Current State of Research Gap-Years in Orthopedic Surgery Residency Applicants: Program Directors' Perspectives

Abstract

Background: The purpose of this study was to determine how orthopedic residency program directors (PDs) evaluate residency applicants who participated in a research gap-year (RGY).

Methods: A 23 question electronically administered survey was created and emailed to all Accreditation Council for Graduate Medical Education (ACGME) orthopedic residency PDs for the 2020-21 application cycle. PDs were emailed directly if active contact information was identifiable. If not, program coordinators were emailed. The survey contained questions regarding the background information of programs and aimed at identifying how PDs view and evaluate residency applicants who participated in a RGY. Descriptive statistics for each question were performed.

Results: Eighty-four (41.8%) of 201 PDs responded. Most respondent programs (N=62, 73.8%) identified as an academic center. The most common geographic region was the Midwest, N=33 (39.3%). Few programs (N=3, 3.8%) utilize a publication "cut-off" when screening residency applicants. When asked how many peer-reviewed publications were necessary to deem a RGY as "productive," responses ranged from 0-15 publications (median interquartile range 4.5 [3-5]). Forty-one (53.3%) PDs stated they would council medical students to take a RGY with USMLE Step 1 scores being the #1 factor guiding that advice. More PDs disagree than agree (N=35, 43.6%; vs N=22, 28.2%) that applicants who complete a RGY are more competitive applicants, and 35 PDs (45.5%) agree research experiences will become more important in resident selection as USMLE Step 1 transitions to Pass/Fail.

Conclusion: Program directors have varying views on residency applicants who did a RGY. While few programs use a publication cutoff, the median number of publications deemed as being a "productive" RGY was approximately 5. Many PDs agree that research experiences will become more important as USMLE Step becomes Pass/Fail. This information can be useful for students interested in pursuing a RGY and for residency programs when evaluating residency applicants. Level of Evidence: IV.

Keywords: gap-year; program directors; publications; research; residency applicants.

Figure 1.

Likert plot representation of program director responses to questions #10, #18, and #20. Corresponding colors are immediately to the left of each response level.

Figure 2.

Likert plot representation of program director responses to questions #11 and #17. Corresponding colors are immediately to the left of each response level.

Figure 3.

Pie chart displaying the responses to Question 15: “How do you compare applicants who have a research gap-year experience with those who don’t?” Scenario: There are two applicants with similar USMLE Step scores, grades, letters, and experiences. Student 1 has no research gap-year experience but has participated meaningfully in a research project while Student 2 has what you consider a “productive” research gap year. Unabridged “Depends on reason” response: The competitiveness of Student 2’s application is in part determined by the reason for taking the research gap-year.

Figure 4.

Pie chart displaying the responses to Question 16: “When do you think a research gap-year experience is most beneficial to increase the competitiveness of an applicant for a residency position, if at all?” Unabridged “After M4 year” and “Prefer no gap-year” responses: “After M4 year, if an applicant does not match” and “I prefer applicants do not do a research gap-year”, respectively.