Orthopaedic Sports Medicine Fellowship Research Articles

Virtual Interviews Are Not Adequate Replacements for In-Person Interviews for Orthopaedic Sports Medicine Fellowship Program Directors and Applicants

To understand the opinions of both orthopaedic sports medicine fellowship program directors (PDs) and applicants regarding the utility of virtual interviews in comparison to in-person interviews following the 2022-2023 application cycle. An anonymous online survey was distributed through the American Orthopaedic Society for Sports Medicine to applicants and PDs of orthopaedic sports medicine fellowship programs. Questions in the survey included how the virtual format affected the applicants' personal connection to the program, the interview day structure, and costs associated with the interview process. Responses were received from 69 of 93 PDs (74%) and 97 of 266 applicants (36%). Ninety-five percent of PDs (59 of 62) preferred in-person interviews, compared to 79% of applicants (70 of 89). Ninety-eight percent of PDs (60 of 61) and 82% of applicants (72 of 88) thought it was important/very important to interview in-person. Sixty-one percent of PDs (35 of 57) and 49% of applicants agreed/strongly agreed that conducting virtual interviews negatively affected their personal connection with the fellowship interviewee/program. The presence of virtual interviews allowed 50% (43 of 86) of applicants to go on more interviews. Thirty-two percent (18 of 57) of fellowship programs saved up to $5,000 conducting virtual interviews, and 85% (69 of 81) of applicants saved up to $5,000 on travel expenses by attending virtual interviews. Virtual interviews allow fellowship applicants to complete more interviews and presented financial savings for both programs and applicants. However, both PDs and applicants stated that interviewing in-person is essential for applicants to meet faculty and tour the facilities. This study may be valuable to fellowship programs considering continued use of virtual interviews.

Poster 154: Top Orthopaedic Sports Medicine Fellowship Programs as Perceived by Applicants

Objectives: Despite the high volume of orthopaedic sports medicine fellowship applicants and growing interest in the field, fellowship applicants’ attitudes and preferences towards programs are not well known. The objectives of this study were to determine the top orthopaedic surgery sports medicine fellowship programs in the United States and the most important aspects of fellowship programs as perceived by applicants. Methods: An anonymous survey was distributed via email and text message to all individuals who applied to one particular orthopaedic sports medicine fellowship program during the 2017-18 through 2021-22 application cycles. The survey asked applicants to rank what they considered to be the top-10 orthopaedic sports medicine fellowship programs in the United States prior to and after completion of their application cycle, based on operative and nonoperative experience, faculty, game coverage, research, and work/life balance. Final rank was calculated by awarding 10 points for a 1st place vote, 9 points for a 2nd place vote, etc., with total number of points used to determine final ranking for each program. Secondary outcomes included application patterns, relative importance of different fellowship program aspects, and preferred type of practice. Results: Ninety-three surveys were completed overall. Based on total numbers of points, applicants voted the top orthopaedic sports medicine fellowships programs to be: 1) the Steadman Philippon Research Institute, 2) Rush University, and 3) Hospital for Special Surgery, both prior to and following the application cycle (Table 1). Forty-two percent of applicants applied to all of their perceived top-10 programs with 66% of respondents applying to at least 8 of their top-10 programs. Interestingly, 10% of applicants applied to 4 or fewer of their top-10 programs. Of those who did not apply to all programs in their top-10, 92% thought the program did not fit their preferences and 47% thought they were not competitive for those programs. When asked to rank programs upon completion of the application cycle, each of the top-10 programs prior to the application cycle remained in the top-10 (Table 1). Nearly all of the applicants agreed/strongly agreed (99%) that the personalities of the attendings they met on their interviews influenced their rank list decision upon completion of the application cycle. When ranking fellowship program aspects, fellowship reputation and faculty members were most likely to be ranked highest in importance. Factors such as research opportunities, private practice versus academic setting, and number of fellows were all more likely to be ranked last in importance (Table 2). Most applicants (83%) applied to both academic and private practice programs. Conclusions: This study demonstrates that most orthopaedic sports medicine fellowship applicants highly valued program reputation and faculty member personalities in choosing a fellowship program and that the application/interview process did not have a significant effect on how individuals perceive the top programs. The findings of this study may have significant implications on future application cycles and the programs to which potential applicants may apply. [Table: see text][Table: see text]

