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April 22, 1988

The Selection of Residents

JAMA. 1988;259(16):2401. doi:10.1001/jama.1988.03720160023014

To the Editor.  —Dr McCollister1 should be more sympathetic to the surgical subspecialty residency selection committees. They have the same problem medical student selection committees have, which is to select the best candidates. Medical schools have available to them numerical college grades, class standing, and results of the Medical College Admission Test as relative quantitative measures of academic performance. Residency selection committees are not as blessed. Most American medical schools provide them with a Pollyannaish dean's letter, which finds complimentary things to say about all students and seldom provides class ranking. The medical school transcript frequently lists grades in terms of pass-fail and few objective relative measures are passed along.Intelligent medical judgment is based, among many factors, on pathophysiological understanding. Thus, a measure of it should be an important criterion in residency selection. In the absence of class standings, numerical grades, and a meaningful dean's letter, scores from