Jurayj Alexander, Timoteo Taylor, Nerys-Figueroa Julio, Kasto Johnny, Mahylis Jared M, Muh Stephanie J
Department of Orthopaedic Surgery, Henry Ford Hospital, Henry Ford Health, Detroit, MI, USA.
JSES Rev Rep Tech. 2024 Oct 9;5(1):53-59. doi: 10.1016/j.xrrt.2024.09.003. eCollection 2025 Feb.
Postresidency training is becoming increasingly common among orthopedic surgeons, with shoulder and elbow surgery growing as a desired subspeciality. There is limited data evaluating how the reputation of an applicants' orthopedic residency influences the outcome of the shoulder and elbow fellowship match. The purpose of this study was to determine if applicants from residencies with better reputation have more favorable odds during the match process compared to applicants from residencies with a less prestigious reputation.
Residency reputation was determined using the 2023 Doximity residency ranking. These residency programs were then divided into 5 tiers (with tier 1 being the highest ranked and tier 5 being the lowest). Fellowship match data was obtained via San Francisco match from 2016 to 2023. Unmatched applicants, international graduates, and applicants without residency information were excluded. Applicants from 2016 to 2017 were excluded due to incomplete match data. Statistical analysis included descriptive statistics, Chi-square, analysis of variance, and nonparametric analysis.
There was a statistically significant difference with residency tier and average matched rank by fellowship program ( < .001). Applicants from tiers 1, 2, and 3 were more likely to be ranked higher compared to applicants from tiers 4 and 5. Applicants from tier 1 programs sent fewer applications and received a greater proportion of interview offers compared to applicants from tiers 3, 4, and 5 ( < .001). Tier 1 applicants were significantly more likely to be "ranked to match" compared to all remaining applicants ( < .001). There was no significant difference associated with residency tier and match position on the applicant's rank list. However, applicants from tier 1 programs were significantly more likely to match at their top 2 desired programs, compared to applicants from tiers 3, 4, and 5 ( = .029, = .023, = .012). Tier 2 applicants were more likely to match at one of their top 2 programs compared to tier 4 and 5 applicants ( = .045, = .023).
Applicants from higher tier residencies are more likely to be ranked higher by shoulder and elbow fellowship programs compared to applicants from lower-tier residencies. Tiers 1, 2, and 3 are ranked approximately equally, while tiers 4 and 5 are ranked significantly lower. There was no association noted between residency tier and applicant match rank; however, applicants from higher-tier residencies were far more likely to match at their top fellowship programs compared to applicants from lower-tier residencies.
住院医师培训后继续深造在骨科医生中越来越普遍，肩肘外科作为一个热门亚专业不断发展。目前评估申请者骨科住院医师培训声誉如何影响肩肘专科医师培训匹配结果的数据有限。本研究的目的是确定与来自声誉较低的住院医师培训项目的申请者相比，来自声誉较好的住院医师培训项目的申请者在匹配过程中是否有更有利的几率。
使用2023年Doximity住院医师排名来确定住院医师培训的声誉。然后将这些住院医师培训项目分为5个等级（1级为排名最高，5级为排名最低）。通过旧金山匹配系统获取2016年至2023年的专科医师培训匹配数据。排除未匹配的申请者、国际毕业生以及没有住院医师培训信息的申请者。由于匹配数据不完整，排除2016年至2017年的申请者。统计分析包括描述性统计、卡方检验、方差分析和非参数分析。
住院医师培训等级与专科医师培训项目的平均匹配排名之间存在统计学显著差异（<0.001）。与4级和5级的申请者相比，1级、2级和3级的申请者更有可能获得较高排名。与3级、4级和5级的申请者相比，1级项目的申请者提交的申请较少，获得面试邀请的比例更高（<0.001）。与所有其他申请者相比，1级申请者“排名匹配”的可能性显著更高（<0.001）。住院医师培训等级与申请者排名列表上的匹配位置之间没有显著差异。然而，与3级、4级和5级的申请者相比，1级项目的申请者在他们最想去的前2个项目中匹配的可能性显著更高（=0.029，=0.023，=0.012）。与4级和5级的申请者相比，2级申请者在他们最想去的前2个项目中的一个匹配的可能性更高（=0.045，=0.023）。
与来自较低等级住院医师培训项目的申请者相比，来自较高等级住院医师培训项目的申请者更有可能在肩肘专科医师培训项目中获得较高排名。1级、2级和3级的排名大致相当，而4级和5级的排名显著较低。住院医师培训等级与申请者匹配排名之间未发现关联；然而，与来自较低等级住院医师培训项目的申请者相比，来自较高等级住院医师培训项目的申请者在他们最想去的专科医师培训项目中匹配的可能性要高得多。
