DePasse J Mason, Palumbo Mark A, Eberson Craig P, Daniels Alan H
Department of Orthopaedics, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
J Bone Joint Surg Am. 2016 May 4;98(9):788-95. doi: 10.2106/JBJS.15.00222.
Based on a relatively stable match rate, several authors have concluded that the competition for orthopaedic residency positions has not changed over the past 3 decades. However, the objective measures of applicant competitiveness have not been quantified in detail.
National Resident Matching Program (NRMP) data from 2007 to 2014 for U.S. orthopaedic surgery applicants were compared with data for applicants to all specialties. Trends in the United Stated Medical Licensing Examination (USMLE) Step-1 and Step-2 scores, publications and research experiences, Alpha Omega Alpha (AOA) status, and the presence of an advanced degree are reported.
From 2007 to 2014, the match rate for orthopaedic surgery applicants remained stable near 80% (p = 0.14). For orthopaedic applicants who matched, the mean USMLE Step-1 scores increased from 234 points in 2007 to 245 points in 2014 (p = 0.005), and the mean scores increased from 220 points in 2007 to 229 points in 2014 for all applicants (p = 0.019). The mean USMLE Step-2 scores of orthopaedic applicants who matched increased from 235 points in 2007 to 251 points in 2014 (p = 0.005), and the mean scores of all applicants increased from 225 points in 2007 to 242 points in 2014 (p = 0.002). The mean number of research publications, presentations, and abstracts reported by orthopaedic applicants who matched more than doubled from 3.0 in 2007 to 6.7 in 2014 (p = 0.02) and increased less dramatically for all applicants from 2.2 in 2007 to 4.2 in 2014 (p = 0.004). The percentage of orthopaedic applicants elected to AOA or with advanced degrees did not significantly change (p > 0.2). Although orthopaedic applicants with AOA status experienced a very high match rate (97.1% in 2014), those with advanced degrees experienced match rates similar to or slightly lower than the applicant pool (73.7% in 2014).
The USMLE Step-1 and 2 scores of U.S. orthopaedic surgery residency applicants have increased significantly from 2007 to 2014. Additionally, the number of publications and presentations reported by orthopaedic applicants has more than doubled. These factors signal an increasing level of academic accomplishment in orthopaedic surgery applicants despite a consistent match rate.
基于相对稳定的匹配率，一些作者得出结论，在过去30年里，骨科住院医师职位的竞争没有变化。然而，申请人竞争力的客观衡量标准尚未得到详细量化。
将2007年至2014年美国骨科手术申请人的全国住院医师匹配计划（NRMP）数据与所有专业申请人的数据进行比较。报告了美国医学执照考试（USMLE）第一步和第二步的分数、发表文章和研究经历、阿尔法欧米茄阿尔法（AOA）资格以及是否拥有高级学位的趋势。
2007年至2014年，骨科手术申请人的匹配率保持在80%左右稳定（p = 0.14）。对于匹配成功的骨科申请人，USMLE第一步的平均分数从2007年的234分提高到2014年的245分（p = 0.005），所有申请人的平均分数从2007年的220分提高到2014年的229分（p = 0.019）。匹配成功的骨科申请人的USMLE第二步平均分数从2007年的235分提高到2014年的251分（p = 0.005），所有申请人的平均分数从2007年的225分提高到2014年的242分（p = 0.002）。匹配成功的骨科申请人报告的研究出版物、报告和摘要的平均数量从2007年的3.0大幅增加到2014年的6.7（p = 0.02），所有申请人的增加幅度较小，从2007年的2.2增加到2014年的4.2（p = 0.004）。当选为AOA或拥有高级学位的骨科申请人的百分比没有显著变化（p > 0.2）。尽管具有AOA资格的骨科申请人匹配率非常高（2014年为97.1%），但拥有高级学位的申请人的匹配率与申请人总体相似或略低（2014年为73.7%）。
2007年至2014年，美国骨科手术住院医师申请人的USMLE第一步和第二步分数显著提高。此外，骨科申请人报告的出版物和报告数量增加了一倍多。尽管匹配率保持不变，但这些因素表明骨科手术申请人的学术成就水平在不断提高。
