Medical School Ranking Research Articles

America's Best Medical Schools: A Renewed Critique of the U.S. News & World Report Rankings.

This Invited Commentary amplifies the continuing critique of the U.S. News & World Report rankings of U.S. medical schools and academic medical centers. The article begins with a critical quote about the medical school rankings published in this journal nearly 20 years ago and points out that little has changed in nearly two decades. The author then reports how the flawed rankings are performed and why U.S. medical school rankings are taken seriously, addresses the varied missions of U.S. medical schools, describes what really matters for success in medical school and professional life, sets a path forward to improve methods of medical school evaluation, and speaks to the irony of dismissing the rankings while still using them for marketing and fund-raising. The article concludes with a critical argument about the U.S. News & World Report rankings not only of medical schools but also of schools across the learned professions.

Medical school ranking and dermatology match results: An analysis of the 2018 match data

Medical school ranking and dermatology match results: An analysis of the 2018 match data

64. APPLICATION FACTORS ASSOCIATED WITH CLINICAL PERFORMANCE DURING PEDIATRIC INTERNSHIP: A 5-YEAR SINGLE CENTER RETROSPECTIVE COHORT STUDY

Background The specific components of an application to residency that predict clinical performance during training in pediatrics remain unknown. Methods Retrospective cohort study of all pediatric interns who matched into the Boston Combined Residency Program from 2013-2017. Demographics, subspecialty track, medical school ranking, USMLE scores, advanced degrees, clerkship grades, Alpha-Omega-Alpha (AOA) and Gold Humanism Honor Society membership, interview day performance, letters of recommendation (LOR) strength, and number of publications were extracted from application materials. The primary outcome was clinical performance at the end of internship, measured as a weighted average of existing ACGME pediatric milestones scores. Linear mixed effects modeling with random effects for grading committee and match year was used to identify factors independently associated with clinical performance. Variables with p-values Results 223 interns were included in the study. In the model (Table 1), higher average LOR score (B=.07, p=.01), having a master's degree (B =.19, p=.03), and not having a PhD (B =.13, p=.03) were associated with more advanced clinical performance at the end of pediatric internship. AOA membership, medical school ranking, public medical school attendance, time off prior to medical school, number of clerkship honors, and interview score were included in the model, but not significant predictors of clinical performance. The fixed effects explained 15% of the variance in milestones score, while the random effects (match year and grading committee) explained 8% of the variance (marginal R2=.15, conditional R2=.23). Conclusions Strong letters of recommendation, having a master's degree and not having a PhD are associated with more advanced clinical performance during pediatric internship. However, much of the variance in clinical performance remains unexplained by quantifiable application variables.

Structured Curriculum Vitae Scoring as a Standardized Tool for Selecting Interview Candidates for Academic Neuroradiology Faculty Positions

Background and PurposeInterview selection of candidates for academic radiology faculty positions is variable and subject to unconscious biases. The purpose of this study was to retrospectively apply a quantitative curriculum vitae (CV) rubric as a screening tool to identify qualified candidates for further consideration in the hiring process. Materials and MethodsArchived CVs submitted by applicants between 2012 and 2017 for neuroradiology faculty positions at our institution were anonymized. One blinded reviewer scored resumes based on categories that included education, work experience, extracurricular/teaching experience, and research. Logistic regression and receiver operating characteristics analysis were performed. This study was IRB exempted. ResultsOf the total 102 applicants, 17 interviews were conducted and 10 candidates were offered a position. Maximum score of the model was 24 points. Mean score was 14 ± 4 (n = 102, range 5-22). Higher total CV score (P = 0.01), medical school ranking (P = 0.03), and number of published manuscripts (P = 0.03) were significantly associated with interview selection. The area under the curve in the ROC analysis for differentiating interview selection based on total CV scoring was 0.69 (95% confidence interval 0.56-0.82). At a cutoff of 14, the model is 82.4% sensitive, and 54.1% specific. ConclusionStandardized CV scoring is feasible with a cut-off score of 14 points providing high sensitivity in identifying candidates eligible for interview. This tool can potentially be applied in the future to the hiring process as it is neutral to factors such as gender and race and provides an opportunity to address diversity in academic medicine.

