16. 12. Orthopedic Surgery Residency Training Experience. Every effort should be made to obtain LORs by faculty at military orthopaedic surgery residency program who worked closely with the applicant during the clerkship rotations. Nationally, the field of orthopedic surgery comprises 14% women, lagging behind other surgical fields. 17. Each ranked factor was given a numerical value to reflect its importance. It is a fully accredited, ﬁve-year program comprised of 20 residents with four residents at each year level of training and a dedicated orthopaedic internship. Individual leaders who did not respond within 1 month (n = 9) were contacted with a second email. Ultimately, all military programs provide excellent training, but certain programs may be better suited for individual personal and professional needs. 13 It is imperative to stay up-to-date on submission deadlines for this system and to recheck submissions on a regular basis. A Review of Parathyroid Surgery for Primary Hyperparathyroidism from the United Kingdom Registry of Endocrine and Thyroid Surgery (UKRETS). Prenatal ultrasonographic findings of esophageal atresia: potential diagnostic role of the stomach shape. The program leadership that ranked grit (73%) did not rank applicant USMLE scores as significantly more important than applicants’ levels of grit (P > 0.05). Inability to perform on-site rotations and interviews is not a discriminating factor; however, failure to attempt telephone interviews in such cases may be detrimental to a candidate's selection potential. Faculty / Attendings The program at Ascension St John is unique in that it has both an MD and DO orthopedic surgery residency program (DO program with initial... Read more Read reviews Write review . Considerations for Acute and Emergent Deployed Mental Health Patient Management and Theater Transports: A Scoping Review, Longitudinal Examination of COVID-19 Public Health Measures on Mental Health for Rural Patients With Serious Mental Illness, Atraumatic Splenic Rupture After Weight Lifting in a Patient Presenting With Left Shoulder Pain. Copyright © 2021 The Society of Federal Health Professionals. Pain prevalence in hospitalized patients at a tertiary academic medical center: Exploring severe persistent pain. We sought to determine which factors were considered most important among leadership within the U.S. Army’s orthopedic surgical training programs when selecting applications and ascertain if grit was one of the primary factors. Does your program utilize any formal assessments of intangible traits (grit scale, personality test, etc.). 1. Standardizing Postoperative Rehabilitation Protocols for the Tri-Service: A Consensus Meeting Hosted by the Musculoskeletal Injury Rehabilitation Research for Operational Readiness Organization, comprehensive osteopathic medical licensing examination, ELIGIBILITY FOR MILITARY ORTHOPAEDIC SURGERY RESIDENCIES, APPLYING TO A MILITARY ORTHOPAEDIC SURGERY RESIDENCY, PROFILE OF A SUCCESSFUL MILITARY ORTHOPAEDIC SURGERY APPLICANT, JOINT SERVICE GRADUATE MEDICAL EDUCATION SELECTION BOARD, https://doi.org/10.7205/MILMED-D-13-00121, http://www.ddeamc.amedd.army.mil/GME/InterResPrograms/OrthopaedicSurgeryResidency.aspx, http://www.mamc.amedd.army.mil/gme/Residencies_Fellowships/G_ORTHO.HTM, http://www.wrnmmc.capmed.mil/ResearchEducation/GME/SitePages/Orthopaedics/Home.aspx, http://www.bamc.amedd.army.mil/saushec/gme/residency/orthopaedic-surgery/, http://www.tamc.amedd.army.mil/residency/mchk-ds/ortho.htm, http://www.wbamc.amedd.army.mil/GME/OrthopedicSurgery/Residency/, http://www.med.navy.mil/sites/NMCP2/EduTrain/GMED/Residencies/Pages/Default.aspx, http://www.med.navy.mil/sites/nmcsd/Staff/Pages/GME-Residencies.aspx, http://www.goarmy.com/amedd/education/hpsp.html, https://education.mods.army.mil/meded/UserLogon/UserLogon.asp, http://www.abos.org/media/2086/abosdiplomate-2012.pdf, https://education.mods.army.mil/MEDED/GME/Mtf/PassRatesummary.aspx, http://www.usuhs.mil/medschool/somadmissions.html, https://education.mods.army.mil/MEDED/GME/WWM/wwwmtoc.aspx, http://www.acgme.org/acWebsite/RRC_280/280_core, http://nrmp.org/data/resultsanddata2008.pdf, Receive exclusive offers and updates from Oxford Academic. Determination of an applicant's potential is based upon letters of recommendation, personal interviews, and most importantly the applicant's performance on military orthopaedic surgery clinical clerkships. We accept two residents per year into a six year residency program with one year of required research. For USUHS students, these are typically established as standard fourth-year clerkships; however, for HPSP students, the rotations represent dedicated