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Original Article| Volume 5, ISSUE 1, e129-e135, February 2023

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

Open AccessPublished:December 14, 2022DOI:https://doi.org/10.1016/j.asmr.2022.10.014

      Purpose

      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 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.

      Results

      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.

      Conclusions

      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.

      Clinical Relevance

      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.
      Orthopaedic surgery is one of the most competitive fields in medicine, with a match rate of approximately 67%.
      • Schrock J.B.
      • Kraeutler M.J.
      • Dayton M.R.
      • McCarty E.C.
      A comparison of matched and unmatched orthopaedic surgery residency applicants from 2006 to 2014: Data from the National Resident Matching Program.
      Over the past 2 decades, there has been a significant trend toward fellowship training and subspecialization in orthopaedic surgery in the United States.
      • Horst P.K.
      • Choo K.
      • Bharucha N.
      • Vail T.P.
      Graduates of orthopaedic residency training are increasingly subspecialized: A review of the American Board of Orthopaedic Surgery Part II Database.
      • Mannava S.
      • Jinnah A.H.
      • Cinque M.E.
      • et al.
      An analysis of orthopaedic job trends in the United States over the past 30 years.
      • Morrell N.T.
      • Mercer D.M.
      • Moneim M.S.
      Trends in the orthopedic job market and the importance of fellowship subspecialty training.
      • Niesen M.C.
      • Wong J.
      • Ebramzadeh E.
      • et al.
      Orthopedic surgery fellowships: The effects of interviewing and how residents establish a rank list.
      • Oladeji L.O.
      • Pehler S.F.
      • Raley J.A.
      • Khoury J.G.
      • Ponce B.A.
      Is the orthopedic fellowship interview process broken? A survey of program directors and residents.
      Due to the advancements and variety of subspecialties within orthopaedic surgery, many residents pursue fellowships to learn advanced techniques, difficult procedures, and improve job opportunities.
      • Schrock J.B.
      • Kraeutler M.J.
      • Dayton M.R.
      • McCarty E.C.
      A comparison of matched and unmatched orthopaedic surgery residency applicants from 2006 to 2014: Data from the National Resident Matching Program.
      ,
      • Yin B.
      • Gandhi J.
      • Limpisvasti O.
      • Mohr K.
      • ElAttrache N.S.
      Impact of fellowship training on clinical practice of orthopaedic sports medicine.
      Of orthopaedic fellowships, sports medicine is the most popular subspecialty choice, with the highest number of fellowship positions.
      • Daniels A.H.
      • Grabel Z.
      • DiGiovanni C.W.
      ACGME Accreditation of Orthopaedic Surgery Subspecialty Fellowship Training Programs.
      • Li X.
      • Pagani N.
      • Curry E.J.
      • et al.
      Factors influencing resident satisfaction and fellowship selection in orthopaedic training programs: An American Orthopaedic Association North American Traveling Fellowship Project.
      • Mulcahey M.K.
      • Hayes M.K.
      • Smith C.M.
      • Kraeutler M.J.
      • Trojan J.D.
      • McCarty E.C.
      Outcomes in the orthopaedic sports medicine fellowship match, 2010-2017.
      As a consequence of its popularity, sports medicine fellowship programs are extremely competitive. Orthopaedic residents apply to a significantly greater number of sports medicine fellowship programs than other subspecialties.
      • Haislup B.D.
      • Kraeutler M.J.
      • Baweja R.
      • McCarty E.C.
      • Mulcahey M.K.
      Orthopaedic sports medicine fellowship interviews: Structure and organization of the interview day.
      • Wera G.D.
      • Eisinger S.
      • Oreluk H.
      • Cannada L.K.
      Trends in the orthopaedic surgery fellowship match 2013 to 2017.
      • Zeoli T.
      • Ashton M.L.
      • Brown S.M.
      • McCarty E.
      • Mulcahey M.K.
      The orthopaedic sports medicine fellowship application process: An analysis of the applicant experience.
      With the coronavirus disease 2019 pandemic, this competition was amplified by the introduction of virtual fellowship interviews, which allowed residents the freedom to apply to more programs and “attend” more interviews.
      • Clark S.C.
      • Kraeutler M.J.
      • McCarty E.C.
      • Mulcahey M.K.
      Virtual interviews for sports medicine fellowship positions save time and money but don’t replace in-person meetings.
      ,
      • Peebles L.A.
      • Kraeutler M.J.
      • Waterman B.R.
      • Sherman S.L.
      • Mulcahey M.K.
      The impact of COVID-19 on the orthopaedic sports medicine fellowship application process.
      Despite this, sports medicine fellowships have excellent match characteristics, with nearly 50% of applicants matching into their #1 ranked program.
      • Mulcahey M.K.
      • Hayes M.K.
      • Smith C.M.
      • Kraeutler M.J.
      • Trojan J.D.
      • McCarty E.C.
      Outcomes in the orthopaedic sports medicine fellowship match, 2010-2017.
      ,
      • Wera G.D.
      • Eisinger S.
      • Oreluk H.
      • Cannada L.K.
      Trends in the orthopaedic surgery fellowship match 2013 to 2017.
      ,
      • Ruddell J.H.
      • Eltorai A.E.M.
      • DePasse J.M.
      • et al.
      Trends in the orthopaedic surgery subspecialty fellowship match: Assessment of 2010 to 2017 applicant and program data.
      Several studies have investigated factors that orthopaedic fellowship program directors consider important when ranking applicants.
      • Haislup B.D.
      • Kraeutler M.J.
      • Baweja R.
      • McCarty E.C.
      • Mulcahey M.K.
      Orthopaedic sports medicine fellowship interviews: Structure and organization of the interview day.
      ,
      • Baweja R.
      • Kraeutler M.J.
      • Mulcahey M.K.
      • McCarty E.C.
      Determining the most important factors involved in ranking orthopaedic sports medicine fellowship applicants.
      • Grabowski G.
      • Walker J.W.
      Orthopaedic fellowship selection criteria: A survey of fellowship directors.
      • Sandhu K.P.
      • Simske N.M.
      • Young P.
      • Wilson N.M.
      • Cannada L.K.
      • Whiting P.S.
      Factors considered in ranking orthopaedic trauma fellowship applicants: A survey of program directors.
      However, despite the high number of orthopaedic sports medicine fellowship applicants and growing interest in the field, fellowship applicants’ attitudes and preferences toward programs are not well understood. The purpose of this study was 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. The authors hypothesized that there would be substantial agreement across former applicants regarding the top orthopaedic sports medicine fellowship programs.