An Evaluation of the Content of Canadian Radiology Fellowship Websites

PurposeProspective radiology fellows utilize the internet to apply for radiology fellowship programs. The aim of this study was to analyze the online content of Canadian radiology fellowship websites. MethodsThe content of all active Canadian radiology fellowship websites were evaluated using 30 criteria in the following domains: application, recruitment, education and research, clinical work and benefits. Fellowships without websites were excluded from the study. The prevalence of assessed elements was compared to geography and Canadian medical school ranking. ResultsWe identified 107 active Canadian radiology fellowship programmes, of which 102 university fellowships (95.3%) had dedicated fellowship websites available for analysis. Of these 102 programs, the median score was 13/30 (43.0%). Websites of fellowship programs affiliated with top ranked medical schools contained more of the assessed criteria than middle and lower ranked schools (17.0 vs 13.0 vs 9.0, p < 0.0001)). Geographical difference was identified across Canada with Atlantic and Central Canada fellowship programs having significantly more criteria than Western programs (15.5 vs 16.0 vs 10.0, p < 0.001). ConclusionsMost Canadian radiology fellowship websites are devoid of content pertinent to prospective radiology fellows. Addressing deficiencies in online content may assist programs to inform and recruit residents into radiology fellowship programs.

Exploring relationships between medical college rankings and performance with big data

BackgroundIt is important to examine the cost-effectiveness of medical education. The public wants to know how government spending is being utilized to train doctors. There are very few studies that examine national data to understand the relationships between medical education and outcomes.We used Big Data analytics with open health data to explore answers. We joined physician data and hospital total performance score data reported by Center for Medicare and Medicaid Services (CMS), containing information for nearly 600,000 practitioners and performance scores from three thousand hospitals in the United States. We combined this data medical college costs from the American Association of Medical Colleges and medical school rankings. We used Mullan’s social mission to compare medical schools. We also computed the correlation between the rankings of 4-year baccalaureate colleges in the US published by the Wall Street Journal, and the in-state tuition at these colleges in the Integrated Post-secondary Education System database.ResultsWe found a statistically significant but negligible correlation (Spearman rank correlation − 0.04, p-value < 0.0001) between the rank of a medical school and the total performance score of the hospitals that their graduates practiced in. We found a statistically significant and high correlation (Spearman rank correlation of − 0.903, p-value = 0.003) between the averaged rank of medical schools and average number of graduates produced by these schools associated with CMS hospitals. Similar results were obtained for the social mission score. In contrast, the correlation between the ranking of 4-year colleges and (a) their tuition was − 0.34 and (b) their outcomes was − 0.86 (p-value < 10− 5).ConclusionsOur results suggest that US medical education is robust and produces satisfactory performance outcomes. Higher tuition is not correlated with higher ranks or better outcomes. Hence, the public needs to question what they are getting in return for higher tuition. We also suggest that it may be better to produce more graduates from existing medical schools than opening new schools.

Selection or education? Medical school ranking and medical students’ speciality choice preferences in the United States

ABSTRACTLimited research exists on the influence of top-ranked medical schools on students’ speciality choice. We surveyed medical students (n = 468) at eight medical schools in the United States including two ranked in the top 10. Significance tests and logistic regressions were used to determine the relationship between school ranking and preferences for various speciality attributes. An analysis was conducted separately for students in lower (1st and 2nd) years versus higher (3rd and 4th) years of medical school. Among students in lower years, speciality preferences by students in top-ranked schools were less likely to be influenced by the length of training or work–life balance compared to students in non-top-ranked schools. Among higher year students, speciality preference of students in top-ranked schools was more likely to be influenced by prestige than their peers, with no difference in the influence of other factors. We also found evidence that students in top-ranked schools were less likely to be interested in primary care specialities, and this was more pronounced among those in higher years. Our findings suggest that top-ranked schools may influence speciality choice through both selection and education, and initiatives aimed at changing the emphasis on speciality prestige at top-ranked schools could increase primary care physician output.

