Applicants Selection Process for Orthodontic Programs in Saudi Arabia: Survey of Program Directors

doi:10.21203/rs.3.rs-4727631/v1

Introduction:

In recent years, Saudi Arabia has experienced a noteworthy increase in the annual influx of dentistry graduates, prompting expectations of a corresponding rise in postgraduate study applications. Consequently, postgraduate program directors find themselves compelled to continually refine their selection criteria, utilizing a combination of objective and subjective measures. Limited research exists on the selection process for orthodontic programs, with no studies conducted to investigate this process in Saudi Arabia. The study aims to describe the applicant selection criteria for orthodontic specialty programs in Saudi Arabia, offering insights from the perspective of orthodontic program directors.

Method:

The research surveyed orthodontic program directors in Saudi Arabia on general program information, details obtained from applications, the interview process, the decision-making process, a retrospective view of currently accepted applicants and the criteria used for selection, and demographic information of program directors. Self-administered questionnaires were distributed via Google Forms. Statistical analysis involved descriptive statistics and ranking.

Results:

Most programs were hospital-based (75%), primarily in central and western regions. Interview ratings, class rank, and recommendation letters were top factors, with research experience and clinical attachment also crucial. Interviews were mandatory, often lasting 15 minutes. Positive characteristics included maturity, attire, and analytical thinking. Selection committees, including program directors and faculty, played a vital role in admitting applicants.

Conclusion:

This study provides valuable insights for dentists aspiring to apply for the Saudi Board of Orthodontics. Understanding the selection criteria, prioritizing training in the desired orthodontic department, and emphasizing research in orthodontics enhance applicants' chances. The findings aim to improve the transparency and fairness of the selection process, ultimately strengthening orthodontic education in the country.

In recent years, Saudi Arabia has experienced a noteworthy surge in the annual influx of dentistry graduates, prompting expectations of a corresponding rise in postgraduate study applications. (1) Consequently, postgraduate program directors find themselves compelled to continually refine their selection criteria, utilizing a combination of objective and subjective measures. This annual refinement is necessary to ensure an equitable and fair selection process, maintaining the integrity of the programs.

Factors influencing program selection for postgraduate studies can vary depending on individual preferences and goals. (2). In a prior study conducted in the United States of America (USA), a survey was administered to 230 prosthodontics residents to assess potential factors that could shape applicants' program preferences (2). The findings indicated that the reputation of the residency program was rated as the most crucial factor by participants. Following this, the personality of the program director, curriculum content, access to cutting-edge digital technologies, and opportunities for dental implant placement were also identified as significant influencers (2).

Green et al examined the selection criteria used by program directors across 21 medical specialties. (3) Their findings shed light on the factors that influence the selection process and the varying importance of these factors within different specialties. (3) One of the key findings is that clinical performance, particularly grades in clerkships and the USMLE Step 1 score, which assesses a student's knowledge and understanding of basic medical concepts, are highly valued across all specialties. (3) Notably, research experience is of greater significance in highly competitive specialties. (3)

Mattar SG et al. conducted a study to evaluate the level of readiness among general surgery graduate trainees as they transition into surgical subspecialty fellowships in North America. (4) The findings brought attention to shortcomings, including limited independent decision-making during surgeries, inadequate patient responsibility, and a lack of scholarly involvement after completing general surgery education. (4)

These insights collectively underscore the multifaceted nature of postgraduate medical and dental education, where the interplay of applicant preferences, program director criteria, and identified educational shortcomings contributes to the complex landscape of residency and fellowship programs. Recognizing the intricate nature of postgraduate dental education, it is imperative to address existing research gaps. There is limited research on the criteria used for selecting candidates in orthodontic programs, especially in Saudi Arabia. This study aims to address this gap by investigating the factors considered by program directors when choosing applicants for orthodontic specialty programs in Saudi Arabia. The results of this study will offer valuable insights that can assist dentists in improving their chances of being accepted into these specialized programs.

