Geographic Trends in the Orthopedic Surgery Residency Match

Residency program location may be an important factor for orthopedic surgery residency applicants. More than half of residents locate their practice near the site of their training, and surgical specialties (eg, otolaryngology, plastic surgery, and general surgery) have shown geographic patterns in their residency matches.

We analyzed geographic trends in the orthopedic surgery Match.

Hometown, undergraduate institution, and medical school "preresidency locations" of all allopathic, nonmilitary, orthopedic surgery residents were recorded from program websites for the 2015-2016 academic year. Program and preresidency locations were coded according to state and US census division. Statistical analysis was used to investigate associations between residency program locations and preresidency locations.

Of 2662 residents in the study, 1220 of 2614 (47%), 536 of 1329 (40%), and 308 of 744 (41%) matched into the same division as their medical school, undergraduate institution, and hometown, respectively. There were significant differences among divisions (P < .001). Also, 817 of 2662 (31%), 319 of 1329 (24%), and 200 of 770 (26%) residents matched in the same state as their medical school, undergraduate institution, and hometown, respectively, with significant differences between states for medical school (P < .0001) and undergraduate institution (P < .0001), but not hometown (P = .22). Overall, 21% of residents (538 of 2612) matched at the program affiliated with their medical school.

There is an association among hometown, undergraduate institution, and medical school for the training program location in which orthopedic surgery residents match, with variability in locations matched at state and census division levels.