Ophthalmology Resident Selection: Current Trends in Selection Criteria and Improving the Process

Published:January 27, 2010DOI:


      To document and assess current ophthalmology resident selection practices as well as to initiate discussion on how best to improve the process.


      Online survey comprising 56 questions.


      Program directors, chairpersons, or members of the resident selection committee representing 65 United States ophthalmology residency programs accredited by the Accreditation Council on Graduate Medical Education.


      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.


      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.


      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 residency 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.
      To read this article in full you will need to make a payment


      Subscribe to Ophthalmology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Black K.P.
        • Abzug J.M.
        • Chinchilli V.M.
        Orthopaedic in-training examination scores: a correlation with USMLE results.
        J Bone Joint Surg Am. 2006; 88: 671-676
        • Borowitz S.M.
        • Saulsbury F.T.
        • Wilson W.G.
        Information collected during the residency match process does not predict clinical performance.
        Arch Pediatr Adolesc Med. 2000; 154: 256-260
        • Boyse T.D.
        • Patterson S.K.
        • Cohan R.H.
        • et al.
        Does medical school performance predict radiology resident performance?.
        Acad Radiol. 2002; 9: 437-445
        • Carmichael K.D.
        • Westmoreland J.B.
        • Thomas J.A.
        • Patterson R.M.
        Relation of residency selection factors to subsequent orthopaedic in-training examination performance.
        South Med J. 2005; 98: 528-532
        • Dirschl D.R.
        • Campion E.R.
        • Gilliam K.
        Resident selection and predictors of performance: can we be evidence based?.
        Clin Orthop Relat Res. 2006; 449: 44-49
        • Lee A.G.
        • Golnik K.C.
        • Oetting T.A.
        • et al.
        Re-engineering the resident applicant selection process in ophthalmology: a literature review and recommendations for improvement.
        Surv Ophthalmol. 2008; 53: 164-176
        • Wagoner N.E.
        Admission to medical school: selecting applicants with the potential for professionalism.
        in: Stern D.T. Measuring Medical Professionalism. Oxford University Press, New York2006: 235-264
        • Clark R.
        • Evans E.B.
        • Ivey F.M.
        • et al.
        Characteristics of successful and unsuccessful applicants to orthopedic residency training programs.
        Clin Orthop Relat Res. 1989; : 257-264
        • Wagoner N.E.
        • Suriano J.R.
        • Stoner J.A.
        Factors used by program directors to select residents.
        J Med Educ. 1986; 61: 10-21
        • Arnold L.
        • Stern D.T.
        What is medical professionalism?.
        in: Stern D.T. Measuring Medical Professionalism. Oxford University Press, New York2006: 15-38
        • Dawkins K.
        • Ekstrom R.D.
        • Maltbie A.
        • Golden R.N.
        The relationship between psychiatry residency applicant evaluations and subsequent residency performance.
        Acad Psychiatry. 2005; 29: 69-75
        • DeSantis M.
        • Marco C.A.
        Emergency medicine residency selection: factors influencing candidate decisions.
        Acad Emerg Med. 2005; 12: 559-561
        • Gordon M.J.
        • Lincoln J.A.
        Family practice resident selection: value of the interview.
        J Fam Pract. 1976; 3: 175-177
        • Komives E.
        • Weiss S.T.
        • Rosa R.M.
        The applicant interview as a predictor of resident performance.
        J Med Educ. 1984; 59: 425-426
        • Korman M.
        • Stubblefield R.L.
        Medical school evaluation and internship performance.
        J Med Educ. 1971; 46: 670-673
        • Kovel A.J.
        • Davis J.K.
        Use of interviews in the selection of pediatric house officers [letter].
        J Med Educ. 1988; 63: 928
        • Tremonti L.P.
        Intern selection.
        Ann Intern Med. 1973; 79: 277
        • Wagoner N.E.
        • Gray G.T.
        Report on a survey of program directors regarding selection factors in graduate medical education.
        J Med Educ. 1979; 54: 445-452
        • Altmaier E.M.
        • Smith W.L.
        • O'Halloran C.M.
        • Franken Jr, E.A.
