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Characteristics of Highly Ranked Applicants to General Surgery Residency Programs
*Steven C Stain1, *Jonathan R. Hiatt2, Stanley W Ashley3, *Karen E Deveney4, *L.D. Britt5, *Ashar Ata1, *Joseph M Galante6, *Richard A Moore7, *Kevin K Roggin8, *E. Christopher Ellison9
1Albany Medical College, Albany, NY;2University of California at Los Angeles, Los Angeles, CA;3Brigham and Women's Hospital, Boston, MA;4Oregon Health Science University, Portland, OR;5Eastern Virginia Medical School, Norfolk, VA;6University of California, at Davis, Sacramento, CA;7University of Tennessee at Chattanooga, Chattanooga, TN;8University of Chicago, Chicago, IL;9Ohio State University, Columbus, OH

Objective: With duty hour debates, specialization and gender distribution changes in the applicant pool; the relative competitiveness for general surgery residency (GSR) is undefined. We sought to determine the modern attributes of top ranked applicants to GSR.
Design: Validation Cohort, Survey
Setting: National sample of university and community based GSR programs
Study Participants: Data were abstracted from ERAS files of the top 20 ranked applicants to 22 GSR programs. Program competitiveness and blinded personal statements were ranked by the authors.
Main Outcome Measures: Poisson regression identified characteristics that predicted applicant ranking by GSR program (top 5 vs. #6-20); and application to highly competitive programs.
Results: There were 333 unique applicants among the 440 ERAS applications. Most applicants had research experience (94%), publications (79%), and 28% were AOA. Nearly half were women (45%), with wide variation by program (20-75%) and a trend toward fewer women at programs in the south and west (38%). Males had higher USMLE Step 1 scores (238 vs. 230; P<0.001), but similar Step 2 scores (245). Using bivariate analysis, highly competitive programs were more likely to rank applicants with publications, research experience, AOA membership, higher Step 1 scores, excellent personal statements, were male or Asian. However, the only significant independent predictors were: Step1 scores (RR 1.03), publication (RR 2.26), personal statements (RR 1.62) and being Asian (RR 1.70 vs. White). AOA membership (RR 1.37) and Step 1 scores (RR 1.01) were the only variables predictive of being ranked in the top 5.
Conclusion: Assessment of this national sample shows GSR is a highly competitive, gender-neutral discipline in which academic performance is the most important factor for ranking, especially at highly competitive programs.


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