Introduction: Screening practices for selecting surgery trainees have been criticized for subjectivity, inefficiency, and inability to predict performance. This study explored applicant perceptions to an untraditional selection process. Methods: Fellowship applicants completed an online assessment containing 26 situational judgment test (SJT) items and a 108-item personality profile. High-performing candidates participated in on-site structured interviews and skills testing. Upon completion of all interviews, but before match results were available, an anonymous, online survey was sent to all applicants. The survey asked about perceptions of the selection system along dimensions of procedural justice theory on a 1 (strongly disagree) to 5 (strongly agree) scale. Results: Twenty-one of 51 applicants completed the survey. Those invited for an interview (N = 12) had more favorable perceptions about communication (3.50 ± 1.38 versus 2.00 ± 0.82,p < 0.05), opportunity to perform (3.33 ± 1.56 versus 1.29 ± 0.49,p < 0.01), fairness (4.50 ± 0.80 versus 3.43 ± 1.40,p < 0.05) and gaining more insight (4.25 ± 1.22 versus 2.29 ± 1.60,p < 0.01) compared to applicants not invited. Content (4.21 ± 0.86) and consistency (4.79 ± 0.42) means were similar. Conclusions: These results suggest that applicant perceptions are directly related to how well they perform in the selection procedure.
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