Podium IIIB - Recruitment / Selection
(S054) THEMATIC DIFFERENCES IN GENERAL SURGERY RESIDENCY PERSONAL STATEMENTS: IMPLICATIONS FOR HOLISTIC REVIEW
Usman Y Panni, MD1, Tiffany Brocke, MD1, Ariana Naaseh, MD1, Nikki Rossetti, MD1, Shinji Rho1, Catherine Zivanov, MD1, Angela Hill, MD1, Seye Oduyale, MD1, Sabrya Jalal2, Maddie Hodous1, Angela Colbeck1, Christa Donald1, Jennifer Yu, MD1, Paul Wise, MD1; 1Washington University in St. Louis, 2University of Kansas Medical Center
Background:
With general surgery residency becoming increasingly competitive and a move away from traditional metrics like Step 1 scores, there is a push to develop holistic review processes that can identify applicants best suited for residency training. Personal statements allow applicants to share their traits and experiences, but they also introduce subjectivity, potentially leading to bias. In this study, we reviewed personal statements to explore which themes were common among applicants invited for interviews versus those who were not.
Methods:
We analyzed the personal statements of 295 randomly selected applicants from the 2023-2024 cycle. Each statement was reviewed by two reviewers, and 24 distinct themes were extracted. Applicants were scored as low, average, or high in each theme. A comparative analysis was conducted to assess the strength of these themes across interview status, gender, and underrepresented minority (URM) status.
Results:
The gender and URM proportions of the 295 applicants mirrored the overall applicant pool of approximately 1300 applicants. The most common themes across all applicants were “self-discovery”, “mastery”, “teamwork”, “compassion”, and “responsibility toward patients”. The personal statements of interviewed applicants frequently scored high on responsibility, mastery, intellectual curiosity, and a commitment to applying research to patient care. Female applicants were more likely to score high in themes about patient connections but lower in mastery. Male applicants more often scored low in discipline but higher in academic research interests. URM applicants frequently scored high on social justice, cultural competence, and resilience but scored lower for intellectual curiosity. In addition, applicants who were placed high on a rank list after interview had described themes of patient empowerment and strategical thinking.
Conclusion:
Our results show distinct differences in themes between high- and low-ranking applicants, with notable variations by gender and URM status. These findings underscore the inherent subjectivity in personal statements and its potential influence on the residency selection process.
(S055) RETURN OF IN-PERSON INTERVIEWS: WILL APPLICATION NUMBERS TO SURGICAL FELLOWSHIPS BEGIN TO DECLINE?
Sophia Williams-Perez, MD, Brian Bednarski, MD, MEHP, Elizabeth Grubbs, MD, Christopher Scally, MD, MS, Heather Lillemoe, MD; The University of Texas MD Anderson Cancer Center
Introduction: The COVID-19 pandemic led to significant training modifications for surgical residents with decreased operative volume and changes to specialty exposure. Further, fellowship interviewing transitioned from in-person to virtual formats. The effect of the pandemic on surgical fellowship application trends has not been assessed. Herein, we characterized trends in the surgical fellowship application process surrounding the COVID-19 pandemic.
Methods: This cross-sectional study used the National Resident Matching Program (NRMP) and Electronic Residency Application Service (ERAS) to extract publicly available data for colon and rectal surgery (CRS), surgical oncology, pediatric surgery, surgical critical care (SCC), thoracic surgery, and vascular surgery from 2017-2024. ERAS data excluded SCC, which uses a separate application service. Data were analyzed using descriptive statistics.
Results: The total number of applicants to surgical fellowships increased by 19%, from 748 applicants in 2017 to 890 applicants in 2024 (Figure 1). After the first year of virtual interviews in 2020, there was the largest increase in applicants, especially for SCC (+45.6%). The number of applicants continued increasing across all specialties until 2024. The total number of submitted applications increased in all specialties (+37.4%) during the study period. This was most pronounced following the pandemic’s start in 2020, when the number of applications submitted increased annually for almost all specialties. However, in the 2023-2024 application cycle when the AAMC no longer required virtual interviews, the number of applications submitted decreased in all specialties except for thoracic surgery, and the number of applicants decreased in all specialties except in CRS and surgical oncology. Concomitantly, the match percentages increased that cycle for all specialties except CRS and surgical oncology.
