Horst Patrick K, Choo Kevin, Bharucha Neil, Vail Thomas P
Department of Orthopaedic Surgery, University of California at San Francisco, Box 0728, MU-320 (P.K.H., K.C., and N.B.) and MU-3326W (T.P.V.), 500 Parnassus Avenue, San Francisco, CA 94143.
J Bone Joint Surg Am. 2015 May 20;97(10):869-75. doi: 10.2106/JBJS.N.00995.
Orthopaedic fellowships first gained popularity in the U.S. in the 1970s, and since that time, the percentage of orthopaedic residency graduates pursuing subspecialty fellowship training has increased. Prior reports have shown an increase in subspecialization from 1988 through 2002; however, the current number and proportion of graduates pursuing fellowship training since 2002 are unknown. The purpose of this study was to determine the percentage of recent graduates who pursue fellowship training and the proportion of procedures that these graduates perform within their area of fellowship training.
Data from the American Board of Orthopaedic Surgery Part II examination for board certification were used to determine the number and percentage of fellowship-trained and non-fellowship-trained applicants from 2003 to 2013. The percentage of cases performed by fellowship-trained applicants within their area of fellowship training was calculated and was analyzed as a function of time and a function of fellowship training category. Linear regression was used to determine trend as a function of time.
The percentage of fellowship-trained applicants increased from 76% in 2003 to 90% in 2013. Of the 1,257,161 procedures performed by fellowship-trained applicants, 981,077 (78%) were performed within the surgeon's area of fellowship training. Spine and hand-trained applicants performed more than 85% of their procedures within their area of fellowship training.
From 2003 to 2013, the percentage of fellowship-trained applicants taking the American Board of Orthopaedic Surgery Part II examination gradually increased to 90%. In the same time period, fellowship-trained surgeons performed an increasing proportion of procedures within their area of subspecialty training. Orthopaedic graduates have become increasingly subspecialized over the past decade.
骨科专科医师培训项目于20世纪70年代在美国首次流行起来，自那时起，接受骨科专科住院医师培训后继续进行亚专科培训的毕业生比例有所增加。先前的报告显示，1988年至2002年期间亚专科化有所增加；然而，自2002年以来接受专科培训的毕业生的当前数量和比例尚不清楚。本研究的目的是确定近期毕业生中接受专科培训的比例以及这些毕业生在其专科培训领域内所进行手术的比例。
使用美国骨科医师协会第二部分认证考试的数据来确定2003年至2013年期间接受专科培训和未接受专科培训的申请者数量及百分比。计算接受专科培训的申请者在其专科培训领域内所进行手术的百分比，并将其作为时间和专科培训类别的函数进行分析。使用线性回归来确定作为时间函数的趋势。
接受专科培训的申请者比例从2003年的76%增加到2013年的90%。在接受专科培训的申请者所进行的1,257,161例手术中，981,077例（78%）是在外科医生的专科培训领域内进行的。接受脊柱和手部培训的申请者在其专科培训领域内进行了超过85%的手术。
从2003年到2013年，参加美国骨科医师协会第二部分考试的接受专科培训的申请者比例逐渐增加到90%。在同一时期，接受专科培训的外科医生在其亚专科培训领域内进行手术的比例不断增加。在过去十年中，骨科毕业生的亚专科化程度越来越高。
