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The Orthopaedic Surgery Residency Application Process: An Analysis of the Applicant Experience

Ramkumar, Prem N. MD, MBA; Navarro, Sergio M. BS; Chughtai, Morad MD; Haeberle, Heather S. BS; Taylor, Samuel A. MD; Mont, Michael A. MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: August 1, 2018 - Volume 26 - Issue 15 - p 537-544
doi: 10.5435/JAAOS-D-16-00835
Research Article

Introduction: Orthopaedic surgery residency positions are highly sought after. The purpose of this survey study was to report the following components of the applicant experience: (1) the number of programs to which applicants applied and interviewed, (2) the performance criteria associated with receiving interviews, (3) the way applicants respond to e-mail interview offers, (4) the pre- and post-interview communication between applicants and programs, (5) the importance of interview day activities and the determinants of the applicant rank order list (ROL), and (6) the financial cost of the application process.

Methods: An online survey was administered and entirely completed by a representative sample of 100 orthopaedic surgery residency applicants for the 2015 to 2016 cycle during the 3-week period between the last interview of the application season and the deadline for ROL certification. The survey included 45 questions: 7 for background, 7 for competitiveness, 15 for the interaction between applicants and programs, 15 for the importance of interview day experience and the determinants of the applicant ROL, and 1 for the cost of attending each interview.

Results: Students applied to 83 ± 27 programs, received 17 ± 10 interviews, and attended 12 ± 5 interviews. Interview offers correlated with, in descending order, Alpha Omega Alpha status, Step 2 Clinical Knowledge, and Step 1. The mean time to reply of interview offer was 17 minutes, yet 25% of the applicants lost at least one interview despite having at least one other person monitor the applicant's e-mail account. Applicants and programs frequently contacted each other to express interest. Although evaluating current residents was the most valuable aspect of interview day to applicants, the strongest determinants for applicants' ROLs were location and surgical experience, with research the least important factor. The cost of interview season was >$7,000 per applicant, excluding away externships.

Conclusion: Applying to orthopaedic surgery residency is a complex, competitive, and costly experience for applicants. The application process may benefit from better expectation management of applicant candidacy and a more prohibitive communication policy between applicants and programs after the interview day.

From Cleveland Clinic, Cleveland, OH (Dr. Ramkumar, Dr. Chughtai, and Dr. Mont), Baylor College of Medicine, Houston, TX (Mr. Navarro and Ms. Haeberle), and the Hospital for Special Surgery, New York, NY (Dr. Taylor).

Correspondence to Dr. Ramkumar:

Dr. Chughtai serves as a paid consultant to DJ Orthopaedics, Sage Products, and Stryker. Dr. Taylor serves as a paid consultant to DJ Orthopaedics and Mitek. Dr. Mont has received royalties from MicroPort and Stryker; serves as a paid consultant to Cymedica, DJ Orthopaedics, Johnson & Johnson, Ongoing Care Solutions, Orthosensor, Orthosensor, Pacira, Performance Dynamics, Sage, Stryker, and TissueGene; held stock or stock options in PeerWell, DJ Orthopaedics, Johnson & Johnson, National Institutes of Health (NIAMS and NICHD), Ongoing Care Solutions, Orthosensor, Stryker, and TissueGene; and is a board member or committee member of the American Academy of Orthopaedic Surgeons. None of the following authors or any of their immediate family members has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Ramkumar, Mr. Navarro, and Ms. Haeberle.

Copyright 2018 by the American Academy of Orthopaedic Surgeons.
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