Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University, Providence, Rhode Island.
J Bone Joint Surg Am. 2018 Nov 7;100(21):e139. doi: 10.2106/JBJS.18.00323.
Orthopaedic surgery has become increasingly specialized, and most trainees currently complete subspecialty fellowship training. The purposes of this investigation were to evaluate recent trends in U.S. orthopaedic fellowship matches and to provide relevant analyses for future orthopaedic fellowship applicants and fellowship program directors.
This study analyzed data from orthopaedic fellowship match programs from 2010 to 2017. For each fellowship, the following variables were analyzed: numbers of positions offered, participating programs, applicant registrations, rank lists submitted by applicants (i.e., completed applications), applicants matched, and filled positions. Applicant-matching success rate and percentage of total fellowship positions filled for each subspecialty were calculated, and trends were evaluated for significance and difference between subspecialties utilizing ordinary least-square regressions, with p < 0.05 indicating significance.
From 2010 to 2017, the number of fellowship positions that were offered increased in all subspecialties (p < 0.05) except for spine (p = 0.44) and trauma (p = 0.92). Participating fellowship programs increased in all subspecialties (p < 0.05) except spine (p = 0.38) and sports medicine; the latter experienced the only significant decrease (p < 0.05). The largest significant increases (p < 0.05) in both applicant registrations (33.5%) and rank lists submitted by applicants (45.3%) were in adult reconstruction. The subspecialty with the highest applicant-matching success rate during the study period of 2010 to 2017 was sports (mean, 93.5%). Spine and trauma had the lowest applicant-matching success rates in 2016 to 2017. The percentage of positions filled across all subspecialties increased from 2011 to 2017 (p < 0.05); hand had the highest mean (96.6% filled), and adult reconstruction had the largest significant increase from 82.0% in 2010 to 95.5% in 2017 (p < 0.05).
This investigation provides data with regard to current trends in the orthopaedic fellowship match. Specifically, adult reconstruction fellowship training has recently gained popularity at a more rapid rate than the other subspecialty fellowship pathways, although hand surgery consistently maintains a very high rate of positions filled. Our results for orthopaedic subspecialty fellowship match trends may assist fellowship directors with program planning and career advising and may also assist current residents with fellowship application expectations and career planning.
骨科手术已经变得越来越专业化，目前大多数受训者都完成了专业 fellowship 培训。本研究旨在评估美国骨科 fellowship 匹配的最新趋势，并为未来的骨科 fellowship申请者和 fellowship 项目主任提供相关分析。
本研究分析了 2010 年至 2017 年骨科 fellowship匹配项目的数据。对于每个 fellowship，分析了以下变量：提供的职位数量、参与的项目、申请人注册、申请人提交的排名列表（即已完成的申请）、匹配的申请人和已填补的职位。计算了每个专业的申请人匹配成功率和总 fellowship 职位填补百分比，并利用普通最小二乘法回归评估了各专业之间的趋势，p<0.05 表示有意义。
从 2010 年到 2017 年，除了脊柱（p=0.44）和创伤（p=0.92）外，所有专业的 fellowship 职位数量都有所增加（p<0.05）。除了脊柱（p=0.38）和运动医学（后者经历了唯一的显著下降（p<0.05）外，参与 fellowship项目的专业数量在所有专业中都有所增加（p<0.05）。在申请人注册（33.5%）和申请人提交的排名列表（45.3%）方面，成人重建的增长幅度最大（p<0.05）。在 2010 年至 2017 年期间，该研究期间申请人匹配成功率最高的专业是运动（平均为 93.5%）。脊柱和创伤在 2016 年至 2017 年的申请人匹配成功率最低。所有专业的职位填补百分比从 2011 年到 2017 年有所增加（p<0.05）；手外科的平均填补率最高（96.6%），成人重建的比例从 2010 年的 82.0%增加到 2017 年的 95.5%，增幅最大（p<0.05）。
本研究提供了骨科 fellowship 匹配的最新趋势数据。具体来说，成人重建 fellowship 培训的受欢迎程度最近比其他专业 fellowship 途径增长得更快，尽管手外科一直保持着非常高的职位填补率。我们对骨科专业 fellowship 匹配趋势的研究结果可以帮助 fellowship 主任进行项目规划和职业咨询，也可以帮助现任住院医师了解 fellowship 申请的期望和职业规划。
