Bellaire Christopher P, Graham Emily M, Bracey Lauren M, Ferlauto Harrison R, Weliver Caleigh, Mendenhall Shaun D, Melamed Eitan
Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount, Sinai, New York, NY, USA.
Division of Hand and Microsurgery, Elmhurst Hospital Center, Elmhurst, NY, USA.
Surg Pract Sci. 2023 Dec 10;15:100228. doi: 10.1016/j.sipas.2023.100228. eCollection 2023 Dec.
Hand surgery is a competitive fellowship that draws applicants from orthopedic, plastic, and general surgery. In 2010, recommendations from the American Academy of Orthopaedic Surgeons (AAOS) Board of Specialty Societies Match Oversight Committee and the American Society of Plastic Surgeons (ASPS) Plastic Surgery Workforce Task Force led to significant reforms to their respective workforces and training. This study characterizes trends in hand fellowship applicants and programs since these recommendations (2010-2023).
We queried hand fellowship applicant and program data from the American Society for Surgery of the Hand (ASSH), the National Resident Matching Program (NRMP), and the Accreditation Council for Graduate Medical Education (ACGME).
From 2010 to 2023, the number of ACGME-accredited hand fellowship programs increased across specialties (orthopedic surgery, 58 to 74 (27.6 % increase, = 0.97, < 0.001); plastic surgery, 14 to 19 (35.7 % increase, = 0.91, < 0.001); general surgery, 1 to 2 (50 % increase, = 0.71, = 0.004). The number of available fellowship positions commensurately increased by 38.8 % over the same time period. The number of applicants did not significantly change between 2010 (155 applicants) and 2023 (198 applicants) ( = 0.32, = 0.27). The ratio of applicants-to-positions significantly decreased from 2010 (1.12 applicants per position) to 2023 (1.04 applicants per position) ( = -0.74, = 0.003). Yet, applicants ranked nearly twice as many programs in 2023 (14.9 programs per applicant) compared to in 2010 (7.5 programs per applicant) ( = 0.98, < 0.001). In light of the American Orthopaedic Association endorsing signal preferencing in the 2022-2023 residency Match, strategies to optimize rank lists in the fellowship application process should be further explored.
手外科是一个竞争激烈的专科培训项目，吸引了骨科、整形外科和普通外科的申请者。2010年，美国骨科医师学会（AAOS）专科协会匹配监督委员会和美国整形外科医师协会（ASPS）整形外科劳动力特别工作组的建议促使其各自的劳动力和培训进行了重大改革。本研究描述了自这些建议发布以来（2010 - 2023年）手外科专科培训申请者和项目的趋势。
我们查询了美国手外科协会（ASSH）、全国住院医师匹配项目（NRMP）和毕业后医学教育认证委员会（ACGME）的手外科专科培训申请者和项目数据。
结果、讨论与结论：2010年至2023年期间，各专科经ACGME认证的手外科专科培训项目数量均有所增加（骨科手术，从58个增至74个（增长27.6%，χ² = 0.97，P < 0.001）；整形外科，从14个增至19个（增长35.7%，χ² = 0.91，P < 0.001）；普通外科，从1个增至2个（增长50%，χ² = 0.71，P = 0.004）。同期可提供的专科培训职位数量相应增加了38.8%。2010年（155名申请者）至2023年（198名申请者）申请者数量无显著变化（χ² = 0.32，P = 0.27）。申请者与职位的比例从2010年（每个职位1.12名申请者）显著降至2023年（每个职位1.04名申请者）（χ² = -0.74，P = 0.003）。然而，2023年申请者排名的项目数量（每位申请者14.9个项目）几乎是2010年（每位申请者7.5个项目）的两倍（χ² = 0.98，P < 0.001）。鉴于美国骨科协会在2022 - 2023年住院医师匹配中支持信号优先排序，应进一步探索在专科培训申请过程中优化排名列表的策略。