Poster 388: Gender Diversity of Orthopaedic Sports Medicine Fellowship Trainees, Faculty and Leadership

Objectives: Orthopaedic surgery has remained the most male-dominated field in medicine, despite recent efforts to recruit and retain more women. The objective of this study was to determine the gender composition of fellows, faculty, and leaders within orthopaedic sports medicine fellowship programs to provide a more complete analysis of gender diversity within this subspecialty. Methods: Official program websites of orthopaedic sports medicine fellowships listed on the Arthroscopy Association of North America (AANA) fellowship directory were examined. Data collected for analysis included the gender of program directors, fellowship faculty, orthopaedic surgery department faculty, current sports medicine fellows and fellows who graduated within the last five years. Results: In the academic year 2021-2022, 132 sports medicine fellows were in fellowship training in the United States within 97 programs. Of these, 113 (85.6%) were men and 19 (14.4%) were women (p<0.001). Within the past five years, 419 fellows were listed as completing a sports medicine fellowship, with 375 (89.5%) being men, and 44 (10.5%) being women (p<0.001). There is no significant difference in the gender composition of current fellows compared to the composition of fellows within the last 5 years (p=0.74). When examining gender trends in sports medicine faculty, 639 (86.6%) were men and 99 (13.4%) were women (p<0.001). There are 14 women (14.4%) orthopaedic sports medicine faculty in leadership positions (i.e., program directors or assistant program directors) compared to 83 men in such positions (85.6%) (p<0.001). Conclusions: Orthopaedic sports medicine fellowships remain heavily male-dominated in their trainees, faculty, and leadership. There was no significant difference in the gender composition of current fellows when compared to those who graduated in the last five years, suggesting further and novel initiatives are needed to enhance gender diversity in sports medicine. [Table: see text][Table: see text]

Persistent Lack of Female Orthopaedic Sports Medicine Fellows

To evaluate the gender composition of fellows, faculty, and leaders within orthopaedic sports medicine fellowship programs to provide a more complete description of gender diversity within this subspecialty. Official program websites of orthopaedic sports medicine fellowships listed on the Arthroscopy Association of North America fellowship directory were examined. Data collected for analysis included the gender of program directors, fellowship faculty, orthopaedic surgery department faculty, current sports medicine fellows, and fellows who graduated within the last 5 years. Of the 132 orthopaedic sports medicine fellows in training in the United States in the 2021 to 2022 academic year, 113 (85.6%) were men and 19 (14.4%) were women (P < .001). Within the past 5 years, 419 fellows were listed as completing a sports medicine fellowship, with 375 (89.5%) being men, and 44 (10.5%) being women (P < .001). There was no significant difference in the gender composition of current fellows compared with the composition of fellows within the last 5 years (P= .74). When we examined gender trends in sports medicine faculty, 639 (86.6%) were men and 99 (13.4%) were women (P < .001). There were 14 women (14.4%) orthopaedic sports medicine faculty in leadership positions (i.e., program director or assistant program director) compared with 83 men in such positions (85.6%) (P < .001). Orthopaedic sports medicine fellowships remain heavily male-dominated on all levels, including fellows, faculty, and leadership. There were no differences in the gender composition of current fellows when compared with those who graduated in the last 5 years, suggesting persistent gender disparity and the need for novel initiatives to enhance gender diversity in sports medicine. IV, descriptive study.

Most Faculty Members at the Top Orthopaedic Sports Medicine Fellowship Programs Trained at Many of the Same Programs

Most Faculty Members at the Top Orthopaedic Sports Medicine Fellowship Programs Trained at Many of the Same Programs

