Cofer J B, Biderman M D, Lewis P L, Potts J R, Laws H L, O'Leary J P, Richardson J D
University of Tennessee College of Medicine, Chattanooga Unit, Department of Surgery, 979 East Third Street, Suite 401, 37403, Chattanooga, TN 37403, USA.
Am J Surg. 2001 Jan;181(1):44-9. doi: 10.1016/s0002-9610(00)00530-4.
Among directors of general surgery residencies, there is a concern that the quality of medical students applying to surgical residencies is declining.
Quality of surgical applicants was assessed by several methods including subjective opinions determined by survey and by objective data including student United States Medical Licensing Examination (USMLE) scores of matched candidates. The number of applicants interviewed, total interviews granted, proportion of Alpha Omega Alpha (AOA) students, and the rank order of the candidates matched was obtained by survey. The survey included data on postgraduate year 1 (PGY-1) residents from July 1996 to July 1999. Three mailings were made to 226 US surgical residency programs.
Data were obtained from 90 programs. Surgery program directors disagreed with a survey statement that overall quality of applicants had declined (P <0.01), but agreed with a statement that activities of medical schools to enroll graduating students into primary care had hurt recruitment (P <0.001). Objective data revealed no change in mean USMLE part I scores of PGY-1 residents over the 4 years (P = 0.265, power = 0.81). There was no change in proportion of matched residents who were AOA over time. The mean score of all new PGY-1 residents, the rank of the first matched resident, the rank of the last ranked resident, and proportion of AOA students was higher in programs with five or more categorical spots when compared with programs of at most four (P <0.001). Across all programs, there was a trend to go lower on the rank list to fill categorical positions over time (P <0.001).
There is a perception that medical school policies act to discourage recruitment of quality medical students into general surgery programs, and surgery programs are going deeper into their rank lists to fill categorical positions. However, the average USMLE part I score of applicants to surgical residencies and proportion of AOA applicants has not decreased.
普通外科住院医师培训项目主任担心申请外科住院医师培训的医学生质量在下降。
通过多种方法评估外科申请者的质量，包括通过调查确定的主观意见以及客观数据，如匹配候选人的美国医师执照考试（USMLE）成绩。通过调查获得面试申请者的数量、给予的总面试次数、阿尔法欧米伽阿尔法（AOA）学生的比例以及匹配候选人的排名顺序。该调查包括1996年7月至1999年7月一年级住院医师（PGY-1）的数据。向226个美国外科住院医师培训项目进行了三次邮件发送。
从90个项目中获得了数据。外科项目主任不同意关于申请者总体质量下降的调查陈述（P<0.01），但同意关于医学院校招收毕业生进入初级保健领域的活动损害了招聘工作的陈述（P<0.001）。客观数据显示，在这4年中，PGY-1住院医师美国医师执照考试第一部分的平均成绩没有变化（P = 0.265，检验效能 = 0.81）。随着时间的推移，匹配住院医师中AOA的比例没有变化。与最多有4个分类名额的项目相比，有5个或更多分类名额的项目中，所有新PGY-1住院医师的平均成绩、第一个匹配住院医师的排名、最后一名住院医师的排名以及AOA学生的比例更高（P<0.001）。在所有项目中，随着时间的推移，为填补分类职位，排名列表上的排名有下降趋势（P<0.001）。
有一种看法认为，医学院校政策不利于吸引高质量医学生进入普通外科项目，并且外科项目正在深入其排名列表以填补分类职位。然而，申请外科住院医师培训的申请者的美国医师执照考试第一部分平均成绩以及AOA申请者的比例并没有下降。
