Predictors of Urology Resident Surgical Skills, Clinical Communication Skills, Common Sense and In-Service Scores

Introduction: We evaluated predictors of urology resident surgical skills, clinical communication skills, common sense and in-service scores. Methods: We reviewed the Mayo Clinic experience with 49 urology residents who graduated between 2006 and 2016. Residents were independently scored 1 to 10 based on surgical skills, clinical communication skills and common sense by the program director and associate program director. Discrepant scoring by more than 2 was resolved by the former program director. Associations of features from the medical student application with an excellent score (defined as 8 to 10) and in-service scores were evaluated with logistic and linear regression. Results: Discrepant scoring greater than 2 was noted in only 1, 0 and 1 resident for surgical skills, clinical communication skills and common sense, respectively. Mean surgical skills, clinical communication skills and common sense scores were 6.4, 7.1 and 7.0, respectively, and an excellent score was noted in 16 (33%), 19 (39%) and 24 (49%) residents, respectively. The strongest feature associated with an excellent score in each category was honors in all core clinical clerkships (p <0.05 for each). The mean percentile in-service score throughout residency was 84.2%. In a multivariable model male sex (p=0.028), USMLE® (United States Medical Licensing Examination®) step I (p=0.010) and II scores (p=0.001), at least 1 publication before residency (p=0.018) and no negative interview comments (p=0.030) were associated with higher in-service scores. Conclusions: An honors grade in all clinical clerkships during medical school is the strongest feature predictive of excellent surgical skills, clinical communication skills and common sense among urology residents. While USMLE scores are associated with in-service scores, they do not predict for clinical skills.