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Factors Utilized by Residents to Choose a Pediatric Orthopedic Fellowship

Sunday, October 21, 2012: 10:48 AM
Melrose (Hilton Riverside)
Joshua M. Abzug, MD, Orthopaedic Surgery, University of Maryland, Timonium, MD, Richard M. Schwend, MD, FAAOS, FAAP, Orthopaedics, Children's Mercy Hospital, Kansas City, MO, Brian Smith, Orthopaedics, Yale University School of Medicine, New Haven, CT and Peter M. Waters, MD, Department of Orthopedic Surgery, Children's Hospital Boston, Boston, MA

Purpose: The purpose of this study was to determine which factors are important to graduating orthopedic residents when choosing their pediatric orthopedic fellowship.

Methods: All pediatric orthopedic fellows who had matched in a pediatric orthopedic fellowship in 2009, 2010, and 2011 were contacted and asked to participate in a post-match survey.  The survey consisted of 20 questions including demographics, questions related to the application process, and questions related to the factors they utilized to choose their fellowship.

Results: 98 of 131 (75%) fellows, over the three year period, responded to the survey, including 69 males and 29 females. On average, each respondent had applied to 4 fellowship programs (range 1-15) and interviewed at 3 programs (range 1-8).  Thirty four (35%) had cancelled at least one interview, having already found a fellowship being the most common reason.  Seventy four percent of applicants matched in their first choice fellowship, 87% matched in their top 2 choices, and 93% matched in one of their top three choices.  The vast majority of applicants had been contacted directly by the fellowship director with a smaller subset being contacted by a mutual professional colleague.  Twenty four applicants (24%) felt pressured by the situation to choose a fellowship early.  The most important factor utilized when choosing a fellowship was personal and/or professional knowledge of the fellowship, followed by the perceived surgical pathology the fellowship will offer.  The least important factors were the salary and the number of co-fellows that would be present.  The most important factors that the applicants felt limited other residents from pursuing a career in pediatric orthopedics was a perceived lower salary, a high clinic to operating room ratio, and a poor experience on the pediatric rotation during orthopedic residency.

Conclusion: Greater than 90% of pediatric orthopedic fellowship applicants match in one of their top three choices.  They are most concerned with having personal and/or professional knowledge of the fellowship and the surgical pathology they will experience.  Additional residents may be interested in pediatric orthopedics if the perception of a low salary and a low operating case volume are refuted.  It is important for pediatric orthopedic fellowships to understand the applicant pool is going forward so that programs can evolve with the wishes of the current applicants.  Changing resident perceptions about low salaries and low case volumes may increase the applicant pool.