Advertisement

Selection into Surgical Education and Training

  • John P. CollinsEmail author
  • Eva M. Doherty
  • Oscar Traynor
Chapter
Part of the Innovation and Change in Professional Education book series (ICPE, volume 17)

Overview

Recruitment and selection of appropriate medical graduates to join a surgical education and training programme is a complex, expensive and high-stakes process. Although there is general agreement on the goals of selection, debate continues on how this should be undertaken.

A number of selection methods are used which include the curriculum vitae, letters of recommendation and the interview. More recently, the addition of aptitude testing and personality assessment techniques has been proposed in an effort to recruit trainees with the highest aptitude for surgery and to avoid selecting those whose personality may be unsuitable for such a career.

A critical review of the processes, criteria and methods involved in selection has been undertaken. The key to effective selection is the identification of the person specification required through an analysis of the job of a surgeon and to then design selection criteria based on these requirements. Different and complimentary selection methods are used to provide the best measurements of each of these selection criteria in order to score each applicant. There is currently insufficient evidence of the value of aptitude tests and personality assessments for these to be included as a routine part of the selection of surgical trainees or residents.

Keywords

Surgical education Selection methods Aptitude testing Personality assessment Evaluation Recruitment Career information Person specification Consensus statement Personal statements Interviews Emotional intelligence 

