Orthopedic Surgery Match Data Deep Dive

Session 19

Today, I’m going to do a deep dive into some match data for orthopedic surgery, which is known to be one of the more competitive specialties out there. Let’s look at the data to see if this holds true. We’ll also discuss how you can set yourself up for success early on if this is something you’re interested in.

So orthopedic surgery is a surgical specialty. It’s a five-year residency with many subspecialties after that. I had Dr. Muppavurapu on to talk about being a hand surgeon back in Episode 05, and he talked about the many areas you can specialize in, such as joints, spine, and so much more. Today we’re going to talk generally about matching into an orthopedic residency as a medical student.

[02:55] Number of Programs and Spots

NRMP is the MD application for residencies. (If you’re reading this way in the future, terms like ACGME and AOA might not really mean much because the MD and DO residency programs will have merged assuming all goes well as planned out for 2020.)

Looking at Table 1 in the NRMP Results and Data 2016 Main Residency Match, there are 163 programs in the country for orthopedic surgery. Just to give you an idea of the number of programs for other specialties, neurosurgery had 105 programs and emergency medicine had 174 programs.

Another important number to look at here is the number of spots available. Orthopedic Surgery had 717 different spots available in those 163 programs, so that’s an average of 4.398 spots per program. Comparing to other programs, emergency medicine had only 11 more programs but more than double the number of spots offered, so many more spots per program.

[Related episode: What Does a Joint-Replacement Specialist Do?]

Assessing the Competitiveness of Medical Specialties

Out of the 163 residency programs for orthopedic surgery, none of the programs went unfilled.

As you think about your specialty, how competitive is it to match into? How many spots are going to be available? If you don’t match for some reason, can you do the Supplemental Offer and Acceptance Program (SOAP)? For something competitive like orthopedics, you probably won’t be able to find one.

So there were 1,058 total applicants competing for the 717 spots. 874 of those applicants were U.S. Seniors. Note that the number of U.S. Seniors applying are even more than the spots offered. Out of the number of students that matched, 650 were U.S. Seniors. That means U.S. Seniors make up 90.6% of students that matched into orthopedic residencies. “U.S. Seniors” here refers to current students at MD Programs.

Ortho does not have any programs that match into PGY-2 positions. They are all categorical spots where you apply for ortho and you stay in that one residency program for five years.

[07:25] Allopathic vs Osteopathic Students

There is always this DO versus MD “competitiveness” going on in the premed world. Here is where there is some bias among residencies. Orthopedic surgery has historically been known as one of the specialties with the most negative bias towards DOs.

Orthopedic surgery has historically been known as one of the specialties with the most negative bias towards DOs.Click To Tweet

Of the 717 positions filled, 650 were U.S. Seniors, 49 were U.S. Grads (those who didn’t match the first time or who took some time off for research or something else), and only 4 were osteopathic students. That is just about half of 1%.

Compared to other specialties, anesthesiology seemed very favorable to DO’s with osteopathic students comprising 14.4% of those who matched. Meanwhile in emergency medicine, 11.8% of those who matched were osteopathic students. So yes, comparatively speaking, these MD orthopedic surgery residencies do not seem to be very “DO friendly.”

Don’t Forget Osteopathic Orthopedic Surgery Programs

But remember that along with the MD residencies tracked in the NRMP data, osteopathic students can also apply to osteopathic residencies.

Based on the AOA Match Data for 2016, there are 40 orthopedic surgery programs in the osteopathic world, with 121 positions, 118 were filled, 3 went unfilled. These programs are not accounted for in the NRMP data. So don’t think that just because you only got into an osteopathic school that your chances of getting into an orthopedic surgery residency are slim to none.

Don't think that just because you only got into an osteopathic medical school that your chances of getting into an orthopedic surgery residency are going to be slim to none.Click To Tweet

[11:06] The Growth of Orthopedic Surgery as a Specialty

Table 3 shows that orthopedic surgery is growing at a good pace of around 2.5% each year, from 682 spots in 2012 to 717 spots in 2016. This is good news if you’re thinking about orthopedics because it means there are more and more spots being offered.

