{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T11:00:26Z","timestamp":1773226826324,"version":"3.50.1"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"9-10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,9,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>The intangible personal characteristic grit has become a popular topic of concentration within contemporary psychology studies. Grit is defined as persistent work on a focused topic for an extended period of time until a desired goal is achieved. Its application to physician selection and development is not well known. We sought to determine which factors were considered most important among leadership within the U.S. Army\u2019s orthopedic surgical training programs when selecting applications and ascertain if grit was one of the primary factors.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>A standardized, 18-question survey was sent to all program chairs, program directors, and assistant program directors at the six U.S. Army orthopedic surgery residency programs. Questions included demographic factors pertaining to both the individual and their respective training program. Participants were asked to rank, in order, the 10 most important variables when considering applicants. Each variable was ranked using a point system (1\u201310 with 10 as the best score), referred to as the factor score (FS). Further statistical analyses using descriptive statistics, paired t-test, and ANOVA were performed and reported.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The response rate was 83% (15\/18). The most important variable considered was the applicant\u2019s performance on their audition rotation (FS\u00a0=\u00a09.8), which was significantly more important than any other variable (P\u00a0=\u00a00.001). The second most important variable was the applicant\u2019s USMLE scores (FS\u00a0=\u00a07.13), followed by involvement in research (FS\u00a0=\u00a05.60) and conscientiousness (FS\u00a0=\u00a04.73), respectively. Grit was considered the fifth most important variable (FS\u00a0=\u00a04.27). There was no significant difference in the ranking of grit among the different programs (P\u00a0=\u00a00.282). In applicants with low United States Medical Licensing Examination scores according to leadership idiosyncrasy, their audition rotation was considered a redeeming portion of their application (P\u00a0=\u00a00.02) followed by their level of grit.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The most important factor when considering an orthopedic surgery applicant was how well the applicant performed on an audition rotation, followed by their United States Medical Licensing Examination scores. Grit has become an important consideration in resident selection.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usaa101","type":"journal-article","created":{"date-parts":[[2020,6,4]],"date-time":"2020-06-04T09:12:03Z","timestamp":1591261923000},"page":"e1603-e1607","source":"Crossref","is-referenced-by-count":6,"title":["Factors Considered When Ranking Military Orthopedic Surgery Residency Candidates"],"prefix":"10.1093","volume":"185","author":[{"given":"Matthew","family":"Wells","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, William Beaumont Army Medical Center, 5005 North Piedras Street, El Paso, TX 79902"},{"name":"Department of Orthopaedic Surgery, Texas Tech University Health Sciences Center, 5001 El Paso Drive, El Paso, TX 79905"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Polmear","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, William Beaumont Army Medical Center, 5005 North Piedras Street, El Paso, TX 79902"},{"name":"Department of Orthopaedic Surgery, Texas Tech University Health Sciences Center, 5001 El Paso Drive, El Paso, TX 79905"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leon J","family":"Nesti","sequence":"additional","affiliation":[{"name":"Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda 20814, MD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John C","family":"Dunn","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, William Beaumont Army Medical Center, 5005 North Piedras Street, El Paso, TX 79902"},{"name":"Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda 20814, MD"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,6,4]]},"reference":[{"key":"2020092112245087300_ref1","author":"The American Academy of Medical Colleges","year":"2019"},{"key":"2020092112245087300_ref2","author":"The National Residency Match Program","year":"2019"},{"issue":"2","key":"2020092112245087300_ref3","doi-asserted-by":"crossref","first-page":"72","DOI":"10.5435\/00124635-201102000-00002","article-title":"Success in orthopaedic training: resident selection and predictors of quality performance","volume":"19","author":"Egol","year":"2011","journal-title":"J Am Acad Orthop Surg"},{"issue":"9","key":"2020092112245087300_ref4","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.7205\/MILMED-D-13-00121","article-title":"Overview of the military orthopaedic surgery residency application and selection process","volume":"178","author":"Belmont","year":"2013","journal-title":"Mil Med"},{"key":"2020092112245087300_ref5","doi-asserted-by":"crossref","first-page":"36","DOI":"10.3389\/fpsyg.2014.00036","article-title":"The grit effect: predicting retention in the military, the workplace, school and marriage","volume":"5","author":"Eskreis-Winkler","year":"2014","journal-title":"Front Psychol"},{"key":"2020092112245087300_ref6","volume-title":"Grit