Persistent Lack of Female Orthopaedic Sports Medicine Fellows

PurposeThe purpose of this study was to evaluate the gender composition of fellows, faculty, and leaders within orthopaedic sports medicine fellowship programs to provide a more complete analysis of gender diversity within this subspecialty. MethodsOfficial program websites of orthopaedic sports medicine fellowships listed on the Arthroscopy Association of North America (AANA) fellowship directory were examined. Data collected for analysis included the gender of program directors, fellowship faculty, orthopaedic surgery department faculty, current sports medicine fellows, and fellows who graduated within the last five years. ResultsOf the 132 orthopaedic sports medicine fellows in training in the United States in the 2021-2022 academic year, 113 (85.6%) were men and 19 (14.4%) were women (p<0.001). Within the past five years, 419 fellows were listed as completing a sports medicine fellowship, with 375 (89.5%) being men, and 44 (10.5%) being women (p<0.001). There was no significant difference in the gender composition of current fellows compared to the composition of fellows within the last 5 years (p=0.74). When examining gender trends in sports medicine faculty, 639 (86.6%) were men and 99 (13.4%) were women (p<0.001). There were 14 women (14.4%) orthopaedic sports medicine faculty in leadership positions (i.e., program director or assistant program director) compared to 83 men in such positions (85.6%) (p<0.001) ConclusionsOrthopaedic sports medicine fellowships remain heavily male-dominated on all levels, including fellows, faculty, and leadership. There were no differences in the gender composition of current fellows when compared to those who graduated in the last five years, suggesting persistent gender disparity and the need for novel initiatives to enhance gender diversity in sports medicine.

The Top 10 Orthopaedic Sports Medicine Fellowship Programs in the United States Frequently Select Fellowship Applicants From the Same Residency Programs

To determine which residency programs the fellows of the top 10 orthopaedic sports medicine fellowship programs attended and whether residents are selected from the same residency programs multiple years. The residency programs of current and former fellows at each of the top 10 orthopaedic sports medicine fellowship programs (based on a recent study) over the last 5 to 10 years was determined by searching program websites and/or contacting program coordinators/directors. For each program, we determined the number of occurrences of at least 3 to 5 fellows from the same residency program. We also calculated a "pipelining ratio," defined as the ratio of the total number of fellows at the program over the duration of the study to the number of different residency programs represented within the fellowship program during that same time period. Data were obtained from 7 of the top 10 fellowship programs. Of the remaining 3 programs, 1 declined to provide the information and 2 did not respond. Pipelining was found to be highly prevalent at one program, with a pipelining ratio of 1.9. Two different residency programs had at least 5 residents match at this fellowship program over the past 10 years. Four additional programs demonstrated evidence of pipelining with ratios of 1.4-1.5. Two programs exhibited minimal pipelining (ratio of 1.1). One program was found to take 2 residents from the same program in the same year on 3 different occasions. Most of the top orthopaedic sports medicine fellowship programs have matched fellows from the same orthopaedic surgery residency programs in multiple years. It is important to understand how fellows are selected for sports medicine fellowship programs and to recognize the potential for inequitable bias in the selection process.

Impact of COVID-19 on the Reported Case Volume of Orthopaedic Sports Medicine Fellows in the United States.

The impact of the coronavirus 2019 (COVID-19) pandemic on reported case volume during orthopaedic sports medicine fellowship training remains poorly understood from a national perspective. It was hypothesized that reported case volume during orthopaedic sports medicine fellowship training would decrease during the 2019-2020 academic year, which corresponded to the COVID-19 outbreak. It was also hypothesized that there would be a subsequent rebound in case volume during the 2020-2021 academic year. Cohort study. Reported mean case volumes were extracted for 4 academic years (2017-2018, 2018-2019, 2019-2020, and 2020-2021), and year-over-year percentage changes were calculated. Parametric tests were used for interyear comparisons. There was a 7% decrease in mean ± SD case volume between the 2018-2019 and 2019-2020 academic years (339 ± 123 vs 316 ± 108; P = .042). Case categories with the greatest percentage declines were foot and ankle (-20%), knee instability (-11%), meniscus (-8%), and glenohumeral instability (-7%). There was a 13% year-over-year increase in case volume between the 2019-2020 and 2020-2021 academic years (316 ± 108 vs 357 ± 117; P < .001). There was a slight decrease in total orthopaedic sports medicine case volume during the 2019-2020 academic year, corresponding to widespread lockdowns during the COVID-19 outbreak. Certain case categories experienced the greatest negative impact. Results from this study may inform accrediting bodies and surgical educators on the impact of future disruptions to health care delivery.

