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Apply smart in general surgery: New data to consider

Included in the study were data from 14,464 U.S. MD applicants who applied to general surgery programs in ERAS® between 2010 and 2015 and who reported a score for the USMLE Step 1 exam.

Apply smart in general surgery

Understanding the figure

Figure 1 shows the relationship between the number of applications submitted and the predicted probability of entering a general surgery program by USMLE Step 1 score. The x-axis shows the number of applications submitted. The y-axis shows the predicted probability of entering a general surgery program. Each line represents a group of applicants with a given range of USMLE Step 1 scores.

The point of diminishing returns is the point at which the value added by submitting one additional application is reduced relative to the value added by each application before reaching the point of diminishing returns. The point of diminishing returns is an estimate and is not perfectly precise. It is best interpreted in the context of a confidence band, which is shown by the shading around the vertical lines. The width of the confidence band (shading) describes the precision of the estimate, with wider bands indicating less precision. The confidence band around the point of diminishing returns marks the range in which an applicant’s true point of diminishing returns likely lies.

What the findings tell us

Applicants with USMLE Step 1 scores ≥232 (green line) submitted fewer applications before reaching the point of diminishing returns (32 applications, confidence band ranging from 30 to 34). The likelihood of entering a residency program at this point is 82%. The addition of one application beyond this point results in a lower rate of return on an applicant’s likelihood of entering a residency program.

Applicants with USMLE Step 1 scores ranging from 218 to 231 (purple line) submitted the same number of applications as applicants with USMLE Step 1 scores ≥232 (green line) submitted before reaching the point of diminishing returns (32 applications, confidence band ranging from 30 to 34). The likelihood of entering a residency program at this point is 79%. The addition of one application beyond this point results in a lower rate of return on an applicant’s likelihood of entering a residency program.

Applicants with USMLE Step 1 scores ≤217 (blue line) submitted the highest number of applications before reaching the point of diminishing returns (45 applications, confidence band ranging from 42 to 49). The likelihood of entering a residency program at this point is 72%. The addition of one application beyond this point results in a lower rate of return on an applicant’s likelihood of entering a residency program.

How to interpret and apply the findings

Use these findings as a starting point for considering the number of programs you’ll ultimately apply to. There is no magic number that applies to all applicants, so consider the point of diminishing returns in the context of your overall residency candidacy and application. Evaluate a wide variety of information—such as your unique experiences, qualifications, and residency application strategy—as you work with your advisor to determine how many programs and which ones to apply to.

For more information about how to understand and apply the findings in this article and for links to information and advice for developing a smart residency application strategy, read the general article about the point of diminishing returns.

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