Postgraduate Medical Education in Arthroplasty: Between Ambition and Reality

The number of arthroplasty procedures on hip and knee joints is expected to continue to rise in the coming years. At the same time, postgraduate training in arthroplasty faces significant structural challenges in German-speaking countries. This study aimed to assess the current state of postgraduate clinical training, the role of external education offered by the German Society of Arthroplasty (AE), and the ways in which young physicians can access AE-YOUTH (the AE's youth organisation).

An online survey was distributed to members of AE-YOUTH. The structured questionnaire included 20 items covering demographic information, clinical training experiences, and participation in AE-provided educational activities. Data analysis was performed, using descriptive and exploratory methods in Excel and SPSS.

A total of 92 AE-YOUTH members responded to the survey (response rate: 21.4%). While 75.3% reported that they had had the opportunity to perform arthroplastic procedures as primary surgeon, only about 22 % met the procedural volume required by official training regulations. Gender (p = 0.021) and stage of training (p = 0.001) were significantly associated with the number of procedures performed. In response to structural deficits, participants expressed a desire for stepwise surgical training concepts and structured mentoring programmes. Satisfaction with clinical training in arthroplasty averaged 2.9 out of 5, while AE-provided continuing education was rated higher, at 4.0 out of 5. More than half of respondents used online formats, and one-third participated in hands-on training courses. Most became aware of AE-YOUTH through colleagues or the AE website, with social media playing only a minor role.

The results reveal a clear discrepancy between expectations and reality in clinical arthroplasty training. In contrast, educational programmes provided by the professional society were perceived as more structured and accessible. These offerings may effectively complement clinical training, which is often constrained by time pressure and administrative workload. Digital content, simulation-based training, and practical courses are especially valuable in this context. As a low-barrier and needs-driven platform, AE-YOUTH has the potential to foster early-career engagement in arthroplasty and to support postgraduate education in a more structured and sustainable manner.