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Disparities in Industry Payments Between Orthopaedic Surgery and General Surgery Residents
Cemil C Gedik1, Claire Saltzman1, Parker D Boyce2
1Department of Orthopedic Surgery, University of Missouri-Kansas City, School of Medicine, Kansas City, Missouri.
JB & JS Open Access
|July 23, 2026
Summary
Orthopaedic surgery residents receive significantly more industry payments than general surgery residents, raising conflict-of-interest concerns. This highlights a need for structured approaches to manage industry funding in surgical training.
Area of Science:
- Medical Education
- Surgical Training
- Conflict of Interest
Background:
- Industry funding in surgical training presents potential conflicts of interest.
- Financially vulnerable residents may be disproportionately affected by these conflicts.
- This study investigates industry payment disparities between orthopaedic surgery (OS) and general surgery (GS) residents.
Purpose of the Study:
- To compare the prevalence and magnitude of Centers for Medicare & Medicaid Services (CMS) Open Payments general payments for PGY-5 OS and GS residents.
- To determine if these payments vary by institution type and geographic region.
- To inform graduate medical education policy and conflict-of-interest oversight.
Main Methods:
- Cross-sectional analysis of CMS Open Payments data (2018-2024).
- Identification of PGY-5 residents in OS and GS programs and linkage to payment records.
- Categorization of payments (Consulting Fees/Grants/Charity, Travel/Education Support, Hospitality) and statistical comparison between specialties, adjusted for covariates.
Main Results:
- 54% of 1,591 analyzed residents received industry payments.
- Orthopaedic surgery residents had a higher payment prevalence (57%) than general surgery residents (52%).
- Adjusted mean payments were substantially higher for OS residents ($3,202) compared to GS residents ($653), a 4.90-fold difference.
Conclusions:
- Over half of graduating surgical residents receive industry payments, with orthopaedic surgery residents receiving significantly more.
- Industry payments are concentrated among a small number of recipients.
- Stakeholders should develop structured approaches to leverage industry support while mitigating bias and ensuring equitable distribution in resident education.