      Methods

      Following approval from the institutional review board at the senior author’s (M.K.M) institution, an anonymous electronic survey was distributed via email in March and April of 2022 to all individuals who applied to one specific orthopaedic sports medicine fellowship program during the 2017-2018 through 2021-2022 application cycles. This date range provided an adequate sample size and was not expanded beyond 5 applicant cycles to reduce applicant recall bias and reflect current applicant rankings and application patterns. Applicants from the 2021-2022 cycle were contacted following the Match in April 2022. For individuals whose listed e-mail no longer worked, the survey was distributed via text message. After initial distribution, a follow-up e-mail/text message was distributed at 2 and 4 weeks to increase participation. The survey consisted of 13 questions (Appendix Table 1, available at www.arthroscopyjournal.org). 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. The survey included all 89 orthopaedic sports medicine fellowships accredited by the Accreditation Council for Graduate Medical Education during the 2021-2022 application cycle. 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. The total number of top-10 votes and average rating of each program were included as additional measures of perceived rank. Average rating was calculated by averaging the top-10 vote ranks each program received. A lower average rating indicates a program received higher rankings. Although respondents were only asked to rank their top-10 programs, the final rankings of the top-20 programs before and upon completion of the application cycle were calculated. Secondary outcomes included rates of applying to perceived top-10 programs, relative importance of different fellowship program aspects, and preferred type of practice. Descriptive statistics were used to analyze the data. Average ranking of fellowship program aspects was calculated as a weighted average of the applicants’ responses, where “1” was the most important and “9” was the least important.

