Journal of Surgical Education最新文献

{"title":"Applying to Orthopaedic Residency: How Is An Applicant’s Parental Background Associated With Opportunity Equity?","authors":"Ashish Vankara MD, MBA,&nbsp;William ElNemer BS,&nbsp;Andrew B. Harris MD,&nbsp;Julius K. Oni MD,&nbsp;Dawn M. LaPorte MD,&nbsp;Amiethab A. Aiyer MD","doi":"10.1016/j.jsurg.2025.103645","DOIUrl":"10.1016/j.jsurg.2025.103645","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate relationships between orthopaedic residency applicants’ parental educational attainment/occupations and their 1) demographic characteristics; 2) educational debt and scholarship funding; 3) medical school characteristics; 4) reported research, volunteer, and work experiences; and 5) match success.</div></div><div><h3>Design</h3><div>We analyzed Association of American Medical Colleges data for 10,697 applicants to orthopaedic surgery residency in the US from 2011 to 2021. Parental education was categorized as doctorate, master’s, bachelor’s, or no college degree, and the highest level was used. Parental occupation was categorized as physician, healthcare, working class, and STEMM (science, technology, engineering, mathematics, medicine) field. We analyzed applicant age, gender, and race/ethnicity; educational debt and scholarship funding; attendance at a private or top-40 NIH–funded medical school; number of research, work, and volunteer experiences reported in the Electronic Residency Application Service; and residency match success. Chi-squared and Student t-tests were used to assess differences between groups. Alpha = 0.05.</div></div><div><h3>Results</h3><div>Of the 19% of applicants who had a physician parent, 11% identified as underrepresented minorities compared with 15% of those without a physician parent (p = 0.004). Applicants with a parent holding a doctorate had less educational debt ($114,000 vs. $205,000, p &lt; 0.001) and received less scholarship funding ($27,000 vs. $43,000, p &lt; 0.001) than those whose parents had no college degree. A larger proportion of applicants with a STEMM parent (33%) attended a top-40 NIH-funded medical school compared with those without (30%) (p = 0.004). Applicants with a doctorate-holding parent reported more research and fewer work experiences (p &lt; 0.001) and had a higher match rate (76% vs. 71%, p = 0.02) compared with applicants whose parents held no college degree.</div></div><div><h3>Discussion</h3><div>Among US orthopaedic surgery residency applicants, parental educational attainment was associated with differences in educational debt, extracurricular experiences, and match success. These findings underscore the need to support equitable opportunities for all aspiring orthopaedic surgeons.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 10","pages":"Article 103645"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144921167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Linguistic Analysis of Narrative and Standardized Letters of Recommendation for Integrated Plastic Surgery Applicants and Impact on Match","authors":"Skyler K. Palmer BS,&nbsp;Zain Aryanpour MD,&nbsp;Ansley N. Wallace BS,&nbsp;Phuong D. Nguyen MD,&nbsp;Katie G. Egan MD","doi":"10.1016/j.jsurg.2025.103675","DOIUrl":"10.1016/j.jsurg.2025.103675","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>Applying to integrated plastic and reconstructive surgery (PRS) has become increasingly competitive and letters of recommendations play a role in matching. This study evaluates narrative and standardized letters for integrated plastic surgery applicants to determine which letter components are most predictive of matching.</div></div><div><h3>DESIGN</h3><div>Linguistic analysis was performed on all narrative letters with Linguistic Inquiry and Word Count software using a customized dictionary. LOR authors, author professional rank, and applicant rankings were collected from standardized letters. Statistical analysis was performed with significance set to p &lt; 0.05.</div></div><div><h3>SETTING</h3><div>This is a single-institution study.</div></div><div><h3>PARTICIPANTS</h3><div>This study included all integrated plastic surgery applicants to our institution in the 2023 to 2024 cycle.</div></div><div><h3>RESULTS</h3><div>About 304 applicants were included with 1124 total narrative LOR. Matched applicants had significantly higher numbers of narrative LOR (3.77 letters vs. 3.54 letters, p &lt; 0.001). Matched applicant LORs had significantly higher counts across several favorable categories including research, grindstone, and likability. Applicants with letters by plastic surgeons versus other specialties had significantly higher odds of matching (OR 7.89, p &lt; 0.001). About 380 standardized letters were available for analysis. Matched applicants had significantly more standardized letters of recommendation (1.52 letters vs. 0.79 letters, p &lt; 0.001). Important factors associated with matching included patient care, professionalism, and team-player. An overall rank of 1 and 2 to 5 was associated with greater odds of matching (OR 3.94, p &lt; 0.001 and OR 1.8, p = 0.02, respectively), while ranking 5 to 10 and 10 to 20 were negatively associated with matching (OR 0.55, p = 0.03 and OR 0.07 p = 0.01, respectively).