Hey all, today we have a different type of blog post, a guest publication ! This one is for the medical students, a good read for some sources that you can use throughout your education. Enjoy !

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Also, if you are a 3rd year medical student pursuing orthopaedic surgery, an orthopaedic PA, or an orthopaedic enthusiast, check out our Ortho Essentials 101 course we released! We go over everything you need to know to stand out on your rotations. How to read/ interpret X-rays & MRI, recognize injuries, high yield ortho topics, how to make a killer presentation, and more! Check us out at courses.naileditortho.com

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Demystifying Orthopaedic Surgery: General Information and Resources Relating to the Specialty

Adriano DellaPolla, B.S.¹

¹Creighton University School of Medicine, Omaha, NE

Introduction

I wanted to create an article to serve as a resource for those interested in orthopaedic surgery. I hope to offer some basic information, demystify aspects of the area, show data for those who have matched, and lastly, give links to resources for those interested in knowing more about orthopaedic surgery. Throughout the article, hyperlinks are available for your convenience.

Orthopaedic Surgery or Orthopedic Surgery?

Ah, a great trivia question. Orthopaedics and orthopedics ultimately mean the same thing; they differ based on the original or Americanized spelling of the term. Orthopaedics was coined by 17th Century Frenchman Nicholas Andry de Bois-Regards, who is also, interestingly, the “father of parasitology.”¹ Etymology of the term derives from Greek, ὀρθός (orthos) meaning “straight” and παιδίον (paidion) meaning “child”, thus orthopaedics roughly translates to “straight or corrected child” a term used to describe the correction of children with spinal or congenital deformities.¹ Today, the traditional orthopaedics spelling is often used in British English, professional organizations, academic institutions. In contrast, Orthopedics is the Americanized spelling of the term. Both are correct and can be used interchangeably.¹

So, what is orthopaedic surgery?

Orthopaedic surgery is not all “there is a fracture, I need to fix it”²; it is more complex and nuanced than just fracture care. According to the AAMC, “orthopaedic surgeons are trained in the preservation, investigation, and restoration of the form and function of the extremities, spine, and associated structures by medical, surgical, and physical means. An orthopaedic surgeon is involved with patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries, and degenerative diseases of the spine, hands, feet, knee, hip, shoulder, and elbow. The orthopaedic surgeon manages special problems, diagnoses the injury or disorder, and establishes the treatment plan using surgery, medication, exercise, and/or physical therapy. They are also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.”³ So, what is so great about the field?

Pros of Orthopaedic Surgery

My opinion here is, biased of course, as I am applying to the field and have been interested in orthopaedic surgery throughout medical school. Still, I will try to stick to the facts. Fractures, arthritis, and musculoskeletal complaints do not discriminate on gender, race, ethnicity, socioeconomic status, or background—these all too common ailments often need the care of an orthopaedic surgeon for treatment. It is a field that provides care to a diverse patient population. Treatment of cure rather than management of symptoms is an alluring factor for most. Fixing a fracture, repairing a ligament, or replacing a joint allows patients to return back to their normal lives in a matter of weeks.

In addition, the variety of surgeries and clinical care are not limited to one particular area of the body or types of operations. orthopaedic surgeons operate on the entire musculoskeletal system. They can subspecialize in nine different areas. They deal with a wide range of patient ages from infants to geriatrics. With a high volume and variety of cases, job market security will likely be stable throughout an orthopaedics surgeon’s career. Orthopaedics is a dynamic, ever-changing field driven by evidence-based medicine full of innovations in surgical equipment, research, and updating standards of care. So, it has a lot of great things, but what about lifestyle?

According to 2020 and 2021 Medscape physician reports, orthopaedic surgery was tied for third as least anxious about their specialty and 4th happiest for overall marriages out of 29 specialties ranked.^4,5 Lastly, it is the highest compensated field in 2020 according to Medscape Physician Compensation Report 2020.⁶ So, what are the cons?