      Results

      Seven-hundred sixty-one surveys were distributed with 107 applicants responding (14% response rate). Most of the respondents were applicants from the 2020-2021 cycle (35%). The respondents’ residency programs represented a relatively even geographic distribution across the 4 regions with slightly more respondents coming from the Northeast (n = 21, 29%) and Midwest (n = 24, 32%). Nearly 70% of applicants (n = 51) were aged 31-35 years (Table 1). Ninety percent of respondents were male (n = 66). The majority of respondents were White (n = 63, 85.1%).
      Table 1Demographic Information of the Survey Respondents
      DemographicsCountPercentage
      Application cycle
       2017-20182625.2%
       2018-20191211.7%
       2019-20202322.3%
       2020-20213635.0%
       2021-202265.8%
      Region
       Northeast2128.8%
       Midwest2432.9%
       South1419.2%
       West1419.2%
      Age, y
       <2500.0%
       26-3022.7%
       31-355169.9%
       36-401723.3%
       41-4534.1%
       46-5000.0%
       >5000.0%
      Sex
       Male6690.4%
       Female79.6%
       Transgender male00.0%
       Transgender female00.0%
       Gender binary nonconforming00.0%
       Other00.0%
       Prefer not to say00.0%
      Race/ethnicity
       White6385.1%
       Asian79.5%
       Native Hawaiian or Pacific Islander11.4%
       Other34.1%
       Black or African American00.0%
       Hispanic, Latino, or Spanish00.0%
       American Indian or Alaska Native00.0%
      When asked to rank what they considered to be the top-10 orthopaedic sports medicine fellowship programs in the United States before their application cycle, applicants voted the top programs to be (1) Steadman Philippon Research Institute (SPRI), (2) Rush University Medical Center (RUMC), and (3) Hospital for Special Surgery (HSS) (Table 2). SPRI received 71 top-10 votes (71/107, 66%) and had an average rating of 2.65 (±2.09). RUMC had 72 top-10 votes (72/107, 67%), but a slightly lower average rating of 3.26 (±2.62). HSS received 66 top-10 votes (66/107, 62%), with an average rating of 3.80 (±2.47).
      Table 2The Top-20 Orthopaedic Sports Medicine Fellowship Programs as Ranked by Fellowship Applicants Before Completion of Their Application Cycle
      Before Application Cycle
      RankProgramNo. Top 10 VotesAvg. RatingScore
      1Steadman Philippon Research Institute Program712.65593
      2Rush University Medical Center Program723.26557
      3Hospital for Special Surgery/Cornell Medical Center Program663.8475
      4Cedars-Sinai Kerlan-Jobe Orthopaedic Clinic Program564.87343
      5OrthoCarolina Sports Medicine, Shoulder & Elbow Program435.28246
      6American Sports Medicine Institute (St. Vincent’s) Program365.01216
      7University of Pittsburgh/UPMC Medical Education Program416.05203
      8Steadman Hawkins Clinic - Denver Program304.67190
      9Duke University Hospital Program386.52175
      10Steadman Hawkins Clinic of the Carolinas Program275.15158
      11Stanford Orthopaedic Sports Medicine Fellowship Program276.7116
      12University of Utah Program226.05109
      13Andrews Research and Education Foundation226.32103
      14Mayo Clinic (Rochester), College of Medicine Program206.0599
      15Mississippi Sports Medicine & Orthopaedic Center Program185.7894
      16University of Virginia Program216.7689
      17University of Connecticut Program176.0684
      18Massachusetts General Hospital/Harvard Medical School Program176.5376
      19University of California San Francisco Program176.5975
      20 (tie)Cleveland Clinic Foundation Sports Medicine Program197.6262
      20 (tie)University of Colorado Health Sciences Center Program177.3562
      NOTE. Ranks were determined by total score.
