An Analysis of Trends in National Residency Matching Program Match Data for Orthopedic Surgery

Abstract

Due to electronic residency applications, US Medical Licensing Examination Step 1 scores are frequently used by orthopedic surgery program directors to screen applicants. Prospective applicants therefore often use Step 1 scores as a proxy for specialty competitiveness. The goal of this investigation was two-fold: (1) to determine whether trends in Step 1 scores are indicative of trends in competitiveness of orthopedic surgery and (2) to report the characteristics that optimize a US medical student's match success. A retrospective review of published National Resident Matching Program data from 2009 to 2018 was performed for orthopedic surgery residency applicants. Additional data from the Charting Outcomes reports were used for specific analyses of applicant characteristics. From 2009 to 2018, the number of orthopedic surgery residency positions grew at an annual rate of 1.51% (95% confidence interval [CI], 1.37% to 1.64%; P <.001), accommodating the 1.26% (95% CI, 0.63% to 1.90%; P =.006) annual increase in the number of applicants who ranked orthopedic surgery as their preferred specialty choice (only choice or first choice). There were no significant changes in the applicant-to-position ratio (95% CI, −0.85% to 0.37%; P =.483) or the match rate for US seniors who ranked orthopedic surgery as their preferred choice (95% CI, −0.23% to 0.87%; P =.313). Increases in mean Step 1 scores of matched orthopedic surgery applicants parallel national Step 1 growth trends (0.49% vs 0.44%, respectively). Although orthopedic surgery is currently a competitive specialty to match into, this has been the case since 2009. Increasing Step 1 scores of matched applicants is not unique to orthopedic surgery and should not be misinterpreted as a proxy for increasing competitiveness of the specialty. [ Orthopedics . 2020;43(6):e616–e622.]

Which Application Factors Are Associated With Outstanding Performance in Orthopaedic Surgery Residency?

“…Residency programs hope to send their residents to the best and most prestigious fellowship training programs and routinely publish their fellowship match results [5,28]. Although research is not a primary focus for many residents, research productivity was included as a criterion because research activity is a major variable considered by most orthopaedic training programs in their evaluation of applicants [12,20,33]. Both residency and fellowship programs hope that their applicants will be productive researchers while training and thus typically recruit applicants with extensive research backgrounds more heavily [5,28,39].…”

“…Many residents have little desire to publish, and most graduates do not do so [20]. Despite this, research activity remains one of the major variables considered by most orthopaedic training programs, both community and academic, in their evaluation of applicants [12,33]. Applicants with extensive research backgrounds are more heavily recruited with the hope and expectation that they will remain productive researchers in residency [39].…”

Orthopedic Surgery Residency Program Website Content and Accessibility During the COVID-19 Pandemic: Observational Study

“…This study highlights the inadequate response of orthopedic surgery residency programs to update their websites during this entirely virtual application cycle. As a competitive specialty with the third-lowest specialty match rate, orthopedic surgery programs still have a lot of work to do to improve their online presence, promote diversity, and enhance opportunities for virtual applicants [ 1 , 19 ]. With limited information, applicants must identify unique ways to learn about residency programs and gauge their chances for a successful match.…”

“…Applicants to orthopedic surgery residencies spend significant time and resources gathering information about potential programs [ 1 - 7 ]. A valuable resource that has been shown to influence application decisions across specialties is program websites [ 8 ].…”

Orthopaedic Surgery Residency Advice on YouTube: Unveiling Gaps, Emphasizing Inclusivity, and Striving for Comprehensive Guidance

“…These variables can be broadly classified into categories, such as academic achievement (e.g., USMLE Step 1 score, clerkship grades, preclerkship grades), professional experiences (e.g., research experiences, work experiences, volunteer experiences), mentoring and networking (e.g., orthopaedic mentors, away rotations), application components (e.g., letters of recommendation and personal statements), and personal qualities (e.g., communication and reliability). In addition, specific circumstances related to applicants (e.g., MD and DO degree holders, US and International Medical Graduate [IMG] applicants), shifts in policy (e.g., Step 1 becoming pass/fail [P/F], shifting to a holistic approach), and decision-making aspects (e.g., choosing a residency program) were considered 1,4,5 . The complete list of the variables is presented in Table I.…”