</div></div><div><h3>CONCLUSION</h3><div>This study comprehensively analyzes narrative and standardized LOR for integrated PRS applicants. Top favorable domains used in matched applicant letters were research, grindstone, likability, and standout. Matched applicants were ranked higher overall, and worse overall rankings had significantly lower odds of matching. This study may inform success in matching.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 10","pages":"Article 103675"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Giving Them the Right Tools:” Obstetrics and Gynecology Program Directors’ Perspectives on Resident Remediation","authors":"Huma Farid MD,&nbsp;Melissa Spiel DO,&nbsp;Daniela Febres-Cordero MD,&nbsp;Sara Neill MD,&nbsp;Brett C. Young MD","doi":"10.1016/j.jsurg.2025.103646","DOIUrl":"10.1016/j.jsurg.2025.103646","url":null,"abstract":"<div><h3>Objective</h3><div>Resident remediation is a multifaceted process requiring tailored and individualized interventions. Our study aimed to better understand the remediation process, from initiation to conclusion, from the perspective of program directors.</div></div><div><h3>Design</h3><div>We conducted individual, semi-structured interviews with obstetrics and gynecology program directors nationwide and identified themes around resident remediation using thematic analysis.</div></div><div><h3>Setting</h3><div>We interviewed participants virtually from a variety of geographic regions across the country at academic and community hospitals.</div></div><div><h3>Participants</h3><div>Participants were required to be current residency program directors or associate program directors in obstetrics-gynecology.</div></div><div><h3>Results</h3><div>Ten respondents were included. Key themes emerged in our interviews, including the role of the Clinical Competency Committee in evaluation and identification of residents in need of remediation, lack of standardized documentation practices, concerns regarding limited engagement of faculty and residents, and difficulties in remediating professionalism concerns.</div></div><div><h3>Conclusions</h3><div>Our findings highlight the need for structured remediation protocols, increased faculty engagement, and standardized support systems to optimize residency remediation outcomes.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 10","pages":"Article 103646"},"PeriodicalIF":2.1,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurosurgery Resident Applicant Research Evaluation: Leveling the Playing Field","authors":"Emmanuel O. Mensah MD, MPH,&nbsp;Shashvat Purohit BS,&nbsp;Omar Alwakaa MS,&nbsp;Christopher S. Ogilvy MD","doi":"10.1016/j.jsurg.2025.103658","DOIUrl":"10.1016/j.jsurg.2025.103658","url":null,"abstract":"<div><h3>Background</h3><div>Neurosurgery residency is highly competitive, with applicants increasingly emphasizing research to strengthen their applications. This has led to a rise in publications but also to applicant anxiety and concerns about exaggerated contributions. To ensure fair assessment, we developed a scoring system that considers authorship position and journal impact factor for a more precise evaluation of research contributions in neurosurgery applications.</div></div><div><h3>Methods</h3><div>A quality-adjusted research index was developed using authorship position and journal impact factor. Peer-reviewed, PubMed-indexed publications were analyzed for 303 applicants to our residency program. Demographic data, including sex, medical school ranking, IMG status, and advanced degrees, were collected. Research index scores were compared between applicants invited to interview (Group A) and those not invited (Group B). Receiver operating characteristic (ROC) curve analysis determined the index’s predictive accuracy for interview invitations.</div></div><div><h3>Results</h3><div>Group A had significantly higher research index scores (78.2 [48.1-133.5] vs. 37.0 [7.8-92.3], p &lt; 0.01) and publication counts (10 [7-15] vs. 6 [2-12], p &lt; 0.01) compared to Group B. First and second authorships were more prevalent among Group A (23.6% vs. 15.0%, p = 0.049 and 23.6% vs. 14.3%, p &lt; 0.01, respectively). Male sex, attendance at highly ranked medical schools, and MD/PhD status were significant predictors of higher research index scores. A cutoff score of ≥41.2 yielded 87% sensitivity and 53% specificity in predicting interview invitations, with an AUC of 69.7%.</div></div><div><h3>Conclusion</h3><div>The proposed research index objectively evaluates the quality and significance of neurosurgery residency applicants’ scholarly contributions, emphasizing meaningful research engagement. By integrating journal impact factors and authorship roles, the system reduces bias from inflated publication counts and misrepresented research claims, fostering transparency and fairness in applicant evaluation. Future efforts should focus on automating this tool for broader applicability across medical specialties.