scale","author":"Duckworth","year":"2020"},{"issue":"2","key":"2020092112245087300_ref7","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1080\/00223890802634290","article-title":"Development and validation of the short grit scale (grit-s)","volume":"91","author":"Duckworth","year":"2009","journal-title":"J Pers Assess"},{"issue":"2","key":"2020092112245087300_ref8","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.amjsurg.2013.09.006","article-title":"The relationship between grit and resident well-being","volume":"207","author":"Salles","year":"2014","journal-title":"Am J Surg"},{"issue":"6","key":"2020092112245087300_ref9","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1016\/j.surg.2014.01.015","article-title":"Grit: a marker of residents at risk for attrition?","volume":"155","author":"Burkhart","year":"2014","journal-title":"Surgery"},{"issue":"2","key":"2020092112245087300_ref10","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1016\/j.amjsurg.2016.10.012","article-title":"Grit as a predictor of risk of attrition in surgical residency","volume":"213","author":"Salles","year":"2017","journal-title":"Am J Surg"},{"issue":"4","key":"2020092112245087300_ref11","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1016\/j.jsurg.2016.01.012","article-title":"Survival of the grittiest? Consultant surgeons are significantly grittier than their junior trainees","volume":"73","author":"Walker","year":"2016","journal-title":"J Surg Educ"},{"issue":"11","key":"2020092112245087300_ref12","doi-asserted-by":"crossref","first-page":"2090","DOI":"10.2106\/00004623-200211000-00026","article-title":"Orthopaedic resident-selection criteria","volume":"84","author":"Bernstein","year":"2002","journal-title":"J Bone Joint Surg Am"},{"issue":"12","key":"2020092112245087300_ref13","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1097\/01.SMJ.0000136233.60966.F2","article-title":"What attributes are necessary to be selected for an orthopaedic surgery residency position: perceptions of faculty and residents","volume":"97","author":"Bajaj","year":"2004","journal-title":"South Med J"},{"issue":"9","key":"2020092112245087300_ref14","doi-asserted-by":"crossref","first-page":"788","DOI":"10.2106\/JBJS.15.00222","article-title":"Academic characteristics of orthopaedic surgery residency applicants from 2007 to 2014","volume":"98","author":"DePasse","year":"2016","journal-title":"J Bone Joint Surg Am"},{"key":"2020092112245087300_ref15","author":"Lettieri"},{"key":"2020092112245087300_ref16","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1097\/01.blo.0000224042.84839.44","article-title":"A quantitative composite scoring tool for orthopaedic residency screening and selection","volume":"449","author":"Turner","year":"2006","journal-title":"Clin Orthop Relat Res"},{"key":"2020092112245087300_ref17","first-page":"238","article-title":"Predictive measures of a resident's performance on written orthopaedic board scores","volume":"31","author":"Dyrstad","year":"2011","journal-title":"Iowa Orthop J"},{"issue":"6","key":"2020092112245087300_ref18","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1016\/j.amjsurg.2014.06.032","article-title":"Is USMLE step 1 score a valid predictor of success in surgical residency?","volume":"208","author":"Sutton","year":"2014","journal-title":"Am J Surg"},{"issue":"6","key":"2020092112245087300_ref19","doi-asserted-by":"crossref","first-page":"e286","DOI":"10.5435\/JAAOS-D-17-00257","article-title":"Factors predictive of orthopaedic in-training examination performance and research productivity among orthopaedic residents","volume":"27","author":"Kreitz","year":"2019","journal-title":"J Am Acad Orthop Surg"},{"issue":"5","key":"2020092112245087300_ref20","doi-asserted-by":"crossref","first-page":"e227","DOI":"10.5435\/JAAOS-D-17-00545","article-title":"Objective predictors of grit, self-control, and conscientiousness in orthopaedic surgery residency applicants","volume":"27","author":"Camp","year":"2019","journal-title":"J Am Acad Orthop Surg"},{"issue":"6","key":"2020092112245087300_ref21","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1177\/1745691615599383","article-title":"Leveraging mindsets to promote academic achievement: policy recommendations","volume":"10","author":"Rattan","year":"2015","journal-title":"Perspect Psychol Sci"},{"issue":"17","key":"2020092112245087300_ref22","doi-asserted-by":"crossref","first-page":"e151","DOI":"10.2106\/JBJS.M.00706","article-title":"Assessment of moral reasoning skills in the orthopaedic surgery resident applicant","volume":"96","author":"Bohm","year":"2014","journal-title":"J Bone Joint Surg Am"},{"key":"2020092112245087300_ref23","author":"Colleges AoAM","year":"2020"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/milmed\/article-pdf\/185\/9-10\/e1603\/33765612\/usaa101.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/milmed\/article-pdf\/185\/9-10\/e1603\/33765612\/usaa101.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,21]],"date-time":"2020-09-21T16:30:28Z","timestamp":1600705828000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/185\/9-10\/e1603\/5850958"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,4]]},"references-count":23,"journal-issue":{"issue":"9-10","published-online":{"date-parts":[[2020,6,4]]},"published-print":{"date-parts":[[2020,9,18]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usaa101","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,9]]},"published":{"date-parts":[[2020,6,4]]}}}