Medical school ranking and dermatology match results: an analysis of the 2018 match data

Dermatology is a specialty with fewer residency positions each year than total applicants, leading to increased competition in the match. Applicants tend to have substantial research experience and high national board scores. This study sought to explore whether there is a difference in the percentage of graduates matching into dermatology residencies based on the rank of the medical school. Publicly available match lists from highly ranked medical schools were compared to match lists from other allopathic schools to determine the proportion of graduates matching into dermatology. The data was analyzed using a chi square test and a significant difference was found between the percentage of students matching into dermatology from top schools (5.19%) compared to control schools (1.92%), (P<0.0001).

Google Ranking of Plastic Surgeons Values Social Media Presence Over Academic Pedigree and Experience.

Patients increasingly rely on online resources to make healthcare decisions. Google dominates the search engine market; first-page results receive most of the web traffic and therefore serve as an important indicator of consumer reach. Our objective was to analyze the respective importance of physician academic pedigree, experience, and social media presence on plastic surgeon Google first-page search result placement. A Google.com search was conducted in the top 25 United States metropolitan areas to identify the top 20 websites of board-certified plastic surgeons. Social media presence was quantified by tracking the number of followers on Facebook, Twitter, and Instagram for every surgeon as well as medical school and year of graduation. The primary outcome was website ranking in the first page of Google search results. To identify the independent predictors of presence on the front page, we performed a multivariate logistic regression. Total number of social medial followers was associated with Google front-page placement (P < 0.001), whereas medical school ranking and years in practice were not (P = 0.17 and 0.39, respectively). A total 19.6% of plastic surgeon practices in our study cohort still had no social media accounts whatsoever. For the past few decades, plastic surgery practices relied on referrals, word of mouth, and the surgeon's reputation and academic pedigree to attract new patients. It is now clear that this practice-building model is being rapidly supplanted by a new paradigm based on social media presence to reach potential patients.

Analysis of "gap year" prevalence, productivity, and funding among radiation oncology residency applicants

Medical students often take one or more years off during medical school (a “gap year”) to strengthen their applications for competitive specialties such as radiation oncology. This has a significant opportunity cost (delaying residency) and financial costs (for living expenses, if unfunded gap year). We characterized the prevalence, nature, and funding of gap years taken by radiation oncology applicants, and the association of gap years with research productivity. All ERAS applications (n=176) received by one residency program were reviewed and data was collected on gender, age, medical school rank (per U.S. News), and other graduate degree(s) obtained. Foreign graduates and those switching from other residency programs (n=9) were excluded. MD/PhD students were analyzed separately. A gap year was defined as any additional year during medical school not part of the standard four-year or MD/PhD program. We classified gap years by primary activity (clinical or lab research, masters’ degree, illness, or family/personal). If specified, funding source was noted. We collected the number of publications and inferred gap year productivity from timing of publications, and their authors. A total of 167 applicants were analyzed (72% male and 28% female). Their average age was 28.1 (IQR 26.1-30.1), with average of 5.5 publications. Of the non M.D./Ph.D. applicants, 24% took a gap year. Other characteristics are listed in the table. The most common gap year activity was research (67.7%, n=21), 12.9% (n=4) obtained an additional degree, 9.7% (n=3) had illness and 9.7% (n=3) had family/personal reasons. Fifteen of 31 (48.4%) applicants listed a source of funding (5 by medical school, 8 by grants, and 2 other). For the remaining 16, no source of gap year funding was apparent.Abstract TU_4_2930; Table: Comparison of applicants (95% Confidence Interval in parenthesis)No Gap YearGap YearM.D./Ph.D.Applicants1013135Average Age27.5 (26.9-28.1)26.3 (25.5-27.1)* *Adjusted for gap year30.2 (29.7-30.9)Average Medical School Ranking39.3 (33.0-45.6)14.8 (8.3-21.3)36.7 (26.4-47.0)Total Publications4.1(3.1-5.1)Pre-gap: 2.1 (1.4-2.8) Post-gap 6.4 (4.8-7.8)8.8 (7.2-10.5) Open table in a new tab Nearly a quarter of non-Ph.D. applicants take a gap year, usually for research, and this gap year results in a significant increase in publications. Gap year applicants are comparable in age but are more likely from higher-ranked medical schools. Nearly half of gap-year applicants may lack a source of funding to support their gap year, raising the question of whether the expectations to take a gap year favors applicants with existing financial resources. We are designing a survey to query applicants directly about their motivations and resources when deciding whether to take a gap year. This data may inform a broader discussion about how residency programs value research experience and the implicit burden this places on potential applicants.