      When asked to rank the top-10 orthopaedic sports medicine fellowship programs in the United States upon completion of their application cycle, applicants still voted the top orthopaedic sports medicine fellowship programs to be: (1) SPRI, (2) RUMC, and (3) HSS (Table 3). There was a 33% decrease in voting for this question (only 592 votes vs 878 initially), so a natural decrease in number of top-10 votes and therefore total score for each program was expected. The top 10 programs remained the same, but with a slightly different order (Table 3). Eighteen of the top-20 programs remained in the top-20 upon completion of the application cycle. Voting remained relatively stable, as the top-10 programs had 54.7% of the votes before the application cycle and had 51.2% of the votes after the application cycle. Despite a decrease in voting for this question, 21 programs gained top-10 votes after completion of the application cycle.
      Table 3The Top-20 Orthopaedic Sports Medicine Fellowship Programs as Ranked by Fellowship Applicants Upon Completion of Their Application Cycle
      Upon Completion of Application Cycle
      RankProgramNo. Top 10 VotesAvg. RatingScore
      1Steadman Philippon Research Institute Program433.35329
      2Rush University Medical Center Program454.11310
      3Hospital for Special Surgery/Cornell Medical Center Program414.71258
      4OrthoCarolina Sports Medicine, Shoulder & Elbow Program315.55169
      5Cedars-Sinai Kerlan-Jobe Orthopaedic Clinic Program305.4168
      6American Sports Medicine Institute (St. Vincent's) Program254.56161
      7University of Pittsburgh/UPMC Medical Education Program245.25138
      8Steadman Hawkins Clinic of the Carolinas Program214.64132
      9Steadman Hawkins Clinic - Denver Program194.21129
      10Duke University Hospital Program246.54107
      11University of Utah Program164.8199
      12University of Colorado Health Sciences Center Program144.2195
      13Mississippi Sports Medicine & Orthopaedic Center Program155.1388
      14University of Virginia Program166.572
      15University of Connecticut Program146.2966
      16Stanford Orthopaedic Sports Medicine Fellowship Program146.563
      17University of California San Francisco Program105.753
      18Mayo Clinic (Rochester), College of Medicine Program107.535
      19Cleveland Clinic Foundation Sports Medicine Program97.2234
      20 (tie)The University of Texas Health Science Center at Houston Sports Medicine86.8733
      20 (tie)NYU Hospital for Joint Diseases86.8733
      NOTE. Ranks were determined by total score.
      Forty-three percent of applicants (43/99) applied to all of their perceived top-10 programs, with 67% of respondents (66/99) applying to at least 8 of their top-10 programs. Interestingly, 13 of 99 applicants (13%) applied to 4 or fewer of their top-10 programs. Of those who did not apply to all programs in their top-10, 43 of 46 (94%) applicants thought the program did not fit their preferences, and 21 of 46 (46%) thought they were not competitive for those programs. Nearly all of the applicants agreed/strongly agreed (70/71, 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, faculty members (average rating of 2.54 ± 1.51) and fellowship reputation (2.69 ± 1.84) were most likely to be ranked highest in importance (Table 4). Most applicants (62/74, 84%) applied to both academic and private practice programs. Interestingly, only 1 of 74 (1.4%) applicants applied exclusively to private practice programs, even though nearly 40% (29/73) wanted to or did go into private practice. Behind private practice, the next most popular options that applicants wanted to join or did join after fellowship were hospital-employed (n = 16, 21.9%) and academic medical centers (n = 15, 20.6%).
      Table 4Average Rankings of the Factors Considered Most Important by Applicants When Deciding to Which Fellowship Programs to Apply
      Factors Considered Most Important by Sports Medicine Fellowship ApplicantsAverage Ranking
      Faculty members2.54
      Reputation2.69
      Specific procedures performed3.2
      Location3.8
      Sports team coverage opportunities4.97
      Number of fellows6.24
      Private practice6.5
      Research opportunities6.72
      Academic hospital7.54
      NOTE. Average ranking is calculated as a weighted average of the applicants’ responses (“1” indicates the most important criterion; “9” indicates the least important criterion).

