The Match: Update 2013 Lisa Cannada, MD Chair BOS Match Oversight Committee.

The Match: Update 2013

Lisa Cannada, MD

Chair

BOS Match Oversight Committee

Disclosures

• This topic: Previous chair of OTA Fellowship Committee and Current Chair of AAOS Match Oversight Committee

• Full disclosures on website

What We Know

• Over 90% residents enter a fellowship• The process was becoming chaotic• Residents were forced to make

decisions…..– Very early in residency– Significant pressure to take position “on

the spot”

AOA Match Symposium 2007

• 79% residents felt process was unaccaptable

• 87% felt match process at that time was “Not fair”

• 86% residents wanted a match process

History

• Most subspecialties had organized process in past…unravelled

• Hand-NRMP since 1991• ASES since 2004• AAOS believed organized match

process a priority

BOS Match Oversight Committee

• Began to identify issues• At the center is the resident and

fellowship program• Worked to put together organized

match process• SF Match key player

– 6 matches– 7 subspecialties

2013 Match Program Participation Data

Adult Recon& Tumor

Foot & Ankle

Hand PedsShoulder &

ElbowSpine Sports Trauma

Match Date for 2013Fellowship Begins 2014 4/26 4/2 5/15 4/18 12/12 4/9 4/11 3/12

# of Programs 70* 42* 80 46* 27* 67* *94 50

# of Positions 140* 67* 157 68* 41* 116* *224 *77

# Applicants 245* 96 97* *61 *145 268* 139*

# IMG/DO88/289/15

37/82/6

43/25/2

14/61/5

66/111/5

50/229/18

50/65/9

More Applicants than Positions in ALL Matches

• Sounds like residency all over again…

• List is be made available of unmatched applicants and unfilled positions by each subspecialty society

• Concern regarding unmatched domestic applicants voiced

Why the Increase?

Year # Positions

2007 606

2008 636

2009 641

2010 656

2011 670

2012 682

2013 693

The Applicant

• Applies to many…– Just one click

• Interviews at more…– Hassles of travel

• Ranks around ??– What is needed to match?

The Applicant

And Broke

What We Have Learned

• Applicants continue to apply to large # programs(15-25)…YET

• Applicants rank a reasonable number (10)

• The average # of interviews should be <10

Information Pathways

• Specialty Society Website

• SF Match Website• Word of Mouth• AAOS Match

Webinar (Fall 2013)

Data

• # Applicants Matched– 1st choice– 2nd choice

• # applicants Matched• Mean # applicants

program ranked• Mean # Programs

applicants ranked

• # Interviews• # days gone for

interviewing• # Applicants

interviewed/position• #Programs filled

Post Match Survey

• The goal is to make this information available to programs and applicants for future use; especially regarding # interviews of matched applicants

Match 2013: Code of Conduct

• Subspecialty Societies– Definite Application Deadline END

• Programs– Send out interview invites w/in 30 days– Let applicants know if they are NOT

getting an interview

Were You Aware?

• ACGME proposes for 2014:– Accredited programs cannot take

IMG/DO applicants unless they completed ACGME residency

– Affects up to 30% in some matches– ALL subspecialty societies responded– Statement regarding DO’s and working

on accreditation 10/24/12

Current Match Issues

• Accreditation• Monitor Sanctions• Ethics/Professionalism• Funding of Fellowships• AAOS Book of Fellowships

OIM Surgeon-Industry Relationships in Orthopaedic Surgery 1/13

Funds from industry for residency and fellowship programs and other training programs should be distributed through

unbiased, independent, third party organizations or through central

administration of the institution. Residency and fellowship training programs should stop accepting individual-focused grants

from companies and require companies to submit funding through either of the

aforementioned approaches.

What We Have Learned

• Rank list should be taken seriously as less than 60% match at first choice

• More applicants than positions in ALL subspecialties

• Increasing number of fellowships to match increasing applicants

What We are Doing

• Working towards Universal match• Annual Progress Report• Submission to JBJS “Topics in

Training”• Collaboration with ARCOS• Collaboration with CORD

Questions/Comments

Thank [email protected]