Program and Faculty Reputation Are Valued Most by Applicants to Orthopaedic Sports Medicine Fellowships

To determine the top orthopaedic surgery sports medicine fellowship programs in the United States and the most important aspects of fellowship programs as perceived by applicants. An anonymous survey was distributed via e-mail and text message to all current/former orthopaedic surgery residents who applied to one particular orthopaedic sports medicine fellowship program during the 2017-2018 through 2021-2022 application cycles. The survey asked applicants to rank what they considered to be the top-10 orthopaedic sports medicine fellowship programs in the United States before and after completion of their application cycle, based on operative and nonoperative experience, faculty, game coverage, research, and work-life balance. Final rank was calculated by awarding 10 points for a first-place vote, 9 points for a second-place vote, etc., with total number of points used to determine final ranking for each program. Secondary outcomes included rates of applying to perceived top-10 programs, relative importance of different fellowship program aspects, and preferred type of practice. Seven-hundred sixty-one surveys were distributed with 107 applicants responding (14% response rate). Applicants voted the top orthopaedic sports medicine fellowships programs to be: (1) Steadman Philippon Research Institute, (2) Rush University Medical Center, and (3) Hospital for Special Surgery, both before and following the application cycle. When ranking fellowship program aspects, faculty members and fellowship reputation were most likely to be ranked highest in importance. This study demonstrates that most orthopaedic sports medicine fellowship applicants highly valued program reputation and faculty members when choosing a fellowship program and that the application/interview process did not have a substantial effect on how individuals perceived the top programs. The findings of this study are important for residents applying to orthopaedic sports medicine fellowships and may have implications on fellowship programs and future application cycles.

Current Gender Diversity and Geographic Trends Among Orthopaedic Sports Medicine Surgeons in the United States.

Female representation varies geographically among orthopaedic residency programs, with the southern region of the United States reported as having relatively lower rates of female orthopaedic surgeons. To determine the gender and geographic distributions of US-based orthopaedic sports medicine surgeons and analyze geographic patterns between their training locations and present-day practices. Cross-sectional study. American Orthopedic Society of Sports Medicine (AOSSM) fellowship completion data from the 2016-2021 academic years were analyzed with regard to gender and fellowship location. Medical school, residency, and current practice locations were obtained via internet searches for all individuals identified within the databases. Locations were categorized into regions based on the US Census Bureau definitions. Descriptive statistical analysis was performed on the data. A total of 1268 sports orthopaedic surgeons who graduated fellowship from 2016 to 2021 were analyzed: 141 (11%) were female and 1127 (89%) were male. The percentage of female sports medicine surgeons in fellowship remained constant (11%-12%) from 2016 to 2021. On average, the annual percentage of female orthopaedic sports medicine fellows was 7.2% in the South, 10.4% in the West, 14.2% in the Midwest, and 14.7% in the Northeast. Based on the orthopaedic sports medicine fellowship graduates from 2016 to 2021, the mean percentage of current female orthopaedic sports medicine surgeons in practice was 7.4% in the South, 11.7% in the Northeast, 12.8% in the Midwest, and 14.4% in the West. Approximately 11% of our sample was female; however, this percentage varied heavily by region, with the southern region having significantly lower rates of gender diversity.

Virtual Interviews for Sports Medicine Fellowship Positions Save Time and Money but Don’t Replace In-Person Meetings

PurposeTo understand the perceptions of program directors (PDs) and fellowship applicants regarding the virtual interview process for orthopaedic surgery sports medicine fellowship programs.MethodsAn anonymous online survey was distributed through the American Orthopaedic Society for Sports Medicine (AOSSM) to applicants and PDs of orthopaedic surgery sports medicine fellowship programs following the 2020-2021 fellowship application cycle.ResultsA total of 40 responses were received from PDs for a response rate of 47% (40 of 85) and 72 responses were received from applicants for a response rate of 27% (72 of 271). All of the surveyed PDs (40/40, 100%) agreed/strongly agreed that the applicant’s interview carries significant weight in determining where an applicant is ranked on the match list. Fifty-eight percent (23 of 40) of PDs agreed/strongly agreed that virtual interviews negatively affected their personal connection with the fellowship interviewee. The presence of virtual interviews allowed 80% (57 of 71) of applicants to go on more interviews. Seventy-three percent (51 of 70) of applicants were able to save greater than $5,000 on travel expenses and 63% (25 of 40) of fellowship programs were able to save greater than $2,500 by conducting virtual interviews.ConclusionsVirtual interviews allowed fellowship programs and applicants to complete more interviews, but both PDs and applicants stated that interviewing in-person was important for applicants to meet faculty and tour the institution where they may be spending a year. In contrast, significant financial savings resulted due to the transition to virtual interviews. Finally, both PDs and applicants were in favor of having the option of interviewing virtually, suggesting that virtual interviews may continue to play a role in future application cycles.Clinical RelevanceThis study may be valuable to fellowship programs that will continue to implement virtual interviews into future application cycles.