Ethical approval was obtained from the research office of King Abdullah International Medical Research Center (KAIMRC), Saudi Arabia (NRC22R/505/10). The study was conducted in Saudi Arabia, focusing on active orthodontic specialty program directors, and in accordance with the Declaration of Helsinki. The initial phase involved acquiring a list of local committee members and program directors affiliated with the Saudi Board of Orthodontic and Dentofacial Orthopedics for the training year 2022-2023. This compilation included contact details such as email addresses and phone numbers of the program directors. An informed consent was provided to and signed by all participants. Communication was initiated through an initial email, subsequently reinforced by a follow-up text message, ensuring comprehensive coverage of the entire target population within the study. This study adopts a self-administered, close-ended questionnaire distributed electronically via Google Forms and distributed to all 34 orthodontic program directors in the country. The inclusion criteria comprise current orthodontic specialty program directors in Saudi Arabia, while exclusion criteria include former directors and those from programs not accredited by the Saudi Commission for Health Specialties (SCFHS). The questionnaire encompasses six main sections, covering general program information (Section A), details obtained from applications (Section B), interview-related inquiries (Section C), the decision-making process for selecting qualifying applicants (Section D), a retrospective view of currently accepted applicants and the criteria used for selection (Section E), and demographic information of program directors (Section F).

Statistical analysis

Upon obtaining the completed surveys, the responses were tabulated on an electronic spreadsheet (Microsoft Excel 2016, Redmond, WA, United States) and obtained descriptive statistics using SPSS (Version 21.0, IBM Corp, Armonk, NY, USA). The data were analyzed and compiled into frequency and percentage. The results were tabulated and ranked appropriately where applicable.

Most participants from accredited orthodontic programs in Saudi Arabia (n=24, 75%) were hospital-based and 8 (25%) were from university. Most of the program directors were male (n=18, 56.3%). In terms of duration in their position as program director, the majority of the program directors (n=22, 69%) had been in this position for 4 years or less, while two program directors were there for 14 years (Table. 1). The mean age of the program directors was 46.18 ± 9.51 years. Most of the program directors (n=18, 56.3%) were orthodontic residents from South Arabia (Table 1).

Table 1: Descriptive statistics of the program directors.

Part F	Options	Frequency	Percent
Gender	Females	14	43.8
Gender	Males	18	56.3
Length of time as program director at this institution: (in years)	< 1 year	3	9.3
	1	3	10.0
	2	8	25.0
	4	8	25.0
	5	1	3.1
	6	1	3.1
	7	2	6.3
	8	1	3.1
	10	1	3.1
	12	1	3.1
	14	2	6.3
	At the beginning of this year	1	3.1
Where did you take your orthodontic residency?	France	1	3.1
	Hong Kong	1	3.1
	Ireland and the United Kingdom	1	3.1
	South Arabia	18	56.3
	United Kingdom	2	6.3
	United States\Canada	9	28.1
Mean age (Mean ± S.D)	46.18 ± 9.51

The orthodontics specialty program was in central (n=15, 46.9%), western (n=12, 37.5%), eastern (n=2, 6.3%), and northern regions (n=1, 3.1%). The number of applicants who attended the interviews varied between the programs. The programs in the central regions were the only programs that had more than 40 applicants attending the interviews. On contrast, other programs in Saudi Arabia reported less number of applicants attending the interviews. Overall, less than 10 applicants showed up to the interview in 50% of the programs (16 training centers), 10-20 applicants showed up to the interview to 6 training centers, while 3 training centers reported attendance of 21-30 applicants. There were 2 program directors who reported attendance of 31-40, while 5 training centers had more than 41 applicants attending the interviews. Around 40% of the program directors , a fresh graduate (Graduated within the last two years) has a higher chance of acceptance in their program than older candidates and the gender of applicants is not important for acceptance in their program according to 30 (93.8%) program directors (Table 2).

Table 2: Descriptive statistics of the training center.

