Development and Initial Validation of a Program Director's Evaluation Form for Medical School Graduates, Successful Strategies for Integrating Bedside Ultrasound Into Undergraduate Medical Education. Military orthopaedic surgery residency programs have a long and storied tradition of producing excellent graduates. Residency applications for Interns/General Medical Officers/Flight Surgeons/Direct Commissions are scored by each of the three services and an aggregate score is obtained for each individual applicant. 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. Each ranked factor was given a numerical value to reflect its importance. Orthopedic Surgery The Eisenhower Orthopedic Surgery Residency Training Program offers four years of intensive study and practice. Applicants with more than two specialty interests may need additional rotations or even a transitional year internship to narrow their interests. More than half of these individuals were foot- and ankle- or hand-fellowship trained (53%) and two were generalists (13%). Medical Operational Data System (MODS) is used to match all U.S. Army–GME applicants (https://education.mods.army.mil/meded/UserLogon/UserLogon.asp). At the beginning of every application cycle, a “World Wide Message” giving a complete overview of the application process is sent out.14Table II details critical steps and deadlines for the 2012 application year. Large academic surgical residency programs have already begun to incorporate these considerations into their residency selection.20,22. During an ADT, positive interaction with the current residents is critical. There were no programs that reported utilizing the grit scale or any other untraditional scoring systems. Despite this, grit and other classically subjective characteristics of an individual are often not objectively measured or considered during resident selection. This research was performed at William Beaumont Army Medical Center. 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. Students obtain the scholarship for a minimum of 2 years and incur a 1-year ADSO for every year of scholarship received, to be repaid following the completion of residency training. Orthopedic surgery residency is one of the most competitive residencies to which medical students apply. Correlating selection criteria with subsequent performance as residents, A quantitative composite scoring tool for orthopaedic residency screening and selection, An analysis of orthopaedic residency selection criteria, Program directors' responses to a survey on variables used to select residents in a time of change, What attributes are necessary to be selected for an orthopaedic surgery residency position: perceptions of faculty and residents, Characteristics of successful and unsuccessful applicants to orthopedic residency training programs, Reliability in evaluating letters of recommendation. The two most recent medical school application cycles in 2018 and 2019 resulted in a 41.9% matriculation rate,1 and the United States Medical Licensing Examination (USMLE) Step 1 score among those accepted to orthopedic surgery residencies was one standard deviation above all candidates across all medical specialties.2 Additionally, there has been a gradual increase in average USMLE scores and research publications among orthopedic surgery applicants over the last 10 years.3 Matching into orthopedic surgery is notoriously vying and attracts academically inclined individuals. With sweeping changes in medical education, including USMLE Step 1 scoring system transitioning to a pass/fail format,23 grit scores and measurements of personality characteristics are likely to become increasingly important during resident selection. A preliminary analysis of different approaches to preparing for the USMLE Step 1, Study month or vacation? Analysis of variance was used to compare the means of values of continuous variables across three or more groups. Grit has become an important consideration in resident selection. The Orthopaedic Surgery Program at the Naval Medical Center Portsmouth (NMCP) was established in 1958. Outcome after single-site robotic cholecystectomy: An initial single center's experience. 3. 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. Previous authors have shown correlations between OITE scores and the reputation of medical school education based on nonvalidated national rankings.15,22. Do you have a specific USMLE (Step 1) score cut off? 4 Cognitive performance measures were objective and reflected in applicants’ USMLE scores, election into the Alpha Omega Alpha honor society, and class rank. c. LOR from current supervisor (if not in training status). More than 85% of leadership would consider candidates with below average USMLE scores if there were redeeming aspects found in that candidate. 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. 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. Students who complete an elective rotation with PCOM will be provided with graduated responsibility in a challenging academic environment, working closely with PCOM residents and clinical faculty. 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. Medical school performance data examined include medical school transcript, Dean's letter, and USMLE steps I and II/COMLEX I and II scores. Marina Rodriguez (right), a third year resident with William Beaumont Army Medical Center’s Orthopaedic Residency Program, assists Army Lt. Col. Justin Orr, orthopaedic residency program director, during a total ankle replacement on a … 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. What is the most important reason for choosing a candidate with an academic pedigree (high USMLE, Alpha Omega Alpha, honors in medical school clerkships, etc.)? Grit, a factor not identified or included in prior similar military analysis,4 was the fifth most important factor in candidates. 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. The Residency quickly adapted and instituted virtual learning platforms. 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). 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. 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. How does your program use USMLE scores during the selection process? All military residency programs are approved by the Accreditation Council for Graduate Medical Education. Each variable was ranked using a point system (1–10 with 10 as the best score), referred to as the factor score (FS). Thank you for your interest in the PCOM Orthopedic Surgery Residency Program. 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. The goals of this study were to determine which factors, including grit, were most influential when ranking candidates in the eyes of current leadership and determine if there were any other forms of personality testing utilized. Any corrections or changes to this require contacting the GME office after this date until November 1, 2012. Throughout medical student clerkship rotations, it is important to conduct personal interviews with all available faculty members. It is critical that the applicant is sure of his/her decision to become an orthopedic surgeon. 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. Welcome to the United States Air Force. 