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Selection Criteria for General Surgery Fellowships: A Survey of Fellowship Program Directors
Ezra N. Teitelbaum*1, Sabha Ganai2, Huan Vu3, Jayleen Grams4, Kenric Murayama5
1Northwestern University, Chicago, IL; 2Southern Illinois University, Springfield, IL; 3Virginia Commonwealth University, Richmond, VA; 4University of Alabama at Birmingham, Birmingham, AL; 5University of Hawaii, Honolulu, HI

Background: Currently, the majority of graduating general surgery residents go on to pursue subspecialty fellowship training. However, little is known about what criteria fellowship program directors use when evaluating resident applicants. In this study we surveyed fellowship program directors to determine which aspects of the application they consider most important, so that current residents seeking to apply to fellowship might better understand the criteria and characteristics by which they will be evaluated.
Methods: All fellowship program directors with published e-mail addresses in twelve general surgery subspecialties (trauma/critical care, minimally invasive/bariatric, colorectal, vascular, pediatric surgery, cardiothoracic, transplant, plastic surgery, hepatobiliary, surgical oncology, and endocrine surgery) in the United States and Canada were invited to complete an online survey. Participants were asked to rank the three most important categories used in selecting applicants to their program. To determine the overall order of importance of these categories, each was assigned a “rank score” by summing 3 points for each first choice response, 2 points for each second choice, and 1 point for each third choice. The program directors’ attitudes regarding the preparedness of graduating residents for both fellowship and independent practice were also assessed using Likert scales.
Results: 105 fellowship program directors (14% of those contacted) completed surveys. Overall, the interview was selected as the most influential component of the application with a “rank score” of 117, and 43% of respondents listing it as their most important criterion. Following the interview in order of importance were letters of recommendation from subspecialty faculty (rank score 99), the quality of the applicant’s residency program (rank score 51), ABSITE scores (rank score 41), and a phone call from faculty on the applicant’s behalf (rank score 28). Less important categories included research (rank score 16), publications (rank score 16), and the personal statement (rank score 3). The majority of program directors felt that residents were prepared for fellowship in terms of both technical skills (65% agreed or strongly agreed) and clinical judgment (63% agreed or strongly agreed). However, a minority of program directors thought that residency graduates are ready for independent practice in terms of either technical skills (only 30% agreed or strongly agreed) or clinical judgment (42% agreed or strongly agreed).
Conclusions: Fellowship program directors use the interview as the most important factor when selecting amongst resident applicants. A majority of respondents felt that current graduating residents are not prepared to be autonomous surgeons.

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