Cons of Orthopaedic Surgery

Despite all the positives, the cons of the field include long work hours for residents and attendings, 68 and 57 hours per week on average, respectively.^3,8 However, most of this time is within E.R. seeing patients or operating in the OR. Trauma call frequently can be hectic, especially if you are covering for multiple hospitals or are hand surgeon on the Fourth of July.

The field is stereotyped as a “Boy’s Club” with a “Bro Stereotype”⁹, although this isn’t true everywhere—statistically speaking, it is the most male-dominated field. Women only make up 16% of all orthopaedists³, and 11% being full-time faculty at academic institutions³—although more than 50% of medical school students are now women¹⁰. Hopefully, this will change in the coming years, and women will make up a more significant percentage.

Along with the “Bro Stereotype,” there is a perceived need to be able to bench more than your step 1 score, a common cliché. To become an orthopedic surgeon, it’s not necessary to be a 6’2″ former linebacker or weekend intramural warrior. Sure, strength helps when patients are over 250 pounds and need to hold traction for a hip arthroplasty or reduce a fracture, but it should not be considered a requirement. Like jiu-jitsu, technique and leverage are often more important than strength.

The field, for the most part, lacks diversity. It has the lowest percentage of females and minorities of all medical and surgical specialties.¹¹ So more diversity, cultural and life experiences are needed among its surgeons if the field is to still attract the best physicians to the field. New programs with professional societies like the AAOS Diversity Dashboard and the AAOS promoting the JEDI initiative are ways the field is making the necessary changes (more about this in the resource section). It is one of the main reasons for creating this article. I wanted to engage future applicants, demystifying aspects of the field, and get people who normally wouldn’t consider orthopaedics to learn more about what it has to offer.

Getting into the orthopaedic surgery residency can be tough. It’s one of the most competitive specialties in medicine. In 2020, there were a total of 849 orthopaedic surgery residency spots for 1,147 applicants, of which 860 were U.S. MD Seniors.¹² More U.S. MD Seniors applied for the specialty than spots were available last year, and 685 of the 849 residency spots were filled by U.S. MD Seniors. More statistics relating to the field are listed later in the article.

Lastly, whether you look at it, con or pro, there is not much medicine involved in orthopaedics. Most of the knowledge learned during your medical training will not be used consistently throughout your career.

What’s the Overview and Timeline from a Medical Student to Orthopaedic Surgeon?

Orthopaedic surgery is its own residency program, separate from general surgery. It is focused on the treatment, care, and repair of the musculoskeletal system. There are currently 190 orthopaedic programs with 4,335 trainees (residents and fellows PGY1-5), with each program averaging 4.5 PGY-1 residency spots per year.^3,8,12 orthopaedic surgery residency is a five-year program.¹⁴ After completion, approximately 94% of graduates continue their education with fellowship.⁸ Although, fellowship is not mandatory to practice. Fellowship training programs are one year long, with graduates focusing on one of nine subspecialties, including Trauma, Spine, Shoulder & Elbow, Hand, Pediatrics, Sports Medicine, Adult Reconstruction, Foot & Ankle, and Musculoskeletal Oncology.^3,8,13 Some fellows will do multiple fellowships to subspecialize further. To avoid getting too into the weeds, I will skip over the board certification and recertification process.

Alternative Routes into Orthopaedic Surgery

There are additional ways to practice orthopaedic surgery, albeit limited in scope if you do not complete an orthopaedic surgery residency. After completing plastic surgery and general surgery residencies, physicians can pursue a one-year fellowship in hand surgery where they can practice orthopaedic care.¹⁴ However, it is a circuitous route into the field.

