The fellowship match will be a single match in 2019

The orthopaedic fellowship match process began failing in the early 2000s. By 2007, it was in chaos and the match process for two subspecialties had dissolved. At that time, residents were forced to make fellowship decisions earlier in their residencies, often before they had rotated through all specialties. In some cases, residents had to accept a fellowship position on the spot or risk losing it to another candidate.

In 2009, AAOS formed the Board of Specialties (BOS) Fellowship Committee to create a closely monitored, regulated match process for most orthopaedic fellowships. That year, the committee selected San Francisco Match (SF Match) to manage orthopaedic fellowship matches for adult reconstruction/tumor, foot and ankle, pediatrics, spine, sports, and trauma. In 2016, shoulder and elbow also joined SF Match. The National Resident Matching Program (NRMP) runs the hand match for fellowship applicants in general surgery, plastic surgery, and orthopaedics.

The committee works closely with specialty societies to serve as a clearinghouse for these matches, representing both the applicants and programs to ensure a fair and equitable match process. The committee is pleased to provide an update for the fellowship match in 2019. Below are five things you need to know.

1. Single match

In the past, all fellowship match dates for the different specialties handled by SF Match occurred at various times between February and April. The BOS Fellowship Committee worked to consolidate the separate specialty matches, except for hand, into a single match for all orthopaedic fellowship applicants, using a uniform computer application form. The committee is happy to announce that this will happen in 2019. The single match will take place on April 30, 2019, for applicants in the class of 2020–2021; the deadline for applicants to submit their rank lists is April 16, 2019.

Important note: There is a new American Society for Surgery of the Hand clearinghouse process for residents participating in the NRMP hand match. For more information, visit www.assh.org/For-Physicians/Fellowship-Programs.

2. Calendar for the match

Within the single match, specialty societies will continue to follow their own calendars of deadlines for applications and interviews (Table 1). This is necessary to spread out timeframes when postgraduate year four residents interview in multiple specialties. With distinct interview periods, the burden on programs and coverage of services will be minimized.

3. Information on fellowship programs

Today’s fellowship applicants rely heavily on information from the Internet. Several recent articles have indicated a lack of information and inconsistencies online for fellowship applicants in every subspecialty. Therefore, the BOS Fellowship Committee recommends that all individual fellowship programs provide updated online information for applicants about the number of positions, faculty, program interview dates, stipends/benefits, case volume, call requirements, accreditation status (Accreditation Council for Graduate Medical Education [ACGME] or specialty society), educational requirements, didactics, and research requirements. In addition, helpful information specific to each specialty should be included, such as coverage of sports teams; specifics on spine fellowships, including correcting deformities and working with pediatric patients; and the amount of micro- and replant work in hand surgery. Applicants often have difficulty locating this crucial up-to-date information on society and program websites. The committee recommends that applicants review program information on SF Match (https://sfmatch.org). It also recommends that all fellowship programs review their online information to ensure it is correct.

4. Numbers needed

Significant data have been compiled since 2010, when the first revised fellowship match was completed, including the number of programs, positions, applicants, and matched applicants (with separate data for international medical graduates, as well as osteopathic and domestic allopathic residents). Additionally, information has been gathered on how many applicants matched with their first or second choice, as well as the numbers of programs applied for, interviews, and programs ranked. It is important that applicants know that most will apply to approximately 25 programs, go on 10 to 12 interviews, and rank 10 to 11 programs. In the most competitive matches, an applicant has a less than 50 percent chance of matching with one of his or her top two choices. The BOS Fellowship Committee will continue to provide useful information to residents and programs as the single match gets underway.

5. Code of conduct

The BOS Fellowship Committee works to ensure that the match process works for applicants and programs. Based on feedback, the committee worked with specialty societies to create a code of conduc, which includes several key tenets and which must be read and acknowledged by applicants and programs upon joining SF Match. For example, the committee recommends that fellowship programs provide information to applicants regarding interview status (i.e., yes, no, waitlist) within 30 days of the application deadline, as applicants want to know and plan their travel, time away, and coverage. In turn, applicants are encouraged to inform programs at least seven days in advance of their intent to cancel accepted interviews. The committee believes that if the programs post interview dates on their websites early and extend invitations within 30 days of application deadlines, there will be fewer late cancellations and applicants will have adequate opportunities for interviews.

The BOS Fellowship Committee meets twice a year; provides educational webinars on the fellowship process for residents and fellows; and works collaboratively with several organizations regarding the fellowship match, including the Resident Assembly, Council on Residency Directors, ACGME, and the Association of Residency Coordinators in Orthopaedic Surgery. In addition, the committee held the inaugural Fellowship Directors Forum at the AAOS 2018 Annual Meeting in March. The forum will continue to meet and address topics crucial to the fellowship match. The second annual Fellowship Directors Forum will be March 13, 2019, in Las Vegas, during the AAOS 2019 Annual Meeting.

References

1. Young BL, Cantrell CK, Ponce BA, et al: Evaluation of orthopaedic trauma fellowship web sites and an assessment of 21 content domains. Iowa Orthop J. 2018;38:39-43.
2. Young BL, Cantrell CK, Patt JC, et al: Accessibility and content of individualized adult reconstructive hip and knee/musculoskeletal oncology fellowship web sites. Arthroplast Today. 2017;4:232-5.
3. Shaath MK, Yeranosian MG, Ippolito JA, et al: Evaluation of the content and accessibility of web sites for accredited orthopaedic trauma surgery fellowships. J Bone Joint Surg Am. 2018;100:e60.
4. Yayac M, Javandal M, Mulcahey MK: Accredited orthopaedic sports medicine fellowship websites: an updated assessment of accessibility and content. Orthop J Sports Med. 2017;5:2325967116683942.
5. Davidson AR, Murphy RF, Spence DD, et al: Accessibility and quality of online information for pediatric orthopaedic surgery fellowships. J Pediatr Orthop. 2014;34:831-4.
6. Mulcahey MK, Gosselin MM, Fadale PD: Evaluation of the content and accessibility of web sites for accredited orthopaedic sports medicine fellowships. J Bone Joint Surg Am 2013;95:e85.

Brian R. Wolf, MD, is the BOS Fellowship Committee chair and also serves as a professor, Callaghan chair, department vice president, and director of Sports Medicine at the University of Iowa.

Lisa K. Cannada, MD, is past chair of the BOS Fellowship Committee. She served as member and chair of the Orthopaedic Trauma Association Match Committee, then chair for the BOS Fellowship Committee before becoming a BOS officer 2015-2018. She is also a professor and program director at the University of Florida–Jacksonville.