JBJS Open Access最新文献

{"title":"Evolution of Medical Students' Interest in Orthopaedic Surgery Careers from Matriculation to Graduation.","authors":"Katherine M Gerull, Maria Pérez, Cara A Cipriano, Donna B Jeffe","doi":"10.2106/JBJS.OA.24.00019","DOIUrl":"10.2106/JBJS.OA.24.00019","url":null,"abstract":"<p><strong>Introduction: </strong>Little is known about risk factors for changes in students' interest in orthopaedics during medical school. We aimed to identify variables associated with diminished (vs. sustained) and emerging (vs. no) plans to become board certified in orthopaedic surgery.</p><p><strong>Methods: </strong>We conducted a retrospective national-cohort study of students who matriculated in US MD-granting medical schools in academic years 1993 to 1994 through 2000 to 2001. The outcome measure was the evolution of students' board-certification plans in orthopaedic surgery from matriculation to graduation using responses on the Association of American Medical Colleges' Matriculating Student Questionnaire and Graduation Questionnaire. Covariates included demographic, attitudinal, experiential, and career intention variables.</p><p><strong>Results: </strong>Of 53,560 graduates with complete data, 2,765 students reported diminished interest in becoming board certified in orthopaedics, 1,345 reported emerging interest, and 1,327 reported sustained interest. In multivariable logistic regression models, students who were female (adjusted odds ratio [aOR] 1.83, 95% confidence interval [CI] 1.43-2.34), Asian (aOR 1.46, 95% CI 1.18-1.82), reported greater importance of social responsibility (aOR 1.16, 95% CI 1.02-1.33) and prestige (aOR 1.20, 95% CI 1.10-1.30) in choosing a medicine career, and planned full-time university faculty careers (aOR 1.58, 95% CI 1.33-1.89) at graduation were independently more likely to have diminished (vs. sustained) interest. Students who participated in research and/or authorship electives (aOR 3.50, 95% CI 3.00-4.07) and who attended private institutions (aOR 1.23, 95% CI 1.10-1.39) were more likely to have emerging (vs. no) interest.</p><p><strong>Conclusions: </strong>Twice as many students lost interest than gained interest in orthopaedics during medical school, and the cohort of students interested in orthopaedics became less diverse over the course of medical school. Several risk factors amenable to change were identified. Interventions that target these risk factors are warranted to increase the diversity of the orthopaedic surgery workforce.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"9 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>JBJS Open Access</i> Awards: 2023 Winners and Journal Update.","authors":"Eng Hin Lee, Robin Richards, Marc Swiontkowski","doi":"10.2106/JBJS.OA.24.00054","DOIUrl":"https://doi.org/10.2106/JBJS.OA.24.00054","url":null,"abstract":"","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"9 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11190999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Education Forum: Restrictive Covenants (Non-competes) in Orthopaedic Fellowships: What Every Resident Should Know Before Applying to Fellowship.","authors":"Joshua W Hustedt, Mark J Spangehl","doi":"10.2106/JBJS.OA.23.00167","DOIUrl":"10.2106/JBJS.OA.23.00167","url":null,"abstract":"<p><strong>Introduction: </strong>More than 90% of orthopaedic surgery residents in the United States complete a fellowship program. While there is significant oversight of the educational process and rights of residents during residency, there is little standardization in fellowships in the United States. Applicants to fellowship need to be aware that they may be required to sign restrictive covenants (\"non-competes\") as part of the fellowship application or acceptance process. These restrictive covenants may be designed to protect the business interests of the host institution but may affect the fellow's ability to obtain employment in a geographic region.</p><p><strong>Methods: </strong>A review of society websites designed to education fellowship applicants was reviewed. Information was gathered on whether the society provided information on restrictive covenants in fellowship programs.</p><p><strong>Results: </strong>There is little standardization of restrictive covenants in orthopedic fellowships in the United States. Only accredited fellowships prohibit restrictive covenants in orthopedic fellowships. Pediatrics is the only sub-specialty society that provides information to applicants on restrictive covenants for fellowship applicants.</p><p><strong>Conclusion: </strong>The current lack of standardization in the fellowship process means applicants need to be well versed in these restrictive covenants before applying. In turn, fellowships themselves, as well as subspecialty societies, should seek to be transparent in providing information on restrictive covenant requirements of their respective fellowships.