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 10","pages":"Article 103658"},"PeriodicalIF":2.1,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144894769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Duty Hour Requirements for Obstetrics and Gynecology Clerkships","authors":"Jonathan Schaffir MD ,&nbsp;Tammy Sonn MD ,&nbsp;Jill Sutton MD ,&nbsp;Laura Baecher-Lind MD, MPH ,&nbsp;Katherine T. Chen MD, MPH ,&nbsp;Angela Fleming DO ,&nbsp;Christine Kim MD ,&nbsp;Shireen Madani Sims MD ,&nbsp;Silka Patel MD ,&nbsp;Didi Saint Louis MD ,&nbsp;Alyssa Stephenson-Famy MD","doi":"10.1016/j.jsurg.2025.103657","DOIUrl":"10.1016/j.jsurg.2025.103657","url":null,"abstract":"<div><h3>Objective</h3><div>Over the last 20 years, the number of American medical schools requiring night call in addition to daytime hours for students in the obstetrics and gynecology (Ob-Gyn) clerkship has dropped dramatically. This study aimed to determine patterns of call assignments and opinions of clerkship directors on this topic.</div></div><div><h3>Design, Setting and Participants</h3><div>The study is a cross-sectional observational study using a survey sent to all US Ob-Gyn clerkship directors. The survey inquired about required hours assigned to students on the clerkship. In addition to questions about personal demographics, participants were also asked about agreement with a set of statements regarding merits and downsides of additional call. 152 surveys were returned out of 241 distributed.</div></div><div><h3>Results</h3><div>Analysis was completed for 106 returned surveys, each representing a US allopathic medical school. 35 clerkships (33%) require some shift in addition to regular daytime hours, including overnight call (11), evening call (6) or weekend call (26). Clerkship directors who require call are more likely to have been in their role longer and are more likely to agree that call is worthwhile and provides additional opportunities for hands-on patient care.</div></div><div><h3>Conclusions</h3><div>Requirements for additional overnight and weekend shifts have declined steadily in US medical schools, often replaced by a night float system. Educators should continue to find opportunities for students to engage in the full spectrum of clinical experiences while balancing the need for restricting duty hours.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 10","pages":"Article 103657"},"PeriodicalIF":2.1,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144892848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proceed with Caution: Assessing for and Increasing Psychological Safety in Obstetrics and Gynecology Residency Teaching and Learning Environments","authors":"Giuliana Guarna HBSc, MD,&nbsp;Jessica Murphy MSc, PhD,&nbsp;Sapna Sharma BHSc, MD","doi":"10.1016/j.jsurg.2025.103653","DOIUrl":"10.1016/j.jsurg.2025.103653","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>The primary objective of this study was to understand resident perspectives on psychological safety in a large Obstetrics/Gynecology program in Ontario, Canada. The secondary objective was to describe the impact of an educational session on psychological safety.</div></div><div><h3>DESIGN</h3><div>A nine-question survey was sent to all residents to assess perspectives on psychological safety during training. Fischer’s exact test was used to explore associations between resident year (junior and senior) and associated perspectives on psychological safety. Based on perspectives expressed in the first survey, an educational session discussing the concept of psychological safety, strategies for increasing psychological safety, and links to resources was designed.</div></div><div><h3>SETTING</h3><div>The survey was sent to all Obstetrics/Gynecology residents at McMaster, University, the third largest training program in Canada. The training session was presented at a virtual grand round; a pre- and post-session survey was distributed to attendees.</div></div><div><h3>RESULTS</h3><div>Nineteen residents (56%) completed the first survey. A significant association was found between year and belief that the learning environment was psychologically safe. Results suggested that juniors tended to disagree more with this statement than senior residents. No other significant associations were found; however, there was a pattern suggesting that junior residents had lower perceptions of psychological safety. Eighteen (43%) grand rounds participants completed the pre-intervention survey. The education session resulted in a higher percentage of people claiming knowledge of psychological safety, feeling psychologically safe in their work environment, and knowledge of resources related to psychological safety.</div></div><div><h3>CONCLUSION</h3><div>Overall, results suggest that junior residents may have lower levels of psychological safety than senior residents. In addition, an education session can increase awareness of educational concepts and where to access resources.