Original reportPredictors of Success in a Urology Residency Program
Introduction
In 1985, the Urology Program Directors, under the direction of the Society of University Urologists, established a matching system for first year residents. The Urology Residency Matching program assigns match numbers to applications and programs that register online. Applicants register with the Electronic Residency Application Service (ERAS) and contact programs to set up interviews. All applicants and programs complete the preference list forms online and submit them to the Urology Matching Program by January of each year. The Urology Residency Matching Program performs the match and sends out results to applicants, medical schools, and training programs.
With the competitive nature of surgical subspecialties such as urology, residency programs are faced with the difficult task of forming rank lists from a growing pool of applicants. While most programs use the same objective criteria to assess applicants, there have been few studies that evaluate which factors are actually predictive of a successful resident. Several studies have demonstrated a correlation between USMLE scores and performance on in-service examinations in various specialties,1, 2, 3, 4, 5, 6 however, this represents only one small aspect of the residency application. To ensure the training of the highest quality clinicians and surgeons, it is crucial to assess whether our current selection criteria are predictive of subsequent resident performance. Furthermore, program directors must identify factors that are associated with poor performance early in the training process to allow for possible proactive intervention, if needed. Our study seeks to evaluate the factors associated with clinical and objective performance as a urology resident.
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Participants and Study Design
A retrospective review of 29 resident files from the Division of Urology at Washington University in St Louis between July 2000 and July 2009 was performed. The study was exempt from institutional review board (IRB) because of the lack of patient identifiers or protected health information. Medical student applications and resident files were reviewed. Data extracted from the medical student application included applicant rank, USMLE part I scores, medical school quality, undergraduate quality,
Results
During the course of training, residents were evaluated every 6 months based on a Likert scale (see Figure 1) by their supervising academic urology faculty as to their clinical and technical performance. The data were subsequently stratified into 2 groups, “excellent” and “average and needing improvement.” Outcomes of this analysis are shown in Table 1. Significant differences were noted between the 2 groups with respect to rank order, quality of the LOR, and evaluations as an intern. Those
Discussion
The goal of our study was to further define the factors which are predictive of success in a urology residency program. Resident success can be defined in terms of clinical performance or objective measures of knowledge (i.e., standardized tests). We sought to address both of these domains by stratifying residents based on in-service scores and clinical evaluations.
With regards to objective measures of performance, our study has several significant findings. As would be expected, performance on
Conclusions
The applicant selection process at our institution is surprisingly predictive of future success as a urology resident. Faculty interviews and letters of recommendation appear to correlate directly with clinical performance during residency. Furthermore, performance on USMLE part I and in-service examination is correlated with successful passage of the board examinations. Larger scale studies are warranted to further define the factors predictive of urology resident success. Early identification
Acknowledgments
Previous Presentations: Grewal S, Yeung L, Brandes, B. “Separating the Wheat from the Chaff: What Criteria Predict a ‘Good’ Urology Resident?” Presented at the 96th Annual Clinical Congress of the American College of Surgeons, 2010.
The authors have no conflicts of interest to report relative to the preparation or publication of this study.
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