References

  1. 1.
    Louridas, M., Szasz, P., de Montbrun, S., et al. (2016). Can we predict technical aptitude? Annals of Surgery, 263, 673–691.CrossRefGoogle Scholar
  2. 2.
    Schaverien, M. V. (2016). Selection for surgical training: An evidenced-based review. Journal of Surgical Education, 73, 723–729.CrossRefGoogle Scholar
  3. 3.
    Nash, L. M., Daly, M. G., Kelly, P. J., et al. (2010). Factors associated with psychiatric morbidity and hazardous alcohol use in Australian doctors. The Medical Journal of Australia, 193, 161–166.CrossRefGoogle Scholar
  4. 4.
    Gough, M. H., Holdsworth, R., Bell, J. A., et al. (1988). Personality assessment techniques and aptitude testing aids to the selection of surgical trainees. Annals of the Royal College of Surgeons of England, 70, 265–279.Google Scholar
  5. 5.
    Collins, J. P. (2009). Editorial overview of proceedings. ANZ Journal of Surgery, 79, 96–99.CrossRefGoogle Scholar
  6. 6.
    Ash, R. A. (1998). Job analysis in the world of work. In S. Gael (Ed.), The job analysis handbook (pp. 3–13). New York: Wiley.Google Scholar
  7. 7.
    Stevenson, H., & Henley, S. (1989). Job analysis report on the role of the surgeon. Thames Ditton: Saville and Holdsworth Ltd.Google Scholar
  8. 8.
    Collins, J. P., Gough, I. R., Civil, I. D., & Stitz, R. W. (2007). A new surgical education and training programme. ANZ Journal of Surgery, 77, 497–501.CrossRefGoogle Scholar
  9. 9.
    Patterson, F., Ferguson, E., & Thomas, S. (2008). Using job analysis to identify core and specific competencies: Implications for selection and recruitment. Medical Education, 42, 1195–1204.CrossRefGoogle Scholar
  10. 10.
    Goldacre, M. J., Turner, G., & Lambert, T. W. (2004). Variation by medical school in career choices of UK graduates of 1999 and 2000. Medical Education, 38, 249–258.CrossRefGoogle Scholar
  11. 11.
    Collins, J. P. (2010). Foundation for excellence – an evaluation of the foundation programme. www.agcas.org.uk/assets/download?file=2053&parent=793.
  12. 12.
    Barden, D. M. (2008). Chronical careers: The unreliability of references. The Chronicles of Higher Education. www.chronicle.com/article/the-unreliability-of/45931.
  13. 13.
  14. 14.
    Kenny, S., McInnes, M., & Singh, V. (2013). Associations between residency selection strategies and doctor performance: A meta-analysis. Medical Education, 47(8), 790–800.CrossRefGoogle Scholar
  15. 15.
    Maker, V. K., Zahedi, M. M., Villines, D., et al. (2012). Can we predict which residents are going to pass/fail the oral boards? Journal of Surgical Education, 69, 705–713.CrossRefGoogle Scholar
  16. 16.
    Paolo, A. M., & Bonaminio, G. (2003). Measuring outcomes of undergraduate medical education: Residency directors’ ratings of first-year residents. Academic Medicine, 78, 90–95.CrossRefGoogle Scholar
  17. 17.
    Robertson, C. M., Klingensmith, M. E., & Coopersmith, C. M. (2007). Long-term outcomes of performing a postdoctoral research fellowship during general surgery residency. Annals of Surgery, 245, 516–523.CrossRefGoogle Scholar
  18. 18.
    Daly, K. A., Levine, S. C., & Adams, G. L. (2006). Predictors for resident success in otolaryngology. Journal of the American College of Surgeons, 202, 649–654.CrossRefGoogle Scholar
  19. 19.
    Dirschl, D. R., & Adams, G. L. (2000). Reliability in evaluating letters of recommendation. Academic Medicine, 75, 1029.CrossRefGoogle Scholar
  20. 20.
    Friedman, R. B. (1983). Fantasy Land. The New England Journal of Medicine, 308, 651–653.CrossRefGoogle Scholar
  21. 21.
    Oldfield, Z., Beasley, S. W., Smith, J., Anthony, A., et al. (2013). Correlation of selection scores with subsequent assessment scores during surgical training. ANZ Journal of Surgery, 83, 412–416.CrossRefGoogle Scholar
  22. 22.
    White, J. S., Lemay, J. F., Brownell, K., et al. (2011). “A chance to show yourself” – how doapplicants approach medical school admission essays? Medical Teacher, 33, e541–e548.CrossRefGoogle Scholar
  23. 23.
    Gough, M., & Bell, J. (1989). Introducing aptitude testing into medicine – surgeons lead the way. BMJ, 298, 975–976.CrossRefGoogle Scholar
  24. 24.
    Deary, I. J., Graham, K. S., & Maran, A. G. (1992). Relationships between surgical ability ratings and spatial abilities and personality. Journal of the Royal College of Surgeons of Edinburgh, 37, 74–79.Google Scholar
  25. 25.
    Gallagher, A. G., Cowie, R., Crothers, I., et al. (2003). PicSOr: An objective test of perceptual skill that predicts laparoscopic technical skill in three initial studies of laparoscopic performance. Surgical Endoscopy, 17, 1468–1471.CrossRefGoogle Scholar
  26. 26.
    Carretta, T. R., & Ree, M. J. (1996). U.S. air force pilot selection tests: What is measured and what is predictive? Aviation, Space, and Environmental Medicine, 67, 279–283.Google Scholar
  27. 27.
    Buckley, C. E., Kavanagh, D. O., & Gallagher, T. K. (2013). Does aptitude influence the rate at which proficiency is achieved for laparoscopic appendectomy? Journal of the American College of Surgeons, 217, 1020–1027.CrossRefGoogle Scholar
  28. 28.
    Buckley, C. E., Kavanagh, D. O., & Nugent, E. (2014). The impact of aptitude on the learning curve for laparoscopic suturing. American Journal of Surgery, 207, 263–270.CrossRefGoogle Scholar
  29. 29.
    Gallagher, A. G., Leonard, G., & Traynor, O. J. (2009). Role and feasibility of psychomotor and dexterity testing in selection for surgical training. ANZ Journal of Surgery, 79, 108–113.CrossRefGoogle Scholar