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"9 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11175871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteopathic Students Have Decreased Match Rates in Orthopaedic Surgery Compared with Allopathic Students.","authors":"Anthony Modica, Rachel Ranson, Tyler Williamson, Brent A Ponce, Randy M Cohn, Adam D Bitterman","doi":"10.2106/JBJS.OA.24.00027","DOIUrl":"10.2106/JBJS.OA.24.00027","url":null,"abstract":"<p><strong>Introduction: </strong>Orthopaedic surgery continues to be one of the most competitive specialties to match into as a medical student, particularly for osteopathic medical students. Therefore, in this study, we sought to examine the prevalence of osteopathic students (DO) matching into orthopaedic surgery at traditional Accreditation Council for Graduate Medical Education (ACGME) accredited programs (former allopathic residency programs) in recent years.</p><p><strong>Methods: </strong>A retrospective review of National Residency Match Program annual reports and Association of American Medical Colleges's Electronic Residency Application Service Statistic reports were performed to determine the number of applications and match rates among osteopathic (DO) and allopathic (MD) medical students into orthopaedic surgery from 2019 to 2023. Data on the degree type of current residents at all ACGME-accredited residency programs were identified.</p><p><strong>Results: </strong>During the analyzed study period of 2019 to 2023, there were 3,473 (74.5%) allopathic students and 571 (59.9%) osteopathic students who successfully matched into orthopaedic surgery. This match rate for allopathic students was 74.5% compared with 59.9% for osteopathic students. Of the 3,506 medical students who hold postgraduate orthopaedic surgery positions at former allopathic programs over the past 5 years, only 58 (1.7%) hold an osteopathic degree. Of the 560 medical students who hold postgraduate orthopaedic surgery positions at former osteopathic programs over the past 5 years, 47 (8.4%) hold an allopathic degree. The match rate of allopathic students at former osteopathic programs is significantly higher than the match rate of osteopathic students at former allopathic programs.</p><p><strong>Conclusions: </strong>Osteopathic students continue to match into orthopaedic surgery at lower rates than their allopathic counterparts. In addition, there remains a consistent and low number of osteopathic students matching into former allopathic programs. Allopathic students also have a higher likelihood of matching into former osteopathic programs when compared with osteopathic students matching into previous allopathic orthopaedic surgery programs.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"9 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11142789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Small Glove Size and Female Gender Are Associated with Greater Reported Difficulty Using Orthopaedic Instruments Among Residents.","authors":"Benjamin Lurie, Jessica Albanese, Gayle Allenback, Iain Elliott, Karen Nelson","doi":"10.2106/JBJS.OA.23.00151","DOIUrl":"10.2106/JBJS.OA.23.00151","url":null,"abstract":"<p><strong>Introduction: </strong>Smaller hand size has been shown to affect ease of instrument use and surgeon injury rates in multiple surgical subspecialties. Women have a smaller average hand size and are more often affected by this issue than men. The goal of this resident survey was to investigate whether hand size and gender impact self-reported difficulty with instrument use among orthopaedic surgery residents.</p><p><strong>Methods: </strong>Residents were surveyed about how often they experience difficulty using common orthopaedic instruments. Self-reported difficulty using surgical instruments was compared between residents with small glove (SG, outer ≤7.0) vs. large glove (LG, ≥ 7.5) sizes and between male and female residents.</p><p><strong>Results: </strong>One hundred forty-five residents (118 males and 27 females) completed the survey for a response rate of 3.7%. The SG group contained 35 residents, with 26 females and 9 males. The LG group contained 110 residents, with 1 female and 109 males. The SG group reported more difficulty than the LG group when using 3/6 instruments: the wire-cutting pliers (71.4% vs. 25.5%), universal T-handle chuck (65.7% vs. 21.4%), and large wire driver (60.0% vs. 24.8%). Female residents reported more difficulty than males for 5/6 instruments. Within the SG group, however, there was no difference in self-reported difficulty between female SG and male SG residents for 4/6 instruments.