Statistics Relating to Competitiveness of Orthopaedics

Table 1. NRMP Match Data 2020 Summary Stats.¹² Most important factors for applicants on whether they matched into a residency included the mean number of continuous ranks (12), USMLE Step 1 & 2 scores (248 and 255, respectively) AOA members (40.3% of applicants), graduated from the top 40 U.S. Medical School with Highest NIH funding (33.6%). Interestingly, persons having another graduate degree had a higher incidence of going unmatched. Other statistics such as number of research experiences, number of abstracts, presentation and publications, work and volunteer experiences were relatively consistent between those who matched and went unmatched.¹²

Graph 1. Table taken from Results of the 2020 NRMP Program Director Survey.¹⁵ The graph was cropped to only include the top mean Importance Rating Factors for Programs for selecting applicants to interview. All other percent citing factors were less than 50%. USMLE Step 1 score is the most highly cited factor for programs to select applicants for an interview (97%). Other highly cited factors include letters of recommendation (86%), rotation at the institution (81%), Professionalism and Ethics (78%), USMLE Step 2 C.K. score (75%), and class rank (75%). Failed attempt of any USMLE was considered a red flag i.e. the majority of responding programs would not consider an applicant for an interview. Sampling data may be skewed as N=36 with a total of 190 orthopaedic programs as sample size makes up ~19% of total programs.¹⁵

Graph 2. Table taken from Results of the 2020 NRMP Program Director Survey.¹⁵ The graph was cropped to only include the top Mean Importance Rating factors of programs in ranking applicants. All other percent citing factors were less than 50%. During interviews, interactions with faculty were the most cited factor for programs when ranking interviewees (95%). Other highly cited factors include feedback from residents (92%), interpersonal skills (89%), interactions with house staff during the interview (89%). Interestingly, USMLE Step 1 & 2 scores were not as highly considered for programs on ranking applicants (65% & 41%, respectively). Data may be skewed as N=36 with a total of 190 orthopaedic programs as sample size makes up ~19% of total programs.¹⁵

Graph 3

Graph 3. Table taken from Results of the 2020 NRMP Program Director Survey.¹⁵ The graph illustrates boxplots for interquartile ranges for USMLE Step 1 & 2 C.K. scores programs generally do and do not consider granting interviews. Programs generally do not consider granting interviews if applicants Step 1 & 2 C.K. scores are 230 and 235 or below, respectively. Median USMLE Step 1 & 2 C.K. scores in which programs almost always grant interviews is 240 for Step 1 & 250 for 2 C.K. The upper 75th percentile for scores in which programs always grant interviews is 250, and 252 for Step 1 & 2 C.K. This data suggests a USMLE Step 1 score of 250, or greater would not hinder an applicant from receiving an interview based on scores alone. Step 2 C.K.’s number of respondents was low; this may be due to programs not requiring Step 2 scores before applying.¹⁵

Graph 4. Table taken from Results of the 2020 NRMP Program Director Survey.¹⁵ The majority of interviews for orthopaedic surgery residency applicants were conducted during the months of December and January or later (93%), with January or later being the most common time (55%) applicants are interviewed. The applicants that interviewed before Oct. 1 date likely interviewed after they finished an away rotation with the program.¹⁵

Graph 5

Graph 6

What does all that mean?

Historically, USMLE Step 1 has been a large factor for applicants to receive interviews. Still, once an applicant is an interviewee, the score does not weigh in as much to match a program. Step 1, therefore, seems to be a “cutoff,” good or bad, for program directors to narrow the number of applications one reviews in an application cycle. With Step 1 becoming pass/fail, program directors will likely start to emphasize Step 2 C.K. scores, filling the place of Step 1 as an objective cutoff for interview offers. However, when and if it will happen is speculation as the data above does not support this claim.

Applicants with scores on USMLE Step 1of 230 or less will likely have a more difficult time receiving the necessary number of interviews to match, as 50% of programs will not extend an interview offer to those with a score below this threshold (Graph 3). Therefore, other aspects of the applicant’s application need to be strong for those interviews the applicant does receive. Median USMLE Step 1 scores in which programs almost always would consider offering applicants an interview is 240. As of now, Step 1 scores above 250 for more than 75% of programs is a great score to shoot for, as most programs will be willing to offer you an interview based on that score alone.

However, interview offers are holistic and extended to applicants for more than just board scores (Table & Graph 1). A great board score will not exclude you from receiving an invitation to interview, but a lackluster application may. Therefore, letters of recommendation, rotations, ethics, and professionalism (assuming this is judged based on leadership positions and extracurriculars), research experience, and clerkship grades are important considerations. These are all important factors for interview invitations irrespective of board scores.

