Allopathic resident prevalence in orthopedic residency programs formerly accredited by the American Osteopathic...

The finalization of the Single Accreditation System (SAS) in 2020 resulted in the combined residency training of both allopathic (MD) and osteopathic (DO) graduates and has raised concerns about residency position availability for DO applicants in competitive specialties.

The purpose of this study was to evaluate formerly American Osteopathic Association (AOA) - accredited orthopaedic surgery programs to identify the prevalence of DO degrees among program directors and residents, and stratify the association of program geography, program director degree, and osteopathic recognition status on resident composition.

A retrospective review of formerly AOA orthopaedic surgery programs was performed. Database information, program websites, and social medial profiles were used to determine program director degree and degree of all residents during academic year 2023-2024. Osteopathic Recognition status and program location were recorded. Associations were analyzed using chi-square and Fisher's Exact Test.

Of the 36 identified formerly AOA programs, 12 (33.3 %) had an MD program director. Among 561 residents in these programs, there were 43 MD residents. MD residents were more likely to train under an MD program director (p < 0.01). Programs with a DO program director were significantly more likely to train zero MD residents (p < 0.01). Programs located in the Midwest trained the highest proportion of DOs (97.2 %, p < 0.01). All 5 programs with Osteopathic Recognition were training zero MD residents during the study period.

The increase in MD leadership in formerly AOA-accredited programs and the associated increase of MD residents in those programs that has occurred since the advent of the Single Accreditation System should be of concern to osteopathic leadership, who are dedicated to matching well qualified DO graduates into increasingly competitive residency positions such as those in orthopaedic surgery.