Factors Considered When Ranking Military Orthopedic Surgery Residency Candidates

Mil Med. 2020 Jun 4;usaa101. doi: 10.1093/milmed/usaa101. Online ahead of print.


Introduction: The intangible personal characteristic grit has become a popular topic of concentration within contemporary psychology studies. Grit is defined as persistent work on a focused topic for an extended period of time until a desired goal is achieved. Its application to physician selection and development is not well known. We sought to determine which factors were considered most important among leadership within the U.S. Army's orthopedic surgical training programs when selecting applications and ascertain if grit was one of the primary factors.

Materials and methods: A standardized, 18-question survey was sent to all program chairs, program directors, and assistant program directors at the six U.S. Army orthopedic surgery residency programs. Questions included demographic factors pertaining to both the individual and their respective training program. Participants were asked to rank, in order, the 10 most important variables when considering applicants. Each variable was ranked using a point system (1-10 with 10 as the best score), referred to as the factor score (FS). Further statistical analyses using descriptive statistics, paired t-test, and ANOVA were performed and reported.

Results: The response rate was 83% (15/18). The most important variable considered was the applicant's performance on their audition rotation (FS = 9.8), which was significantly more important than any other variable (P = 0.001). The second most important variable was the applicant's USMLE scores (FS = 7.13), followed by involvement in research (FS = 5.60) and conscientiousness (FS = 4.73), respectively. Grit was considered the fifth most important variable (FS = 4.27). There was no significant difference in the ranking of grit among the different programs (P = 0.282). In applicants with low United States Medical Licensing Examination scores according to leadership idiosyncrasy, their audition rotation was considered a redeeming portion of their application (P = 0.02) followed by their level of grit.

Conclusions: The most important factor when considering an orthopedic surgery applicant was how well the applicant performed on an audition rotation, followed by their United States Medical Licensing Examination scores. Grit has become an important consideration in resident selection.