Use of an Individualized Development Plan to Identify Career Development Needs in Prospective Orthopaedic Sports Medicine Fellows.

Background:Mentorship is a key aspect of leadership development for orthopaedic surgeons, but there are few formalized mentorship programs in medical training. The individualized development plan (IDP) is a tool that potentially improves mentorship opportunities through identifying specific competency deficiencies and facilitating communication with mentors.Purpose:To assess the views of prospective orthopaedic surgery sports medicine fellows on the skills necessary for career development and the utility of an IDP for longitudinal career mentorship during a sports medicine fellowship.Study Design:Cross-sectional study.Methods:Candidates who interviewed for an orthopaedic surgery sports medicine fellowship voluntarily completed an anonymous IDP as well as a survey to assess their perceptions of the IDP tool to define their career goals and its use for longitudinal mentorship. The IDP included quantitative and qualitative responses for the self-assessment of multiple skill domains (general research, teaching, professional, interpersonal, leadership, and management) using a 5-point Likert scale (1 = needs improvement, 5 = highly proficient). Quantitative results were analyzed using analysis of variance and Student t test.Results:A total of 25 candidates completed the IDP and survey. The mean ± standard deviation composite score of all skill domains was 3.62 ± 0.91. The candidates’ greatest deficit was in grant writing (2.28 ± 0.94; P < .01), while their greatest strength was getting along with others (4.52 ± 0.65; P < .01). Candidates identified, as short-term goals, obtaining a fellowship training position, completion of research/academic projects, and improvement of surgical skills; their common long-term goals included having a role in an academic institution, professional society, and/or research and innovation environment. The majority of participants agreed that the IDP is a valuable tool to characterize career and personal goals (74%) and facilitate longitudinal fellowship mentorship (83.3%).Conclusion:The majority of candidates valued the IDP for their short- and long-term goals. Program implementation of an IDP could be beneficial in allowing trainees to effectively identify areas of weakness and strengths while facilitating efficient communication of these needs to mentors.

Evaluation of Sports Medicine Fellowships in the United States Based on Academic Productivity.

Background:Institutional academic productivity remains an influential factor in an applicant's selection of fellowship training. This study aimed to determine the quality and quantity of research in the United States orthopaedic sports medicine fellowship programs and identify those with highest productivity.Methods:The Arthroscopy Association of North America Fellowship Directory was used to evaluate 88 fellowships in the United States. Publication data and Hirschberg indices (h-index) were collected from the Scopus database. Subanalysis was performed based on the number of publications and mean h-index.Results:Total number of publications per faculty member ranged from 0 to 866, with a median of 20. The median h-index per faculty member was 9. The number of fellows was correlated with a higher mean average h-index of faculty members (P = 0.05). The five programs with the highest number of publications included Hospital for Special Surgery, Rush University, University of Pittsburgh Medical Center, Mayo Clinic in Rochester, and Boston Children's Hospital.Conclusions:Most academic productivity in sports medicine is produced by a relatively small number of fellowship programs in the United States. Of interest, the number of fellows or faculty does not affect significantly the quality or quantity of research productivity at top institutions.