Part A	Options	Frequency	Percent
What best describes your program?	Hospital-based	24	75.0
What best describes your program?	University-based	8	25.0
Where is your program located?	Central Region	15	46.9
	Eastern Region	2	6.3
	Northern region	1	3.1
	Southern region	2	6.3
	Western Region	12	37.5
How many applicants showed up to the interview this year (2022)?	10-20	6	18.8
	21-30	3	9.4
	31-40	2	6.3
	less than 10	16	50.0
	More than 41	5	15.6
How many applicants were accepted in your program for this academic year (2022), current R1s?	0	4	12.5
	1	13	40.6
	2	10	31.2
	3	3	9.4
	4	1	3.1
	Did not accept any	1	3.1
What percentage of the applicants met your basic requirements for consideration?	1%-20%	2	6.3
	21%-40%	4	12.5
	41%-60%	7	21.9
	61%-80%	9	28.1
	81%-100%	10	31.3
Of the applicants who were accepted, what percentage was it from your own institution?	1%-20%	6	18.8
	21%-40%	2	6.3
	41%-60%	3	9.4
	61%-80%	2	6.3
	81%-100%	7	21.9
	N/A	12	37.5
How many students will graduate from your program next year?	0	6	18.8
	1	10	31.2
	2	12	37.5
	4	2	6.3
	6	1	3.1
	The seniors are still in R3	1	3.1
Has your program changed the number of accepted applicants within the last 5 years?	No	15	46.9
	Yes	17	53.1
If ''yes''	NA	15	46.9
	Decreased	7	21.9
	Increased	10	31.3
Are you considering increasing or decreasing the number of accepted residents?	Decreasing	3	9.4
	Increasing	11	34.4
	No changes planned	18	56.3
Does a fresh graduate (Graduated within the last two years) have a higher chance of acceptance in your program than older candidates?	No	19	59.4
	Yes	13	40.6
Is the gender of applicants important for acceptance in your program?	No	30	93.8
	Yes	2	6.3
If ''yes''	Male	30	93.8
If ''yes''	Female	2	6.3

According to the participants, the top three factors in the application were interview ratings, dental school class rank, and letters of recommendation. The least important factors or those that were not commonly requested were a personal statement, resident feedback, SDLE score, Academic score, academic honors, publication/research experience, extracurricular activity, private practice experience, orthodontic-related knowledge, orthodontic externship, dexterity skills, onsite oral presentations. For letters of recommendation, the most highly regarded source was the reputation of the recommending person (n=20, 62.5%) followed by the quality of the language and content of the recommendation (n=6, 18.8%) and the number of recommendations (n=2, 6.3%). The majority of the program directors (n=12, 37.5%) opined that orthodontic faculty was the nested source of applicant recommendation letters followed by a graduate program (n=11, 34.4%), private practice orthodontist (n=5, 15.6%), orthodontic department chair (n=3, 9.4%) and from the research advisor (n=1, 3.1%). (Figure 1) The majority of the participants gave feedback that (n=15, 46.9%) research related to the field of orthodontics is the most important factor to be seen with respect to research experience followed by quality of publications, publishing in prestigious journals, research related to the field of orthodontics and quantity of publications. Most of the program directors opined that (n=22, 68.8%) the applicant worked/took an elective board is the most important factor to be seen in their previous background in orthodontics (Table 3).

