title: An objective evaluation of a multi-component, competitive, selection process for admitting surgeons into higher surgical training in a national setting.
abstract: BACKGROUND
  Changing work practices make it imperative that surgery selects candidates for training who demonstrate the spectrum of abilities that best facilitate learning and development of attributes that, by the end of their training, approximate the characteristics of a consultant surgeon.
  
  
  OBJECTIVE
  The aim of our study was to determine the relative merits of components of a program used for competitive selection of trainees into higher surgical training (HST) in general surgery.
  
  
  METHODS
  Applicants (N = 98, males 69, mean age 31 years [range 29-40]) to the Royal College of Surgeons in Ireland program for HST in general surgery between 2006 and 2008 were assessed. Clinical, basic surgical training, logbook, research performance, and reference scores were evaluated. A total of 51 candidates were shortlisted and completed a further objective assessment of their technical skills and interview performances.
  
  
  RESULTS
  Shortlisted candidates performed better (p < 0.003) on all assessed parameters. Compared with candidates who were not selected for HST, those who were selected (N = 31) significantly outperformed on individual assessments and overall (p < 0.0001). Logistic regression analysis showed that clinical, technical skills, and research assessments, but not interview, predicted (92.2 %) HST selection outcomes.
  
  
  CONCLUSIONS
  Candidates selected for the national HST program in Ireland consistently outperformed those who were not. The assessments reliably and consistently distinguished between candidates, and all of the assessed parameters (except interview) contributed to a highly predictive selection model. This is the largest reported dataset from an objective, transparent, and fair assessment program for selection of the next generation of surgeons.
authors.affiliation: The ASSERT (Application of Science to Simulation, Education and Research on Training) for Health Centre, School of Medicine, University College Cork, Brookfield Health Sciences Complex, College Road, Cork, Ireland, ag.gallagher@ucc.ie.
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Gallagher
authors.forename: Gerald C
authors.initials: GC
authors.lastname: O'Sullivan
authors.forename: Paul C
authors.initials: PC
authors.lastname: Neary
authors.forename: Sean M
authors.initials: SM
authors.lastname: Carroll
authors.forename: Gerald
authors.initials: G
authors.lastname: Leonard
authors.forename: Brendan P
authors.initials: BP
authors.lastname: Bunting
authors.forename: Oscar
authors.initials: O
authors.lastname: Traynor
mesh_terms: D000328:Adult; D002983:Clinical Competence; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D016015:Logistic Models; D008297:Male; D015233:Models, Statistical; D010560:Personnel Selection / Q000458:organization & administration*