10. Letters of recommendation (LORs) should be requested early in the application year to allow the writer adequate time for preparation. Regardless, higher class rank is certainly advantageous and has been shown in at least one study to be a positive predictor of success during orthopaedic surgical residency.19 Finally, reputation of medical school is considered during the selection process as well; however, we recognize that this is a largely subjective measure. Table I provides contact information for all military orthopaedic surgery residency programs. Does your program utilize any formal assessments of intangible traits (grit scale, personality test, etc.). The statistical analysis operations were performed utilizing the IBM SPSS software platform. The majority of program leadership were between the ages of 35 and 45 (60%) with one individual below the age of 35 (7%). The grit scale ranges from a score of 0 to 5, with increasing scores being correlated with increasing levels of grit. 4. 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. The second most important variable was the applicant’s USMLE scores (FS = 7.13), followed by involvement in research (FS = 5.60) and conscientiousness (FS = 4.73), respectively. 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). 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. The average MCAT score for 2012 HPSP recipients was 30.2 (Graduate Medical Education Review 2012, previously cited presentation by COL Nace). With few exceptions, all USUHS and HPSP medical students are given opportunities during the third or fourth years of medical school to complete 1 or 2 clinical rotations at military orthopaedic surgery residency programs (19 Army, 11 Navy, 3 USAF). 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. 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. 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. How many years have you been in practice? 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. The summed FS for each variable was calculated, averaged by the number of respondents (n = 15), and reported according to the top 10 most important factors when considering orthopedic surgery residency candidates (Figure 1). Grit was considered the fifth most important variable (FS = 4.27). A medical officer can complete Navy or civilian orthopedic surgery residency followed by serving as a military orthopedic surgery attending, or serve as a flight surgeon prior to entering residency (see Scenarios 1–6). Application Schedule Dermatology. Objective: To determine baseline knowledge of emergency medicine (EM) residents at 2 different residency training programs and assess if a 4-week orthopedic surgery rotation would improve musculoskeletal (MSK) knowledge as assessed by the basic competency exam (BCE). The USUHS Class of 2,016 selected 171 (6.0%) of 2,845 applicants (Graduate Medical Education Review 2012, previously cited presentation by COL Nace). We also accept 12 preliminary PGY-1 only interns per year. This analysis should then be combined with personal decision factors to create an individualized rank order list of programs with which the applicant desires to schedule either a clinical rotation or an interview in person. About 10% of current orthopedic surgery residents are women; about 20% are members of minority groups. 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. 3 The HPSP provides qualified prospective students with full tuition and additional financial benefits for their education at any allopathic or osteopathic medical doctorate program in the United States or Puerto Rico. 3. Orthopedic surgery programs should consider measuring and quantifying applicants’ personal characteristics, such as grit, in addition to considering their academic achievements. Health and Wellness. Summary for Orthopaedic Surgery Residency Applications: A solid orthopaedic surgery application would include a 245+ on Step 1, 245+ on Step 2, a LOR from 1 … The Army has 19 orthopedic surgery residency positions and averaged 1.47 applicants per position from 2007 to 2011. 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? MODS is used to match all prospective military orthopaedic surgery applicants. 1. All supporting documents (listed above) are due. Measures for assessing an applicant’s potential for successful practice as an orthopedic surgeon were more subjective such as overall performance during an audition rotation or levels of dexterity.4 However, there are factors of applicants that have largely been unreported in the military application literature such as personality traits, attitude, and ability to overcome obstacles and setbacks. The Duke Orthopaedic Surgery Residency is a comprehensive, five-year, ACGME-approved training program. Multicenter, Observational Study of Lanreotide Autogel for the Treatment of Patients with Acromegaly in Routine Clinical Practice in Germany, Austria and Switzerland. Is USMLE step 1 score a valid predictor of success in surgical residency? When arranging ADT clinical rotations at military orthopaedic surgery residency training programs, applicants generally fall into one of two categories: those who know by early spring of their third year of medical school that they desire to be orthopedic surgeons or those who remain undecided between orthopedic surgery and another specialty. Anesthesiology Bariatric Surgery Clinic Cardiothoracic Surgery. Does Combat Hearing Preservation Equipment Affect Balance? Incidence of Posterior Shoulder Instability in the United States Military: Demographic Considerations From a High-Risk Population. The ranking of all orthopedic surgery residency applicants is based 50% upon objective cognitive domain criteria regarding the applicant's performance during the preclinical and clinical years of medical school and 50% on the applicant's potential for successful practice as an orthopaedic surgeon and career officer (affective domain). Preparing for USMLE Step 2, The impact of a peer-designed and -led USMLE Step 1 review course: improvement in preparation and scores, The effect of three commercial coaching courses on Step One USMLE Performance, Letters of recommendation: rating, writing, and reading by clerkship directors of Internal Medicine, Writing more informative letters of reference, Directorate of Medical Education Table of Contents for School Year 2013 GME Announcement, Success in orthopaedic training: resident selection and predictors of quality performance, Resident selection: a key to the future of orthopaedics, Relation of residency selection factors to subsequent orthopaedic in-training examination performance, Factors associated with successful performance in an orthopaedic surgery residency. Specific grit scores were not obtained from individual applicants as the focus of this analysis was to determine the orthopedic surgery leadership’s consideration for grit and determine if there were any personality scoring modalities utilized when ranking 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. Are Commonly Used Premedical School or Medical School Measures Associated With Board Certification? Board certification involves completion of an orthopedic surgery residency lasting at least 5 years. Such orthopaedic clinical rotations are in many regards a chance to “audition” for a residency position. 2020; 185(9-10):e1603-e1607 (ISSN: 1930-613X) Wells M; Polmear M; Nesti LJ; Dunn JC. Reprint & Copyright © Association of Military Surgeons of the U.S. 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. USUHS offers a fully funded 4-year medical doctorate program at the F. Edward Hebert School of Medicine. 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. In which geographic region is your program? 17. 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? These clinical rotations, typically 4 weeks in duration, provide prospective candidates with opportunities to interact directly with the current residents and various members of faculty.