Ophthalmology Resident Selection: Current Trends in Selection Criteria and Improving the Process Sudha Nallasamy, MD, 1 Tara Uhler, MD, 2 Nambi Nallasamy, AB, 3 Paul J. Tapino, MD, 1 Nicholas J. Volpe, MD 1 Objective: To document and assess current ophthalmology resident selection practices as well as to initiate discussion on how best to improve the process. Design: Online survey comprising 56 questions. Participants: Program directors, chairpersons, or members of the resident selection committee represent- ing 65 United States ophthalmology residency programs accredited by the Accreditation Council on Graduate Medical Education. Methods: Study participants completed an online, anonymous survey consisting primarily of multiple choice questions, with single or multiple answers. Main Outcome Measures: Ophthalmology resident selection practices were evaluated and included: screening of applications, interview processes, selection factors, and formation of rank lists; recommendations given to applicants; and respondent satisfaction with the current selection process. Results: As a group, survey respondents deemed the following factors most important in resident selection: interview performance (95.4%), clinical course grades (93.9%), letters of recommendation (83.1%), and board scores (80%). Statistical analyses deemed that the best predictors of resident performance are interviews, clinical course grades, recommendation letters, and ophthalmology rotation performance. Conclusions: Ophthalmology resident selection is a relatively subjective process, continuing to rely heavily on cognitive factors. Because these factors are not always indicative of ultimate resident quality, it would be helpful if ophthalmology training programs improved selection practices to discern who most likely will become a successful resident and future ophthalmologist. Long-term studies correlating applicant attributes with resi- dency and postresidency success are needed to recommend guidelines for a more standardized selection process. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. Ophthalmology 2010;117:1041–1047 © 2010 by the American Academy of Ophthalmology. Studies across a number of medical specialties have shown the limited value of traditional cognitive measures (e.g., grades, reputation of medical school, United States Medical Licensing Examination [USMLE] scores) in predicting overall resident success. These cognitive measures may predict in-service and board examination performance (Acad Med 68 [2 Suppl]:S51– 6, 1993) 1–5 ; however, noncognitive measures (personal traits such as work ethic and professionalism) may be equally or more predictive of overall resident performance across a number of specialties. 6 The literature also suggests that reliability of noncognitive measures, at least in medical school admissions, has been problematic. 7 After reviewing the literature, Lee et al 6 reported that cognitive measures may be relied on far too heavily in competitive specialties such as ophthalmology. 6,8,9 They proposed an implementa- tion strategy to reengineer and improve the resident selec- tion process in ophthalmology and to develop assessments that may be predictive of downstream resident performance. The most common current resident selection practices among ophthalmology departments have not been reported. Obviously, there is variability in the type of applicants sought out by each program, and there likely are a variety of methods for resident selection used by programs across the United States. The examination of how programs screen, interview, and rank applicants may yield useful information for improving the overall process. Ultimately, it would be desirable to be able to identify the following: (1) which applicants are most likely to thrive as residents in a given program; (2) which applicants perform well as future oph- thalmologists and academicians; (3) which applicants display the highest level of professionalism, as demonstrated through a foundation of clinical competence, communication skills, and ethical and legal understanding; and (4) which applicants have the aspiration to excellence, humanism, accountability, and altruism. 10 Similarly, it would be extremely valuable if we could identify which applicants are more likely to become problem residents or incompetent ophthalmologists. To that end, this survey study was designed to obtain baseline data concerning the ophthalmology resident selec- tion process. The expectation is for these results to serve as a starting point for future efforts aimed at revising the resident selection process which may lead to selection of 1041 © 2010 by the American Academy of Ophthalmology ISSN 0161-6420/10/$–see front matter Published by Elsevier Inc. doi:10.1016/j.ophtha.2009.07.034