periods of active duty training (ADT). The Duke Orthopaedic Surgery Residency is a comprehensive, five-year, ACGME-approved training program. Many orthopaedic surgeons choose to continue their training after residency to complete fellowships in a wide variety of subspecialties including: spine surgery, hand surgery, sports medicine, total joint replacement (hip and knee), pediatric orthopaedics, foot and ankle, and orthopaedic oncology. Medical school performance is also strongly factored during the application process as a measure of cognitive skills and academic potential, as it has been demonstrated in multiple previous series to be predictive of success during residency training.19,–22 In particular, military programs apply significant consideration to Honors grades earned during the clinical medical school years, especially during General Surgery and Internal Medicine clerkships. Many military programs use the interview process as an opportunity to assign a final order of merit to the applicant pool. Applicants with continued interest in orthopedic surgery should actively research the military programs to which they would like to apply and submit early requests for clinical clerkship rotations at those programs (Table II). The most important factor when considering an orthopedic surgery applicant was how well the applicant performed on an audition rotation, followed by their United States Medical Licensing Examination scores. For example, if a program director reported that an applicant’s audition rotation at their program was the most important factor and their USMLE score was the second most important factor, then 10 points would be assigned to the audition rotation and 9 points would be assigned to their USMLE scores. Our survey found that the most important factors were performance on their audition rotation followed by USMLE scores, research involvement, conscientiousness and grit. One study by Bernstein et al23 indicated that two-thirds of all program directors reported that the majority of their current residents performed medical student clerkship rotations at their programs. Each variable was ranked using a point system (1–10 with 10 as the best score), referred to as the factor score (FS). Orthopaedic Surgery PGY-I positions are selected based upon the individual applicant preference and program director preference in compliance with the ACGME bylaws. Orthopaedic surgery is a five-year residency after medical school. Premier Residency Training Programs The Department of Orthopaedic Surgery at the Perelman School of Medicine has one of the premier residency training programs in the nation. Minimum application criteria for an HPSP scholarship include a GPA of 3.2 and an overall MCAT score of 24, with the additional requirement of obtaining a minimum score of 8 in all 3 scored categories (Graduate Medical Education Review 2012, previously cited presentation by COL Nace). The selection of applicants directly from medical school is based half upon applicant's cognitive performance during medical school and half on the applicant's potential for successful practice as an orthopaedic surgeon. The intangible personal characteristic grit has become a popular topic of concentration within contemporary psychology studies. Do you select candidates who report a low USMLE score or those who have not met your program’s academic achievement threshold? LORs serve as a final assessment for military orthopaedic surgery residency programs when selecting potential candidates. MODS application due. Attendance at USUHS medical school, participation in the HPSP and direct commission are pathways for an applicant to be eligible to apply for a military orthopaedic surgery residency. 8. 15. All military orthopaedic surgery residency programs are listed in Table I, along with pertinent contact information. 2600521193 University of Southern California/LAC+USC Medical Center Orthopaedic surgery residency program California. The 18-Question Survey that Was Completed for the Purpose of This Study. The final OML for each service is then used to match each orthopaedic surgery residency applicant directly from medical school in conjunction with each individual's ranking of the potential orthopaedic surgery residency training programs. Applicants should strongly consider scheduling either a clinical rotation or an interview visit at a minimum of 3 to 4 military orthopaedic surgery residency programs on his/her rank order list. HPSP and USUHS students must apply to both the military Joint Service Graduate Medical Education Selection Board (JSGMESB) and the civilian Electronic Residency Application Service, and they must rank their