[Related episode: Interview with a Private Practice General Orthopedic Surgeon]

[14:15] Percentage of Applicants Who Went Unmatched

Figure 6 shows that 25.1% of all those who applied to orthopedic surgery went unmatched. For U.S. Seniors, the number was 20.8% unmatched, whereas 56.6% of independent applicants (the DOs and international medical grads) were left unmatched. So as a non-US allopathic medical school grad, it’s very hard to match into an allopathic orthopedic surgery residency.

It's very hard for a non-US allopathic medical school grad to match into an allopathic orthopedic surgery residency.Click To Tweet

[17:05] Charting the Outcomes for U.S. Allopathic Seniors

Looking at the data found in NRMP Charting the Outcomes 2016, Table 1 shows the number of applicants per spot. Orthopedia surgery had 1.4 applicants per position. In this respect, orthopedic surgery was the fifth most competitive specialty. Dermatology also had 1.4 applicants per spot, General Surgery had 1.49, Psychiatry had 1.54, and Vascular Surgery had 1.91.

In terms of applicants per spot, orthopedic surgery is the fifth most competitive specialty. First place goes to vascular surgery.Click To Tweet

How Many Residency Programs Should You Rank?

Chart 4 shows the “Median Number of Contiguous Ranks of U.S. Allopathic Seniors.” This chart shows how many programs were ranked by applicants who matched versus how many programs were ranked by applicants who didn’t match.

This is always one of the biggest reasons people don’t match: They don’t apply to enough programs. For orthopedic surgery, the applicants who got accepted ranked a median of 12 programs each. Those who did not match only ranked 6. If you apply to half as many programs, you have much lower odds of getting in.

[19:15] Step 1 Scores for Matching into Orthopedic Surgery

Charting the Outcomes 2016 also shows the USMLE Step 1 scores for U.S. Seniors. For orthopedic surgery, those who matched averaged 248-250, and those who did not match averaged 240. These are among the highest Step 1 scores of any specialty. You need to do well on Step 1 to match into Ortho.

You need to do well on Step 1 to match into Ortho.Click To Tweet

Orthopods are Not Dumb Jocks

One of the misconceptions about Orthopods is that they are dumb jocks, but that’s obviously not true. You need to get great board scores to get into Ortho, and research experience doesn’t lack either.

Chart 12 shows what percentage of the applying U.S. Seniors were in AOA (Alpha Omega Alpha), which highlights the students who do well in the first two years of medical school. For orthopedic surgery, 34% of those who matched were AOA students while 12% for those who did not match.

[21:47] Are Orthopods Burned Out? Are They Happy With Their Job?

The Medscape Lifestyle Report presents data on burnout, bias, race, and more. Orthopedic surgery is in the bottom half of the burnout chart at 49%. Yes, this is still a lot of burnout, but this is the bottom half of the chart. A lot of physicians are burned out, but orthopedics is one of the least, which is good. They also reported less severe burnout than other specialties.

[Related episode: A Burnout Story and What You Can Do to Avoid It]

When looking at which physicians are the happiest, orthopods score in the top half of specialties, with 37% saying they’re happy at work and 71% saying they’re happy outside of work. Again this is pretty good data compared to the other specialties.

49% of orthopedic surgeons say they're burned out, and that's actually a smaller percentage than in many other medical specialties.Click To Tweet

[23:00] How Much Money Do Orthopedic Surgeons Make?

Looking at the recently updated Medscape Physician Compensation Report 2017, Orthopedics is at the top of the list for most compensated physicians with an average annual compensation of $489,000. If you’re interested in orthopedics then you will probably make a very good income, which is well-deserved. And this is up 10% from last year.

Only 48% of Orthopods feel fairly compensated, and this is strange considering they’re the highest paid of all the specialties. 79% of orthopods say they’d choose medicine again, and unsurprisingly, 95% of orthopods say that they’d choose orthopedics again. In general, orthopods are pretty happy with their career choice.

[24:29] My Final Thoughts

I hope this helped you get some clarity about orthopedic surgery as a specialty. If you’re interested in orthopedics I hope you’re pretty early in your journey because as I’ve mentioned, research is necessary and you need to do well on Step 1 and try to get AOA. Therefore, you need to start setting yourself up for success as soon as you can.

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