Once applicants receive interview offers, interactions with faculty, residents, and staff are the most important factors for ranking applicants, with board scores becoming a less important factor (Graph 1 & 2). Most interviews occur in December or January (Graph 4), so using vacation time or an “easy” course during these months would be wise. Programs typically interview 60 applicants (of the 600) for four spots, 1:15 odds of matching once you interview; therefore, applicants need to apply broadly and interview multiple programs to match (Graph 5). Applicants interviewing and ranking 12 or more programs have a 90% probability of matching an orthopaedic surgery residency program (Graph 6).

It’s a competitive process but do not be overwhelmed with all the numbers. Just do the best you can on exams, become involved in some extracurriculars you love, and be a person attendings want to go out of their way to write you a LOR for. Regardless of your year in medical training, the steps below will help you on your journey.

How to Prepare M1 and M2 Year

It might be obvious but do as well as you can in your classes. Just because courses are pass-fail with honors and Step 1 will be  pass-fail too does not mean you can do the minimum to pass courses if you hope to match. The core concepts you learn during your first two years set you up to do well in clerkships’ third year. Still put in the work to do as well as you can on Step 1, regardless if it is pass-fail.

Besides course work, reach out to faculty. Find an upperclassman, alumni, or faculty member you can talk to relating to orthopaedic surgery. They will be a wealth of knowledge for you during your medical training and will help you navigate the field.

Become involved in a research project during your first two years. M1s can wait until the second semester or even M2 year to feel more established with the pace of medical school. That is perfectly fine. When you feel you have a grasp of school, reach out to faculty about projects they are currently working on or ask if they know anyone who would need assistance on a project you could be part of. The research does not have to be related to the field of orthopaedics. It is ideal to find a project; however, any project is still a great opportunity.

Program directors care that you invested yourself in a research project, so they know you can advance the field come residency. If your project is not directly related to orthopaedics that’s okay! It’s equally important how you spin your research as the research itself. Saying something like, “I was not able to become involved in an orthopaedic research project at my home institution, due to A, B, C, however knowing the importance and impact research has to advance the medical field, I joined Dr. XXXX lab to gain experience in research design and began my projects relating to YYYY.  I gained X, Y, Z skills throughout my time in Dr. XXXX’s lab” sounds a whole lot better than saying, “I did not do any research during medical school.” Additionally, if you start an orthopaedic research project but decide orthopaedics is not the specialty you wish to pursue, you can spin it similarly for the specialty you do want to go into.

For those looking for research to become involved with summer research programs between M1-M2 summer are great opportunities to become involved between semesters. Equally important, though, is doing something you are passionate about, like service. If your institution has a summer medical service program, become involved with that. That’s what I did and went to Guatemala for 5 weeks with three classmates between M1-M2 year on medical service trip. If you can’t choose, find a way to do both. Talk to past members of the organization to see if there are any current or ongoing projects, see if you could help out. If not, consider creating a project with your group and writing an IRB for your project. Not only does that show interest in research, but it also shows leadership and initiative. It will give you a lot more to talk about when interviews occur.

Lastly, to save yourself from headaches during M3 and M4 years, start a draft of your CV and personal statement during M1 or M2 years. Write down the activities, dates, and times that are involved in organizations. It will help when applying for away rotations and residency interviews later in your medical training. Your personal statement does not have to be the final draft, just think about why you like orthopaedics and go with it and drop some ideas; a draft of working ideas is great; it always easier to edit than to start from a blank canvas.

Tips and preparation for M3 and M4 year

M3 and M4 years, similar to your first two years, focus on your courses. Even more so, you should strive to honor as many clerkships during your 3rd year as possible. It shows programs one that you can perform well on standardized examinations and two puts you in a position to be eligible for Alpha Omega Alpha (AWA) Honor society. Continue to work on research projects and consider writing to newsletters and journals—shameless plug—such as this one and others to increase the number of publications you have under your name. Talk to attendings during rotations about research opportunities and case reports on patients you see.

