McKeeman Jonathan D, Greenhill Dustin A, Sharma Akhil, Harrast John J, Martin David F, Lundy Douglas W
Department of Orthopaedic Surgery, St. Luke's University Health Network, Bethlehem, Pennsylvania.
Data Harbor Solutions, Chicago, Illinois.
J Bone Joint Surg Am. 2025 Feb 19;107(4):431-435. doi: 10.2106/JBJS.24.00040. Epub 2024 Sep 26.
The claim that "50% of orthopaedic surgeons leave their first job within 2 years" did not originate from evidence. The purpose of this study was to investigate practice change rates among board- eligible orthopaedic surgeons using the American Board of Orthopaedic Surgery (ABOS) database.
We utilized information provided by orthopaedic surgeons taking the ABOS Part II Examination across 6 different years. Surgeons who trained outside of the United States and members of the uniformed services of the U.S. were excluded. Move rates within 2 years of starting practice and before the candidate's Part II examination were determined. All surgeons were then subcategorized as having followed a traditional or nontraditional certification timeline based on whether they took Part II of the examination within 2 practice years after becoming board-eligible. Candidate-specific variables were analyzed according to whether the surgeon did or did not change practices.
Among 3,784 orthopaedic surgeons, 215 (5.7%) left their first practice within 2 years. On average, candidates sat for the Part II examination at a mean (and standard deviation) of 2.1 ± 1.1 years (range, 0.7 to 31.9 years) after reporting their first practice location. Seventy-six percent of surgeons took the Part II examination within a traditional timeframe. On average, nontraditional candidates left their first practice at a significantly higher rate than traditional candidates (20.5% versus 1.3%; p < 0.001), changed practices more often (1.5 versus 1.2 moves; p = 0.021), and moved farther (500.1 versus 304.4 miles; p = 0.023). Fellowship training and/or Part II examination subspecialty were not strongly associated with a surgeon leaving his or her first practice.
While it is possible that >5.7% of orthopaedic surgeons leave their first job during their early career, it is unlikely that many relocate within 2 years. This is especially true among orthopaedic surgeons pursuing ABOS certification within a traditional timeframe.
“50%的骨科外科医生在两年内离职”这一说法并无证据依据。本研究旨在利用美国骨科医师协会(ABOS)数据库调查符合委员会资质的骨科外科医生的执业变更率。
我们利用了在6个不同年份参加ABOS第二部分考试的骨科外科医生提供的信息。排除在美国境外接受培训的外科医生以及美国军队的成员。确定开始执业后两年内以及考生参加第二部分考试之前的变动率。然后根据所有外科医生在获得委员会资质后的2个执业年份内是否参加第二部分考试,将其分为遵循传统或非传统认证时间表两类。根据外科医生是否变更执业情况分析特定考生变量。
在3784名骨科外科医生中,215名(5.7%)在两年内离开了他们的第一份工作。平均而言,考生在报告其第一个执业地点后的平均(及标准差)2.1±1.1年(范围为0.7至31.9年)参加第二部分考试。76%的外科医生在传统时间范围内参加了第二部分考试。平均而言,非传统考生离开其第一份工作的比率显著高于传统考生(20.5%对1.3%;p<0.001),变更执业的频率更高(1.5次对1.2次变动;p = 0.021),且变动距离更远(500.1英里对304.4英里;p = 0.023)。专科培训和/或第二部分考试亚专业与外科医生离开其第一份工作的关联不强。
虽然可能有超过5.7%的骨科外科医生在其职业生涯早期离开第一份工作,但不太可能有很多人在两年内重新安置。在传统时间范围内追求ABOS认证的骨科外科医生中尤其如此。