Are We Choosing and Training the Best Surgeons?

Area of Science:

• Orthopaedic Surgery
• Medical Education
• Residency Selection

Background:

• The U.S. orthopaedic surgery residency match is highly competitive, with 40% of applicants unmatched in 2024.
• Applicants seek differentiation, while programs aim for holistic candidate evaluation.

Purpose of the Study:

• To examine medical student advising, national organizational roles, and programmatic practices in orthopaedic surgery resident selection.
• To identify areas for improvement in the orthopaedic residency match process.

Main Methods:

• Analysis of medical student advising strategies.
• Evaluation of national initiatives like the Orthopaedic Residency Information Network (ORIN).
• Review of programmatic resident selection practices, including holistic review and preference signaling.

Main Results:

• Effective career advising and early exposure are crucial for attracting diverse applicants.
• National initiatives improve information access but require further standardization.
• Preference signaling shows promise, but barriers like research access and rotation costs disproportionately affect underrepresented groups.

Conclusions:

• Collaborative efforts are needed to refine the match process, address systemic barriers, and ensure fair selection.
• Holistic review, structured interviews, and mission-driven scoring can improve alignment with program values.
• Systemic changes are essential to select and train surgeons who meet diverse patient needs and advance orthopaedic surgery.