Table 3: Evaluation factors

Part B		Options	Frequency	Percent
	Interview	Important	6	18.8
	Interview	Not very important	2	6.3
	Ratings	Not very important	2	6.3
	Ratings	Very important	24	75.0
Q/ On a scale from (Very important) to	Dental school class rank	Important	19	59.4
		Important, Not very important	1	3.1
		Not very important	6	18.8
(Not important		Not very important	6	18.8
(Not important		Very important	6	18.8
at all), please		Very important	6	18.8
at all), please		Important	19	59.4
choose the		Important	19	59.4
response that best describes the importance	Letters of recommendation	Important, Not very important	2	6.3
response that best describes the importance	Letters of recommendation	Not very important	9	28.1
of each factor		Very important	2	6.3
considered in		Very important	2	6.3
considered in		Important	15	46.9
the orthodontic applicant selection	Dental School Grades	Important	15	46.9
		Not very important	4	12.5
		Very important	13	40.6
process:		Very important	13	40.6
process:		Important	9	28.1
	Personal	Important	9	28.1
	Personal	Not very important	10	31.3
	Statement	Not very important	10	31.3
	Statement	Very important	13	40.6
		Important	19	59.4
	Resident feedback	Not very important	5	15.6
	Resident feedback	Very important	8	25.0
	SDLE score	Important	20	62.5
		Not important at all	2	6.3
		Not very important	4	12.5
		Very important	5	15.6
		Very important, Important	1	3.1
	Academic Honors	Important	22	68.8
		Not very important	4	12.5
		Very important	6	18.8
	Publications/ research experience	Important	15	46.9
		Not very important	10	31.3
		Very important	7	21.9
	Extracurricular activity	Important	17	53.1
		Not important at all	2	6.3
		Not very important	6	18.8
		Very important	7	21.9
	Private practice experience	Important	12	37.5
		Not important at all	3	9.4
		Not very important	11	34.4
		Not very important, Not important at all	1	3.1
		Very important	5	15.6
	Orthodontic- related knowledge	Important	19	59.4
		Not very important	4	12.5
		Very important	8	25.0
		Very important, Important	1	3.1
	Orthodontic externship	Important	21	65.6
		Not very important	4	12.5
		Very important	7	21.9
	Dexterity skills	Important	18	56.3
	Dexterity skills	Not important at all	2	6.3
		Not very important	12	37.5
	On-site oral presentations	Important	17	53.1
		Not important at all	2	6.3
		Not very important	4	12.5
		Very important	9	28.1
Which of the following recommendations criteria is more important?		Mode of recommendation, such as phone calls or written letters	4	12.5
		Number of recommendations	2	6.3
		Quality of the language and content of the recommendation	6	18.8
		The reputation of the recommending person	20	62.5
In your opinion, what is the best source of applicant recommendation letters?		Orthodontic department chair	3	9.4
		Orthodontic faculty	12	37.5
		Orthodontic graduate program director	11	34.4
		Private practice orthodontist	5	15.6
		Research advisor	1	3.1
Which of the following is the most important regarding research experience?		Publishing in prestigious journals	6	18.8
		Quality of publications (In terms of proper design, well execution, and writing quality)	9	28.1
		Quantity of publications (Regardless of if they are in Orthodontics or not)	2	6.3
		Research related to the field of orthodontics	15	46.9
Which of the following is the most important factor regarding "previous background in Orthodontics"?		The candidate worked/ took an elective abroad	2	6.3
		The candidate worked/ took an elective session at your department	22	68.8
		The candidate worked/ took an elective with a distinguished orthodontist in the private sector	8	25.0

All 32 program directors reported requiring an interview as part of the applicant selection process. The final decision on which applicants to invite for an interview was commonly the responsibility of a committee. The committee was composed of various people, including the program director, chair and faculty members. The duration of the interview process varied greatly, but more than half of the training centers (n=18, 56.3%) had interviews that lasted 15 minutes. Maturity, presentable attire, and analytical thinking were the top three positive characteristics, ranked in order of importance. The least favored characteristics were aggressiveness and nervousness (Table 4).

