Gap Year Delivers Unexpected Benefits for Orthopedic Students

While it’s terrific that many institutions offer gap years where those seeking orthopedic careers can engage in research, we don’t have a lot of information on which student populations are most affected.

Nearly 20 years ago, Kenneth Egol, M.D. of the New York University (NYU) Langone Orthopedic Hospital in Manhattan, started a gap year for research at his institution. Dr. Egol, also vice chair of Academic Affairs, Orthopedic Surgery and Chief of the Division of Orthopedic Trauma, published a study with colleagues from the University of Miami and Brigham and Women’s Hospital looking at 129 students who participated in this program at NYU Langone Health from 2001-2018.

Their work, “A Focused Gap Year Program in Orthopaedic Research: An 18-Year Experience,” appears in the July 15, 2020 edition of The Journal of the American Academy of Orthopaedic Surgeons.

Dr. Egol told OTW, “I developed this as a formal program 18 years ago. Other divisions in our department followed suit and this type of program has been replicated by a number of other institutions since.”

For this study, the students were categorized based on the timing of their gap year: the year following college, during or after medical school, or after an unsuccessful orthopedic match.

Participants were asked to complete a survey; for those ranking orthopedic surgery, the match rate was compared with the mean for the U.S. orthopedic surgery match rates from 2006 to 2018. The researchers also compared the number of publications before and after the gap year.

Eighty percent of studens returned questionnaires. “Of all learners who applied to and ranked orthopaedic surgery, 91% matched into an orthopedic surgery residency program,” wrote the authors. “These results compared favorably with the US orthopaedic match from 2006 to 2018, despite a 4-point lower United States Medical Licensing Examination (USMLE) Step 1 score for the research cohort. Finally, the research cohort had a greater percentage of woman and minority practicing orthopaedic surgeons.”

Commenting on the success of the program, Dr. Egol told OTW, “We were able to get some very hard working students into a career in orthopedics despite what some would consider lower than needed metrics. In addition, we have been able to target previously underrepresented students in orthopedics and give them a leg up.”

“We have demonstrated that this approach is successful in mentoring interested student towards a career in orthopedic surgery. Given the likely future that has less objective metrics (standardized tests, rankings etc..) for students to demonstrate, programs like this will likely play a larger role in trainee selection down the road.”

Co-author Richard Iorio, M.D., the Richard D. Scott, MD Distinguished Chair of the Department of Orthopaedic Surgery at Brigham and Women’s Hospital, added, “This program, which Ken started with Dr. [Joseph] Zuckerman’s support, gives applicants a second chance at entering orthopaedic training programs. Some students need to improve their medical school pedigree either during their four years or after graduation in order to improve their chances of matching in orthopaedic surgery, which is extremely competitive. Additionally, it may help higher achieving students improve the quality of residency program they match with by improving their curriculm vitae and research background.”

“The silver lining of this program is the benefit to under represented groups in orthopaedic surgery. Women and minority candidates have benefited from this program and helped increase their numbers in a field which has traditionally been male- and Caucasian-dominated.”