Orthopaedic Sports Medicine Fellowship Directors Are Predominantly White Men With a High Degree of Research Productivity

PurposeTo determine the objective characteristics of fellowship directors (FDs) in orthopaedic sports medicine by focusing on the demographics, academic background, institutional history, research experience, and professional affiliations of FDs in this field. MethodsData was collected for each FD via institutional biographies or publicly available curriculum vitae (CV). The data collected for each FD included age, gender, race/ethnicity, previous training institutions, residency and fellowship graduation years, additional advanced degrees, military affiliation, institutional loyalty, year hired by current institution, career timeline, Scopus H-index, number of publications, and total number of citations. ResultsOf the 88 FDs, 87 (98.9%) were male and 1 (1.1%) was female. The mean age for all FDs was 54.7 years (± 9.1 standard deviation). The majority of FDs were White (n = 80; 90.9%). The mean Scopus H-index, total number of publications, and total number of citations were 22.5 ± 16.6, 90.0 ± 91.6, and 2773.9 ± 3962.9, respectively. On average, it took 9.5 ± 7.3 years from fellowship graduation until FD appointment. Additionally, the mean number of years of employment or affiliation with the current institution was 17.2 ± 9.4, and the mean number of years in an FD role was 10.9 ± 9.3. ConclusionOrthopaedic sports medicine fellowship directors are largely distinguished by their high level of research productivity and accomplishment. Additionally, orthopaedic training pedigree seems to play a role in FD role attainment, with a handful of orthopaedic residency and sports medicine fellowship programs producing a large percentage of current FDs. Finally, FDs are overwhelmingly white males with little female or minority representation. Clinical RelevanceThis study outlines some of the most important characteristics among orthopaedic sports medicine fellowship directors and identifies racial and gender disparities within this population of leaders that may have detrimental effects on the field as a whole.

Status Quo: Trends in Diversity and Unique Traits Among Orthopaedic Sports Medicine Fellowship Directors.

Fellowship directors (FD) in sports medicine are distinguished leaders and mentors of trainees. There is little literature available regarding their demographics and unique factors and training that have allowed them to rise to their prominent positions. The goal of this study was to identify FDs' demographics, research output, and education with an emphasis on surveying the diversity in these leadership positions. The Accreditation Council for Graduate Medical Education Public Accreditation Data System was used to identify all accredited and active orthopaedic sports medicine fellowship positions for 2019 to 2020. Primary data points for the FDs included race/ethnicity, age, sex, residency and fellowship training institutions, year of fellowship completion, year of hire at the current institution, year of FD appointment, and H-index. Student t-tests were used to compare FDs who trained at their current institution versus those who did not. Significance was set at P < 0.05. The 87 active sports medicine fellowship programs surveyed were led by 86 FDs and 2 co-FDs. One (1.1%) FD was female, whereas 87 (98.9%) were male. The mean age of the 88 total FDs was 54.5 years (n = 81). FDs were predominantly White (n = 75, 85.2%), followed by Asian American (n = 6, 6.8%), African American (n = 3, 3.4%), Middle Eastern (n = 3, 3.4%), and then Hispanic/Latino (n = 1, 1.1%). Certain associations were observed between FDs' residency and fellowship and future leadership positions. The most frequently reported training locations were Hospital for Special Surgery (residency, N = 10) and the Steadman Clinic (Vail) (fellowship, N = 10). The mean H-index was 22.33 ± 16.88, and FDs leading the fellowship where they trained had significantly lower mean H-indices than FDs who were not (12.57 ± 12.57 versus 24.85 ± 17.56, respectively) (P = 0.02). More diversity is possible among sports medicine FDs, who are prominent leaders. Moreover, certain programs are associated with producing a greater number of FDs.

Research Productivity of Orthopaedic Sports Medicine Fellowship Programs in the United States