Table 4: Interview Assessment

Part C	Options	Frequency	Percent
In your program, how long the interview process last for each applicant?	15 minutes	18	56.3
	15-30 minutes	11	34.4
	30-45 minutes	3	9.4
Does the interview process include an informal event (e.g., social event )?	No	25	78.1
	Yes	7	21.9
The interview process is usually conducted by:	Program director	6	18.8
	Program director, Current residents, Department chairman, Full- time orthodontic faculty	1	3.1
	Program director, Current residents, Department chairman, Full- time orthodontic faculty, Staff members	1	3.1
	Program director, Current residents, Department chairman, Part-time orthodontic faculty	1	3.1
	Program director, Current residents, Department chairman, Part-time orthodontic faculty, Full-time orthodontic faculty, Staff members	2	6.3
	Program director, Current residents, Full-time orthodontic faculty	1	3.1
	Program director, Department chairman	1	3.1
		Program director, Department chairman, Full- time orthodontic faculty	4	12.5
		Program director, Department chairman, Part-time orthodontic faculty, Full-time orthodontic faculty	2	6.3
		Program director, Department chairman, Part-time orthodontic faculty, Full-time orthodontic faculty, Staff members	1	3.1
		Program director, Department chairman, Staff members	2	6.3
		Program director, Full-time orthodontic faculty	4	12.5
		Program director, Full-time orthodontic faculty, Other dental school faculty, Staff members	1	3.1
		Program director, Full-time orthodontic faculty, Staff members	1	3.1
		Program director, Part-time orthodontic faculty	1	3.1
		Program director, Part-time orthodontic faculty, Full-time orthodontic faculty	2	6.3
		Program director, Staff members	1	3.1
	Maturity	Important	5	15.6
On a scale from (Very important) to (Not important at all), please tick the response that best describes favorability considered in applicant character traits:		Very important	27	84.4
	Presentable appearance/attire	Important	17	53.1
	Presentable appearance/attire	Very important	15	46.9
	Analytical thinking	Important	7	21.9
		Not very important	2	6.3
		Very important	23	71.9
	Co-operation skills	Important	9	28.1
	Co-operation skills	Very important	23	71.9
	Social skills	Important	12	37.5
		Not very important	2	6.3
		Very important	18	56.3
	Confidence	Important	11	34.4
	Confidence	Very important	21	65.6
	Honesty	Important	6	18.8
	Honesty	Very important	26	81.3
	Empathy	Important	13	40.6
	Empathy	Very important	19	59.4
	Organization skills	Important	8	25.0
	Organization skills	Very important	24	75.0
	Enthusiasm	Important	10	31.3
		Not very important	1	3.1
		Very important	21	65.6
	Research experience	Important	13	40.6
		Important, Not very important	1	3.1
		Not important at all	1	3.1
		Not very important	12	37.5
		Very important	5	15.6
	Agreeability	Important	20	62.5
		Not very important	3	9.4
		Very important	9	28.1
	Teaching potential	Important	15	46.9
		Not very important	9	28.1
		Very important	7	21.9
		Very important, Important	1	3.1
	Aggressiveness	Important	5	15.6
		Not important at all	10	31.3
		Not very important	5	15.6
		Not very important, Not important at all	1	3.1
		Very important	10	31.3
		Very important, Not important at all	1	3.1
	Anxiousness/nervousness	Important	8	25.0
		Not important at all	11	34.4
		Not very important	5	15.6
		Very important	8	25.0

The final decision on the applicants admitted to the program was the responsibility of a selection committee in the majority of the institutions (n=27, 84.45%). The selection committee included full-time orthodontic faculty, program directors, Department chair, part-time orthodontic faculty, residents, and others, but the most prevalent combinations included the program director, department chairman, and full-time orthodontic faculty (n=12, 37.5%) (Table 5).

Table 5: Acceptance Process

Part D	Options	Frequency	Percent
Who makes the final decision on candidate acceptance?	Program director alone	5	15.6
Who makes the final decision on candidate acceptance?	Selection Committee	27	84.4
Which of the following individual(s) participates in the decision process in your program? (Check all that apply)	Full-time orthodontic faculty	1	3.1
	Program director	1	3.1
	Program director, Department chairman, Full-time orthodontic faculty	12	37.5
	Program director, Department chairman, Full-time orthodontic faculty, Part-time orthodontic faculty	3	9.4
	Program director, Department chairman, Full-time orthodontic faculty, Part-time orthodontic faculty, Other/s	1	3.1
	Program director, Department chairman, Full-time orthodontic faculty, Part-time orthodontic faculty, Residents	1	3.1
	Program director, Department chairman, Full-time orthodontic faculty, Residents	2	6.3
	Program director, Department chairman, Part-time orthodontic faculty	1	3.1
	Program director, Department chairman, Part-time orthodontic faculty, Residents	1	3.1
	Program director, Department chairman, Residents	1	3.1
	Program director, Full-time orthodontic faculty	2	6.3
	Program director, Full-time orthodontic faculty, Part-time orthodontic faculty	1	3.1
	Program director, Full-time orthodontic faculty, Part-time orthodontic faculty, Residents	1	3.1
	Program director, Full-time orthodontic faculty, Residents	3	9.4
	Program director, Other/s	1	3.1

About 56.3% (n=18) of the program directors reported satisfaction with their current selection process and the majority (n=18, 56.3%) of them reported that they would select all of their current and former residents from the past 5 years again. According to half of the respondents, the applicants have remained the same over the past 5 years in terms of credentials and quantity. Most of the program directors (n=7, 21.9%) reported that 61%-80% of the residents would get admission again. (Figure 2) Half of the program directors (n=16, 50%) were satisfied with the current applicant pool to their program (Table 6).