Association between physician US News & World Report medical school ranking and patient outcomes and costs of care: observational study

ObjectiveTo investigate whether the US News & World Report (USNWR) ranking of the medical school a physician attended is associated with patient outcomes and healthcare spending.DesignObservational study.SettingMedicare, 2011-15.Participants20% random sample...

74 Sex Differences in Language of Standardized Letter of Evaluation Narrative for Emergency Medicine Residency Applicants

Sex differences in language for letters of recommendation have been identified in many professional fields. Our prior study evaluated the narrative portion of the emergency medicine Standardized Letter of Evaluation (SLOE) for all applicants invited to interview during a single residency application cycle. In this prior study, we found that letters of recommendation for women applicants had more frequent words related to “affiliation,” and contrary to prior research, “ability” words appeared with greater frequency for women applicants. We now aim to examine the differences in language used to describe men and women applicants within the SLOE narrative for all applicants in one application cycle, rather than only the invited applicants. All applicants to a 4-year urban, academic EM residency program within a single application year were included in the sample. Only SLOEs from the applicants’ first EM rotation were included. Exclusion criteria were: SLOE of applicants from non-Liaison Committee on Medical Education (LCME) schools or first rotation SLOE not available for download. Data was collected on applicant sex, age, Alpha Omega Alpha (AOA) designation, and medical school rank. The previously validated Linguistic Inquiry and Word Count (LIWC) program was used to analyze frequency of words within categories relevant to letters of recommendation. We assessed for differences by sex in 16 word categories (9 defined by the LIWC and 7 defined by word lists created by previous studies in the field). Descriptive statistics, chi-squared and t-tests were used to describe the sample, and Mann-Whitney U tests were used to compare the word counts by sex. Of 1001 applicants in the 2016 application cycle to our institution, 822 (82%) had a first rotation SLOE available for analysis. 64% were men and 36% were women; there were no differences between sex for baseline characteristics including: age (mean 27 years), top 25 schools (22.5%), AOA rates (12.7%), and having earned advanced degrees (10%). The median word count per SLOE narrative for men was 170 and for women was 180, which was not statistically different (p=0.15). Within the 16 word categories, after adjusting for letter length, word frequency differences between sex were only present in 2 categories: social words (women: 23 words/letter; men: 21 words/letter, p=0.05) and ability words (women: 2 words/letter; men: 1 word/letter, p=0.04).The remaining categories, including words representing communal or agentic traits and “standout” adjectives, “grindstone” traits, and teaching and research words were also not statistically different between men and women applicants. Building upon prior research in this expanded study population, our results indicate that there are minimal language differences by sex in SLOEs for EM applicants. The wording differences noted in 2 categories were statistically significant, but of unclear real-world significance with only a 1-2 word difference between sex. Future work could evaluate how the SLOE format may contribute to this relative lack of bias compared to other fields and formats.

Analysis of the 1990-2007 neurosurgery residency match: does applicant gender affect neurosurgery match outcome?

