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Table 2 Comparison of selection process in a centralized vs decentralized country

From: Different approaches to selection of surgical trainees in the European Union

   Centralized (Ireland) Decentralized (Sweden)
Governing body responsible for training   Royal College of Surgeons
UNIVERSITY based education
Local Hospital
APPRENTICESHIP model. Guidelines from Swedish surgical Society and National Board of Health and Welfare
Announcement of training positions   Core Surgical Training positions are announced once/year and open to all eligible applicants. Local traditions at each recruiting hospital.
Locum positions are customarily not externally announced.
Application process
  Checklist of eligibility, required documents and exams Checklist available No standardization or checklist exist
Trainee positions are internally and/or externally announced depending on employer’s choice.
Personal letter - Email or letter to head of surgical department or head surgeon responsible for trainee doctors
CV Standardized.
1) Verification of presentations, publications
2) case reports
3) audits
4) attendance at meetings, courses
Not standardized
No checklist available
Reference forms Two references required Not standardized
Contact details to one or two references
Letter of support from supervisor If applicable -
Exams 1. MRCS Part A/B results
If applicable
2. Verification of Eligibility for the Irish Medical Council Trainee Division
Medical exam and passed internship resulting in medical license.
Assessment of candidates
Exams Undergraduate academic record
15% of total score
Objective assessment Pass/fail medical exam
Aptitude Surgical Aptitude
15% of total score
Psychomotor skills,
Visuospatial ability perception
Laparoscopy test
Not investigated
Interview Multiple Mini Mini Interviews at four stations, each lasting 8 min, 2 faculty members interview and rate individually No guidelines exist.
All interviews differ between hospitals and depend on the head of departments own structure. Clinical scenarios are not customarily assessed.
Clinical judgment
15% of total score
Structured sequential clinical scenario × 2
Interpersonal skills
15% of total score
Crisis management
Negotiation/conflict resolution
Professional Development
15% of total score
Clinical research projects
Attendance at meetings /courses
Audit projects
Teaching activities
Suitability for speciality training
15% of total score
Knowledge of speciality
Time/stress management
Work ethic/professionalism
Score & ranking Ranking of candidates. Highest score chose first Maximum score 100 Not performed in a structured and transparent manner
Cut After 2 years selection for higher surgical training is conducted -