Table 6: Assessment of currently accepted residents

Part E	Options	Frequency	Percent
How satisfied are you with the current selection process?	Not satisfied	1	3.1
	Somewhat satisfied	18	56.3
	Very satisfied	13	40.6
Would you select all of your current and/or former residents from the last 5 years again?	No	14	43.8
	Yes	18	56.3
If "no," what is the percentage of the residents that you would admit again?	NA	15	46.9
	1%-20%	3	9.4
	21%-40%	2	6.3
	41%-60%	1	3.1
	61%-80%	7	21.9
	81%-100%	4	12.5
How satisfied are you with the current applicant pool to your program?	Not satisfied	1	3.1
	Somewhat satisfied	15	46.9
	Very satisfied	16	50.0

The orthodontic programs face a substantial influx of applicants annually, highlighting the imperative need for a systematic methodology to optimize their selection criteria and identify the most suitable candidates (5). In the current study, a total of 32 program directors were involved, with 24 individuals (75%) affiliated with hospital-based programs and the remaining 8 (25%) associated with a university-based program. In terms of gender distribution, a majority of the participants were male, comprising 18 individuals (56.3%).

When it comes to the selection process among the study's participants, decisions were made through varying mechanisms, including program directors alone in 5 cases (15.6%) and selection committees in 27 cases (84.4%). Notably, despite differences in the decision-making authority, the factors influencing the selection process remained consistent, with interview ratings, dental school class rank, and letters of recommendation emerging as key determinants. This aligns with the findings of a study conducted by Galang et al., which aimed to evaluate the selection procedures for orthodontic specialty programs in the United States, revealing that class ranking within dental school and the strength of letters of recommendation played pivotal roles (5).

Moreover, research experience emerged as another crucial factor in the selection of applicants. The Commission on Dental Accreditation in the United States mandates research involvement as a prerequisite for orthodontic specialty programs (6). In our study, a majority of participants, specifically 15 individuals (46.9%), expressed a preference for applicants with research experience directly related to the field of orthodontics. This underscores the significance of research work in the nomination process, further emphasizing its importance within the realm of orthodontic program admissions.

Ardeshna et al. conducted a study that demonstrated that applicants with National Board Dental Exam (NBDE-1) scores below 90 were excluded from the high-ranking group of applicants. However, in contrast to their findings, our present study did not reveal a significant preference for Saudi Dental Licensure Exam (SDLE) scores as a determining factor in the selection process (6).

Brodie et al. reported that the Joint Commission on National Dental Examinations (JCNDE) recommended that NBDE scores should not be considered in ranking candidates (7). In line with this recommendation, our study reinforces the importance of the SDLE score in the selection process but does not position it as one of the primary factors driving candidate ranking.

When it comes to evaluating the effectiveness of the current selection process, it's noteworthy that half of the study's participants, comprising 16 individuals (50%), expressed satisfaction with their applicant pool. However, what sets our findings apart from those of Galang et al. is that the majority of our participants, specifically 18 individuals (56.3%), indicated their intention to re-choose their current and former residents from the past 5 years. This contrasts with Galang et al.'s study, where the percentage dropped to only one-third (36%) (5). Interestingly, our study also revealed that 13 participants (40.6%) believed that fresh graduates had a higher chance of acceptance. This observation finds support in a study conducted in the United States by Grillo et al., which reported that younger dental graduates demonstrated an elevated level of proficiency within orthodontic residencies (8).