residencies by preference. Eleven respondents (73%) ranked grit in their top 10 most important factors considered when ranking applicants. According to the 2019 U.S. Army Medical Education Directorate, the average Step 1 and Step 2 scores of accepted orthopedic surgery candidates were 244 (range 221–259) and 253 (range 227–271), respectively.15 It has been shown that candidates who perform well on the USMLE are more likely to perform well on the Orthopaedic In-Training Examination.16–18 However, the associations between the USMLE and success on the licensing ABOS credentialing examination are relatively weak.17 Additionally, those with greater authored publications are more likely to continue research during residency,19 likely contributing it to its level of third most important factor. Nutrition Links Hospital Care & Surgery. If data demonstrated the ABOS pass rates were not significantly different between those with good USMLE scores and those with great USMLE scores, would you consider placing less weight on the USMLE in the resident selection process? Some residency programs receive several hundred applications annually, due to a large number of applications submitted by each applicant. Grit: a marker of residents at risk for attrition? Furthermore, there has been conflicting evidence that USMLE scores correlate with passing professional orthopedic board examinations. Each orthopaedic surgery residency program in the Army and Navy submits its own medical school applicant order of merit list (OML) through its respective GME Committee. This work is written by US Government employees and is in the public domain in the US. Although it may seem ideal to schedule as many away rotations as possible, evidence has not demonstrated an advantage of performing more than two. Anecdotally, this has been the experience of most military orthopedic surgery residency programs as well. More than half of these individuals were foot- and ankle- or hand-fellowship trained (53%) and two were generalists (13%). This study was administered utilizing convenience sampling with the inherit risk of sampling bias and response bias. An applicant’s audition rotation performance was considered the most important factor in the eyes of leadership (FS = 9.8) and was significantly more important than any other factor, including USMLE scores (FS 7.17; P = 0.001) involvement in research (FS 5.6; P = 0.002), conscientiousness (FS 4.73; P = 0.002), and grit (FS 4.27; P = 0.001). Learn about great opportunities for enlisted airmen, officers and health care professionals. The importance of medical student rotations in the selection process cannot be overemphasized. In the case of the Air Force, a representative from the Army, Air Force and Navy individually grade each orthopaedic surgery applicant at the JSGMESB, and the aggregate scores are used to produce an Air Force final OML. Large academic centers have assessed applicants’ grit scores, and when compared to candidate credentials, many of the typical accolades favored by program directors3 did not predict any the subjective personal characteristics.20 Former college athletes, older applicants, and females were found to have the highest level of grit, and an increase of 3.5 percentile points in grit score was associated with a 20-point decrease in board score.20 Camp and colleagues20 suggested that these individuals’ willingness to pursue the same goal as more traditional applicants may be a direct reflection of higher levels of grit and the possession of a growth mindset defined as desiring to learn and develop their abilities, pursue challenges, value effort, and display resiliency with setbacks.21 This demonstrates that applicants who are persistent and drive toward their goals despite lower board scores may have the highest grit among applicants, possess a growth mindset, and ultimately display characteristics that are desirable in orthopedic surgery residents.20, The applicants with lower USMLE scores according to leadership idiosyncrasy, but other redeeming qualities, such as grit, may prove to become among the best residents and physicians. The Military Operational Data System begins registration on July 1st of the preceding year and is used to match all applicants. Army orthopedic surgery residency leadership also placed an emphasis of USMLE board scores, as it was the second most important factor in this analysis. Despite this, grit and other classically subjective characteristics of an individual are often not objectively measured or considered during resident selection. In addition to the 33 military orthopaedic surgery positions, a select number of candidates each year are offered opportunities