When residency programs evaluate medical school applicants for a few coveted spots, they typically consider grades, standardized test scores, recommendations and interviews.

But researchers from one head and neck specialty program found that a resident having excelled in team sports was a more accurate predictor of success in the program than any of those other factors.

Lead researcher Dr. Richard Chole from Washington University School of Medicine in St. Louis said he'd been "mystified" that applicants with great grades and medical school recommendations didn't end up necessarily being the best doctors by the end of residency training.

But now, he said, it makes sense that being part of a team helps prepare people for a career in medicine.

"There's a lot more to being a good doctor than answering multiple-choice questions," Chole told Reuters Health.

"In the operating room, it's not just a principal surgeon doing the surgery - it's an anesthesiologist and all the nurses," he said. "Unless a person is willing and able to work with a team, they don't do well."

Chole and co-author Dr. M. Allison Ogden went back and evaluated the original applications of their last 46 residents in the head and neck training program, comparing applicant qualities with faculty members' assessments of who ended up being a good doctor.

There was no link between applicants' scores on medical licensing exams or their medical school recommendation letters and the post-residency assessments, the researchers reported in the Archives of Otolaryngology-Head & Neck Surgery.

Interview scores from the application process were "weakly correlated" with residency performance, as were the rankings of applicants' medical schools.

Only students' past "established excellence in a team sport" - as opposed to mere proficiency in an athletic skill, or no sports experience - was clearly linked to faculty members' assessments.

"Team sports are actually a very telling thing. That's what medicine is nowadays," said Dr. Marvin Fried, an otorhinolaryngologist from Albert Einstein College of Medicine and Montefiore Medical Center in the Bronx, New York.

"If they have achieved well as team player, they tend to do the same as a professional physician," Fried, who wasn't involved in the new study, told Reuters Health.

Chole said the results of the study have already changed the way he and his colleagues evaluate applicants for their residency programs. Rather than focusing on test scores and grades, he said they're now looking for evidence that a candidate has experience in something that requires teamwork, like a sport or a musical group.

"It's disturbing really that the goal of most medical students is just to get great grades," he said.

The researchers are looking to conduct a bigger study across more residency programs and possibly other disciplines, Chole added. The current research was "not a very rigorously-done study - it was sort of ad hoc," he said.

What's more, he said, his team's sample was skewed: all of the residents were very good students to begin with. It's possible that if the study included medical students with much lower grades and test scores, there would be a clearer difference in which ones went on to make good doctors based on those measures.

Still, Chole said those limitations don't change the main message.

"We really look at this as a combination of being able to hold others accountable for what they do, holding yourself accountable and having others hold you accountable," he said. "Medicine is a team sport."

SOURCE: bit.ly/NDm4xb Archives of Otolaryngology-Head & Neck Surgery, online August 20, 2012.

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