Surgical Skills of Applicants to Residency in Otolaryngology

Abstract

Objective: 1) Measure baseline competence in the performance of a basic surgical task by 4th-year medical students applying to otolaryngology residency. 2) Determine whether information available in the standardized otolaryngology residency application correlates with competence in performance of the basic surgical task. Method: Applicants to residency in otolaryngology with the University of Tennessee Health Science Center in 2010 and 2011 constituted the study population. During the interview, the applicant was asked to close a simulated incision with sutures. A blinded observer recorded a 15-point Objective Surgical Assessment of Technical Skill score. Results: The OSATS score provided a measure of the suturing skills of individuals applying to residency training in otolaryngology. The OSATS score was incorporated into the calculation of an overall OSCE (Objective Structured Clinical Examination) score modified to focus on surgical skill performance and a professionalism measure. Initial data analysis produced a correlation value ( R value) between the OSCE score and data points gleaned from the standardized application (USMLE step I score, prior employment-related surgical experience, hobbies, musical background, athletic background, research experience that includes performance of surgical procedures). Conclusion: In contrast to other high-skill professions such as the airline industry, surgical educators have not universally developed a practice of testing prospective trainees for aptitudes that can be deemed critical to surgical competence. This study represents a methodology for assessment of a simple surgical skill to which all applicants to otolaryngology training should have been exposed. It also determines correlation with applicant data commonly used in selection, such as USMLE score.