to pursue a “civilian sponsored” residency position. Any prior medical license, certificates of completion of prior internship for those with such experience. The ranking and selection of applicants from medical school is based 50% upon objective criteria regarding the applicant's medical school performance and 50% on the applicant's potential for successful practice as an orthopaedic surgeon. One analysis of 1,217 medical students found mean USMLE Step I scores improved significantly using commercial textbooks, medical school course textbooks and syllabi, the USMLE general instructions book, and coaching courses.6 However, that same study's statistical analysis found the majority of variance in score was accounted for by students' MCAT performance and undergraduate science GPA as well as study time. Overall, grit was the fifth most important factor reported, and there was not a significant variance in the ranking of grit between the different programs (ANOVA; P = 0.282). The American Orthopaedic Association Steering Committee on Residency Selection recognizes three areas that may be predictive of resident success: cognitive skills, noncognitive factors (e.g., affective domain), and motor abilities.16 Similarly, all military programs adhere to the six core competencies emphasized by the ACGME to monitor successful residency training performance (Table III).17, Accreditation Council of Graduate Medical Education Six Core Competencies. Within the military it was reported that cognitive performance and potential for successful practice as an orthopedic surgeon were considered important in ranking residency applicants. The five-year residency is a categorical orthopedic surgery training. It was considered even more important among applicants with lower USMLE scores according to leadership idiosyncrasy, emphasizing that each candidate is taken into consideration beyond just their academic achievements on their curriculum vitae. 3. Applicants should seek LORs from individuals who can speak to the applicant's strengths in an honest fashion, are familiar with qualities that make good orthopaedic surgeons or are prominent orthopaedic surgeons themselves, and ideally have experience writing LORs.11,12 When asking for a LOR, the applicant should provide his/her CV, as well as a step-by-step guide for submission of the LOR to make the process as easy as possible for that writer. The top 15 variables in descending order were reported accordingly (Figure 1). All supporting documents (listed above) are due. The Orthopedic Clinic at William Beaumont Army Medical Center offers evaluation and treatment for fractures, sports injuries, foot and ankle injures, congenital deformities, management of arthritis in conjunction with rheumatology, and oversee the rehabilitation of patients with musculoskeletal problems. 0.0 . It is recognized that some candidates (e.g., direct commission candidates) are unable to perform on-site rotations and that most candidates are unable to personally visit all military orthopaedic surgery residency programs. The grit scale ranges from a score of 0 to 5, with increasing scores being correlated with increasing levels of grit. Medical school performance data examined include medical school transcript, Dean's letter, and United States Medical Licensing Examination steps I and II/Comprehensive Osteopathic Medical Licensing Examination of the United Sates I and II scores. Although the value of applicant interviews has been debated extensively in civilian literature, military programs place a high premium on interviews during the selection process.24,27 Most military programs do not conduct psychomotor abilities testing during the interview process. Class ranking/quartile isn’t as important in Orthopaedic surgery as in other specialties . Grit is defined as persistent work on a focused topic for an extended period of time until a desired goal is achieved. A simple CV structure is best to allow interviewers to quickly analyze the CV and recognize the strengths presented therein. What Influences the Decision to Interview a Candidate for Medical School? 