Regardless of whether you want to go into orthopaedic surgery, keep an open mind in each rotation and learn from each rotation. Remember you are in school to learn medicine, not solely orthopaedics; residency is where you will learn the bulk of what you need to know for practice. Continue to work on your CV and personal statement throughout the third year and think about away rotations you will want to apply to come March. Get your titers done for Hep B, MMR, and varicella early in the third year; Most programs require you to have them complete before you apply for away rotations.

During your orthopaedic elective third year, try to work with as many orthopaedic surgeons as you can. Get to know them and begin to build a professional relationship. Identify those you think you’ll ask during your fourth year for letters of recommendation. Work with them when you have time.

GENERAL RESOURCES AND LINKS

• Women and Under-Represented Minorities in orthopaedics
  • Ruth Jackson Orthopaedic Society – Dedicated to provide professional development of and for women in orthopaedics throughout their career
  • The Perry Initiative – Conducts outreach programs for woman in medicine who wish to be connected with orthopaedic mentors and like-minded peers
  • 2020 AAOS diversity Dashboard¹⁶ – Initiatives and steps AAOS is taking to provide opportunities, embrace culture, diversity, inclusion and equity for women and under-represented minorities in orthopaedic surgery. 
  • J. Robert Gladden Orthopaedic Society– Taken from website “to increase diversity within the orthopaedic profession and promote the highest quality musculoskeletal care for all people”
  • CORD JEDI Program-AOA/CORD sponsored webinar supporting orthopaedics specialty to becoming Just, Equitable, Diverse and Inclusive (JEDI). Conversation with panelists with detailed notes regarding orthopaedic education.

• Research Dates and Deadlines for Orthopaedic Conferences
  • OHSU Orthopaedic Surgery Interest Group Conference Schedule¹⁷– detailed pdf page showing dates and deadlines for orthopaedic conferences medical students can submit research to across the US. 

• Professional Societies
  • AOA– From the AOA website “oldest orthopaedic association, AOA has had significant involvement in the founding of several major orthopaedic organization. AOA as the formal home and supporter of Department Chairs, Program Directors, Fellowship Directors and academic faculty, furthering the AOA’s commitment to academics.” This not to be confused with Alpha Omega Alpha (AWA) Honors Society which distinguishes students for their academic excellence and leadership.
  • AAOS – From the AAOS website “American Academy of Orthopaedic Surgeons Founded in 1933, the Academy is the preeminent provider of musculoskeletal education to orthopaedic surgeons and others in the world.” 

• Textbooks/Articles.
  • Netter’s Concise Orthopaedic Anatomy, Updated Edition, 2e (Netter Basic Science). This is more specific to orthopaedic surgery than the Netter used for anatomy. Book covers diagnostic and treatment algorithms for orthopaedic cases.
  • Handbook of Fractures Practical coverage of adult and pediatric fractures covering information of fracture management (operative or non-operative care) and classification. Includes information relating to anatomy and mechanism of injury to clinical and radiologic evaluation and treatment. A great book to have for away rotations and residency.
  • Surgical Exposures in Orthopaedics: The Anatomic Approach Details approach, technique, and pitfalls of surgical approach of a surgeons-point of view of orthopaedic anatomy and easy to follow steps. Highly regarded for fourth year medical students on away rotations and residents.
  • Pocket Pimped A new orthopaedic surgery handbook for students doing away rotations on some of the most common (1,500) questions asked during your rotation. Reviews are limited since this book is just over a year old however seems promising for those needing some last minute help on cases so you are not stumped.
  • Fracture and Dislocation Compendium Fracture classification system relating to orthopaedic trauma of long bone fractures.

• More Information Regarding Specific Orthopaedic Programs

  AOA/CORD Orthopaedic Residency Information Network (ORIN) The Orthopaedic Residency Information Network (ORIN) is a residency explorer tool developed by the American of Orthopaedic Association for medical students to explore programs who highlight program information, strengths, and opportunities. It is a free database with information on select programs relating to current residents, program interview details, application process, rank list and program contact info.

