Based on a relatively stable match rate, several authors have concluded that the competition for orthopaedic residency positions has not changed over the past 3 decades. However, the objective measures of applicant competitiveness have not been quantified in detail.Methods:
National Resident Matching Program (NRMP) data from 2007 to 2014 for U.S. orthopaedic surgery applicants were compared with data for applicants to all specialties. Trends in the United Stated Medical Licensing Examination (USMLE) Step-1 and Step-2 scores, publications and research experiences, Alpha Omega Alpha (AOA) status, and the presence of an advanced degree are reported.Results:
From 2007 to 2014, the match rate for orthopaedic surgery applicants remained stable near 80% (p = 0.14). For orthopaedic applicants who matched, the mean USMLE Step-1 scores increased from 234 points in 2007 to 245 points in 2014 (p = 0.005), and the mean scores increased from 220 points in 2007 to 229 points in 2014 for all applicants (p = 0.019). The mean USMLE Step-2 scores of orthopaedic applicants who matched increased from 235 points in 2007 to 251 points in 2014 (p = 0.005), and the mean scores of all applicants increased from 225 points in 2007 to 242 points in 2014 (p = 0.002). The mean number of research publications, presentations, and abstracts reported by orthopaedic applicants who matched more than doubled from 3.0 in 2007 to 6.7 in 2014 (p = 0.02) and increased less dramatically for all applicants from 2.2 in 2007 to 4.2 in 2014 (p = 0.004). The percentage of orthopaedic applicants elected to AOA or with advanced degrees did not significantly change (p > 0.2). Although orthopaedic applicants with AOA status experienced a very high match rate (97.1% in 2014), those with advanced degrees experienced match rates similar to or slightly lower than the applicant pool (73.7% in 2014).Conclusions:
The USMLE Step-1 and 2 scores of U.S. orthopaedic surgery residency applicants have increased significantly from 2007 to 2014. Additionally, the number of publications and presentations reported by orthopaedic applicants has more than doubled. These factors signal an increasing level of academic accomplishment in orthopaedic surgery applicants despite a consistent match rate.