</p><p><strong>Conclusions: </strong>The predominantly male LG group reported significantly less difficulty than the more gender mixed though still predominantly female SG group. A subanalysis comparing males and females within the SG group found that there was no difference between SG female and SG male residents for 4/6 of the instruments, suggesting that glove size might impact reported difficulty independently from gender. Although the effect of glove size vs. gender is difficult to differentiate in this study, the high rate of difficulty experienced by male and female residents in the SG group should be considered by residency programs, surgeon educators, and instrument manufacturers as the field of orthopaedic surgery continues to become more diverse.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"9 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11108343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Midterm Outcomes of Surgical Reconstruction and Spontaneous Recovery of Upper-Extremity Paralysis Following Acute Flaccid Myelitis.","authors":"Kazuteru Doi, Yasunori Hattori, Sotetsu Sakamoto, Dawn Sinn Yii Chia, Vijayendrasingh Gour, Jun Sasaki","doi":"10.2106/JBJS.OA.23.00143","DOIUrl":"10.2106/JBJS.OA.23.00143","url":null,"abstract":"<p><strong>Background: </strong>Acute flaccid myelitis (AFM) is a disabling, poliomyelitis-like illness that mainly affects children. Although various surgical interventions are performed for intractable paralysis due to AFM, the timing of surgery and its long-term outcomes have yet to be established, especially for shoulder reconstruction. This study aimed to analyze the midterm outcomes of nonsurgically and surgically treated upper-extremity AFM and the factors influencing shoulder functional outcomes after surgical reconstruction.</p><p><strong>Methods: </strong>We retrospectively examined 39 patients with AFM in 50 upper extremities between 2011 and 2019. The degree of spontaneous recovery of completely paralyzed muscles was evaluated at a median of 3, 6, and 37 months after the onset of paralysis. Twenty-seven patients with 29 extremities underwent surgery involving nerve transfer, muscle-tendon transfer, or free muscle transfer for shoulder, elbow, and hand reconstruction.</p><p><strong>Results: </strong>Patients with complete paralysis of shoulder abduction at 6 months did not show later recovery. Twenty-two patients with 24 extremities underwent shoulder surgery, and all but 1 were followed for at least 24 months after surgery. Although postoperative shoulder abduction recovery was similar between transfer of the spinal accessory nerve and of the contralateral C7 nerve root to the suprascapular nerve, the outcomes obtained with spinal accessory nerve transfer had more variability, likely related to latent spinal accessory nerve paralysis, shoulder instability related to pectoralis major paralysis, and the type of paralysis. Shoulder abduction recovery was also greatly affected by scapulothoracic joint movement. In contrast, the outcomes of the elbow flexion and hand reconstructions were more consistent and acceptable.</p><p><strong>Conclusions: </strong>All patients had loss of shoulder abduction, and restoration of shoulder function was less predictable and depended on the quality of the donor nerves and recovery of the synergistic muscles. Strict donor nerve selection and additional nerve transfer for shoulder reconstruction are imperative for satisfactory outcomes.</p><p><strong>Level of evidence: </strong>Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"9 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11104719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141076972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orthopaedic Surgery Attrition Before Board Certification: A National-Cohort Study of US MD Graduates in Orthopaedic Surgery Residency Programs.","authors":"Katherine M Gerull, Maria Pérez, Cara A Cipriano, Donna B Jeffe","doi":"10.2106/JBJS.OA.23.00175","DOIUrl":"10.2106/JBJS.OA.23.00175","url":null,"abstract":"<p><strong>Introduction: </strong>Little is known about attrition before American Board of Orthopaedic Surgery (ABOS) board certification for orthopaedic residents training in Accreditation Council for Graduate Medical Education (ACGME)-accredited orthopaedics programs. This national-cohort study examined orthopaedic surgery attrition, associated risk factors, and specialties pursued by residents who left orthopaedics.