The debate surrounding the reliance on applicants' grades and scores is a well-discussed issue, as highlighted in studies by Brodie AJ et al., Brothers TE et al., and Dirschl DR et al. (7, 9, 10). While medical school grades were found to have a negative impact on residents' clinical performance, they had a positive influence on standardized licensure examination scores (10). At the Saudi Board of Orthodontics (SBO), the admission process does not solely depend on applicants' scores and grades. The first match is primarily based on these factors, with exceptions made for work or clinical experience. However, it's important to note that the first match does not guarantee final acceptance to the program. This underscores the significance of the interview as a crucial component in the acceptance process, which allows for a more holistic evaluation of candidates.

In the realm of medical fields, the interview has consistently emerged as the most crucial factor in applicant selection (4, 11). In alignment with this perspective, all participants in our study required an interview as part of their applicant selection process. However, it's notable that the number of applicants varied among different centers. The highest percentage, comprising 16 participants (50%), reported that in 2022, less than 10 applicants appeared for the interview. This variation starkly contrasts with the findings of Galang et al., who reported a wider range of 10 to 60 applicants per center. This variability underscores the potential impact of the size of the applicant pool on the selection process.

Similarly, the number of applicants accepted into the program for the current academic year exhibited variability among our participants. While the majority accepted one or two applicants, a smaller proportion accepted three, and some even reported not accepting any applicants. This variability indicates a degree of selectivity within the selection process.

The duration of the interview process is another important consideration. Galang et al. reported a range of 4 to 8 hours (5), whereas in our present study, 18 participants (56.3%) conducted 15-minute interviews with each applicant. Among the positive characteristics considered important by our participants, maturity, presentable attire, and analytical thinking were ranked highest. Conversely, aggressiveness and nervousness were the least favored characteristics, aligning with the findings of Galang et al. (5).

In terms of trends over the past five years, a majority of participants reported either a decrease or an increase in the number of accepted applicants, indicating potential shifts in program capacity or demand. However, most participants did not anticipate significant changes in the near future, suggesting stability in the program's admissions.

Other studies in various dental specialties, such as pediatric dentistry (Justema et al.) (12), endodontics (Bell et al.) (13), and periodontics (Khan et al.) (14), have also assessed factors influencing resident acceptance. Across these specialties, the maturity of the resident consistently emerged as a highly desirable quality. Notably, almost half of the postdoctoral periodontal programs (49%) accepted residents from their own institutions (14). In our study, a significant number of participants (22, or 68.8%) preferred candidates who had previously worked or completed elective sessions in their department. For endodontic specialty programs, a valuable letter of recommendation was associated with endodontists in academia (13). In contrast, our study indicated that 20 participants (62.5%) placed greater emphasis on the reputation of the recommending person. These findings emphasize the diverse factors influencing resident acceptance across different dental specialties.

The findings of our present study offer a valuable resource for dentists aspiring to join the Saudi Board of Orthodontics (SBO). As a result, applicants can better align their qualifications and characteristics with SBO's preferences. Notably, candidates should consider acquiring training within the same department or center they aspire to join, as this was a preference among a significant number of participants. Furthermore, research work in the field of orthodontics should be prioritized, with less emphasis on factors like journal ranking and the quantity and quality of publications.

However, it's important to acknowledge the limitations of the study. The research may have missed valuable insights that could have been gleaned through open-ended questions or interviews. Additionally, considering the evolving nature of orthodontic education and practice, the study's ability to capture these evolving perspectives may have been limited, especially if conducted over an extended period. To address these limitations in future research, a mixed-methods approach could be beneficial. This approach would combine quantitative data from closed-ended questions with qualitative data obtained through open-ended questions or interviews, providing a more comprehensive understanding of the subject matter. Furthermore, adopting a longitudinal study design could help track changes in perspectives over time, ensuring that evolving viewpoints are accurately documented. This way, future studies can offer even more nuanced and up-to-date insights into the dynamics of orthodontic program admissions and selection criteria.

Ethics declarations

Ethical approval of the Study Protocol

Ethical approval was obtained from the research office of King Abdullah International Medical Research Center (KAIMRC), Saudi Arabia (NRC22R/505/10). Written informed consent was obtained from all participants.

Human Ethics and Consent to Participate declarations: not applicable

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

This study received no financial funding.

