MEDI 9331 Scholarly Activities Clinical Years

Document Type

Article

Publication Date

2025

Abstract

Background: Historically, the Step 1 exam served as a major factor in the residency selection process. We aim to analyze how the shift of Step 1 to pass/fail impacts residency applications in terms of number of applicants and application criteria, such as research experiences, step 2 CK scores, etc.

We also aim to analyze how the shift in criteria will impact the quality of orthopedic surgery residents. Using the Orthopedic in Training Examination (OITE) which provides valuable insights into the performance and preparedness of orthopedic surgery residents.

Methods: We began by analyzing the data from the AAMC Report on Residents data from 2019-2024. We then examined the match summary data from the National Resident Matching Program (NRMP) starting from 2019 until 2024. We also reviewed the ERAS data from 2019-2024.Finally, we examined and analyzed the Orthopedics in training examination (OITE) using the data by the OITE technical reports from 2020-2024, we excluded the 2019 results due to a change in the categorizing system of the residents. We categorized them into two groups ACGME and non-ACGME and then performed two sample t-tests with equal variances and Cohen’s d tests comparing every year at every PGY-level. Finally, we performed a Bonferroni correction test to decrease the probability of a type I error.

Results: There was a rise in orthopedic surgery applicants as well as in positions, however, at a slower rate indicating an increase in the competitiveness of the field. Of note, is the decline in the number of international applicants (IMGs) which may indicate a potential loss in confidence among this group.

As expected, there was an increase in research experiences, abstract presentations, publications, and volunteer experiences, however, one interesting point was that Step 2 CK scores have remained stable despite the shift of Step 1 to pass/fail.

Moving on to the OITE scores, for the ACGME programs, the scores have remained relatively stable over the past 5 years, with the exception of 2022, which appears to have been an outlier, indicating stability in orthopedic surgery training. For the non-ACGME programs there were significant fluctuations, indicating less stability in their residency selection and training.

Conclusion: This study provided interesting insights into the residency application and its dynamics and impact on orthopedic surgery trends, such the increased emphasis on extracurricular aspects of the application. However, several limitations should be acknowledged. Firstly, the reliance on aggregated data may obscure individual program variations and nuances. Additionally, the analysis spans a relatively short timeframe, limiting the ability to discern long-term trends or assess the full impact of the recent changes in the USMLE Step 1 exam. A repeat study in several years when more data is available would shed a better light on the performance trend of orthopedic surgery residents.

Academic Level

faculty

Mentor/PI Department

Surgery

Download

Available for download on Tuesday, November 10, 2026

Included in

Surgery Commons

Share

COinS