OBJECTIVE With nearly half of graduating US medical students being female, it is imperative to understand why females typically make up less than 20% of the neurosurgery applicant pool, a number that has changed very slowly over the past several decades. Organized neurosurgery has strongly indicated the desire to overcome the underrepresentation of women, and it is critical to explore whether females are at a disadvantage during the residency application process, one of the first steps in a neurosurgical career. To date, there are no published studies on specific applicant characteristics, including gender, that are associated with match outcome among neurosurgery resident applicants. The purpose of this study is to determine which characteristics of neurosurgery residency applicants, including gender, are associated with a successful match outcome. METHODS De-identified neurosurgical resident applicant data obtained from the San Francisco Fellowship and Residency Matching Service for the years 1990-2007 were analyzed. Applicant characteristics including gender, medical school attended, year of application, United States Medical Licensing Exam (USMLE) Step 1 score, Alpha Omega Alpha (AOA) status, and match outcome were available for study. RESULTS Of the total 3426 applicants studied, 473 (13.8%) applicants were female and 2953 (86.2%) were male. Two thousand four hundred forty-eight (71.5%) applicants successfully matched. USMLE Step 1 score was the strongest predictor of match outcome with scores > 245 having an OR of 20.84 (95% CI 10.31-42.12) compared with those scoring < 215. The mean USMLE Step 1 score for applicants who successfully matched was 233.2 and was 210.8 for those applicants who did not match (p < 0.001). Medical school rank was also associated with match outcome (p < 0.001). AOA status was not significantly associated with match outcome. Female gender was associated with significantly lower odds of matching in both simple (OR 0.59, 95% CI 0.48-0.72) and multivariate analyses (OR 0.57, 95% CI 0.34-0.94 CI). USMLE Step 1 scores were significantly lower for females compared to males with a mean score of 230.1 for males and 221.5 for females (p < 0.001). There was no significant difference in medical school ranking or AOA status when stratified by applicant gender. CONCLUSIONS The limited historical applicant data from 1990-2007 suggests that USMLE Step 1 score is the best predictor of match outcome, although applicant gender may also play a role.

ADDRESSING THE OPIOID EPIDEMIC: IS THERE A ROLE FOR PHYSICIAN EDUCATION?

Using national data on opioid prescriptions written by physicians from 2006 to 2014, we uncover a striking relationship between opioid prescribing and medical school rank. Even within the same specialty and practice location, physicians who completed their initial training at top medical schools write significantly fewer opioid prescriptions annually than physicians from lower ranked schools. Additional evidence suggests that some of this gradient represents a causal effect of education rather than patient selection across physicians or physician selection across medical schools. Altering physician education may therefore be a useful policy tool in fighting the current epidemic.

Gender Differences in Language of Standardized Letter of Evaluation Narratives for Emergency Medicine Residency Applicants.

While gender differences in language for letters of recommendation have been identified in other fields, no prior studies have evaluated the narrative portion of the emergency medicine (EM) standardized letter of evaluation (SLOE). We aim to examine the differences in language used to describe male and female applicants within the SLOE narrative. Invited applicants to a 4-year academic EM residency program within a single application year with a SLOE were included in the sample. Exclusion criteria were SLOE of applicants from non-Liaison Committee on Medical Education (LCME) schools or first rotation SLOE not available for download. Data were collected on applicant gender, age, rotation grade, Alpha Omega Alpha designation, and medical school rank. The previously validated Linguistic Inquiry and Word Count (LIWC) program was used to analyze frequency of words within categories relevant to letters of recommendation. Descriptive statistics, t-tests, and chi-square tests were employed in analysis. Of 1,025 applicants within a single application year, 265 were invited to interview; 237 applicants had a first rotation SLOE available for analysis. There were no differences between male and female applicants for baseline characteristics. The median word count per SLOE narrative was 199; within the LIWC dictionary and user-defined categories, words within the categories of affiliation and ability appeared more frequently for female applicants. Our results with respect to the SLOE narrative reinforce prior research that letters of recommendation for female applicants highlight communal characteristics of teamwork, helpfulness, and compassion. Contrary to prior research, ability words highlighting intelligence and skill appeared with greater frequency for female applicants. No pervasive differences were found in other word categories. In this sample, the standardized format of the SLOE resulted in letters that were relatively free of gender bias.

