that will do well on their board examinations, should consider incorporating an SSWE into their application process. Surg 69:807-812. (C) 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)