Does Residency Rank List Placement Predict Clinical Performance in Interventional Radiology Training?

Area of Science:

• Medical Education
• Interventional Radiology
• Residency Training

Background:

• The selection process for Interventional Radiology (IR) residents relies on various metrics, but their correlation with actual clinical performance is not well-established.
• Understanding predictive factors for successful IR trainees is crucial for optimizing residency programs.

Purpose of the Study:

• To assess the relationship between Interventional Radiology trainees' residency performance and their National Residency Matching Program (NRMP) rank order list (ROL) placement.
• To identify application metrics that predict strong clinical performance during IR training.

Main Methods:

• Retrospective review of IR residents' application data (2020-2025), including USMLE scores, experiences, publications, and awards.
• Faculty surveys assessed clinical performance based on Accreditation Council for Graduate Medical Education (ACGME) milestones.
• Statistical analysis using Spearman correlation and linear regression evaluated associations between metrics and performance.

Main Results:

• Moderate inter-rater reliability was found for medical knowledge, procedural competence, and patient care assessments.
• No significant correlation was observed between NRMP ROL placement and clinical performance (p=0.82).
• United States Medical Licensing Examination (USMLE) Step 2 score was the sole significant predictor of clinical performance (p=0.01), with a cutoff of 239.

Conclusions:

• NRMP rank order list placement, driven by interviews, may not reliably predict high-performing IR residents.
• USMLE Step 2 scores appear to be a more valuable predictor of clinical success in IR training.