A. Ozair1, K. K. Singh1, A. Faruqi1, V. Suresh1, A. A. Sonkar1 1King George’s Medical University,Department Of General Surgery,Lucknow, UTTAR PRADESH, India
Introduction:
Little work exists worldwide on the objective institutional preference of top medical students and graduates (MSGs) selected for surgical residencies, who represent the future of surgery. Since 2017, India has been having a single annual test for MSGs. Ranks here serve as the sole criterion for selection into residency at nearly all training institutions. The latter lack any say in selecting individual MSGs. High-ranking candidates on this exam, the national eligibility-cum-entrance test – postgraduation (NEET-PG), represent the best MSGs in India. However, no study has yet determined the institutions most preferred for general surgery training, for which there are 3663 positions annually available. Hence, we sought to determine the institutional preference for residency of top-ranking MSGs who chose general surgery via NEET-PG.
Methods:
We utilized the Medical Council of India (MCI) database of accredited training institutions and the anonymized, publicly available NEET-PG database of rank list and seat selection from 2017-20. We analyzed data of the top-100 ranked MSGs who chose general surgery every year from the round-one seat-selection session during 2017-20. We correlated this to the data of the national ranking of healthcare institutions (NIRF) published annually by the Government of India.
Results:
India currently has 331 accredited 3-year programs in general surgery, with median (IQR) number of seats being 10 (10). We found significant clustering of top 400 MSGs who chose surgery into a few residency programs (figure 1). The overall distribution was heavily skewed, with 53.5% of the top MSGs preferring residency at just 7 institutions. These were amongst the 39 that were represented in the choices. Despite the complete absence of visiting student rotations in India, we found that a select few institutions consistently were the most preferred across all years. We discovered that preferred institutions were overwhelmingly located in major metropolitan cities and their degree of preference did not correlate well with their institutional ranking. The 2 most preferred institutions were absent from the government rankings across all 4 years.
Conclusion:
We report for the first time the objective institutional preferences of top MSGs for general surgery residency in India. With a lack of visiting rotations, MSGs lack the means to compare programs. Additionally, there exists a need to determine the best practices from the preferred institutions and incorporate them at others. Top MSGs definitively prefer training in large metropolitan cities even though the institution may not be highly ranked, indicating that location is perhaps a key factor in selection. A multicentric, pan-India survey is needed to determine the reasons behind these preferences.
