Innate Versus Acquired: A Review of Predictive Technical Aptitude Assessments in Surgical Trainee Selection

The evaluation and selection process of similarly qualified applicants for surgical residency positions in the United States (US) is challenging. Technical aptitude assessments may provide an opportunity to improve the selection process by offering insight into a candidate's technical skills. The use of these assessments prompts consideration of the degree to which technical aptitude in surgery is innate versus acquired. In this narrative review, we review the state of these assessments and the limitations of developing and validating these instruments.

Recent evidence suggests that technical aptitude can be quantified in medical students prior to selection for surgical training; however, both technical aptitude and dedicated practice of technical skills influence operative performance. In the US, technical aptitude assessments are inconsistently used in selecting candidates for surgical residency. Internationally, few countries have implemented standardized technical aptitude assessments in their surgical trainee selection processes. The development of technical aptitude assessments is ongoing worldwide. Technical aptitude assessments may help identify individuals particularly well-suited for a surgical career or those who might benefit from additional practice or remediation. The potential role of technical aptitude assessments in the selection process for surgical trainees remains uncertain. Consideration of these instruments requires an understanding of meaningful outcomes associated with particular technical assessments as well as the assessments' limitations.