A national , stratified random sample of 405 graduate medical education program directors was surveyed on the way they selected their residents . The results from the 237 respondents reaffirm earlier studies which found that the interview was the most important selection variable . The results indicate that the recent increase in competition for residency positions has increased the importance of academic variables . For example , 86 percent of the respondents stated that they would not rank a candidate who had not passed the National Board of Medical Examiners Part I examination . Because 86 percent also stated that they give preference in ranking students to those who have done well in an elective at their hospitals , the senior year of medical school may be used as a “residency chase ” rather than for the general professional education of the physician .