Abstract
Purpose
As surgical residency programs adopt a holistic review, it is important to understand how applicants’ past educational decisions and future practice goals relate. This study aimed to better understand trainees’ educational and career decisions, which can be used to inform evolving holistic review practices.
Methods
This qualitative study consisted of in-person, semi-structured interviews with residents at one Midwestern, community-based general surgery program (October 2019–March 2020). The interview guide domains were: background, residency selection, work hours, professionalization, wellness, teaching, and future plans. Interviews were audio recorded and transcribed verbatim. We used NVivo to facilitate inductive coding, then thematic network analysis. The first author completed the codebook and consulted with the second author on the final thematic network.
Results
Of 30 residents, 13 (43.3%) participated. Primary themes were: (1) Values, (2) Knowledge, (3) The Profession, and (4) Place. Interviewees shared a range of experiences that shaped career interests, such as shadowing. As medical students, interviewees observed resident behavior and treatment, which affected residency program applications and inclinations toward future behaviors. Interviewees identified “good surgeon” characteristics, such as technical skills and clinical judgment. They also observed “work/life integration” behaviors that influenced their future practice plans, such as a desire not to “live” in the hospital. Educational decisions were also shaped by geographic preferences.
Conclusions
Values, knowledge, and role modeling witnessed during shadowing and medical school, and geographic preferences related to familiarity and lifestyle were influential in surgical residents’ educational decisions and future practice plans. Without Step 1 scores, program directors may want to consider analyzing application materials for these or similar themes as a way to examine alignment between applicants’ experiences and key aspects of their programs’ missions.
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Availability of data and materials
The data collected and analyzed in the current study are not publicly available because they consist of verbatim transcripts available only to the study team per Institutional Review Board requirements. Excerpts may be available from the corresponding author on reasonable request.
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Acknowledgements
The authors gratefully acknowledge Dr. Michael Porter, Dr. Kyle Vincent, and Ms. Dawn Fountain of the University of Kansas School of Medicine-Wichita for their support and expertise.
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Hughes, D., Brooks, J.V. Aligning applicant goals and program mission: using qualitative research to inform holistic review. Global Surg Educ 2, 11 (2023). https://doi.org/10.1007/s44186-022-00084-3
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DOI: https://doi.org/10.1007/s44186-022-00084-3