Katsma Mark S, Murray Jett B, Balazs George C, Speicher Mark R, Olsen Aaron A
Department of Orthopaedic Surgery, Naval Medical Center San Diego, San Diego, California.
Idaho College of Osteopathic Medicine, Meridian, Idaho.
JB JS Open Access. 2025 Apr 25;10(2). doi: 10.2106/JBJS.OA.24.00002. eCollection 2025 Apr-Jun.
Orthopaedic surgery remains one of the most competitive residency matches for both senior allopathic (MD) and senior osteopathic (DO) medical students. Despite the completion of a transition to single accreditation of residency programs accredited by the American Osteopathic Association and the Accreditation Council for Graduate Medical Education in 2020, little is known about the subsequent impact of this new environment for DO and MD orthopaedic applicants. The purpose of this study was to evaluate the differences between MD and DO match rates using both Electronic Residency Application Service (ERAS) and National Residency Matching Program (NRMP) data.
ERAS applicant data from 2020 to 2023 specific to orthopaedic surgery were obtained from the Association of American Medical Colleges. NRMP data were queried for the same years. Both NRMP (unadjusted) and ERAS (adjusted) match rates were calculated and compared for each year and cumulatively. In addition, the proportion of ERAS applicants that failed to rank orthopaedic surgery in the NRMP was calculated and compared between senior MD and senior DO applicant groups.
From 2020 to 2023, the unadjusted match rate dropped for MDs (79% vs 73%, p = 0.002) and DOs (63% vs 50%, p = 0.009). Adjusted match rates over this time were not different for MDs (59% vs 57%, p = 0.22) or DOs (39% vs 37%, p = 0.67). Overall, the unadjusted and adjusted match rate for DO applicants was lower than MD across all years (p < 0.05). For every year except 2023 (p = 0.15), a larger proportion of US DO senior students with ERAS applications did not submit a final NRMP rank list for orthopaedics (p < 0.05).
Aspiring DO orthopaedic surgeons have lower match rates and higher rates of abandoning plans to apply for orthopaedic surgery between ERAS application and NRMP compared with their US MD peers despite single accreditation. Active identification of bias, orthopaedic mentorship, and focused advising may help prepare qualified applicants for competitive specialty matches.
Level III. See Instructions for Authors for a complete description of levels of evidence.
骨科手术仍然是高级西医（MD）和高级正骨医（DO）医学生竞争最激烈的住院医师匹配项目之一。尽管2020年美国正骨协会和毕业后医学教育认证委员会认可的住院医师项目已完成向单一认证的转变，但对于这种新环境对DO和MD骨科申请者的后续影响知之甚少。本研究的目的是使用电子住院医师申请服务（ERAS）和国家住院医师匹配计划（NRMP）的数据评估MD和DO匹配率之间的差异。
从美国医学院协会获取2020年至2023年特定于骨科手术的ERAS申请者数据。查询同一年的NRMP数据。计算并比较每年以及累积的NRMP（未调整）和ERAS（调整后）匹配率。此外，计算并比较高级MD和高级DO申请者组中未在NRMP中对骨科手术进行排名的ERAS申请者比例。
2020年至2023年，MD的未调整匹配率下降（79%对73%，p = 0.002）以及DO的未调整匹配率下降（63%对50%，p = 0.009）。在此期间，MD（59%对57%，p = 0.22）或DO（39%对37%，p = 0.67）的调整后匹配率没有差异。总体而言，所有年份DO申请者的未调整和调整后匹配率均低于MD（p < 0.05）。除2023年外（p = 0.15），每年有更大比例申请ERAS的美国DO高年级学生未提交骨科的最终NRMP排名列表（p < 0.05）。
尽管是单一认证，但与美国MD同行相比，有抱负的DO骨科外科医生在ERAS申请和NRMP之间的匹配率较低，放弃申请骨科手术计划的比例较高。积极识别偏见、骨科指导和针对性建议可能有助于使合格申请者为竞争激烈的专科匹配做好准备。
三级。有关证据水平的完整描述，请参阅作者指南。
