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Comment & Response
September 2018

How We Measure Surgical Trainee Performance Matters—Reply

Author Affiliations
  • 1School of Health Professions, Department of Surgery, Baylor College of Medicine, Houston, Texas
  • 2Department of Surgery, Houston Methodist Hospital, Houston, Texas
JAMA Surg. 2018;153(9):865. doi:10.1001/jamasurg.2018.1655

In Reply We thank the Editor for the opportunity to respond to the letter from Leeds et al about our article.1 From their letter, we were able to deduce 3 major concerns.

The performance outcome used in our study is one of the most comprehensive resident performance criteria in the published literature and triangulates data representing all of the Accreditation Council for Graduate Medical Education competencies from multiple stakeholders and sources. Of note, the “most heavily weighted” factor, monthly faculty evaluations, contributed little more than one-third of the total performance criterion and thus was not the main driver of any outcome. The rest was pulled from administrative logs (18%), procedural case activity (17%), in-training examination scores (14%), research output (8%), and medical student evaluations (6%) (Table 11).

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