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The Real Match Rate? US DO Students Match Into Orthopaedic Surgery at Significantly Lower Rates than US MD Students

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Senior osteopathic (DO) medical students face lower orthopaedic surgery match rates and higher dropout rates compared to allopathic (MD) students, even after single accreditation. Targeted mentorship and bias identification are crucial for DO applicants.

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Area of Science:

  • Medical Education
  • Orthopaedic Surgery Residency
  • Graduate Medical Education

Background:

  • Orthopaedic surgery is a highly competitive residency match for both MD and DO students.
  • The transition to single accreditation in 2020 aimed to unify residency programs, but its impact on DO and MD applicants is not well understood.
  • Understanding disparities in the match process is crucial for equitable opportunities in competitive specialties.

Purpose of the Study:

  • To evaluate and compare the orthopaedic surgery residency match rates between MD and DO applicants.
  • To analyze the impact of the single accreditation system on DO and MD applicants' success in the match.
  • To identify differences in application abandonment between DO and MD candidates.

Main Methods:

  • Utilized Electronic Residency Application Service (ERAS) and National Residency Matching Program (NRMP) data from 2020 to 2023.
  • Calculated and compared unadjusted (NRMP) and adjusted (ERAS) match rates for MD and DO applicants annually and cumulatively.
  • Assessed the proportion of applicants who did not finalize their NRMP rank list after applying through ERAS.

Main Results:

  • Unadjusted match rates declined for both MD and DO applicants from 2020-2023.
  • Adjusted match rates showed no significant difference between MD and DO applicants over the study period.
  • DO applicants consistently had lower unadjusted and adjusted match rates than MD applicants.
  • A higher proportion of DO applicants than MD applicants withdrew from the NRMP ranking process each year (except 2023).

Conclusions:

  • Despite single accreditation, DO applicants experience lower orthopaedic surgery match rates and higher attrition from the application process compared to MD peers.
  • Addressing potential bias and enhancing mentorship and advising for DO students are vital for improving their competitiveness in specialty matches.
  • Further research is needed to understand and mitigate the factors contributing to these disparities.