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 10","pages":"Article 103653"},"PeriodicalIF":2.1,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144892849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exposure to U.S. Rural Practice During General Surgery Residency: How do Programs Select Sites and Sustain Rural Rotations?","authors":"James E. Coverdill PhD ,&nbsp;Jeff S. Shelton PhD ,&nbsp;Benjamin T. Jarman MD ,&nbsp;Paula M. Termuhlen MD","doi":"10.1016/j.jsurg.2025.103650","DOIUrl":"10.1016/j.jsurg.2025.103650","url":null,"abstract":"<div><h3>Objective</h3><div>Despite the dire need for rural surgeons and increasing interest in exposing residents to rural practice, there remains little systematic information about how programs establish and sustain rural rotations.</div></div><div><h3>Design</h3><div>A website review (12/2022-7/2023) of the 342 civilian surgery programs listed by the ACGME identified those offering elective or required U.S. rural rotations. In addition, all programs were contacted by email to confirm or deny that they offered rural rotations to account for webpage inaccuracies. The effort identified 81 programs (24%). A qualitative design was then adopted, whereby the first author interviewed 58 general surgery program leaders (72% participation rate) to explore strategies used to arrange and sustain rural rotations. Interviews focused on the 2023-24 academic year, were conducted from August 2023 to August 2024, and were recorded, transcribed, and analyzed collaboratively to discern program strategies.</div></div><div><h3>Results</h3><div>Programs are more likely to use rural training sites outside their healthcare system (59% or 34/58) than inside (41% or 24/58), but system sites were preferred when available. At both site types, programs drew heavily upon professional ties, primarily to program graduates (64% or 37/58). Alumni were eager to help and knew program traditions and expectations. Their presence also bolstered confidence in the educational value of the rotation. Additional alumni joining rural sites were evidence of rotations as a recruitment pathway, thus fostering sustainable relationships. Within-system rotations were easier to arrange and finance than those outside the system.</div></div><div><h3>Conclusions</h3><div>The results offer practical insights into how a diverse mix of surgery programs across the U.S. select and sustain required and elective rural rotations in the U.S. The prominence of professional ties to program graduates and healthcare-system links are especially notable. Variability across programs in how they select and sustain sites also suggests that many approaches are feasible.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 10","pages":"Article 103650"},"PeriodicalIF":2.1,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144892164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Arts and Humanities Into Surgical Education: A Novel Curriculum for Facial Analysis Training","authors":"Razan Baabdullah BDS, MS, FRCDC","doi":"10.1016/j.jsurg.2025.103652","DOIUrl":"10.1016/j.jsurg.2025.103652","url":null,"abstract":"<div><h3>Objective</h3><div>The transition to independent surgical practice requires not only technical proficiency but also finely tuned observational skills and patient-centered communication, areas that may receive less emphasis in traditional training. This study introduces From Canvas to Clinic (FCC), a structured curriculum designed to explicitly cultivate visual literacy and diagnostic reasoning in oral and maxillofacial surgery trainees.</div></div><div><h3>Design</h3><div>Implemented as a 6-week longitudinal course, FCC integrates Visual Thinking Strategies (VTS), progressive drawing exercises, and clinical application through structured facial analysis. Each session combines seminar-style discussion, VTS-facilitated peer analysis, aesthetic practice, and diagnostic exercises anchored in patient-based cases. Learning is scaffolded through a multimodal framework and captured in a comprehensive processfolio documenting metacognitive and clinical growth.</div></div><div><h3>Results</h3><div>Preliminary findings indicate improvements in observational acuity, visual recall, clinical reasoning, and empathetic engagement. Assessment tools, including Direct Observation of Procedural Skills (DOPS), Chart-Simulated Recall (CSR), structured sketch assignments, and formal exams demonstrated significant learner gains across knowledge, skills, and attitude domains. Participants reported greater diagnostic confidence and cited specific techniques, such as grid use and slow looking, as transformative to their clinical practice.</div></div><div><h3>Conclusions</h3><div>FCC repositions facial analysis as a deliberately taught core skill in surgical training, blending artistic inquiry with clinical rigor, providing a replicable model that balances technical precision with humanistic understanding essential for comprehensive patient care in maxillofacial surgery.