Conclusions: The overall number of applicants and applications submitted to surgical fellowships has increased since prior to the COVID-19 pandemic. The largest increases occurred in the year immediately following the pandemic’s inception, particularly in surgical critical care. As fellowship programs return to in-person interviews, the number of applicants per specialty and submitted applications has started to decrease. The return of in-person interviews may begin to combat application inflation, and it is important to consider its financial impact on applicants.
(S056) IMPROVING THE RESIDENT INTERVIEW PROCESS WITH STRUCTURAL AND STATISTICAL BIAS CORRECTION
Sultan Abdelhamid, Zaid Haddadin, Afshin Parsikia, Threshia Malcolm, Benjamin Moran, Ramsey Dallal; Einstein Jefferson
Introduction: Biases in the general surgery interview selection process may exclude promising students from a residency program. There are biases inherent to both the evaluator and the structure of the interview process. Several studies have questioned the reliability of the interview process. We aimed to improve the resident interview structure through structural improvements in the interview and increasing the validity of the selection methodology.
Methods: We performed a prospective comparative analysis of our general surgery residency interview process over two consecutive academic years (AY 2022 and 2023). We used descriptive statistics and a mixed-effects ordered logit model to measure bias and guide process improvement.
Results: Eighty total students were interviewed. We found numerous statistical biases, including leniency bias exacerbated by the unequal distribution of evaluators, significant differences in the variance from evaluator’s scoring (p<0.0001), and non-normal distribution (p<0.001). Rater reliability was “good” in both years: 0.69 (C.I. 0.51-0.82). Using uncorrected means, on average, each student was statistically different from 11.5±1.1 other students. Using our model, we improved the number of statistically distinct groupings as each student now differed by 30±1.0 others (p<0.0001). In AY23, we restructured the interviews so that all the evaluators scored every student, which significantly improved the interview accuracy using the same mixed model: R-squared of 0.95 versus 0.70, and a smaller percent of students had a change in their rank using the improved structure (57% versus 90%, p<0.05), compared to AY22.
Conclusions: Among a pool of students applying for general surgery residency at a single institution, our study shows that using the uncorrected evaluators’ impressions results in a minimal distinction between any of the candidates except at the extremes of the score range, statistically demonstrating that the interview, in its raw form, cannot be a valuable tool in the resident selection. Due to numerous statistical biases, there is little differentiation between students and thus little validity in scoring students using raw mean scores. This can be overcome by developing a structured interview and correcting for statistical biases. We suggest that interviews be independently performed (not in a group), and evaluators should be blinded to others’ impressions.
(S057) ADDRESSING SURGICAL RESIDENCY APPLICANTS' PRIORITIES: INSIGHTS FROM SECONDARY APPLICATION RESPONSES
Alayna Craig-Lucas, MD, Michael Villeneuve, MD, Arjumand Ali, MD, Daniel Relles, MD; Lehigh Valley Health Network
Background: Surgical residency programs are challenged to meet the evolving expectations of incoming residents who seek not only technical skills but also support systems that foster professional growth and personal well-being. To determine perspectives of current applicants we analyzed secondary application responses to question “How can Surgery training be improved”
Methods: A qualitative analysis of two hundred and eighty secondary application responses was conducted to capture applicants' ideas for improvement in surgical training. Themes were identified around simulation-based practice, mentorship, feedback mechanisms, technical skill development, interdisciplinary exposure, and wellness.
Results: Applicants highlighted simulation-based training, including the integration of AI and augmented reality, as essential for skills development outside the OR. Strong mentorship, where seasoned surgeons guide early-career residents, was cited as a critical factor for a successful residency. Additionally, applicants expressed a need for regular, constructive feedback to drive consistent improvement. Increased opportunities for hands-on experience and autonomy in the OR were viewed as central to technical competence. Emphasis was also placed on interdisciplinary collaboration to ensure comprehensive patient care, and a focus on wellness and work-life balance was recognized as essential for sustaining both personal health and professional excellence.
Conclusion: Insights from this review suggest that today’s surgical residency applicants seek a balanced training experience that combines advanced simulation, mentorship, and mental health support with core surgical training. By addressing these priorities, programs can cultivate an environment that aligns with applicants' expectations and prepares them to thrive both in and beyond the OR.