PurposeTo survey orthopaedic sports medicine fellowship program directors to determine the current research productivity of both fellows and faculty in Accreditation Council for Graduate Medical Education–accredited orthopaedic sports medicine fellowship programs in the United States.MethodsAn anonymous 18-question survey was distributed via e-mail to all 95 Accreditation Council for Graduate Medical Education–accredited orthopaedic sports medicine fellowship program directors in the United States. Descriptive statistics were used for data analysis. Questions included whether fellows are required to complete a certain number of projects during their fellowship year and whether fellows have protected research time.ResultsOf the programs, 31 (33%) responded to the survey. Twenty-four programs (80%) require fellows to complete 1 to 4 projects. Twenty-one programs (71%) provide 4 to 8 hours of weekly protected research time. Twenty-four programs (77%) publish 1 to 2 manuscripts per fellow during the fellowship. Twenty-two programs (71%) have fellows work on 1 to 2 projects at a time. Annually, 26 programs (84%) give 0 to 5 podium presentations, 24 (80%) present 0 to 5 posters, and 15 (48%) report 0 to 5 publications. Twenty-four programs (77%) have research fellows and/or assistants to help with research. The presence of dedicated research assistants and more than 25 annual fellowship program publications were found to be useful screening data for more than 2 and more than 4 average publications per fellow, respectively.ConclusionsThe research productivity of orthopaedic sports medicine fellowship programs may be an important consideration for applicants. Applicants who desire to be productive in research during their fellowship year should consider programs with dedicated research assistants and/or programs that publish more than 25 times annually.Clinical RelevanceThis is a descriptive epidemiologic study that helps define the research productivity landscape in orthopaedic sports medicine fellowships. A more accurate understanding of sports medicine fellowship research experience may facilitate a better match between a program’s research expectations and an applicant’s research interests.

Variety and Complexity of Surgical Exposure, Operative Autonomy, and Program Reputation Are Important Factors for Orthopaedic Sports Medicine Fellowship Applicants

PurposeTo identify the factors considered most important by sports medicine fellowship applicants when deciding where to apply and ultimately interview.MethodsAn anonymous, electronic survey was distributed in 2018 via e-mail to orthopaedic surgery residents who applied to a specific orthopaedic sports medicine fellowship program in 2015 and 2016. The survey included questions regarding the number of fellowships applications per respondent and the number of interviews they were offered and accepted. Questions regarding the application process were included. Participants also were asked to rank 9 criteria from most to least important (1 being most important; 9 being least important) when deciding where to apply or accept interviews. Each criterion’s score reflects its average ranking among respondents.ResultsAmong the 99 orthopaedic surgery residents applying to this fellowship program, 42 (42.4%) completed the survey. The factors considered most influential included variety and complexity of surgical exposure (2.16), autonomy (3.72), and reputation of faculty members (4.05). The factors considered least important were program size (7.21), job placement of past fellows (7.07), and geographic location (5.68).ConclusionsVariety and complexity of surgical exposure, operative autonomy, and program reputation were valued as the most important factors for orthopaedic surgery residents applying to sports medicine fellowship programs.Clinical RelevanceThe information obtained in this study may provide sports medicine fellowship programs and orthopaedic residents with a better understanding of factors that are considered to be important by sports medicine fellowship applicants. This will improve training for future sports medicine specialists, thus improving the care that they provide to their patients.

Orthopaedic Sports Medicine Fellowship Websites: Information Considered Most Important to Fellowship Applicants

IntroductionThe purpose of this study was to determine which components of sports medicine fellowships are most important to applicants when reviewing fellowship websites during the application process.MethodsAn anonymous survey was distributed to 492 fellowship applicants from the 2017-2018 and 2018-2019 cycles. The survey included questions about the importance of including components of fellow education, recruitment, and experience on program websites. The weighted average of responses determined each component’s rank, with 5 being “very important” and 1 being “not at all important.” Responses were analyzed by application cycle, current position, and sex using the Wilcoxon rank-sum test.ResultsSixty-five applicants participated in the survey and completed the demographics section, resulting in a 13.2% response rate. According to participants, the most important components to include on fellowship websites were exposure to advanced operative sports medicine techniques (weighted average, 4.62), complexity of cases performed (4.52), and number of cases performed (4.50). Analysis demonstrated statistically significant differences in opinion between application cycles for flexibility for conducting a remote interview (P = .0074), jobs obtained by previous fellows (P = .019), national rank of department (P = .021), program’s geographic location (P = .026), protected academic time (P = .038), current positions for criteria for fellows’ performance evaluations (P = .028), program’s geographic location (P = .0097), and protected academic time (P = .0079). There were statistically significant differences in opinion between current positions regarding flexibility for conducting a remote interview (P = .0026), jobs obtained by previous fellows (P = .012), and national rank of department (P = .0013).ConclusionsOrthopaedic sports medicine fellowship applicants believe that it is most important to include information about the volume and complexity of fellows’ cases and their day-to-day commitments on program websites.Clinical RelevanceThis information would enable applicants to identify programs that will support professional development and allow program directors to communicate expectations.

