The Power of Preference Signaling: A Monumental Shift in the Orthopaedic Surgery Application Process.

INTRODUCTION: Orthopaedic surgery has consistently been one of the most competitive specialties in the US residency selection process. This is due in part to the steady upward trend in average applications received per program and average applications submitted per applicant, which is of growing concern. With the implementation of the Preference Signaling Program, the total number of applications has now dropped for the first time in many years, indicating signaling may improve the application process. The hypothesis is that signaling has led to a decrease in applications sent by applicants and a decrease in applications received by programs. METHODS: A 7-question survey regarding their interview and match statistics was sent to orthopaedic surgery residency programs that participated in the Electronic Residency Application Service during the 2023-2024 application cycle. A response from the program director/administrator was then recorded. RESULTS: Our program search yielded 159 programs with 106 respondents (66.7%). 82 programs (78.8%) solely interviewed applicants who signaled their program. 92.7% of current interns signaled the program where they matched, and 88 programs (84.6%) matched only applicants who signaled. 95 programs (89.6%) revealed that implementing signaling has improved the application process. CONCLUSION: Most of the programs only interviewed applicants who also signaled, and nearly all matched orthopaedic surgery applicants from the 2022-2023 cycle signaled their matching program. Orthopaedic surgery applicants should consider only applying to 30 programs and using all 30 available signals. Applicants should also be more confident knowing that beyond the 30 signals they use, there is limited support to say that they will receive an interview outside of these 30 applications. Orthopaedic surgery programs will also now have the ability to allocate more time to applicants most interested in their program, given the reduction of applications.

The Value of Signaling an Orthopaedic Surgery Program: A Survey to Orthopaedic Surgery Programs.

INTRODUCTION: A new system was implemented by the Association of American Medical Colleges called the preference signaling program for the 2022 to 2023 orthopaedic surgery residency match. Applicants were able to signal 30 orthopaedic surgery programs to indicate high interest in a specific program. The purpose of this study was to address how important signaling was to an orthopaedic surgery program this 2022 to 2023 application cycle. METHODS: A five-question survey was sent to orthopaedic surgery residency programs participating in the Electronic Residency Application Service this application cycle. Contact information was gathered through the Accreditation Council for Graduate Medical Education residency website and program websites. RESULTS: Responses were obtained from 69 of the 151 programs (46%) contacted. The average number of applicants per program was 727 (range, 372 to 1031, SD 155). Thirty-four of 61 respondents (56%) stated that 100% of their interviewees signaled their program. Fifty-five of 61 respondents (90%) indicated that their interviewee pool consisted of 75% or more applicants who signaled. Applicants who signaled had a 24.4% (range, 12.77 to 47.41, SD 8.04) chance of receiving an interview. Applicants who did not signal had just a 0.92% (range, 0 to 13.10, SD 2.08) chance of receiving an interview. Fifty-four of the 63 applicants (86%) answered that signaling played an important role in considering an applicant for an interview. CONCLUSION: Over half of the responding programs only interviewed applicants who signaled their program, and over 90% of programs' interview lists consisted of at least 75% of signaling applicants. Eighty-six percent of programs indicated that signaling played an important role in considering an applicant for an interview. Applicants who signaled were 26.5 times more likely to receive an interview than those who did not (P < 0.0001). With this information, applicants can narrow down their list of programs to apply to, knowing that their signal to a program will give them a better chance at receiving an interview.

Assessing the Correlation Between a Surgeon's Ability to Draw a Procedure and Ability to Perform the Procedure.

OBJECTIVES: The ability to assess a trainee's technical skill in a manner that maintains patient safety is critical to resident education. To do so, senior plastic surgery educators frequently ask residents to draw their proposed operation, presuming that a surgeon's ability to perform a surgery is reflected in his or her ability to diagram the procedure, independent of artistic ability. The purpose of this study was to delineate the relationship between the ability to draw a surgical procedure and execute it in a simulated model, and to determine if the ability to draw a procedure depends on artistic ability. DESIGN: Participants in varying levels of knowledge and surgical skill were asked to draw a 4-strand cruciate tendon repair and subsequently perform the procedure on a validated, simulated model. The participants were graded according to Objective Structured Assessment of Technical Skills scales by 2 blinded hand surgeon examiners. Statistical analysis was performed in SAS 9.4 with Spearman's rank correlation coefficient. SETTING: The study was performed at Baylor Scott and White Health in Temple, TX in an office-based laboratory setting. Participants Forty participants comprised of senior medical students, plastic/orthopedic surgery residents, and plastic/hand surgery attendings. All 40 participants entered and completed the study. RESULTS: A statistically significant strongly positive correlation was found between overall assessment of drawing and overall assessment of performing the surgical procedure (p = 0.004). At the same time, the assessment of ability to draw the procedure was not associated with a general ability to draw or previous art training (p = 0.28). CONCLUSIONS: Our findings support the use of drawing a specific procedure as an assessment tool to evaluate a surgeon's ability to perform a procedure.