From the Department of Orthopedic Surgery, Mayo Clinic, Rochester, MI (Levy, Currier, Huddleston, Nassr, Freedman, and Sebastian), the Department of Orthopaedic Surgery, Rothman Institute at Thomas Jefferson University, Philadelphia, PA (Boere, Bodnar, Paulik, Kurd, Rihn, Canseco, Schroeder, Kepler, Vaccaro, Hilibrand), and the Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT (Randell, Spina, Spiker, Lawrence, Brodke, Karamian).
J Am Acad Orthop Surg. 2024 Sep 15;32(18):e940-e950. doi: 10.5435/JAAOS-D-24-00120. Epub 2024 Jul 12.
The factors most important in the spine fellowship match may not ultimately correlate with quality of performance during fellowship. This study examined the spine fellow applicant metrics correlated with high application rank compared with the metrics associated with the strongest clinical performance during fellowship.
Spine fellow applications at three academic institutions were retrieved from the San Francisco Match database (first available to 2021) and deidentified for application review. Application metrics pertaining to research, academics, education, extracurriculars, leadership, examinations, career interests, and letter of recommendations were extracted. Attending spine surgeons involved in spine fellow selection at their institutions were sent a survey to rank (1) fellow applicants based on their perceived candidacy and (2) the strength of performance of their previous fellows. Pearson correlation assessed the associations of application metrics with theoretical fellow rank and actual performance.
A total of 37 spine fellow applications were included (Institution A: 15, Institution B: 12, Institution C: 10), rated by 14 spine surgeons (Institution A: 6, Institution B: 4, Institution C: 4). Theoretical fellow rank demonstrated a moderate positive association with overall research, residency program rank, recommendation writer H-index, US Medical Licensing Examination (USMLE) scores, and journal reviewer positions. Actual fellow performance demonstrated a moderate positive association with residency program rank, recommendation writer H-index, USMLE scores, and journal reviewer positions. Linear regressions identified journal reviewer positions (ß = 1.73, P = 0.002), Step 1 (ß = 0.09, P = 0.010) and Step 3 (ß = 0.10, P = 0.002) scores, recommendation writer H-index (ß = 0.06, P = 0.029, and ß = 0.07, P = 0.006), and overall research (ß = 0.01, P = 0.005) as predictors of theoretical rank. Recommendation writer H-index (ß = 0.21, P = 0.030) and Alpha Omega Alpha achievement (ß = 6.88, P = 0.021) predicted actual performance.
Residency program reputation, USMLE scores, and a recommendation from an established spine surgeon were important in application review and performance during fellowship. Research productivity, although important during application review, was not predictive of fellow performance.
III.
Cohort Study.
在脊柱研究员匹配中最重要的因素可能最终与研究员期间的表现质量无关。本研究检查了与高申请排名相关的脊柱研究员申请人指标，以及与研究员期间最强的临床表现相关的指标。
从旧金山匹配数据库（最早可追溯到 2021 年）中检索了三个学术机构的脊柱研究员申请，并对其进行了去识别以进行申请审查。提取了与研究、学术、教育、课外活动、领导力、考试、职业兴趣和推荐信相关的申请指标。参与所在机构脊柱研究员选择的主治脊柱外科医生被发送了一份调查，要求他们根据自己认为的候选人资格和以前的研究员的表现强度来对（1）研究员申请人进行排名。使用 Pearson 相关分析评估了申请指标与理论研究员排名和实际表现的相关性。
共纳入 37 份脊柱研究员申请（机构 A：15 份，机构 B：12 份，机构 C：10 份），由 14 名脊柱外科医生（机构 A：6 名，机构 B：4 名，机构 C：4 名）进行评分。理论研究员排名与整体研究、住院医师项目排名、推荐人 H 指数、美国医师执照考试（USMLE）分数和期刊审稿人职位呈中度正相关。实际研究员表现与住院医师项目排名、推荐人 H 指数、USMLE 分数和期刊审稿人职位呈中度正相关。线性回归确定了期刊审稿人职位（ß = 1.73，P = 0.002）、Step 1（ß = 0.09，P = 0.010）和 Step 3（ß = 0.10，P = 0.002）分数、推荐人 H 指数（ß = 0.06，P = 0.029，和 ß = 0.07，P = 0.006）和整体研究（ß = 0.01，P = 0.005）是理论排名的预测因素。推荐人 H 指数（ß = 0.21，P = 0.030）和 Alpha Omega Alpha 成就（ß = 6.88，P = 0.021）预测了实际表现。
住院医师项目声誉、USMLE 分数和来自知名脊柱外科医生的推荐信在申请审查和研究员期间表现中很重要。研究生产力虽然在申请审查中很重要，但不能预测研究员的表现。
III。
队列研究。
