23. The Utility of the Standardized Letter of Recommendation Form in Assessing Integrated Plastic Surgery Residency Applicants

Abstract

PURPOSE: Identifying the right applicants to train as plastic surgeons is critical for both programs and our specialty. The ACAPS Standardized Letter of Recommendation (SLOR) form serves as an adjunct to narrative letters and is meant to provide objective, comparable data across applicants. The SLOR assesses applicants in 10 domains and asks the evaluator where they would place the applicant on their rank list (Question 6). The utility of the SLOR in predicting Match outcomes has not been studied. METHODS: From the 2020-21 cycle, 100 first-time applicants from US medical schools were randomly selected. Application characteristics were collected from applications submitted to one integrated program. Match outcomes were determined from publicly available data. Logistic regression modeling identified variables that were significant in predicting Match outcomes. RESULTS: The Match rate for this cohort was 69%, consistent with the specialty norm. None of the 10 SLOR domains contributed significantly (p>0.05) to predicting Match outcomes. There were no differences in SLOR scores based on gender or race. However, female gender (p=0.018), older age (p=0.025), higher Step 1 score (p=0.0005), more publications (p=0.0003), and Question 6 (p<0.0001) had a significant role in predicting Match outcomes. These variables alone successfully predicted matching in 93% of applicants using the logistic regression model. CONCLUSIONS: Based on these results, it is time to reconsider the questions and structure of the SLOR form to minimize data overload on evaluators. Further work should be done to identify questions that better stratify applicants in meaningful, unbiased ways.