Parental Status among Successful Applicants to Urology Residency

IntroductionIn this study we assessed academic and demographic factors, including parental status, associated with men and women entering urology residency. MethodsAn anonymous, Internet based survey was created, asking about academic and demographic characteristics at the time of residency application. The survey was e-mailed to 1,184 urology residents and fellows on 3 occasions. E-mail addresses were obtained through the AUA (American Urological Association) website, PubMed® or familiar contacts. Subjects were excluded from analysis if they had completed training, trained outside of the United States or if they had nonworking e-mail addresses. Chi-squared testing and logistic regression analysis were performed. ResultsA total of 215 responses were suitable for analysis (150 men, 65 women). There were no significant differences between successful male and female applicants in age, relationship status, AOA (Alpha Omega Alpha Honor Society) membership, publication status or medical school ranking. Successful male applicants were significantly more likely to have children than female applicants at residency application (18% vs 3.1%, OR 6.91, p=0.0038). Significance persisted on multivariable analysis after adjusting for age and relationship status (OR 6.75, p=0.0185). ConclusionsDespite similar demographics and academic achievements, successful female applicants to urology residency are less likely to have children upon residency application. Given the challenges women face in childbearing later in their careers, efforts should be considered to foster an academic and professional environment that enables them to have children earlier if they so choose.

Academic Productivity of US Cardiothoracic Surgical Centers.

We investigated which metrics represent valid correlates of the academic productivity of cardiothoracic (CT) surgical centers. We collected data from 57 US academic CT surgical groups (663 surgeons), including H index and institutional role of each surgeon, ranking by US News & World Report (USNWR) and NIH funding, and designation as department versus division. Academic productivity (median H-index of each group) was significantly different across institutions (p < 0.001). Several USNWR hospital categories ("Honor Roll", "Adult Cardiology and Heart Surgery", "Adult Pulmonology", "Adult Cancer") and medical school ranking for research were associated with differences in academic productivity, while ranking by NIH funding or designation as department versus division was not. Groups with chairperson's individual H-index ≥50 were overall more productive than those with chairperson's H-index <50 (median H-index: 18 vs. 14; p = 0.005). USNWR rankings provide a good representation of academic productivity, while NIH funding ranking or designation as department versus division does not. The individual productivity of the chairperson is correlated with that of the whole group. doi: 10.1111/jocs.12773 (J Card Surg 2016;31:423-428).

Outcome Analysis of Factors Impacting the Urology Residency Match

IntroductionMatch outcome studies allow applicants and counselors to adequately prepare and make informed decisions. We sought to characterize predictors of success in URMP (Urology Residency Match Program) using standard application data. MethodsAll residency applications received at our department for the 2015 URMP, representing 56% of the national applicant pool, were prospectively entered in an applicant database. Data pertaining to applicant demographics and academic achievement were collected. Nationally published medical school and urology residency rankings were abstracted into tiers. The primary outcome was successful matching into urology and the secondary outcome was quality of the matched residency by ranking. Logistic and linear univariate and multiple regression modeling was performed to detect associations among all independent and outcome variables. ResultsThe final analysis included 244 applicants, of whom 191 (78.3%) successfully matched. On multivariable analysis significant positive predictors included the number of honors grades (p = 0.047, OR 1.4), away subinternships (p = 0.013, OR 1.8) and USMLE (United States Medical Licensing Examination) Step 1 score (median 245 vs 232, p = 0.024). Negative predictors included noncurrent medical school senior status (p = 0.044, OR 0.24) and lower ranked medical school tier (p = 0.003, OR 0.78). Medical school tier (p <0.001), USMLE Step 1 score (p = 0.002) and number of published abstracts (p = 0.042) were predictive of entering a more highly ranked residency program. ConclusionsBased on an institutional sample of the national applicant cohort we identified multiple independent predictors of URMP outcome. This may be useful for applicant counseling in preparation for the match process, although findings may not be applicable to all candidates.

