Predicting Resident Performance from Preresidency Factors: A Systematic Review and Applicability to Neurosurgical...

Area of Science:

• Medical Education
• Surgical Training
• Resident Selection

Background:

• Neurosurgical educators seek optimal applicant identification.
• Formal study of resident selection processes is difficult.
• This review addresses objective and subjective preresidency factors predicting resident success.

Purpose of the Study:

• To systematically review preresidency factors (PRFs) predicting neurosurgery resident success (RS).
• To identify objective and subjective factors correlating with residency outcomes.
• To assess the evidence base for neurosurgery resident selection.

Main Methods:

• Systematic review of PubMed, ProQuest, Embase, and CINAHL (1952-2015).
• Inclusion of studies on PRFs and RS across surgical subspecialties.
• Qualitative summary and heat map due to data heterogeneity.

Main Results:

• 21 of 1489 studies met criteria, evaluating 1276 residents across five surgical subspecialties; no neurosurgery-specific studies included.
• Objective factors: Standardized test scores correlated well with in-training/board exams but poorly with faculty evaluations.
• Subjective factors: Aggregate rank scores, letters of recommendation, and extracurricular talents moderately correlated with faculty evaluations.

Conclusions:

• Standardized testing predicts exam performance but not faculty evaluations.
• Aggregate rank scores, recommendations, and extracurriculars moderately predict faculty evaluations.
• Evidence for predicting neurosurgery resident success is limited, supporting a national prospective study for improved selection.