Making the Cut: A Six-Year "Bone-afide" Membership Trend From Student to Surgeon

Abstract

Background: Mentorship and early exposure vary greatly from school to school for osteopathic medical students. Historically, allopathic medical students have matched at a higher rate for competitive surgical specialties, like orthopedic surgery, compared to osteopathic medical students. The unique position of medical student interest organizations in filling those gaps and their related outcomes, including successful residency acceptance, is unknown.

Objective: The purpose of our study was to investigate whether membership in the Student Section of the American Osteopathic Academy of Orthopedics (SAOAO) plays a role in osteopathic medical student match success in orthopedic surgery residency programs.

Methods: This comprehensive observational study was conducted using six years of all public resident data collected from residency program websites and affiliated social media accounts of 200 Accreditation Council for Graduate Medical Education (ACGME)-accredited orthopedic surgery residency training programs and was cross-referenced to the National SAOAO membership directory for the 2019-2024 match cycles, as of August 2024. Data analysis of the 5112 data points was conducted using a two-proportion z-test with significance set at a p-value of less than 0.05. Dataset normality is assumed based on the Central Limit Theorem.

Results: In the 2024 orthopedic surgery match cycle, the data demonstrated 51.8% of matched osteopathic medical students were members of SAOAO, a statistically significant increase compared to previous years of 2019, 28.3%; 2020, 22.3%; 2021, 20.3%; 2022, 41.2%; and 2023, 19.4%. The change over 2019-2024 revealed a positive correlation with SAOAO membership in the orthopedic residency match results. There was a statistically significant increase in female osteopathic residents matching into orthopedic surgery between 2019 and 2024. Among the male osteopathic residents, the percentage of residents with prior SAOAO membership significantly increased from 22.1% in 2019 to 51.2% in 2024. SAOAO membership representation among female residents experienced a statistically significant decrease in 2020 and an increase in 2024. Also in 2024, 25.4% of matched SAOAO members were female. Broken down by gender, the male match rate was 56.3% and the female match rate was 60.0%. From 2018-2019 to 2023-2024, the SAOAO executive board experienced a statistically significant increase in representation of female board members of 12.5% (one of eight) to 62.5% (five of eight), respectively.

Conclusion: Our study trending six years of osteopathic orthopedic surgical match results from 200 ACGME residency programs indicates that over time SAOAO membership has had increased success with osteopathic medical students matching into orthopedic surgery residency programs. Looking at the increased match rates for those on the SAOAO executive board, leadership could be an important factor to consider in applicants. Additionally, SAOAO has been shown to provide an avenue for supporting and showcasing future female osteopathic orthopedic surgeons. Furthermore, continuing with this holistic approach of student engagement, education, and mentorship, future studies are planned to continue tracking trends including characteristics and activities that may provide valuable insight for career success with membership in surgical, medical, and professional academies and associations.

Keywords: acgme; match; organization; orthopedics; osteopaths; residency.

Figure 1. SAOAO membership of osteopathic orthopedic residents from 2019 to 2024

This data represents the percentage of all osteopathic (DO) residents with student section of the American Osteopathic Academy of Orthopedics (SAOAO) membership in each match cycle year representing their first postgraduate year in a five-year orthopedic surgery residency program accredited by the Accreditation Council for Graduate Medical Education (ACGME). For 2019, the total residents, N = 827; total DO residents, N = 120. For 2020, the total residents, N = 851; total DO residents, N = 130. For 2021, the total residents, N = 851; total DO residents, N = 118. For 2022, the total residents, N = 884; total DO residents, N = 119. For 2023, the total residents, N = 882; total DO residents, N = 124. For 2024, the total residents, N = 827; total DO residents, N = 114. Statistical analysis was computed using a two-proportion z-test where the statistical significance is noted at a p-value of less than 0.05

Figure 2. The 2019-2024 gender distribution among osteopathic orthopedic residents (A) and those residents with SAOAO membership (B)

This data in A represents the percentage of all osteopathic (DO) residents who are female in each match cycle year representing their first postgraduate year in a five-year orthopedic surgery residency program accredited by the Accreditation Council for Graduate Medical Education (ACGME). For 2019, the total residents, N = 827; total DO residents N = 120. For 2020, the total residents, N = 851; total DO residents, N = 130. For 2021, the total residents, N = 851; total DO residents, N = 118. For 2022, the total residents, N = 884; total DO residents, N = 119. For 2023, the total residents, N = 882; total DO residents, N = 124. For 2024, the total residents, N = 827; total DO residents, N = 114. This data in B represents the percentage of osteopathic (DO) residents with the student section of the American Osteopathic Academy of Orthopedics (SAOAO) membership who are female residents in each match cycle year representing their first postgraduate year in a five-year orthopedic surgery residency program accredited by the Accreditation Council for Graduate Medical Education (ACGME). For 2019, the total residents N = 827, total residents with SAOAO membership N = 34. For 2020, the total residents N = 851, total residents with SAOAO membership N = 29. For 2021, the total residents N = 851, total residents with SAOAO membership N = 24. For 2022, the total residents N = 884, total residents with SAOAO membership N = 49. For 2023, the total residents N = 882, total residents with SAOAO membership N = 24. For 2024, the total residents N = 827, total residents with SAOAO membership N = 59. Statistical analysis was computed using a two-proportion z-test where statistical significance is noted at a p-value of less than 0.05

Figure 3. The 2019-2024 male (3A) and female (3B) distribution of osteopathic orthopedic residents matching with SAOAO membership

A represents the percentage of all male osteopathic (DO) residents who have student section of the American Osteopathic Academy of Orthopedics (SAOAO) membership in each match cycle year representing their first postgraduate year in a five-year orthopedic surgery residency program accredited by the Accreditation Council for Graduate Medical Education (ACGME). For 2019, the total residents, N = 827; total male DO residents, N = 104. For 2020, the total residents, N = 851; total male DO residents, N = 116. For 2021, the total residents, N = 851; total male DO residents, N = 104. For 2022, the total residents, N = 884; total male DO residents, N = 95. For 2023, the total residents, N = 882; total male DO residents, N = 108. For 2024, the total residents, N = 827; total male DO residents, N = 86. This data in B represents the percentage of all female osteopathic (DO) residents who have the student section of the American Osteopathic Academy of Orthopedics (SAOAO) membership in each match cycle year representing their first postgraduate year in a five-year orthopedic surgery residency program accredited by the Accreditation Council for Graduate Medical Education (ACGME). For 2019, the total residents, N = 827; total female DO residents, N = 16. For 2020, the total residents, N = 851; total female DO residents, N = 14. For 2021, the total residents, N = 851; total female DO residents, N = 14. For 2022, the total residents, N = 884; total female DO residents, N = 24. For 2023, the total residents, N = 882; total female DO residents, N = 16. For 2024, the total residents, N = 827; total female DO residents, N = 28. Statistical analysis was computed using a two-proportion z-test where statistical significance is noted at a p-value of less than 0.05

Figure 4. Orthopedic match by gender among SAOAO executive board 2019-2024

This data represents the percentage of the unique student section of the American Osteopathic Academy of Orthopedics (SAOAO) executive board members matching in a five-year orthopedic surgery residency program accredited by the Accreditation Council for Graduate Medical Education (ACGME) separated by male and female. All residents collected were N = 5112, N = 25 were male executive board members, and N = 16 were female executive board members for SAOAO who have applied for the match process in the 2019-2024 match cycles. Statistical analysis was computed using a two-proportion z-test where statistical significance is noted at a p-value of less than 0.05