The fellowship match process: the history and a report of the current experience.

Abstract

Beginning in 2007, there was substantial movement from the American Academy of Orthopaedic Surgeons (AAOS) and the American Orthopaedic Association (AOA) to promote a coordinated match process for orthopaedic fellowships. It is estimated that at least 90% of all orthopaedic surgery residents participate in a year of fellowship training1. The results of a survey at the 2007 AOA Symposium on Fellowships found that 79% of attendees believed that the current process was unacceptable and 87% believed that the process was unfair to residents2. The situation of those disciplines that were not in an organized match process was compared with problems often seen in a decentralized labor market2. A survey of residents indicated that 80% of residents were in favor of an organized match for fellowship and wanted a later date in their fourth postgraduate year for the decisions2. The problems of the fellowship process at that time were obvious, with no formal match process. There were multiple subspecialties competing and applicants were asked to commit to a position as early as their third postgraduate year, sometimes without full exposure to all subspecialties. In some instances, residents were forced to accept or decline an offer, during or shortly after an interview. This did not allow the resident to have an opportunity to compare programs. The benefits of a fellowship match include optimal consideration of all options by both the applicant and the program. The purpose of this article is to review the history of the fellowship match process, to report on four years (2010 to 2013) of the formalized orthopaedic fellowship match process, and to provide information for applicants, residency, and fellowship programs on the match. Specifically, we will report on the information accumulated regarding fellowship applications and positions, as well as data …