Abstract
Background The interview process for surgical trainees aims to select those individuals who
will perform best during training and have the greatest potential as future surgeons.
The objective of this study was to evaluate the relationship between criteria assessed
at interview, technical skills, and performance, for the first time, to optimize the
selection process for a Microsurgery fellowship.
Methods Twenty microsurgery fellows in three consecutive annual cohorts at a single academic
center were prospectively evaluated. At interview, subjects were scored for multiple
standardized domains. At the start and at end of the fellowship, microsurgical technical
skill was assessed both in the laboratory and operating room (OR) using a validated
assessment tool. At the end of the fellowship, there was a final evaluation of performance.
Results At the start, microsurgical skill significantly correlated with almost all domains
evaluated at interview, most closely with prior plastic surgery training experience.
At the end of the fellowship, skill level improved in all trainees, with the greatest
improvement made by the lowest ranked and skilled trainees. The highest ranked trainees,
however, made the greatest improvement in speed.
Conclusions The results of this study, for the first time, validate the current interview process
to correctly select the highest performing and most skilled candidates and support
the effectiveness of a 1-year microsurgical fellowship in improving microsurgical
skill in all trainees, irrespective of their initial ability. The importance of valuing
the relative quality of prior training and experience at selection is also highlighted.
Keywords
fellow - microsurgery - assessment