        The predictive utility of behavior-based interviewing compared with traditional interviewing in the selection of radiology residents.
        Invest Radiol. 1992; 27: 385-389
        • Wood P.S.
        • Smith W.L.
        • Altmaier E.M.
        • et al.
        A prospective study of cognitive and noncognitive selection criteria as predictors of resident performance.
        Invest Radiol. 1990; 25: 855-859
        • Erlandson E.E.
        • Calhoun J.G.
        • Barrack F.M.
        • et al.
        Resident selection: applicant selection criteria compared with performance.
        Surgery. 1982; 92: 270-275
        • Gonnella J.S.
        • Hojat M.
        Relationship between performance in medical school and postgraduate competence.
        J Med Educ. 1983; 58: 679-685
        • Wingard J.R.
        • Williamson J.W.
        Grades as predictors of physicians' career performance: an evaluative literature review.
        J Med Educ. 1973; 48: 311-322
        • Fortune J.B.
        The content and value of letters of recommendation in the resident candidate evaluative process.
        Curr Surg. 2002; 59: 79-83
        • Leichner P.
        • Eusebio-Torres E.
        • Harper D.
        The validity of reference letters in predicting resident performance.
        J Med Educ. 1981; 56: 1019-1021
        • Smith W.L.
        Diminishing value of letters of recommendation [letter].
        AJR Am J Roentgenol. 1984; 143: 199-200
        • Dirschl D.R.
        • Adams G.L.
        Reliability in evaluating letters of recommendation.
        Acad Med. 2000; 75: 1029
        • O'Halloran C.M.
        • Altmaier E.M.
        • Smith W.L.
        • Franken Jr, E.A.
        Evaluation of resident applicants by letters of recommendation: a comparison of traditional and behavior-based formats.
        Invest Radiol. 1993; 28: 274-277
        • McCollister R.J.
        The use of part I national board scores in the selection of residents in ophthalmology and otolaryngology.
        JAMA. 1988; 259: 240-242
        • Fine P.L.
        • Hayward R.A.
        Do the criteria of resident selection committees predict residents' performances?.
        Acad Med. 1995; 70: 834-838
        • Yindra K.J.
        • Rosenfeld P.S.
        • Donnelly M.B.
        Medical school achievements as predictors of residency performance.
        J Med Educ. 1988; 63: 356-363
        • Dirschl D.R.
        • Dahners L.E.
        • Adams G.L.
        • et al.
        Correlating selection criteria with subsequent performance as residents.
        Clin Orthop Relat Res. 2002; : 265-271
        • Gunderman R.B.
        • Jackson V.P.
        Are NBME examination scores useful in selecting radiology residency candidates?.
        Acad Radiol. 2000; 7: 603-606
        • Adusumilli S.
        • Cohan R.H.
        • Marshall K.W.
        • et al.
        How well does applicant rank order predict subsequent performance during radiology residency?.
        Acad Radiol. 2000; 7: 635-640
        • Thordarson D.B.
        • Ebramzadeh E.
        • Sangiorgio S.N.
        • et al.
        Resident selection: how are we doing and why?.
        Clin Orthop Relat Res. 2007; 459: 255-259

      Linked Article

      • Erratum
        OphthalmologyVol. 117Issue 8
        • Preview
          With apologies from the authors of “Ophthalmology resident selection: current trends in selection criteria and improving the process” (Ophthalmology 2010;117:1041–7). AOA was erroneously identified as American Optometric Society. AOA in this article stands for the Alpha Omega Honor Society in the legends for Table 2, Figure 1, as well as in the Results and Discussions sections. The abbreviation refers to membership in the Alpha Omega Alpha Honor Society. Status in the American Optometric Society was not a criteria used by any program directors.
        • Full-Text
        • PDF
      • Resident Selection
        OphthalmologyVol. 118Issue 4
        • Preview
          I would like to thank Nallasamy et al1 for highlighting important (and scary) issues in the ophthalmology resident selection. At the national level we are moving from the initial phases of simply teaching and assessing the Accreditation Council for Graduate Medical Education (ACGME) competencies in just residency programs to a more comprehensive strategy for incorporating and aligning the assessment methods for the competencies across the spectrum of our profession that will hopefully include practicing physicians (i.e., maintenance of certification) and our lifelong learning (e.g., continuing medical education) process.
        • Full-Text
        • PDF