9. A preliminary analysis of different approaches to preparing for the USMLE Step 1, Study month or vacation? We also accept 12 preliminary PGY-1 only interns per year. Even when an applicant had below average USMLE scores according to leadership idiosyncrasy, performance on an audition rotation and grit were considered redeeming in the eyes of leadership. Applicants should reconsider their rank order list based on their experience, paying special attention to the dynamics of interaction between residents, as well as between residents and staff. Matthew Wells, DO, Michael Polmear, MD, Leon J Nesti, MD, John C Dunn, MD, Factors Considered When Ranking Military Orthopedic Surgery Residency Candidates, Military Medicine, Volume 185, Issue 9-10, September-October 2020, Pages e1603–e1607, https://doi.org/10.1093/milmed/usaa101. The Joint Service Graduate Medical Education Selection Board (JSGMESB) is convened under the authority of the Assistant Secretary of Defense for Health Affairs and the Surgeon Generals of the Army, Air Force and Navy, and has been selecting residency and fellowship positions for the military since 1993. Medical school performance data examined include medical school transcript, Dean's letter, and USMLE steps I and II/COMLEX I and II scores. Army Capt. Strong performance during clinical clerkship years of medical school has been shown by some authors to correlate with cognitive and motor abilities as well as residency OITE scores and ABOS examination success.20,22 In contrast, we recognize that overall class rank and subsequent induction into various medical honor societies (e.g., Alpha Omega Alpha) are highly variable from one medical school to the next. The Department and Residency Program led innovative changes to maintain patient access to orthopaedic surgical care while limiting faculty and resident COVID exposure and protecting our ability to fulfill DOD's mission. Throughout medical student clerkship rotations, it is important to conduct personal interviews with all available faculty members. 4. Applicants most commonly become eligible for military orthopaedic surgery residency through attendance of the Uniformed Services University of the Health Sciences or participation in the Health Professions Scholarship Program. Angela Duckworth, a clinical psychologist from the University of Pennsylvania, sought to elucidate what sets dedicated leaders apart from their peers and found the defining feature in these leaders are their level of “grit.” Grit is defined as passion and perseverance for long-term objectives or the willingness to continue toward a desired long-term goal in spite of setbacks and short-term failures.5 Dr. Duckworth’s work and a quantifiable grit score were summarized in her book released in 2016, titled “Grit: The Power of Passion and Perseverance.” Since her original publications, a grit scale and scoring system have become widely available online with open access.6 Since its inception, newer versions of the grit scale have been introduced and validated with improved psychometric properties than older versions.7 The purpose of the grit scale questionnaire is to asses an individual’s steadfastness toward their desired goals regardless of setbacks or shortcomings in a quantifiable, objective manner. (Graduate Medical Education Review 2012, William Beaumont Army Medical Center, 2012, a presentation by COL Cathy Nace, MD, Director of Army Graduate Medical Education. USUHS has a highly competitive medical school application process. The survey questions were pre-determined based on a previous, similar study within the civilian sector,14 and free text responses were not factored into the rank variables, which may have limited additional attributes that leadership consider when ranking candidates. Additional points may be earned for research and/or prior military service. Determination of an applicant's potential for success is based upon LORs, personal interviews, and the applicant's performance on ADT orthopaedic surgery rotations at respective military orthopaedic residency training programs. Direct commission provides candidates who have completed medical school, and in particular cases some postgraduate training, the option to directly enter the military for orthopaedic surgery residency training. Compton S, Schwartz L, Henderson W, Wyte C, Alcamo AM, Davids AR, Way DP, Lynn DJ, Vandre DD, DeZee KJ, Thomas MR, Mintz M, Durning SJ, Accreditation Council for Graduate Medical Education, Carmichael KD, Westmoreland JB, Thomas JA, Patterson RM, Spitzer AB, Gage MJ, Looze CA, Walsh M, Zuckerman JD, Egol KA, Dirschl D, Dahners L, Adams G, Crouch J, Turner N, Shaughnessy W, Berg E, Larson D, Bernsstein AD, Jazrawi LM, Elbeshbeshy B, Della Valle CJ, Zuckerman JD, Oxford University Press is a department of the University of Oxford. NMCP is a proven leader in academic and military medicine Resident selection: are we putting the cart before the horse? Orthopedic Surgery is the medical and surgical specialty that includes the study and prevention of musculoskeletal diseases, disorders and injuries and their treatment by medical, surgical and physical methods. Entry is either at the internship level or at the PGY2 level after completion of one year's training in an ACGME-accredited orthopedic surgery internship. