BACKGROUND: With the transition of many plastic surgery training programs from the traditional to the integrated/coordinated model, critical evaluation of the process by which medical students are selected for residency is needed. To increase the understanding of this process and to improve the manner in which candidates are vetted, a survey study was designed. METHODS: A 29-question online survey was designed to discern desired qualities regarding resident selection, interview processes, resident participation, and program director satisfaction with the current process. This survey was sent to all 49 integrated/coordinated program directors in the United States. RESULTS: Forty-three of 49 program directors (87.8 percent) responded. High-quality letters of recommendation (author and substance) and performance on subinternship rotations and interviews were considered the most important qualities in selecting residents. Candidates interview performance and rank order list position were considered by many to be indicative of resident quality, but responses varied. Forty-two of 43 program directors reported that their own residents participate in the interview and/or selection process. Overall, only 43.2 percent of respondents found the current process adequate for identifying potential problems. Furthermore, 39.5 percent of programs have dismissed a resident for academic or ethical reasons within the last 10 years. CONCLUSIONS: Residency selection is a relatively subjective, unstandardized process. Because medical school performance is not always indicative of ultimate resident quality, it is imperative that integrated/coordinated plastic surgery training programs improve selection protocols to discern who will most likely become a successful resident. A number of program directors are dissatisfied with the process, and better systems for selection would be beneficial.
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