Impacts of COVID-19 on orthopaedic surgery residency / spine trainee application trends

Abstract

Background: The COVID-19 pandemic has had widespread impact across medical educational sectors, including cancellations and delays of board exams, interruptions in clinical rotations and electives, altered processes for away rotations, and conversion to virtual interviews. These changes, combined with applicant and program uncertainty, may affect the 2021 residency application cycle for competitive fields such as orthopaedic surgery. In consideration of spine trainees and the spine fellow application pipeline, the current study aims to evaluate for deviations in trends found in applications to an orthopaedic surgery residency program from the 2021 cycle compared to six years prior.

Methods: After institutional review board approval, applications to a single orthopaedic surgery residency program from application cycles 2015 to 2021 were evaluated in the Electronic Residency Application System (ERAS) and analyzed for trends. Supplementary information was taken from publicly available ERAS statistics.

Results: Compared to existing trends, the ERAS 2021 cycle had a greater number of applicants, more research items, and lower rates of USMLE Step 2 test administration. Of the 4,965 applications analyzed, no deviations in trends were found in number of female applicants, Black and Hispanic applicants, applicants from medical schools outside the US, DO applicants, applicants with interruptions in their training, or USMLE scores.

Conclusions: The orthopaedic surgery applicant pool increased amidst the COVID-19 pandemic and applicants had more research items than previous years. No significant deviations in the demographics of the applicant pool were noted. This is thought to be reassuring about the integrity of the orthopaedic residency application process / spine fellow application pipeline and should continue to be observed in the coming years.

Keywords: COVID-19; Medical education; Orthopaedic pipeline; Residency; Surgical education.

Fig. 1

Trends in orthopedic surgery residency applications from 2015-2021 for (A) total applicants, (B) Black and Hispanic identifying applicants, (C) female applicants (D) applicant from medical schools outside US, (E) applicants from osteopathic medical schools, and (F) applicants with training interruptions are shown. Trendlines were created from 2015-2020 data only and * signifies when 2021 data deviate greater than 2 standard deviations from the expected trendline.

Fig. 2

Trends in orthopedic surgery residency applications from 2015-2021 for (A) USMLE Step 1 average scores, (B) USMLE Step 2 CK average scores, (C) USMLE Step 2 CS pass rate and exam administration, (D) number of research items per applicant are shown. Trendlines were created from 2015-2020 data only and * signifies when 2021 data deviate greater than 2 standard deviations from the expected trendline.