The Student You Know: Orthopedic Surgery Home Program Match Rates and Geographic Relationships Before and After COVID-19

Abstract

Objective: In March 2020, COVID-19 was declared a pandemic by the World Health Organization. This led to the outright cancellation of away rotations and in person residency interviews for the class of 2021. This study aims to identify the geographic relationships in the orthopedic match and further explore COVID-19's effect on these geographic relationships. Furthermore, we aim to compare the home program match rates before and after COVID-19.

Setting: Southern Illinois University School of Medicine, Department of Orthopedic Surgery (tertiary, university-based).

Design and participants: Residency websites and social media sites were used to record basic residency information as well as each resident's year, matriculated medical school, and matriculated medical school geographic data. This information was used to evaluate the proportion of orthopedic residents from "home program" medical schools and evaluate the geographic relationship of matched orthopedic residents. 202 Orthopedic residencies were initially identified and 134 allopathic and nonmilitary residency programs met the inclusion criteria. In all, 3253 of the 3931 (82.7%) current U.S orthopedic residents were included in the analysis.

Results: In the 4 orthopedic surgery residency classes before the pandemic (2017-2020), 21.8% of residency slots were filled by home program students. During the pandemic match cycle (2021), this number jumped to 28.2% (p < 0.0006). The increase was observed consistently across residency subgroup analysis: class size, doximity rank, and doximity research rank. Correspondingly, there was a statistically significant increase from 34.7% (2017-2020) to 39.3% (2021) (p = 0.0318) in residencies matching with same state medical students. Regional trends stayed consistent. Our study showed that residency programs matched applicants who went to same region medical schools during the 2020 to 2021 cycle at nearly the exact same rate as they did pre-pandemic (63.6%, up from 63.3%).

Conclusions: Our study demonstrates that despite widespread virtual away rotations and virtual open houses, residency programs showed an increased preference for their home program students. This trend was significant and widespread, highlighting the generalized nationwide hesitation of both residency programs and students on the virtual interview process.

Keywords: COVID-19; away rotations; home program; in-state; orthopedic surgery; residency match.

FIGURE 1

depicts the regional breakdown of orthopedic residency programs and the percent of the residents who attended a medical school in the same geographic region as their residency program.

FIGURE 2

A state-by-state breakdown of orthopedic residency programs, illustrating the percent of current residents who attended medical school in the same state as their residency program. The far-right hand “total” column demonstrates the percent of all residents who attended medical school in the same state as their current residency.

FIGURE 3

depicts the regional breakdown of orthopedic residency programs and the percent of the current residents who attended a medical school in the same region as their residency program, before and after COVID-19. * p < 0.05, **p < 0.001.

FIGURE 4

Comparing the percent of orthopedic surgery residents who matriculated from medical schools in the same state as their current residency before and after COVID-19. * p < 0.05.

FIGURE 5

A regional breakdown of orthopedic residency programs depicting the percent of the current residents who were “home program” students both before and after COVID-19. The far-right hand “total” column shows the percent of current residents who were “home program” students before and after COVID-19 across all regions. * p < 0.05, **p < 0.001.

FIGURE 6

A subgroup analysis of Doximity rank, Research rank, and PGY-1 Class size illustrating the respective percent of the current residents who were “home program” students both before and after COVID-19. * p < 0.05, **p < 0.001.