Apurva S Choubey, Peter Chebi, Brett Drake, Deepa Dhillon, Sean Cooke, Majd Mzeihem, Alfonso Mejia, Mark H Gonzalez
{"title":"From Residency to Specialization: A Critical Analysis of Residency Leadership and Impact on Specialty Selection.","authors":"Apurva S Choubey, Peter Chebi, Brett Drake, Deepa Dhillon, Sean Cooke, Majd Mzeihem, Alfonso Mejia, Mark H Gonzalez","doi":"10.3928/01477447-20260722-01","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Orthopedic surgery fellowships have evolved from optional to nearly mandatory since accreditation in 1981, yet factors influencing subspecialty selection remain incompletely defined. We evaluated orthopedic residency program director (PD) and department chair demographics and training backgrounds, resident fellowship match patterns, fellowship availability, and concordance between leadership training and resident subspecialty selection.</p><p><strong>Materials and methods: </strong>Using programs accredited by the Accreditation Council for Graduate Medical Education, we analyzed available PD and department chair demographics and fellowship training. Five years of alumni fellowship data and fellowship availability at each institution were collected from program websites. Descriptive statistics, chi-squared tests, and crude odds ratios (ORs) were used, with <i>P</i> < .05 considered significant.</p><p><strong>Results: </strong>Among 109 residency programs and 5,443 recent graduates, residents most often matched into sports medicine (24.44%), arthroplasty (17.86%), and hand surgery (16.57%). PDs were most commonly trained in trauma, sports medicine, and hand surgery; chairs were most commonly trained in sports medicine, trauma, and spine surgery. Leadership was predominantly male and White (PDs: 87.16% male, 78.90% White; chairs: 93.58% male, 88.07% White). Programs offering spine, hand, or orthopedic oncology fellowships had higher match rates into those specialties than programs without them (OR: 1.20, 1.42, and 1.94; all <i>P</i> < .05). Residents were also more likely to enter arthroplasty when their PD was arthroplasty trained and to enter hand surgery or orthopedic oncology when their chair had concordant training.</p><p><strong>Conclusion: </strong>Fellowship availability and leadership training background were each associated with resident subspecialty selection. Applicants with subspecialty interests should consider both factors when evaluating residency programs.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":"49 4","pages":"e368-e375"},"PeriodicalIF":1.3000,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Orthopedics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3928/01477447-20260722-01","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/8/14 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Orthopedic surgery fellowships have evolved from optional to nearly mandatory since accreditation in 1981, yet factors influencing subspecialty selection remain incompletely defined. We evaluated orthopedic residency program director (PD) and department chair demographics and training backgrounds, resident fellowship match patterns, fellowship availability, and concordance between leadership training and resident subspecialty selection.
Materials and methods: Using programs accredited by the Accreditation Council for Graduate Medical Education, we analyzed available PD and department chair demographics and fellowship training. Five years of alumni fellowship data and fellowship availability at each institution were collected from program websites. Descriptive statistics, chi-squared tests, and crude odds ratios (ORs) were used, with P < .05 considered significant.
Results: Among 109 residency programs and 5,443 recent graduates, residents most often matched into sports medicine (24.44%), arthroplasty (17.86%), and hand surgery (16.57%). PDs were most commonly trained in trauma, sports medicine, and hand surgery; chairs were most commonly trained in sports medicine, trauma, and spine surgery. Leadership was predominantly male and White (PDs: 87.16% male, 78.90% White; chairs: 93.58% male, 88.07% White). Programs offering spine, hand, or orthopedic oncology fellowships had higher match rates into those specialties than programs without them (OR: 1.20, 1.42, and 1.94; all P < .05). Residents were also more likely to enter arthroplasty when their PD was arthroplasty trained and to enter hand surgery or orthopedic oncology when their chair had concordant training.
Conclusion: Fellowship availability and leadership training background were each associated with resident subspecialty selection. Applicants with subspecialty interests should consider both factors when evaluating residency programs.
期刊介绍：
For over 40 years, Orthopedics, a bimonthly peer-reviewed journal, has been the preferred choice of orthopedic surgeons for clinically relevant information on all aspects of adult and pediatric orthopedic surgery and treatment. Edited by Robert D''Ambrosia, MD, Chairman of the Department of Orthopedics at the University of Colorado, Denver, and former President of the American Academy of Orthopaedic Surgeons, as well as an Editorial Board of over 100 international orthopedists, Orthopedics is the source to turn to for guidance in your practice.
The journal offers access to current articles, as well as several years of archived content. Highlights also include Blue Ribbon articles published full text in print and online, as well as Tips & Techniques posted with every issue.
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