New Survey Finds Fellowship Demand/Supply Mis-Match

What information might help fellowship applicants and fellowship program directors tackle the field of the future? That is the question posed by researchers from the Warren Alpert Medical School at Brown University in Providence, Rhode Island.

Their study, “Trends in the Orthopaedic Surgery Subspecialty Fellowship Match,” appears in the November 7, 2018 edition of The Journal of Bone and Joint Surgery.

Alan H. Daniels, M.D. chief of the Adult Spinal Service at University Orthopedics in Rhode Island and co-author on the study explained the genesis of the study to OTW, “Orthopaedics as a specialty is becoming increasingly specialized with over 90% or trainees pursuing fellowship training after residency; thus, the subtleties of fellowship placement are becoming more and more relevant.”

“My colleagues and I were interested in the topic of fellowship matching since there has been no report synthesizing or analyzing the most recent match statistics, as they come from multiple entities, and much of the information is often taken offline after a few years.”

“Further, certain information is not readily available to the public, but rather, kept privately by the different matches and organizations involved. With such a diversity of disciplines within orthopaedic surgery, we wanted to provide insight into the direction of each field over the last eight years with regard to the fellowship matching process.”

“For each specialty, this study provides the annual number of positions, participating programs, applicant registrations, completed applications, applicant matching success rate, number of matched applicants, and fellowship percent of positions filled.”

“The fellow positions for the majority of orthopaedic subspecialties have become increasingly saturated, particularly for hand and adult reconstruction due to rising residency class sizes and increasing application numbers. Applicant matching success rates are highly variable across specialty and time, but the 6-year average across specialties was 83.4% success, while the 7-year average of positions filled was 87.0%.”

“Fellowship applicants and fellowship directors alike can utilize the information in this study to obtain details regarding their specific subspecialty to inform their application processes and expectations.”

“Demand for orthopaedic surgeons is projected to continue to increase nationally over the next few decades, particularly in adult reconstruction. Academic orthopaedic surgery programs have compensated for this by slowly increasing the number of residency spots; however, there has been a disproportionally slow rise in the number of fellowship training positions offered, despite such a large supply of graduating applicants. Furthermore, certain fields have an efficiency mismatch in positions available, submitted applications, and positions filled (i.e., applications are high relative to positions available, yet many unfilled positions persist), which is something for applicants, mentors, advisors, and program directors alike to consider.”