Trends in the Orthopaedic Surgery Fellowship Match 2013 to 2017

Wera, Glenn D.; Eisinger, Sarah; Oreluk, Hazel; Cannada, Lisa K.

doi:10.5435/jaaosglobal-d-18-00080

Cited by 21 publications

(32 citation statements)

References 10 publications

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“…Over the last decade, hip and knee fellowship training has gained popularity at a more rapid rate than any other orthopaedic surgery subspecialty [4]. This field, also commonly referred to as "adult reconstruction," is considered the most selective of the orthopaedic subspecialties, with a fellowship match rate of only 68% [5]. In their annual match statistics report, the American Association of Hip and Knee Surgeons (AAHKS) noted that there were 235 total applicants for 183 total positions equating to 1.28 applicants per available position.…”

Section: Introductionmentioning

confidence: 99%

Factors Considered in Ranking Hip and Knee Arthroplasty Fellowship Applicants: A Survey of Program Directors

et al. 2020

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Background: Variables considered by hip and knee arthroplasty fellowship program directors (PDs) to select fellowship candidates are not well known. Methods: A web-based questionnaire containing 5 questions was developed and sent to all 92 adult reconstruction fellowship PDs via email. Three questions collected program information including the number of positions available, the number of candidates interviewed, and ranked annually. PDs were then given a list of 12 factors and asked to rank them in the order of importance. A weighted score for each factor was calculated using the following scale: 5 points each time a factor was ranked 1st, 4 points each time a factor was ranked 2nd, 3 points for each 3rd place rank, 2 points for each 4th place rank, and 1 point for each 5th place rank. PDs were also allowed to write in other factors they considered important when ranking fellowship candidates. Results: The overall response rate was 34.8% (32/92). Seventy-five percent of responding programs indicated that they interview between 21 and 40 applicants per year for their fellowship position(s). The interview was ranked as the most important variable in selecting applicants by 53.1% of responding PDs, followed by letters of recommendation (ranked first by 25% of PDs) and personal connections to the applicant and/or letter writer(s) (ranked first by 9% of PDs). A positive correlation was identified between the program size and an applicant's geographical ties to the city/town of the fellowship program (r s ¼ 0.472; P ¼ .006). Conclusions: According to hip and knee arthroplasty fellowship PDs, the interview, letters of recommendation, and personal connections to the applicant and/or letter writers are the most important factors considered in selecting arthroplasty fellowship candidates.

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Section: Introductionmentioning

confidence: 99%

Factors Considered in Ranking Hip and Knee Arthroplasty Fellowship Applicants: A Survey of Program Directors

et al. 2020

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“…Orthopedic fellowship training, particularly adult reconstruction fellowship training, is at its height of popularity [5]. This growing demand for fellowship training is likely driven in part by the job market demand for specialization [8].…”

Section: Discussionmentioning

confidence: 99%

“…While the general trend has been that more applicants are applying for orthopedic fellowships on an annual basis, there are also subspecialty-specific trends [4]. In the case of adult reconstruction fellowship, applications are currently at an all-time high as the number of applicants has increased nearly 35% from 204 in 2014 to 276 in 2019 and 275 in 2020 [5]. In 2019, these applicants competed for 207 spots, and in 2020, 219 spots were offered.…”

Section: Introductionmentioning

confidence: 99%

“…In 2019, these applicants competed for 207 spots, and in 2020, 219 spots were offered. As such, a recent analysis found that adult reconstruction now has the lowest odds of an applicant successfully matching (68% in 2017) [5]. Accordingly, the mean number of applications submitted per applicant is increasing and has reportedly approached 30 programs per applicant [5].…”

Section: Introductionmentioning

confidence: 99%

“…As such, a recent analysis found that adult reconstruction now has the lowest odds of an applicant successfully matching (68% in 2017) [5]. Accordingly, the mean number of applications submitted per applicant is increasing and has reportedly approached 30 programs per applicant [5]. In addition, applicants may feel pressured to attend a greater number of interviews to increase their perceived match likelihood.…”

Section: Introductionmentioning

confidence: 99%

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The Cost of Getting in: Is It Time for Change in the Adult Reconstruction Fellowship Application Process?

