Where Do Orthopaedic Surgery Applicants Match on Their Rank Lists? A Survey of Incoming Residents

Abstract

Background: The National Resident Matching Program reports match results by rank list position for all specialties in aggregate, but these data have not been previously reported for orthopaedic surgery specifically. The purpose of this study was to determine where orthopaedic applicants match on their rank lists in comparison to the national average for all specialties and to evaluate which factors may influence match results. Methods: This was a cross-sectional survey study distributed to all applicants to a single institution's orthopaedic surgery residency program. Metrics such as match result, USMLE scores, Alpha Omega Alpha (AOA) status, and research productivity, in addition to other applicant-specific traits were captured. Results were stratified by match status and rank list position, with subgroup analyses completed for applicants matching at highly ranked programs (1-3) vs. lower ranked programs ( ‡ 4). Results: The survey was distributed to 698 applicants with a response rate of 32% (n = 224), with a match rate of 85% (n = 191). Thirty-four percent of respondents matched at their top choice program, 15.2% at their second choice, 9.9% at their third, and 40.8% at their fourth or lower. When comparing the matched to unmatched applicant cohorts, there was a significant difference in number of programs ranked, AOA status, and sex. When comparing applicants who matched at highly ranked (1-3) vs. lower ranked ( ‡ 4) programs, there was a significant difference in USMLE board scores. Conclusions: Orthopaedic surgery residency applicants are significantly less likely to match at their first choice or within their top 3 choices when compared to the national average for all specialties. Number of contiguous ranks, AOA status, and female sex were found to be associated with successfully obtaining an orthopaedic residency position, whereas USMLE board scores were associated with matching higher on one's rank list, thus resulting in greater match satisfaction. Level of Evidence: III. Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSOA/A451).

The Impact of Signaling on the 2022 to 2023 Orthopaedic Residency Application Cycle: A Survey of Incoming Residents

“…Irrespective of signaling status, high board scores were still associated with more interviews per application. This finding is consistent with previous studies that evaluated the orthopaedic surgery match process 1 .…”

“…Previous literature had found that other factors, such as female sex, were associated with a higher match rate in orthopaedic surgery 1 . However, our study found no differences in match rate or interviews per application between sexes or ethnicities.…”

“…It is worth noting that over 20% of applicant interviews did come from programs that they did not signal. Historically, the number of interviews that applicants receive is closely linked toward the likelihood of an applicant matching 1 . Although half of the survey respondents indicated that signaling incentivized them to decrease their number of applications, many likely felt that applying broadly was still the best way to maximize their chances of achieving a successful match.…”

“…O rthopaedic surgery has historically been one of the most competitive residencies to match into 1 . In 2022, there were 1,435 applicants for 875 post graduate year-1 positions, a ratio of 1.64 applicants per available position 2 .…”

Understanding the Match: The Effect of Signaling, Demographics, and Applicant Characteristics on Match Success in the Orthopaedic Residency Application Process

“…The applicant characteristics predictive of match success in orthopaedic surgery have been studied in some detail and include United States Medical Licensing Examination (USMLE) step 1 and step 2 Clinical Knowledge (CK) scores, number of honored clerkships, Alpha Omega Alpha (AOA) membership, and number of peer-reviewed publications, metrics which have been found to differ markedly between matched and unmatched applicants. 10-12…”