Yes, shockingly, selecting a surgeon based on an academic transcript and 15-minute interview is a fallible process. The best we can do is look for glaring red flags, and at least once a year we blackball someone who is clearly crazy. One year, there was a set of identical twins. They each spent the whole interview slamming the other. That is the reddest flag, and neither became neurosurgeons.
Some students try to increase their chances by doing an away-rotation at the hospital of their desired residency. They'll basically spend a month at our hospital trying to impress everybody, usually closing out with a lecture. One year a kid clicked open the wrong folder right before his lecture started and accidentally showed his porn preferences to the audience. We're talking hardcore anal. If he'd been a proctologist, that might have been forgivable...
Here's how Match Day works: On the hiring team, we interview candidates and submit our hiring preferences, and then a mysterious computer algorithm sorts through both those and the applicants' preferences, and jobs get assigned. Both the program and the applicant are then legally obliged to offer and accept the job. You may have noticed there's no time allotted there for a psychological profile, an evaluation of how they will fit into a team, or how they will respond to pressure.