title: Characteristics of highly ranked applicants to general surgery residency programs.
abstract: OBJECTIVE
  With duty hour debates, specialization, and sex distribution changes in the applicant pool, the relative competitiveness for general surgery residency (GSR) is undefined.
  
  
  OBJECTIVE
  To determine the modern attributes of top-ranked applicants to GSR. DESIGN Validation cohort, survey.
  
  
  METHODS
  National sample of university and community-based GSR programs.
  
  
  METHODS
  Data were abstracted from Electronic Residency Application Service files of the top 20-ranked applicants to 22 GSR programs. We ranked program competitiveness and blinded review of personal statements.
  
  
  METHODS
  Characteristics associated with applicant ranking by the GSR program (top 5 vs 6-20) and ranking by highly competitive programs were identified using t and χ2 tests and modified Poisson regression.
  
  
  RESULTS
  There were 333 unique applicants among the 440 Electronic Residency Application Service files. Most applicants had research experience (93.0%) and publications (76.8%), and 28.4% had Alpha Omega Alpha membership. Nearly half were women (45.2%), with wide variation by program (20.0%-75.0%) and a trend toward fewer women at programs in the South and West (38.0% and 37.5%, respectively). Men had higher United States Medical Licensing Examination Step 1 scores (238.0 vs 230.1; P < .001) but similar Step 2 scores (245.3 vs 244.5; P = .54). Using bivariate analysis, highly competitive programs were more likely to rank applicants with publications, research experience, Alpha Omega Alpha membership, higher Step 1 scores, and excellent personal statements and those who were male or Asian. However, the only significant predictors were Step 1 scores (relative risk [RR], 1.36 for every 10-U increase), publications (RR, 2.20), personal statements (RR, 1.62), and Asian race (RR, 1.70 vs white). Alpha Omega Alpha membership (RR, 1.62) and Step 1 scores (RR, 1.01) were the only variables predictive of ranking in the top 5.
  
  
  CONCLUSIONS
  This national sample shows GSR is a highly competitive, sex-neutral discipline in which academic performance is the most important factor for ranking, especially in the most competitive programs. This study will inform applicants and program directors about applicants to the GSR program.
authors.affiliation: Department of Surgery, Albany Medical College, Albany, New York 12208-3479, USA. stains@mail.amc.edu
authors.forename: Steven C
authors.initials: SC
authors.lastname: Stain
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Hiatt
authors.forename: Ashar
authors.initials: A
authors.lastname: Ata
authors.forename: Stanley W
authors.initials: SW
authors.lastname: Ashley
authors.forename: Kevin K
authors.initials: KK
authors.lastname: Roggin
authors.forename: John R
authors.initials: JR
authors.lastname: Potts
authors.forename: Richard A
authors.initials: RA
authors.lastname: Moore
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Galante
authors.forename: L D
authors.initials: LD
authors.lastname: Britt
authors.forename: Karen E
authors.initials: KE
authors.lastname: Deveney
authors.forename: E Christopher
authors.initials: EC
authors.lastname: Ellison
mesh_terms: D000328:Adult; D002321:Career Choice; D015331:Cohort Studies; D004521:Educational Measurement; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D008297:Male; D012737:Sex Factors; D013337:Students, Medical; D014481:United States; D055815:Young Adult