Objective assessment of surgical performance and its impact on a national selection programme of candidates for higher surgical training in plastic surgery

Objective: The objective of this study was to develop and validate a transparent, fair and objective assessment programme for the selection of surgical trainees into higher surgical training (HST) in plastic surgery in the Republic of Ireland. Methods: Thirty-four individuals applied for HST in plastic surgery at the Royal College of Surgeons in Ireland (RCSI) in the academic years 2005-2006 and 2006-2007. Eighteen were short-listed for interview and further assessment. All applicants were required to report on their undergraduate educational performance and their postgraduate professional development. Short-listed applicants completed validated objective assessment simulations of surgical skills, an interview and assessment of their suitability for a career in surgery. Results: When applicants' short-listing scores were combined with their interview scores and assessment of their suitability for a career in surgery, individuals who were selected for HST in plastic surgery performed significantly better than those who were not (P < 0.002). However, when the assessment of technical skills scores were added the significance level of this difference increased further (P < 0.0001) as did the statistical power of the difference to 99.9%, thus increasing the robustness of the selection package. Conclusion: The results from this study suggest that the assessment protocol we used to select individuals for HST in plastic surgery reliably and statistically significantly discriminated between the performances of candidates. (C) 2008 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.