</p><p><strong>Methods: </strong>From August 2022 through July 2023, we analyzed deidentified, individual-level data from the Association of American Medical Colleges for 129,860 US MD-granting medical-school matriculants in academic years 1993 to 1994 through 2000 to 2001. Graduates with records of training ≥1 year in orthopaedic surgery during GME and of board certification as of May 2020 were included. Retention was defined as being ABOS-certified; attrition was defined as being certified by another specialty board and not ABOS. We identified variables independently associated with attrition from orthopaedics using multivariable logistic regression analysis and reported adjusted odds ratios (OR) and 95% confidence intervals (CI).</p><p><strong>Results: </strong>Of 4,319 US medical-school graduates from 1997 to 2009 with ≥1 year of orthopaedic surgery GME, 4,085 (94.6%) obtained ABOS board certification (retention) and 234 did not (attrition). Women (OR 2.8, 95% CI 2.0-3.9), first-generation college graduates (OR 1.6, 95% CI 1.1-2.2), Asians (OR 1.9, 95% CI 1.4-2.7), and residents who placed greater importance on innovation/research in choosing medicine as a career (OR 1.4, 95% CI 1.1-1.7) and completed ≥1 year of research during GME (OR 2.4, 95% CI 1.7-3.5) were more likely to leave orthopaedics. Overall, 121 trainees who left orthopaedics selected surgical specialties for board certification, most commonly plastic surgery (n = 66) and general surgery (n = 45).</p><p><strong>Conclusions: </strong>The increased risk of attrition among women, Asians, first-generation college graduates, and trainees endorsing higher importance of innovation/research in choosing medicine and participating in research during GME raises concerns about the potential loss of underrepresented groups among orthopaedic surgeons and surgeon-scientists. Efforts to mitigate attrition among residents in high-risk groups are warranted.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"9 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11101223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141071773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender Diversity in Orthopaedic Surgery Residencies Does Not Translate to Accreditation Council for Graduate Medical Education-Accredited Fellowships.","authors":"David Haddad, Deborah Nelson, Nathan Sherman, Megan Tatusko, Gregory DeSilva","doi":"10.2106/JBJS.OA.23.00124","DOIUrl":"10.2106/JBJS.OA.23.00124","url":null,"abstract":"<p><strong>Introduction: </strong>Gender representation among orthopaedic surgery applicants and residents has increased over the past two decades. The aims of this study were to evaluate trends of female fellows in ACGME-accredited orthopaedic subspecialties between 2007 and 2021, and to compare the fellowship trends of female representation to those of ACGME-accredited orthopaedic residencies.</p><p><strong>Methods: </strong>We conducted a retrospective review of publicly available ACGME-accredited fellowship demographic data from 2007 to 2021. The distribution of genders (male vs. female) across subspecialties and orthopaedic surgery residency programs was compared. Chi-square, Spearman correlation, and logistic regression tests were performed to analyze the relationships between year, gender, and fellowship.</p><p><strong>Results: </strong>Chi-square analysis demonstrated a significant relationship between gender and year for orthopaedic residency (p < 0.001), but not for any fellowship. There was a significant negative Spearman correlation between the two variables for hand (r(1844) = -0.06, p = 0.02) and sports medicine (r(2804) = -0.05, p = 0.01) fellowships. The negative Spearman correlation for pediatrics (r(499) = -0.09, p = 0.054) approached but did not reach statistical significance. Logistic regression analysis revealed that, holding year constant and comparing to orthopaedic residency, the odds of male participation increased by 173% (95% CI, 1.8-4.1) in spine, increased by 138% (95% CI, 1.7-3.3) in adult reconstruction, increased by 51% (95% CI, 1.3-1.7) in sports medicine, decreased by 41% (95% CI, 0.5-0.7) in hand, decreased by 36% (95% CI, 0.5-0.9) in foot and ankle, decreased by 48% (95% CI, 0.4-0.7) in musculoskeletal oncology, and decreased by 68% (95% CI, 0.3-0.4) in pediatrics.</p><p><strong>Conclusion: </strong>Although the percentage of female orthopaedic residents in ACGME-accredited programs increased significantly from 2007 to 2021, this has not translated to ACGME-accredited fellowship positions. Future research optimizing methods to improve the representation of females in orthopaedic surgery should be considered.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"9 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11093577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of Factors Associated with Orthopaedic Surgery Residency Programs That Preferentially Match Students Who Performed an Elective Rotation Before the Interview Process.","authors":"Kenneth H Levy, Akram Al Ramlawi, Lucy R O'Sullivan, Miguel A Cartagena-Reyes, Andrew B Harris, Dawn M LaPorte, Amiethab A Aiyer","doi":"10.2106/JBJS.OA.23.00165","DOIUrl":"https://doi.org/10.2106/JBJS.OA.23.00165","url":null,"abstract":"<p><strong>Introduction: </strong>The role of elective rotations in the orthopaedic residency selection process varies between programs. Our study aims to identify factors associated with residency programs that interview and match a greater proportion of applicants who have completed an elective rotation with their program.