What Predicts Outstanding Orthopedic Residents among the Program?



1 Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, USA

2 Department of Orthopaedic Surgery, Harvard Medical School, Brigham and Women’s Hospital, USA


Background: An oversupply of qualified applicants leads to intense competition for the limited number of
first year orthopedic residency positions. Therefore, program directors can be more selective in choosing
their future residents. However, it is unclear if there are resident characteristics that correspond with trainee
Methods: We asked (1) what resident characteristics are associated with subjective residency performance
score? and (2) what resident characteristics are associated with Orthopedic In-Training Examination (OITE)
A total of 119 orthopedic residents accepted at the Harvard Combined Orthopedic Residency Program from
1999 – 2009 were included in this study. The current program director together with two former program
directors in the selected time period defined the subjective residency performance score based on the
clinical skills of the residents during training.
Results: Former Olympic or varsity athlete (P=0.018) and Alpha Omega Alpha (AOA) status (P=0.014)
were associated with a better subjective residency performance score. Higher USMLE step 1 score
(P=0.0038), known person within faculty prior to the residency (did a research rotation, or local medical
student) (P=0.041), and AOA (P=0.015) status were associated with a higher OITE score.
Conclusion: AOA status of the applicant for orthopedic residency is associated with both a higher OITE
score and a better subjective residency performance score.
Level of evidence: IV


Main Subjects