(S058) IMPLEMENTING CULTURAL HUMILITY TRAINING: EMPOWERING LEARNERS AND SURGEONS TO ADDRESS BIAS AND IMPROVE PATIENT CARE
Brandon Apagüeño, MS, Mary P Martos, MD, Ana M Reyes, MD, Alexandra Hernandez, MD, MPH, Oluwantumininu Akintowa, MD, Timothy Ko, BA, Nicholas Eynon, BS, Miriam G Lipsky, PhD, Heidi Allespach, PhD, Mehmet Akin, PhD, Shevonne Satahoo, MD, Stefan Kenel-Pierre, MD, Patricia M Byers, MD, FACS; University of Miami Miller School of Medicine
Introduction: Bias, discrimination, and microaggressions are pervasive in surgical education, and can affect the learning environment and patient outcomes. Up to 50% of surgical residents report experiencing some form of mistreatment. Patients experience higher complication rates and report lower satisfaction when treated by racially or gender-biased teams. While most surgical training programs have recognized that awareness of cultural issues is important, many lack structured approaches to address them. The objective of our study was to explore the benefits of implementing a cultural humility curriculum at our institution.
Methods: We adapted the “To Err is Helpful” Cultural Complications Curriculum (Harris) into virtual, hour-long sessions which were presented at our surgical grand rounds conference during the 2023-2024 academic year. Scenarios of bias and discrimination covered 12 distinct themes. Participants were divided into break-out rooms by academic status (medical students, residents/fellows, faculty) to allow for open communication. Small group discussions were relayed back to the larger group anonyomously by designated reporters. Post-program surveys were administered to all program participants.
Results: Of 51 individuals who completed the survey, the majority were male (61%) and white (65%). 41% of respondents were medical students, 20% were fellows, and 33% were faculty. 98% of respondents agreed that understanding issues of diversity, equity, and inclusion (DEI) are important to delivering good patient care. 67% reported that the curriculum provided them with strategies for addressing issues of discrimination and/or harassment, and 41% had used the strategies. 92% stated it was important to continue the Cultural Complications program. Among medical students, 48% reported that the curriculum positively impacted their perception of the surgery department and 29% reported that it positively influenced their desire to pursue a surgical specialty.
Conclusion: The Cultural Complications Curriculum is a valuable tool for empowering learners and surgeons to recognize and address bias. The high proportion of participants who felt equipped with strategies for addressing bias is encouraging. Fewer participants had used the strategies, highlighting the need for continued DEI training. Future evaluations will consider the influence of participant demographics on perceptions and outcomes of the program.
(S059) FROM PRELIMINARY TO CATEGORICAL: A SUPPORTIVE CURRICULUM FOR GENERAL SURGERY RESIDENCY RE-APPLICATION
Alyssa Justus, MD, Baila Maqbool, MD, FACS; University of New Mexico
]Introduction
With increasing competitiveness in residency applications, 18% of applicants across all specialties went unmatched in 2023. For general surgery applicants, particularly those in preliminary positions, securing a categorical role remains a significant challenge. Current research on mentorship specific to general surgery preliminary residents aiming for categorical re-application is limited. Preliminary residents often rely on informal mentorship rather than structured guidance, which may impact their re-application success and confidence.
Development of Curriculum
We conducted a survey among general surgery preliminary residents at our institution over the past five years, achieving a 41% response rate (7/17). Results indicated a reluctance to disclose mentorship experiences; only one resident rated official mentorship on re-application as above average. Respondents reported independently seeking guidance from past preliminary residents. To address these issues, we developed a structured curriculum led by former preliminary residents, covering:
- Curriculum Topics: CV and personal statement writing, obtaining letters of recommendation, dual application strategies, program selection, interview skills, mock interviews, and SOAP process preparation.
- Session Design: Group sessions aligned with the ERAS timeline and integrated with existing faculty mentorship schedules to support focused, one-on-one mentorship interactions.
Preliminary results indicate that participants gained valuable insights and planned to adjust their application strategies based on the curriculum. Faculty mentors also noted that residents appeared more prepared and engaged in mentorship sessions than in prior years, suggesting an increase in self-confidence and application readiness.
Conclusion
This targeted curriculum for general surgery preliminary residents offers a structured, peer-led framework to strengthen re-application skills, foster professional development, and potentially improve match outcomes. Ongoing evaluation will further assess its long-term impact on categorical match success.