A Practical Approach for Implementing Holistic Review for General Surgery Resident Recruitment

To describe the implementation of a holistic review process in an academic general surgery residency program.

Creation of a Residency Recruitment Committee and formal applicant evaluation using a 5-attribute rubric. The rubric evaluates clinical and academic excellence, leadership skills, integrity, work ethic, and interest in academic surgery. We incorporated implicit bias training in this process. Recommendations were made on whether to offer interviews.

A single academic institution in the United States.

Faculty and residents serving as application reviewers.

The holistic review process was successfully implemented, with 26 to 38 evaluators reviewing 22 to 28 applications each. A transparent, structured approach helped select applicants for interviews whose missions and values aligned with the program. Once chosen for an interview, applicants are asked standardized interview questions, such as their reaction to stressful circumstances and ability to work in a team. Finally, all members of the Resident Recruitment Committee are invited to attend the rank list meeting.

Holistic review is a comprehensive and feasible approach to improving transparency in residency selection while promoting the recruitment of diverse candidates. While our program prioritizes academic development, the rubric and process can be adapted for programs with different priorities. Long-term evaluation of outcomes is needed to assess its broader impact on resident recruitment and retention.