Wilson¹,

Schwartz²,

Farley³

et al. 2021

Arthroplasty Today

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Background: The number of applicants to adult reconstruction fellowships (ARFs) has increased significantly in recent years, making the application process increasingly competitive. With this, applicants are applying to and interviewing at more programs which has inherent cost and time implications. The purpose of this study was to assess these implications as well as investigate applicant attitudes toward proposed changes. Methods: This is a cross-sectional survey study of 2019 and 2020 ARF applicants (n ¼ 278) to a single institution. A 10-question survey was distributed to applicants regarding the application and interview process. This survey focused on application and interview volumes, financial and temporal commitments, as well as perceptions regarding potential application process changes. Descriptive statistics and chi-squared analysis were then performed. Results: Of the 110 (40%) respondents, 87% spent >$3000 and 43% spent >$5000 during the application process. Most respondents applied to 26 programs (84%) and both received and attended 11 interviews (87% and 74.5%, respectively). Applicants missed significant training time for interviews (99% missed at least 1 week, 62% two weeks, and 15% three weeks). Attending more interviews (P ¼ .001) and multiple visits to the same city (P ¼ .049) were associated with spending >$5000. Most applicants (72%) felt change to the process would be beneficial. Conclusions: Applicants to ARF are applying to and interviewing at many programs resulting in significant time away from training and financial investment. Most applicants feel that a change to the system would be beneficial, although no consensus on the best solution was delineated. These data should be considered during the continued evaluation of the match process.

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Comparative Analysis of Total Knee Arthroplasty Outcomes Between Arthroplasty and Nonarthroplasty Fellowship Trained Surgeons

et al. 2021

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Background: An adult reconstruction (AR) fellowship is designed to provide advanced training for a broad range of primary reconstructive and complex knee revision surgeries. This study aims to identify outcome differences between primary total knee arthroplasty (TKA) performed by AR fellowship-trained surgeons and non-AR (NAR) fellowship-trained surgeons. Material and Methods: We retrospectively reviewed 7415 patients who underwent primary TKA from 2016 to 2020. Two cohorts were established based on whether the operation was performed by an AR or NAR fellowship-trained surgeon. Demographic, clinical data, and patient-reported outcome measures were collected at various time-points (preoperatively, 3 months, 1 year). Demographic differences were assessed with chi-square and independent sample t-tests. Primary outcomes were compared using multilinear regressions, controlling for demographic differences. Results: AR surgeons performed 5194 (70%) cases while NAR surgeons performed 2221 (30%) cases. Surgical time (minutes) significantly differed between the 2 groups (101.26 vs 111.56; P < .001). Length of stay, 90-day all-cause readmissions, revisions, and all-cause emergency department visits did not statistically differ (P ¼ .079, P ¼ .978, P ¼ .094, and P ¼ .241, respectively). AR surgeons were more likely to discharge their patients home than NAR surgeons (P ¼ .001). NAR group reported lower KOOS, JR scores at 3 months and 1 year (preop: 45.30 vs 45.79, P ¼ .728; 3 months: 64.73 vs 59.47, P < .001; 1 year: 71.66 vs 69.56, P ¼ .234); however, only 3-month scores statistically differed. Veterans RAND-12 Physical and Mental components scores (VR-12 PCS and MCS) were not statistically significant at any time-point between the cohorts. Delta-improvements preoperatively to 1 year in KOOS, JR (26.36 vs 23.77; P < .001) and VR-12 PCS (11.98 vs 10.62; P < .001) scores were significantly higher for the AR cohort but did not exceed the minimal clinically important difference. Conclusion: This study demonstrates significantly shorter surgical times and greater improvements in KOOS, JR and VR-12 PCS scores associated with TKAs performed by AR fellowship-trained surgeons.

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Trends in the Orthopaedic Surgery Fellowship Match 2013 to 2017

Cited by 21 publications

References 10 publications

Factors Considered in Ranking Hip and Knee Arthroplasty Fellowship Applicants: A Survey of Program Directors

Factors Considered in Ranking Hip and Knee Arthroplasty Fellowship Applicants: A Survey of Program Directors

The Cost of Getting in: Is It Time for Change in the Adult Reconstruction Fellowship Application Process?

Comparative Analysis of Total Knee Arthroplasty Outcomes Between Arthroplasty and Nonarthroplasty Fellowship Trained Surgeons

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