In Response to COVID-19: Current Trends in Orthopaedic Surgery Sports Medicine Fellowships.

Background:The COVID-19 (SARS-COV-2) pandemic has brought unprecedented challenges to the health care system and education models. The reduction in case volume, transition to remote learning, lack of sports coverage opportunities, and decreased clinical interactions have had an immediate effect on orthopaedic sports medicine fellowship programs.Purpose/Hypothesis:Our purpose was to gauge the response to the pandemic from a sports medicine fellowship education perspective. We hypothesized that (1) the COVID-19 pandemic has caused a significant change in training programs, (2) in-person surgical skills training and didactic learning would be substituted with virtual learning, and (3) hands-on surgical training and case numbers would decrease and the percentage of fellows graduating with skill levels commensurate with graduation would decrease.Study Design:Cross-sectional study.Methods:In May 2020, a survey was sent to the fellowship directors of all 90 orthopaedic sports medicine fellowships accredited by the Accreditation Council for Graduate Medical Education; it included questions on program characteristics, educational lectures, and surgical skills. A total of 37 completed surveys (41%) were returned, all of which were deidentified. Responses were compiled and saved on a closed, protected institutional server.Results:In a majority of responding programs (89%), fellows continued to participate in the operating room. Fellows continued with in-person clinical visits in 65% of programs, while 51% had their fellows participate in telehealth visits. Fellows were “redeployed” to help triage and assist with off-service needs in 21% of programs compared with 65% of resident programs having residents rotate off service. Regarding virtual education, 78% of programs have used or are planning to use platforms offered by medical societies, and 49% have used or are planning to use third-party independent education platforms. Of the 37 programs, 30 reported no in-person lectures or meetings, and there was a sharp decline in the number of programs participating in cadaver laboratories (n = 10; 27%) and industry courses (n = 6; 16%).Conclusion:Virtual didactic and surgical education and training as well as telehealth will play a larger role in the coming year than in the past. There are effects to fellows’ exposure to sports coverage and employment opportunities. The biggest challenge will be how to maintain the element of human interaction and connect with patients and trainees at a time when social distancing is needed to curb the spread of COVID-19.

Characteristics of Orthopaedic Sports Medicine Fellowship Directors.

Background:No study in the orthopaedic literature has analyzed the demographic characteristics or surgical training of sports medicine fellowship directors (FDs). Objective determinations as to what makes a physician qualified for this leadership position remain unclear; thus, it is important to identify these qualities as future physicians look to fill these roles.Purpose:To illustrate characteristics common among sports medicine FDs.Study Design:Cross-sectional study.Methods:The 2020 Accreditation Council for Graduate Medical Education Fellowship Directory was used to identify the FDs for all orthopaedic sports medicine fellowship programs in the United States. The characteristics and educational background data for FDs were gathered by 2 independent reviewers from up-to-date curricula vitarum, Web of Science, and institutional biographies and consolidated into 1 database. Data points gathered included age, sex, residency/fellowship training location and graduation year, name of current institution, length of time at current institution, time since training completion until being appointed FD, length of time in current FD role, and personal research H-index.Results:We identified 90 current orthopaedic sports medicine FDs. The mean Scopus H-index was 24.1 (median, 17). The mean age of FDs was 55.4 years; 87 of 90 (96.7%) were male and 3 (3.3%) were female; and 79/90 (87.8%) were White and 3/90 (3.3%) were African-American. The mean time to complete residency was 5.1 years (range, 5.0-6.0 years), and the most attended residency programs were the Hospital for Special Surgery (n = 9), the Harvard Combined Orthopaedic Residency Program (n = 5), and Duke University Medical Center (n = 4). The mean time required to complete a fellowship was 1.1 years (range, 1.0-2.0 years), and the fellowship programs that produced the most future FDs were the American Sports Medicine Institute (n = 11), the Steadman Hawkins Clinic (Vail) (n = 8), the Kerlan-Jobe Orthopaedic Clinic (n = 7), and the Hospital for Special Surgery (n = 7). The mean time from completion of fellowship to appointment as a FD was 12.8 years (range, 1-39 years).Conclusion:Women and minority groups are largely underrepresented among leadership positions in the field of orthopaedic sports medicine.