Trends in Artificial Intelligence Usage in Orthopaedic Surgery Residency Applications

The public adoption of artificial intelligence (AI) tools such as ChatGPT has expanded rapidly in recent years, including growing use among healthcare professionals. The purpose of this study was to assess the use of AI and plagiarism in orthopaedic surgery residency applications across the 2022 to 2023, 2023 to 2024, and 2024 to 2025 application cycles.

Deidentified letters of recommendation (LORs) and personal statements (PSs) from interviewed applicants across 3 consecutive application cycles at a single institution were analyzed. Blinded reviewers input the documents into an online platform designed to detect AI-generated language and plagiarism.

There was a statistically significant increase in the AI usage in LORs during the 2024 to 2025 application cycle (17.8%) compared with the 2023 to 2024 (5.0%) and 2022 to 2023 (5.6%) cycles (p < 0.001). Correspondingly, the originality scores of LORs significantly decreased in 2024 to 2025 (92.4%) compared with 2023 to 2024 (97.3%) and 2022 to 2023 (97.7%) (p < 0.001). By contrast, the AI usage in personal statements significantly decreased in 2024 to 2025 (43.5%) compared with 2023 to 2024 (60.3%) and 2022 to 2023 (65.2%) (p = 0.031). There was no significant difference in plagiarism scores across the 3 cycles for either LORs (p = 0.28) or PSs (p = 0.39).

The 2024 to 2025 application cycle showed a marked increase in AI usage in letters of recommendation, while the usage of AI in personal statements declined. These trends reflect evolving patterns in how applicants and letter writers are integrating AI tools into the application process.

Level III; Retrospective Cohort Study. See Instructions for Authors for a complete description of levels of evidence.