title: Predicting Success of Preliminary Surgical Residents: A Multi-Institutional Study.
abstract: OBJECTIVE
  A nondesignated preliminary surgery (NDPS) position encompasses 1 year of training provided by many general surgery residencies. Our aim was to assess factors predicting success and provide evidence for program directors to support career guidance to preliminary residents.
  
  
  METHODS
  Retrospective cohort study of 221 NDPS residents who entered 5 university-based institutions were identified from 2009 to 2013. Records for trainees were reviewed. We defined primary success as obtaining a categorical position in the specialty of choice and secondary success as obtaining a categorical position in any specialty immediately after finishing their NDPS training. Statistical evaluation was performed using chi-square analysis, independent t-test and logistic regression using α <0.05.
  
  
  RESULTS
  Of the 221 NDPS residents, 217 (98%) completed postgraduate year (PGY)-1 and 65 (29%) completed PGY-2. Totally, 90 (41%) obtained categorical general surgery positions, 89 (40%) obtained categorical positions in other specialties, and 42 (19%) failed to obtain a categorical position immediately after their NDPS years. Ultimately, 139 (63%) of residents achieved primary success and 40 (18%) additional residents obtained categorical positions in specialties other than their first choice, resulting in a total of 179 (81%) of residents obtaining categorical positions. Mean United States Medical Licensing Examination step 1 and step 2 scores for those who obtained secondary success were 227 and 234 vs. 214 and 219, respectively, for those who failed to secure a categorical position (p < 0.01). United States Medical Licensing Examination step 2 score was a significant predictor of primary (p < 0.03) and secondary success (p < 0.02). Of 65 PGY-2 NDPS residents, 32 (49%) achieved primary success, and 11 (17%) others achieved secondary success for a total of 43 (66%). For PGY-2 NDPS, American Board of Surgery In-Training Examination was the only significant predictor of primary and secondary success (p < 0.02 and p < 0.05).
  
  
  CONCLUSIONS
  NDPS training provides a viable and successful opportunity for at least 81% of young physicians to pursue their career goals even after an unsuccessful first match.
authors.affiliation: Department of Surgery, School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas. Electronic address: Mj.alfayyadh@gmail.com.
authors.forename: Mohammed J
authors.initials: MJ
authors.lastname: Al Fayyadh
authors.affiliation: Department of Surgery, Mayo Clinic, Rochester, Minnesota.
authors.forename: Stephanie F
authors.initials: SF
authors.lastname: Heller
authors.affiliation: Department of Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: Taufiek Konrad
authors.initials: TK
authors.lastname: Rajab
authors.affiliation: Department of Surgery, University of Texas Southwestern, Dallas, Texas.
authors.forename: Aimee K
authors.initials: AK
authors.lastname: Gardner
authors.affiliation: Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: Jordan P
authors.initials: JP
authors.lastname: Bloom
authors.affiliation: Department of Surgery, School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas.
authors.forename: Jeremy A
authors.initials: JA
authors.lastname: Rawlings
authors.affiliation: Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: John T
authors.initials: JT
authors.lastname: Mullen
authors.affiliation: Department of Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Smink
authors.affiliation: Department of Surgery, Mayo Clinic, Rochester, Minnesota.
authors.forename: David R
authors.initials: DR
authors.lastname: Farley
authors.affiliation: Department of Surgery, School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas.
authors.forename: Ross E
authors.initials: RE
authors.lastname: Willis
authors.affiliation: Department of Surgery, School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas.
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Dent
mesh_terms: D000046:Academic Medical Centers; D000076363:Academic Success; D000328:Adult; D019540:Area Under Curve; D002983:Clinical Competence; D015331:Cohort Studies; D004503:Education, Medical, Graduate / Q000379:methods; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D008297:Male; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013043:Specialties, Surgical / Q000706:statistics & numerical data; D014481:United States
keywords: Interpersonal and Communication Skills; Professionalism; Systems-Based Practice; general surgery residency; preliminary residents; resident; success; surgical education