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Review
. 2020 Jun 24;5(2):e20.00043.
doi: 10.2106/JBJS.OA.20.00043. eCollection 2020 Apr-Jun.

The Fate of Unmatched Orthopaedic Applicants: Risk Factors and Outcomes

Michael M Kheir  1 , Timothy L Tan  2 , Alexander J Rondon  2 , Antonia F Chen  3
Affiliations
Review

The Fate of Unmatched Orthopaedic Applicants: Risk Factors and Outcomes

Michael M Kheir et al. JB JS Open Access. .

Abstract

Introduction: Orthopaedic surgery residency has become increasingly competitive for medical school applicants with at least one in five applicants not matching annually. For unmatched applicants, the new application cycle is a perplexing and disconcerting period, where unique decisions must be addressed by the applicant. We aimed to investigate the risk factors and outcomes of unmatched orthopaedic applicants.

Methods: This was a retrospective study using a survey-based questionnaire administered electronically to medical students annually from 2016 to 2019 immediately after match day. Applicant responses totaled 934 completed surveys, of which 81 identified themselves as unmatched from the previous year and reapplied for a subsequent cycle. Variables collected through the survey included demographics, United States Medical Licensing Examination scores, Electronic Residency Application Service application characteristics, and interim year pursuits. A univariate analysis was performed with an alpha level of 0.05 denoting statistical significance.

Results: Overall, 58.0% of unmatched applicants subsequently matched into an orthopaedic residency. Applicants who pursued a research year or surgical internship after initially not matching had a subsequent match rate of 52.1% and 64.0%, respectively (p = 0.46). Of those who matched, 19.1% were Alpha Omega Alpha (AOA) compared with 2.9% in the unmatched group (p = 0.04). When stratified by gender, 83.3% of women matched subsequently compared with 50.8% of men (p = 0.02). There were no differences in Step 1 scores (242.5 vs. 240.7, p = 0.60), Step 2 clinical knowledge (CK) scores (248.3 vs. 244.5, p = 0.60), or the number of publications (15.6 vs. 10.9, p = 0.25) between applicants who matched or did not match, respectively.

Discussion: Our findings demonstrate that most orthopaedic applicants matched during their subsequent attempt. Women and those with AOA status had a significantly higher match rate than their counterparts. There was no difference in outcomes between those who pursued a research year or surgical internship, Step 1 or 2CK scores, or the number of publications. Further study is warranted to properly analyze risk factors for not matching on a subsequent attempt.

Level of evidence: Prognostic Level IV.

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Conflict of interest statement

Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSOA/A177).

Figures

Fig. 1
Fig. 1
Subsequent match rates based on specific applicant factors.
See this image and copyright information in PMC

References

    1. Report Archives. The Match, National Resident Matching Program. Availabel at: http://www.nrmp.org/report-archives/. Accessed February 11, 2020.
    1. Main Residency Match Data and Reports. The Match, National Resident Matching Program. Availabel at: http://www.nrmp.org/main-residency-match-data/. Accessed February 11, 2020.
    1. Dirschl DR, Dahners LE, Adams GL, Crouch JH, Wilson FC. Correlating selection criteria with subsequent performance as residents. Clin Orthop Relat Res. 2002(399):265-71. - PubMed
    1. Dirschl DR, Campion ER, Gilliam K. Resident selection and predictors of performance: can we be evidence based? Clin Orthop Relat Res. 2006;449:44-9. - PubMed
    1. Egol KA, Collins J, Zuckerman JD. Success in orthopaedic training: resident selection and predictors of quality performance. J Am Acad Orthop Surg. 2011;19(2):72-80. - PubMed