JBJS | AOA Symposium: Current State of Fellowship Hiring: Is a Universal Match Necessary? Is It Possible?*

The Journal of Bone & Joint Surgery, Volume 90, Issue 6

The Orthopaedic Forum | June 01, 2008

AOA Symposium: Current State of Fellowship Hiring: Is a Universal Match Necessary? Is It Possible?^*

Christopher D. Harner, MD¹; Anil S. Ranawat, MD²; Muriel Niederle, PhD³; Alvin E. Roth, PhD⁴; Peter J. Stern, MD⁵; Shepard R. Hurwitz, MD⁶; William N. Levine, MD⁷; G. Paul DeRosa, MD⁶; Serena S. Hu, MD⁸

¹ University of Pittsburgh Medical Center, Center for Sports Medicine, 3200 South Water Street, Pittsburgh, PA 15203. E-mail address: harnercd@upmc.edu
² Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021
³ Department of Economics, Stanford University, Stanford, CA 94305
⁴ Department of Economics, Harvard University, 308 Littauer Hall, Cambridge, MA 02138
⁵ Department of Orthopaedic Surgery, University of Cincinnati College of Medicine, P.O. Box 670212, Cincinnati, OH 45267
⁶ American Board of Orthopaedic Surgery, 400 Silver Ceder Court, Chapel Hill, NC 27514
⁷ The New York Orthopaedic Hospital, Columbia University, 622 West 168th Street, PH-11, New York, NY 10032
⁸ University of California Medical Center, 400 Parnassus Avenue, Third Floor, San Francisco, CA 94143

The Journal of Bone & Joint Surgery. 2008; 90:1375-1384 doi:10.2106/JBJS.G.01582

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Currently, approximately 90% of the 620 graduating orthopaedic residents in the United States are planning on entering a postgraduate fellowship. Since January 2005, two of the largest fellowship match programs, sports medicine and spine surgery, were dissolved by the National Resident Matching Program (NRMP) because of a gradual decline in participation, leaving approximately 70% of applicants in a nonmatching, decentralized system. This leaves hand, shoulder and elbow surgery, and foot and ankle as the only three orthopaedic subspecialties that remain in some type of match program, creating an extremely complicated hiring environment for all residents. This paper focuses on the current state of fellowship employment and hiring in orthopaedic surgery in the United States, on the likely effects of reinstituting a match, and on how this might be accomplished. For this purpose, we present the results of surveys of fellowship directors and residents that we conducted and we describe how the present market for orthopaedic surgery fellows resembles the market for medical residents prior to the introduction of the NRMP^1,2 and how another fellowship market has successfully reinstituted a match after experiencing a comparable failure³.

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Topics

internship and residency ; personnel selection ; foot ; hand surgery ; medical residencies ; ankle ; sports medicine specialty ; shoulder region ; gastroenterology ; matching

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These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.

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