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide, This PDF is available to Subscribers Only. Army Body Composition Program Study Results Concerning: Enrollees Are More Over Fat Than Expected, Mass Properties Comparison of Dismounted and Ground-Mounted Head-Supported Mass Configurations to Existing Performance and Acute Injury Risk Guidelines, Body Mass Index Effect on Health Service Utilization Among Active Duty Male United States Army Soldiers. Thank you for your interest in the PCOM Orthopedic Surgery Residency Program. Anesthesiology. Orthopedic surgery training across the country is phenomenal, and I firmly believe you will graduate well equipped for practice regardless of the institution. Within the medical community, higher grit scores have correlated with greater surgical resident well-being,8,9 lower surgical resident attrition rates,10 and decreased burnout for attending surgeons.11 Grit has been assessed and analyzed in orthopedic surgery applicants at large academic centers including the Mayo Clinic, Hospital for Special Surgery, Rush Medical Center, and the University of Cincinnati.10 However, no study has assessed the importance of grit within the military’s orthopedic surgery residencies’ applicants nor how it compares to more classic factors such as USMLE scores. How does your program use USMLE scores during the selection process? Standardizing Postoperative Rehabilitation Protocols for the Tri-Service: A Consensus Meeting Hosted by the Musculoskeletal Injury Rehabilitation Research for Operational Readiness Organization, https://www.aamc.org/download/321508/data/factstablea23.pdf, http://www.nrmp.org/wp-content/uploads/2018/04/Main-Match-Result-and-Data-2018.pdf, https://www.mods.army.mil/medicaleducation/, Receive exclusive offers and updates from Oxford Academic. Published by Oxford University Press on behalf of the British Geriatrics Society 2020. Application Schedule Dermatology. After the completion of each rotation/interview, it is important for the applicant to appropriately acknowledge those staff and residents with whom he/she had significant interactions, as well as the program director. USUHS offers a fully funded 4-year medical doctorate program at the F. Edward Hebert School of Medicine. Both performance on a rotation and grit are important in army orthopedic surgery candidate selection, as there is more to physician training than academic accolades. With the exception of Army and Navy postgraduate year one (PGY-I) orthopaedic surgery residency positions, all of the selections are conducted jointly. Also, applicants should consider whether the opportunities provided at that program are most consistent with his/her career goals. Mean FS of the top 15 ranked variables when considering Army orthopedic surgery applicants. 2020; 185(9-10):e1603-e1607 (ISSN: 1930-613X) Wells M; Polmear M; Nesti LJ; Dunn JC. In applicants with low United States Medical Licensing Examination scores according to leadership idiosyncrasy, their audition rotation was considered a redeeming portion of their application (P = 0.02) followed by their level of grit. Further statistical analyses using descriptive statistics, paired t-test, and ANOVA were performed and reported. The rigors of applying to medical school and ultimately matching into an orthopedic surgery residency foster a highly competitive environment. Search for other works by this author on: Directorate of Medical Education Program Pass Rate Summary, Uniformed Services University of the Health Sciences Admissions, Army Medicine Health Professions Scholarship Program. The American Academy of Medical Colleges: Belmont PJ, Hoffmann JD, Tokish JM, Arrington ED, Shawen SB, Orr JD: Eskreis-Winkler L, Shulman EP, Beal SA, Duckworth AL: Burkhart RA, Tholey RM, Guinto D, Yeo CJ, Chojnacki KA: Bernstein AD, Jazrawi LM, Elbeshbeshy B, Della Valle CJ, Zuckerman JD: DePasse JM, Palumbo MA, Eberson CP, Daniels AH: Turner NS, Shaughnessy WJ, Berg EJ, Larson DR, Hanssen AD: Dyrstad BW, Pope D, Milbrandt JC, Beck RT, Weinhoeft AL, Idusuyi OB: Sutton E, Richardson JD, Ziegler C, Bond J, Burke-Poole M, McMasters KM: Camp CL, Wang D, Turner NS, Grawe BM, Kogan M, Kelly AM: Rattan A, Savani K, Chugh D, Dweck CS: Bohm KC, Van Heest T, Gioe TJ, Agel J, Johnson TC, Van Heest A: Oxford University Press is a department of the University of Oxford. Classically subjective characteristics of an orthopedic surgery residency is fully compliant with the submitted article ensure have! Previously cited presentation by COL Nace ) a desired goal is achieved was! 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