Author Contribution

S.A. , G.A. S.A. Data collection, S.A. Statistics, S.A. , G.A. S.A. Wrote initial draft of the manuscript , E.A. Wrote final draft, All authors reviewed the manuscript

AlBaker AA, Al-Ruthia YSH, AlShehri M, Alshuwairikh S. The characteristics and distribution of dentist workforce in Saudi Arabia: A descriptive cross-sectional study. Saudi Pharm J. 2017;25(8):1208–16.
Wojnarwsky P, Wang Y, Shah K, Koka S. Factors Influencing Resident Choice of Prosthodontic Residency Program. J Prosthodont [Internet]. 2017;26(4):339–343. Available from: https://www.semanticscholar.org/paper/511cbfbeb2db391257f4d6d4c37061a44954d91e
Green, Marianne MD; Jones, Paul MD; Thomas, John X. Jr PhD. Selection Criteria for Residency: Results of a National Program Directors Survey. Academic Medicine 84(3):p 362-367, March 2009. | DOI: 10.1097/ACM.0b013e3181970c6b
Mattar SG, Alseidi AA, Jones DB, Jeyarajah DR, Swanstrom LL, Aye RW, Wexner SD, Martinez JM, Ross SB, Awad MM, Franklin ME. General surgery residency inadequately prepares trainees for fellowship: results of a survey of fellowship program directors. Annals of surgery. 2013 Sep 1;258(3):440-9.
5. Galang M, Yuan J, Lee DJ, Sukotjo C. Applicant selection procedures for orthodontic specialty programs in the United States: survey of program directors. Am J Orthod Dentofac [Internet]. 2011;140 6(6):822-827.e4. Available from: https://www.semanticscholar.org/paper/3ec2d49653d3f9c2c22956d83c1953f961314b91
Commission on Dental Accreditation. Accreditation Standards for Advanced Specialty Education Programs in Orthodontics and Dentofacial Orthopedics. Chicago: American Dental Association; 2008.
Brodie AJ, Crow H, Eber R, Handysides R, Holexa R, Kiat-amnuay S, et al. Evaluating postdoctoral dental candidates: assessing the need and recommendations for a national qualifying examination. J Dent Educ [Internet]. 2011;75 6(6):719–25. Available from: https://www.semanticscholar.org/paper/e545e44cad3e3fba4c8c0a4f32208c4ff7a1e7e7
Grillo AC, Ghoneima A, Garetto L, Bhamidipalli S, Stewart K. Predictors of orthodontic residency performance: An assessment of scholastic and demographic selection parameters. Angle Orthod [Internet]. 2019;89 3(3):488–94. Available from:https://www.semanticscholar.org/paper/5bfca7225e13ebaff47b44c3fe5a0621255dfb85
Brothers TE, Wetherholt S. Importance of the faculty interview during the resident application process. J Surg Educ 2007;64: 378-85
Dirschl DR, Campion ER, Gilliam K. Resident selection and predictors of performance: can we be evidence based? Clin Orthop Relat Res 2006;449:44-9
Taylor CA, Weinstein L, Mayhew HE. The process of resident selection: a view from the residency director’s desk. Obstet Gynecol 1995;85:299-303.
Justema RB, Majewski R, Salzmann L, Murdoch-Kinch C, Boynton J. Contemporary appraisal of factors influencing pediatric dental program director’s selection of residents. J Dent Educ [Internet]. 2020;(7). Available from:https://www.semanticscholar.org/paper/f6b60d1a62d62b12b454e9ab89dc8d8349f84bee
Bell LT, Sukotjo C, Yuan J, Johnson BR. Applicant selection procedures in endodontic specialty programs in the United States: program director’s perspective. J Endodont [Internet]. 2013;40 6(6):797– 804. Available from: https://www.semanticscholar.org/paper/4e0e940120a197602f1b0d73745653533b684ce6
Khan S, Carmosino AJ, Yuan JC, Lucchiari N, Kawar N, Sukotjo C. Postdoctoral Periodontal Program Directors’ Perspectives of Resident Selection. J Periodontol. 2015;86(2):177–84.

No competing interests reported.

Applicants Selection Process for Orthodontic Programs in Saudi Arabia: Survey of Program Directors

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Abstract

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Introduction

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Author Contribution

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