What Predicts Outstanding Orthopedic Residents among the Program?

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 performance. 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) score? 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