Perspectives on the Orthopaedic Surgery Residency Application Process During the COVID-19 Pandemic

Abstract

Introduction: The COVID-19 pandemic has led to the cancellation of away rotations and other experiences fundamental to orthopaedic surgery residency application. Limited information is available on the experiences of applicants and program directors (PDs) during the COVID-19 pandemic residency application cycle. This study aimed to evaluate the current perspectives of applicants and PDs regarding the orthopaedic surgery residency application process. Methods: This was a cross-sectional study using 2 independent but similar surveys that addressed multiple aspects of the application process during the COVID-19 pandemic, including perceived effect of virtual experiences. Between February and March 2021, the surveys were distributed to orthopaedic surgery applicants and orthopaedic residency PDs. Results: In total, 113 applicants (20.1%) and 29 PDs (19.6%) completed the survey. Applicants applied to 97.6 programs and received 13.3 interviews. They participated in 2.4 virtual away rotations. In total, 79.3% of programs reported offering some form of virtual opportunity, including virtual away rotations (24.0%), virtual happy hours (64.0%), and virtual conferences (64.0%). Programs offering virtual away rotations hosted 46.8 rotators and only invited back 54.5% for an interview. Applicants were most concerned about the lack of away rotations, the interview, and networking during this cycle, and 51% reported less confidence in matching. The most important factors for influencing applicant rank lists were perceived happiness of residents, resident camaraderie, and geographic location. However, residency program social events were not well replicated in a virtual setting. Discussion: The COVID-19 pandemic presented new challenges for applicants and PDs. Applicants had less clinical exposure and received less interview invites after virtual away rotations. Despite applying to more programs, applicants received fewer interviews than in previous years. The virtual experiences adopted in this cycle did not adequately replicate the social factors that applicants found most important when ranking a program. Even during the COVID-19 pandemic, PDs most highly valued away rotation performance, clinical rotation performance, and board examination scores when offering interviews.

Assessing the Impact of COVID-19 on the 2021 Orthopaedic Surgery Match Outcomes

“…Virtual away rotations have rapidly emerged as an innovative response to the cancellation of in-person aways during the pandemic. However, less than half of programs surveyed in this study reported offering a virtual away rotation in 2020, which was similar to the findings of previous studies 11 , 14 . Furthermore, programs ranked in the Doximity top 30 were more likely than lower-ranked programs (OR = 6.75) to offer a virtual away rotation.…”

“…During the 2020 to 2021 cycle, however, 82% of applicants altered their rank list due to the lack of in-person away rotations 11 . Applicants and program directors also felt that residency program social events during the cycle were not replicated well in the virtual setting 11 . Without adequate opportunities to evaluate each other, unaffiliated programs and applicants may have weighed home program affiliation more heavily when they developed their match rank lists 30 .…”

“…Indeed, program directors ranked virtual rotations in the 2020 to 2021 cycle as a less important selection criterion than away rotations in the previous cycle 14 . Programs were also less likely to invite back virtual away rotators for an interview compared with in-person rotators in prior years 11 , 12 . It remains unclear how student performance on virtual away rotations will factor into the orthopaedics applicant evaluation process as in-person away rotations resume.…”

Virtual Interviews for Sports Medicine Fellowship Positions Save Time and Money but Don’t Replace In-Person Meetings

“…Without being able to visit the program in-person, the applicant may not have a sense of the program culture, resources available, and whether or not they will enjoy living in the area for a year. 19,20 Similarly, Chandler et al 21 surveyed residents applying to a pediatric surgery fellowship at a single institution and found that only 35% believed that virtual interviews allowed them to decide if the program was the right fit for them. Bamba et al 22 surveyed applicants who interviewed at a plastic surgery residency program and found that those who interviewed in-person felt more acquainted with the program, faculty, and residents more than those who interviewed virtually.…”

“…Without being able to visit the program in-person, the applicant may not have a sense of the program culture, resources available, and whether or not they will enjoy living in the area for a year. 19 , 20 Similarly, Chandler et al. 21 surveyed residents applying to a pediatric surgery fellowship at a single institution and found that only 35% believed that virtual interviews allowed them to decide if the program was the right fit for them.…”