• Texas Star– Clearing house submitted by participating programs that recently matched fourth-year medical students provide real data to so future students can use this data to target programs they are more likely to receive interviews from. School must be a participating member. Great resource to input stats to compare yourself to recent applicants.
• AAMC Residency Explorer Tool– Ability to explore residency programs and compare your experience and scores to applicants who matched in each program. Easier to navigate M3 year as program is most beneficial with Step 1 score and updated CV for experiences.
• Reddit Ortho Match 2022 v2.0 data and information Excel Spreadsheet for orthopaedic surgery applicants to chat and communicate about programs throughout the country with links to general information, added feature of program directors directly answering chat questions.
• Doximity– Residency explorer tool free for students. Requires creation of a login and password in order to use. Has all orthopaedic programs to help with searching for residency statistics.
• FRIEDA– American Medical Association’s specialty guide and explorer designed for medical students to and provide students detailed information relating to medical specialties. Need to be AMA member to access.
• NRMP 2020 Residency Match Information¹²– Charting Outcomes in Medicine for senior U.S. MD Students. Provides detailed statistics for students based on 2020 match data. 

• Helpful Websites to Learn More about Orthopaedics
  • OrthoBullets-The go-to, gold standard resource to learn about orthopaedic care. Free and premium versions available but the paid service is not necessary until residency.
  • OrthoMentor YouTube– YouTube series hosted by Dr. Amiethab Aiyer (Orthopaedic Surgeon) and program directors throughout the country on what they as program directors are looking for in applicants. Provides solid advice on away rotations, interviews, and how to successfully match.
  • OrthoACCESS Consortium– Orthopaedic surgeons throughout the country helped develope the Ortho Acting-Intern Coordinated Clinical Education and Surgical Skills (OrthoACCESS). Directly from website “a structured, peer-reviewed curriculum specifically for MS4 students to take part in as they traveled between institutions on their sub-internships.” Students need to create an account in order to utlize. Includes “weekly live webinar teaching sessions, recorded teaching sessions for asynchronous participation, PowerPoint presentations for you to use at your institution.”
  • Ortho Info– Website developed by AAOS for patients to understand more about their symptoms, cause and treatment options for their musculoskeletal problems.
  • AAOS Access Guidelines– Current guidelines related to orthopaedic care.
  • Orthopaedic Residency Application Article– Article from Med School Declassified detailing and outlining the process of applying to residency
  • University of Washington Orthopaedics Youtube channel– Channel dedicated to detailing orthopaedic surgery approaches and physical exams.
  • Radiology Assistant– Free website to learn how to interpret fracture radiographs
  • Radiopaedic Orthopaedic Classification Eponyms-Website of radiologic findings for the most common fracture classification eponyms (e.g. Garden, Schatzker, etc.)

Hip and Knee Book- Free website detail pre-op templating, intra-op procedure, and post-op management of hip and knee joint replacements

• Dr. Antonio Webb YouTube– Orthopaedic surgeon who detailed his time throughout residency and fellowship. Now as an attending provides weekly videos related to his practice in orthopaedics.

• Podcasts
  • The Undifferentiated Medical Student Podcast – podcasts dive deep into majority of specialties in medicine (not just ortho) asking physicians about their specialty, advice irrespective of field, and advice about long term career planning.
  • NailedIt Ortho – OrthoPodcast hosted by orthopaedic residents interviewing national and international experts within the field.
  • White Coach Coaching Podcast – Orthopaedic residency advice podcast breaking down must know topics for students.
  • OrthoBullets Podcast – audio version of written text on OrthoBullets website.
  • Other Orthopaedic Podcasts recommended by American Orthopaedic Association

• Mobile Apps
  • AO surgery Reference App– Free app for fracture management and care.
  • OrthoBullets App– Free mobile app version for iPhone and Android
  • Ortho Traumapedia– paid app ($9.99) with common fracture and dislocations and based on bone. Additionally, the app has radiological images overlayed with critical structures. Additional has a facts sheet page about the fracture or dislocation.