Beyond the Ivory Tower: A Comparison of Grades Across Academic and Community OB/GYN Clerkship Sites

abstractConstruct: Decentralized clinical education is the use of community facilities and community physicians to educate medical students. The theory behind decentralized clinical education is that academic and community sites will provide educational equivalency as determined by objective and subjective performance measures, while training more medical students and exposing students to rural or underserved communities. One of the major challenges of decentralized clinical education is ensuring site comparability in both learning opportunities and evaluation of students. Background: Previous research has examined objective measures of student performance, but less is known about subjective performance measures, particularly in the field of obstetrics and gynecology (OB/GYN). This study explores the implications of clinical site on the adequacy of subjective and objective performance measures. Approach: This was a retrospective cohort study of 801 students in the University of Washington School of Medicine OB/GYN clerkship from 2008 to 2012. Academic sites included those with OB/GYN residency programs (n = 2) and community sites included those without residency programs (n = 29). The association between clerkship site and National Board of Medical Examiners (NBME) grade was assessed using linear regression and clinical and final grade using multinomial regression, estimating β coefficient and relative risks (RR), respectively, and 95% confidence intervals (CIs), adjusting for gender, academic quarter of clerkship, and year of clerkship. Results: There were no differences in NBME exam grades of students at academic sites (76.4 (7.3) versus 74.6 (8.0), β = –0.11, 95% CI [1.35, 1.12] compared to community sites. For clinical grade, students at community sites were 2.4 times more likely to receive honors relative to high pass (RR 2.45), 95% CI [1.72, 3.50], and for final grade, students at community sites were 1.9 times more likely to receive honors relative to pass (RR 1.98), 95% CI [1.27, 3.09], and 1.6 times more likely to receive honors relative to high pass (RR 1.62), 95% CI [1.05, 2.50], compared to those at academic sites. Conclusions: Students at community sites receive higher clinical and final grades in the OB/GYN clerkship. This highlights a significant challenge in decentralized clinical education—ensuring site comparability in clinical grading, Further work should examine the differences in sites, as well as improve standardization of clinical grading. This also underscores an important consideration, as the final grade can influence medical school rank, nomination into honor societies, and ranking of residency applicants.

Correlation of personality assessments with standard selection criteria for neurosurgical residency applicants.

OBJECTIVE Neurosurgery is among the most competitive residencies, as evidenced by the high number of applicants for relatively few positions. Although it is important to recruit candidates who have the intellectual capacity and drive to succeed, traditional objective selection criteria, such as US Medical Licensing Examination (USMLE) (also known as Step 1) score, number of publications, and class ranking, have not been shown to consistently predict clinical and academic success. Furthermore, these traditional objective parameters have not been associated with specific personality traits. METHODS The authors sought to determine the efficacy of a personality assessment in the selection of neurosurgery residents. Specifically, the aim was to determine the correlation between traditional measures used to evaluate an applicant (e.g., USMLE score, number of publications, MD/PhD status) and corresponding validated personality traits. RESULTS Fifty-four neurosurgery residency applicants were interviewed at the Cleveland Clinic during the 2014-2015 application cycle. No differences in validated personality scores were identified between the 46 MD applicants and 8 MD/PhD applicants. The mean USMLE score (± SD) was 252.3 ± 11.9, and those in the high-USMLE-score category (USMLE score ≥ 260) had a significantly lower "imaginative" score (a stress measure of eccentric thinking and impatience with those who think more slowly). The average number of publications per applicant was 8.6 ± 7.9, and there was a significant positive correlation (r = 0.339, p = 0.016) between greater number of publications and a higher "adjustment" score (a measure of being even-tempered, having composure under pressure). Significant negative correlations existed between the total number of publications and the "excitable" score (a measure of being emotionally volatile) (r = -0.299, p = 0.035) as well as the "skeptical" score (measure of being sensitive to criticism) (r = -0.325, p = 0.021). The average medical school rank was 25.8, and medical school rankings were positively correlated with the "imaginative" score (r = 0.287, p = 0.044). CONCLUSIONS This is the first study to investigate the use of personality scores in the selection of neurosurgical residents. The use of personality assessments has the potential to provide insight into an applicant's future behavior as a resident and beyond. This information may be useful in the selection of neurosurgical residents and can be further used to customize the teaching of residents and for enabling them to recognize their own strengths and weaknesses for self-improvement.