Away Rotations Have Increased Importance for Matching in Orthopaedic Surgery

Orthopaedic surgery is one of the most competitive specialties. In 2024, 1,492 medical students applied to 916 orthopaedic surgery first-year training positions. There are no recent data examining trends in the number of away rotations performed by medical students interested in orthopaedic surgery. The purpose of this study was to enhance understanding about the significance of away rotations and home rotations for successfully matching into orthopaedic surgery.

In January 2024, the survey was distributed to orthopaedic surgery postgraduate year 1 (PGY-1) students at programs participating in the Collaborative Orthopaedic Education Research Group (COERG). The survey was distributed in March 2024 to 4th-year medical students who rotated at participating COERG residency programs. Data were collected on away rotations completed, motivations for participating, barriers encountered, and if the respondent matched at a program where they rotated.

Survey responses were collected from 37 of 90 PGY-1 students (41.1%) and 62 of 325 4th-year medical students (19.1%). The study cohort consisted of 99 applicants from the 2023 and 2024 orthopaedic surgery residency match cycles. PGY-1 students and 4th-year medical students completed an average of 3.4 away rotations and applied to an average of 4.4. Eight of 62 4th-year medical students (12.9%) did not match, with their average number of away rotations being 3.75. Of the 91 respondents who matched, 50 (54.9%) matched at an outside program where they rotated during 4th year. Fifteen (16.5%) matched at their home program. Fifteen (16.5%) matched at a program they had no prior exposure to before the residency interview. Six (6.6%) matched at a program with prior exposure and no away rotation. Five (5.5%) matched at a program with geographical ties and no away rotation.

Medical students applying to orthopaedic surgery residency are completing more away rotations than noted in previous studies. Most medical students match at programs where they complete away rotations or their home program, which subsequently increases the importance of where students decide to do rotations and the number they complete.