References

1. Kohler R. Nicolas Andry de Bois-Regard (Lyon 1658–Paris 1742): the inventor of the word “orthopaedics” and the father of parasitology. Journal of Children’s Orthopaedics. 2010;4(4):349-355. doi:10.1007/s11832-010-0255-9

2. Orthopedia vs anesthesia (orthopaedics, anaesthetics conversation). www.youtube.com. Published July 23, 2010. https://www.youtube.com/watch?v=3rTsvb2ef5k

3. Orthopaedic Surgery | Careers in Medicine. www.aamc.org. Accessed August 23, 2021. https://www.aamc.org/cim/explore-options/specialty-profiles/orthopaedic-surgery#overview

4. Martin K. Medscape Physician Lifestyle & Happiness Report 2021. Medscape. Published January 15, 2021. Accessed August 23, 2021. https://www.medscape.com/slideshow/2021-lifestyle-happiness-6013446

5. Martin K. Medscape Physician Lifestyle & Happiness Report 2020: The Generational Divide. Medscape.com. Published January 8, 2020. https://www.medscape.com/slideshow/2020-lifestyle-happiness-6012424

6. Kane L. Medscape Physician Compensation Report 2020. Medscape.com. Published May 14, 2020. https://www.medscape.com/slideshow/2020-compensation-overview-6012684

7. Mannava S, Jinnah AH, Cinque ME, et al. An Analysis of Orthopaedic Job Trends in the United States Over the Past 30 years. JAAOS Global Research & Reviews. 2018;2(8). doi:10.5435/JAAOSGlobal-D-17-00056

8. FREIDA Orthopaedic Surgery Residency and Fellowship Listing. freida.ama-assn.org. https://freida.ama-assn.org/specialty/orthopaedic-surgery

9. Jubbal K. Doctor Stereotypes by Surgical Specialty (vs. Reality). Med School Insiders. Published April 27, 2019. Accessed August 23, 2021. https://medschoolinsiders.com/video/doctor-stereotypes-by-surgical-specialty-vs-reality/

10. Boyle P. More women than men are enrolled in medical school. AAMC. Published December 9, 2019. https://www.aamc.org/news-insights/more-women-men-are-enrolled-medical-school

11. Day MA, Owens JM, Caldwell LS. Breaking Barriers: A Brief Overview of Diversity in Orthopedic Surgery. The Iowa Orthopaedic Journal. 2019;39(1):1-5. Accessed August 23, 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6604536/

12. Charting Outcomes in the Match: Senior Students of U.S. MD Medical Schools Characteristics of U.S. MD Seniors Who Matched to Their Preferred Specialty in the 2020 Main Residency Match 2nd Edition. (2020). https://mk0nrmp3oyqui6wqfm.kinstacdn.com/wp-content/uploads/2020/07/Charting-Outcomes-in-the-Match-2020_MD-Senior_final.pdf

13. ACGME Program Requirements for Graduate Medical Education in Orthopaedic Surgery. ; 2020. Accessed August 23, 2021. https://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/260_OrthopaedicSurgery_2021.pdf?ver=2021-06-23-113231-937

14. BECOME A HAND SURGEON. www.assh.org. Published 2021. https://www.assh.org/s/become-a-hand-surgeon

15. Results of the 2020 NRMP Program Director Survey. (2020). https://mk0nrmp3oyqui6wqfm.kinstacdn.com/wp-content/uploads/2020/08/2020-PD-Survey.pdf

16. 2020 AAOS DIVERSITY DASHBOARD Full Year Progress Update. (2020). Accessed August 23, 2021. https://www.aaos.org/globalassets/about/diversity/2020-aaos-diversity-dashboard-update.pdf

17. OHSU Orthopaedic Surgery Interest Group Conference Schedule. OHSU Orthopaedic Surgery Interest Group. Published April 2021. Accessed August 23, 2021. https://www.ohsu.edu/sites/default/files/2021-06/Abstract%20Deadlines_v3_2021-22.pdf