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 10","pages":"Article 103652"},"PeriodicalIF":2.1,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144892166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orthopedic Surgery Residency Match Trends in 2024: Step Scores and Research on the Rise","authors":"Matthew J. Weintraub BSE,&nbsp;Roshan V. Patel BS,&nbsp;Rohan Singh BS,&nbsp;David B. Ahn BA,&nbsp;Dhruv Mendiratta BS,&nbsp;Neil K. Kaushal MD,&nbsp;Michael M. Vosbikian MD","doi":"10.1016/j.jsurg.2025.103647","DOIUrl":"10.1016/j.jsurg.2025.103647","url":null,"abstract":"<div><h3>Background</h3><div>Orthopedic surgery residency remains 1 of the most competitive specialties in the United States. Recent changes in residency selection criteria, including the transition of the United States Medical Licensing Examination (USMLE) Step 1 to pass/fail scoring, have shifted emphasis toward alternative metrics such as Step 2 Clinical Knowledge (CK) scores and research productivity. This study aims to analyze trends in orthopedic residency match competitiveness from 2016 to 2024, including program growth, applicant characteristics, and selection metrics.</div></div><div><h3>Methods</h3><div>Data were obtained from the National Residency Matching Program (NRMP) and the Charting Outcomes in the Match reports from 2016 to 2024. Metrics included applicant-to-position ratios, match rates, Step 2 CK scores, research output, Alpha Omega Alpha (AOA) membership rates, and representation from medical schools with the most National Institutes of Health (NIH) funding. Linear regression calculated annual growth rates, and between-group differences were analyzed using t-tests.</div></div><div><h3>Results</h3><div>The number of orthopedic residency programs increased from 163 in 2016 to 218 in 2024, with positions expanding from 717 to 916; the applicant to position ratio did not change throughout this time. Matched applicants demonstrated an increase in Step 2 CK scores (average 253 in 2016 and 257 in 2024, p = 0.010) and number of research items (8.2 in 2016 and 23.8 in 2024, p = 0.001). AOA membership (34.2%) and top medical school representation (33%) remained stable. Notably, MD/PhD applicants were disproportionately represented among unmatched candidates (3.2% vs. 1.3% matched, p = 0.073).</div></div><div><h3>Conclusion</h3><div>Trends from 2016 to 2024 reveal an evolving orthopedic residency match. While traditional metrics such as AOA membership and institutional prestige remain stable, increasing emphasis on Step 2 CK scores and research productivity underscores their growing importance. The expanding number of programs and positions has not eased competition, and the specialty remains highly selective.</div></div><div><h3>Level of Evidence</h3><div>II</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 10","pages":"Article 103647"},"PeriodicalIF":2.1,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Review of Gender Differences in Reference Letters for Postgraduate Surgical Training Programs","authors":"Betty Wen MD ,&nbsp;Rajan Bola MSc ,&nbsp;Tracy Scott MD ,&nbsp;Ahmer Karimuddin MD","doi":"10.1016/j.jsurg.2025.103659","DOIUrl":"10.1016/j.jsurg.2025.103659","url":null,"abstract":"<div><h3>Objective</h3><div>This study is the first systematic review to synthesize the literature examining gender bias within reference letters for postgraduate training programs of all surgical disciplines.</div></div><div><h3>Design</h3><div>MEDLINE, Embase, and CINAHL databases were searched to June 2023 and original studies on gender differences in reference letters were included in a systematic review.</div></div><div><h3>Setting</h3><div>Surgical postgraduate (residency and fellowship) programs</div></div><div><h3>Participants</h3><div>n/a</div></div><div><h3>Results</h3><div>After screening 477 studies, 39 met inclusion criteria and were included in the systematic review. Key gender differences included the greater use of communal terminology for female applicants and increased discussion of male applicants’ leadership skills. There were no consistent gender differences in the use of agentic language or discussions of applicants’ research and teaching skills.</div></div><div><h3>Conclusions</h3><div>There are gender differences in reference letters written for male and female applicants to postgraduate surgical training programs. Although strides have been made towards improving gender representation in surgery, bias in reference letters may negatively affect female applicants’ success in obtaining postgraduate training positions, which serve as the initial barrier to entering the field of surgery. Awareness of these biases and development of strategies by selections committees and letter writers to mitigate these biases are recommended.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 10","pages":"Article 103659"},"PeriodicalIF":2.1,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144892165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}