</p><p><strong>Methods: </strong>Data were collected through the American Orthopaedic Association's Orthopaedic Residency Information Network database. Bivariate correlations and multivariate regression models were used to identify independent predictors of programs with a greater proportion of interviewees or residents who completed an elective rotation at the respective program.</p><p><strong>Results: </strong>One hundred seventy-eight of the 218 existing residency programs were included in this study. Programs that offered fewer interviews and more away rotation positions per year were associated with a greater odds of its interviewees (OR = 0.36, p = 0.01; OR = 4.55, p < 0.001, respectively) and residents (OR = 0.44, p = 0.04; OR = 4.23, p < 0.001, respectively) having completed an elective rotation with the program. In addition, programs with fewer attendings (OR = 0.39, p = 0.03) and in-person interviews (OR = 3.04, p = 0.04) matched a greater proportion of their rotators. However, programs that interviewed applicants during the elective rotation were less likely to match their rotators (OR = 0.35, p = 0.04).</p><p><strong>Conclusion: </strong>Certain program characteristics independently predict the likelihood of a program interviewing and matching their rotators. These findings may provide information for applicants and programs regarding the rotation process.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"9 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11062750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preference Signaling in the Orthopaedic Surgery Match: Applicant and Residency Program Attitudes, Behaviors, and Outcomes.","authors":"Stuart Trent Guthrie, Tanios Dagher, Jodi Essey-Stapleton, Tessa Balach","doi":"10.2106/JBJS.OA.23.00146","DOIUrl":"https://doi.org/10.2106/JBJS.OA.23.00146","url":null,"abstract":"<p><strong>Introduction: </strong>The orthopaedic surgery match has experienced a consistent increase in both the number of applicants and applications submitted per applicant. Preference signaling was implemented during the 2022 to 2023 application cycle in part to curtail the rising application burden on both applicants and residency programs. Our aim was to explore the impact of the preference signaling system on applicant and residency program leader attitudes, behaviors, and outcomes.</p><p><strong>Methods: </strong>We distributed surveys to American Orthopaedic Association/Council of Orthopaedic Residency Directors member program leaders (program directors, assistant program directors, and program coordinators) and applicants registered for the Electronic Standardized Letter of Recommendation after Universal Interview Offer Day 2022 (Fall Survey) and Match Day 2023 (Spring Survey). The surveys contained multiple-choice and numeric response questions on attitudes, behaviors, and outcomes that were analyzed and reported as percentages and medians, respectively. Open-text responses were reviewed for dominant themes.</p><p><strong>Results: </strong>One hundred program leaders and 378 applicants (47%) completed the Fall Survey, and 146 program leaders and 290 applicants (36%) completed the Spring Survey. A majority of applicants (71%) and program leadership (91%) support the continued use of signaling. Applicants reported a 16% reduction in the number of programs to which they applied. Program directors largely used signaling as a tool for screening applications (75%), with few programs using signaling in the ranking process (20%). Applicants reported that 81% of their interviews were from programs they signaled. Slightly more than half of programs (53%) reported filling their last slot at a higher rank order position than the average of the previous 5 years. Qualitative analysis suggests a need for more transparency in the use of signals, consideration of application and/or interview caps, and reconsideration of the other components of the application.</p><p><strong>Conclusion: </strong>Preference signaling in the orthopaedic surgery match was met with positive feedback and led to a reduction in the number of applications. Future research will examine the continued impact of preference signaling and assess alterations for optimizing the match process.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"9 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11049719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}