  30. 30.
    Papadakis, M. A., Teherani, A., Banach, M. A., et al. (2005). Disciplinary action by medical boards and prior behaviour in medical school. The New England Journal of Medicine, 22(353), 2673–2682.CrossRefGoogle Scholar
  31. 31.
    Bruinsma, W. E., Becker, S. J., Guitton, T. G., et al. (2015). How prevalent are hazardous attitudes among orthopaedic surgeons? Clinical Orthopaedics and Related Research, 473, 1582–1589.CrossRefGoogle Scholar
  32. 32.
    Kadzielski, J., McCormick, F., & Herndon, J. H. (2015). Surgeons’ attitudes are associated with reoperation and readmission rates. Clinical Orthopaedics and Related Research, 473, 1544–1551.CrossRefGoogle Scholar
  33. 33.
    Doherty, E. M., & Nugent, E. (2011). Personality factors and medical training: A review of the literature. Medical Education, 45, 132–140.CrossRefGoogle Scholar
  34. 34.
    Patterson, F., Knight, A., Dowell, J., et al. (2015). How effective are selection methods in medical education? A systematic review. Medical Education, 50, 36–60.CrossRefGoogle Scholar
  35. 35.
    Mayer, J. D., Roberts, R. D., & Barsade, S. G. (2008). Human abilities: Emotional intelligence. Annual Review of Psychology, 59, 507–536.CrossRefGoogle Scholar
  36. 36.
    Cook, C. J., Cook, C. E., & Hilton, T. N. (2016). Does emotional intelligence influence success during medical school admissions and program matriculation? A systematic review. Journal of Education Evaluation for Health Professions, 13, 40.CrossRefGoogle Scholar
  37. 37.
    Prideaux, D., Roberts, C., Eva, K., et al. (2011). Assessment for selection for the health care professions and specialty training: Consensus statement and recommendations from the Ottawa 2010 conference. Medical Teacher, 33, 215–223.CrossRefGoogle Scholar
  38. 38.
    Rosenfeld, J. M., Reiter, H. I., Trinh, K., et al. (2008). A cost efficiency comparison between the multiple mini-interview and traditional admissions interviews. Advances in Health Sciences Education: Theory and Practice, 13, 43–58.CrossRefGoogle Scholar
  39. 39.
    Stephenson-Famy, A., Houmard, B. S., Manyak, A., et al. (2015). Use of the interview in resident candidate selection: A review of the literature. Journal of Graduate Medical Education, 7, 539–548.CrossRefGoogle Scholar
  40. 40.
    Eva, K. W., Rosenfeld, J., & Reiter, H. I. (2004). An admissions OSCE: The multiple mini-interview. Medical Education, 38, 314–326.CrossRefGoogle Scholar
  41. 41.
    Knorr, M., & Hissbach, J. (2014). Multiple mini-interviews: Same concept, different approaches. Medical Education, 48, 1157–1175.CrossRefGoogle Scholar
  42. 42.
    Reiter, H. I., Eva, K. W., & Rosenfeld, J. (2007). Multiple mini-interviews predict clerkship and licensing examination performance. Medical Education, 41, 378–384.CrossRefGoogle Scholar
  43. 43.
    Smith, F. (2016). Will behavioural-based interviewing improve resident selection and decrease attrition? Journal of Graduate Medical Education, 8, 280.CrossRefGoogle Scholar
  44. 44.
    Petty-Saphon, K., Walker, K. A., & Patterson, F. (2016). Situational judgment tests reliably measure professional attributes important for clinical practice. Advances in Medical Education and Practice, 8, 21–23.CrossRefGoogle Scholar
  45. 45.
    Quintero, A. J., Segal, L. S., & King, T. S. (2009). The personal interview: Assessing the potential for personality similarity to bias the selection of orthopaedic residents. Academic Medicine, 84, 1364–1372.CrossRefGoogle Scholar
  46. 46.
    Laurence, C. O., Zajac, I. T., Lorimer, M., et al. (2013). The impact of preparatory activities on medical school selection outcomes: A cross-sectional survey of applicants to the University of Adelaide Medical School in 2007. BMC Medical Education, 13, 159.CrossRefGoogle Scholar
  47. 47.
    Roberts, C., Walton, M., & Rothnie, I. (2008). Factors affecting the utility of the multiple mini-interview in selecting candidates for graduate-entry medical school. Medical Education, 42, 396–404.CrossRefGoogle Scholar
  48. 48.
    Standards for Assessment and Accreditation of Specialist Medical … (Standards 6 &7). (2015). www.amc.org.au/files/2c1fb12996b0f6e6e5cb5478dde9d9e991409359_original.pdf.
  49. 49.
    Rosenstein, A. H., & O ‘Danie, M. (2008). A survey of the impact of disruptive behaviour and communication defects on patient safety. Joint Commission Journal on Quality and Patient Safety, 34, 464–471.CrossRefGoogle Scholar
  50. 50.
    Satin, B., & Kaups, K. (2015). The disruptive physician. ACS Bull, 100, 20–24.Google Scholar
  51. 51.
    Crebbin, W., Campbell, G., Hillis, D., et al. (2015). Prevalence of bullying, discrimination and sexual harassment in surgery in Australasia. ANZ Journal of Surgery, 85, 905–909.CrossRefGoogle Scholar
  52. 52.
    Collins, J. P. (2011). International consensus statement on surgical education and training in an era of reduced working hours. The Surgeon, S2–S5.Google Scholar
  53. 53.
    Whitfield, N., & Schlich, T. (2015). Skills through history. Medical History, 59, 349–360.CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • John P. Collins
    • 1
    • 2
    Email author
  • Eva M. Doherty
    • 3
  • Oscar Traynor
    • 3
  1. 1.University of MelbourneMelbourneAustralia
  2. 2.University of OxfordOxfordUK
  3. 3.Royal College of Surgeons in IrelandDublinIreland

Personalised recommendations