      Discussion

      Based on the results of our study, orthopaedic sports medicine fellowship applicants voted the top fellowship programs to be (1) SPRI, (2) RUMC, and (3) HSS, both before and following the application cycle. When asked to rank programs upon completion of the application cycle, each of the top-10 programs before the application cycle remained in the top-10 and 18 of the top-20 programs remained in the top-20. These findings suggest the application process does not have a substantial effect on how applicants perceive the top programs. When ranking fellowship program aspects, faculty members and fellowship reputation were most likely to be ranked highest in importance.
      Sports medicine is the most competitive subspecialty of the orthopaedic surgery fellowships, and these applicant rankings may give future applicants insight into which programs are considered top tier. From 1984 to 2014, orthopaedic job openings requiring fellowship training increased from 5% to 68%.
      • Mannava S.
      • Jinnah A.H.
      • Cinque M.E.
      • et al.
      An analysis of orthopaedic job trends in the United States over the past 30 years.
      In addition, sports medicine has the highest number of fellows per advertised jobs (6.3) of all orthopaedic subspecialities.
      • Chan J.Y.
      • Charlton T.P.
      • Thordarson D.B.
      Analysis of orthopaedic job availability in the United States based on subspecialty.
      Completing fellowships at top-tier programs will likely give graduates an advantage by making them more competitive for job opportunities in the future. For example, one study found that a majority of orthopaedic shoulder and elbow fellows believed completing a fellowship enhanced their job opportunities.
      • Chen A.Z.
      • Knudsen M.L.
      • Jobin C.M.
      • Levine W.N.
      Early career opportunities and practice characteristics of recent graduates of shoulder and elbow fellowship programs.
      Our study demonstrated that orthopaedic sports medicine fellowship applicants find faculty members and fellowship reputation to be the most important factors when deciding to which programs to apply. This finding is supported by previous studies,
      • Niesen M.C.
      • Wong J.
      • Ebramzadeh E.
      • et al.
      Orthopedic surgery fellowships: The effects of interviewing and how residents establish a rank list.
      ,
      • Zeoli T.
      • Ashton M.L.
      • Brown S.M.
      • McCarty E.
      • Mulcahey M.K.
      The orthopaedic sports medicine fellowship application process: An analysis of the applicant experience.
      which found that orthopaedic surgery residents applying to fellowship programs value faculty and staff member personalities more than other factors when choosing a program. Previous literature regarding the importance of program reputation to applicants has provided mixed conclusions. In contrast with our findings, Zeoli et al.
      • Zeoli T.
      • Ashton M.L.
      • Brown S.M.
      • McCarty E.
      • Mulcahey M.K.
      The orthopaedic sports medicine fellowship application process: An analysis of the applicant experience.
      reported that although many orthopaedic sports medicine fellowship applicants ranked program reputation as very/extremely important, it was not considered a top 3 factor when forming an impression of a program. In 2021, Oser et al.
      • Oser F.J.
      • Grimsley B.M.
      • Swinford A.J.
      • Brown S.M.
      • Mulcahey M.K.
      Variety and complexity of surgical exposure, operative autonomy, and program reputation are important factors for orthopaedic sports medicine fellowship applicants.
      found that sports medicine fellowship applicants viewed reputation of faculty members as one of the most important factors whereas program prestige was ranked with moderate importance. Li et al.
      • Li X.
      • Pagani N.
      • Curry E.J.
      • et al.
      Factors influencing resident satisfaction and fellowship selection in orthopaedic training programs: An American Orthopaedic Association North American Traveling Fellowship Project.
      reported that orthopaedic fellowship applicants of all subspecialities ranked overall program reputation as more important than faculty and staff reputation. In our study, “reputation” was listed as one factor and was not segregated into program and faculty reputations. It is possible that survey respondents viewed reputation as more important in our study because they interpreted reputation to mean both overall program and faculty reputation. Interestingly, the majority of research shows that fellowship applicants find surgical case volume/complexity/variety to be the most important factor when ranking programs.
      • Niesen M.C.
      • Wong J.
      • Ebramzadeh E.
      • et al.
      Orthopedic surgery fellowships: The effects of interviewing and how residents establish a rank list.
      ,
      • Li X.
      • Pagani N.
      • Curry E.J.
      • et al.
      Factors influencing resident satisfaction and fellowship selection in orthopaedic training programs: An American Orthopaedic Association North American Traveling Fellowship Project.
      ,
      • Zeoli T.
      • Ashton M.L.
      • Brown S.M.
      • McCarty E.
      • Mulcahey M.K.
      The orthopaedic sports medicine fellowship application process: An analysis of the applicant experience.
      ,
      • Oser F.J.
      • Grimsley B.M.
      • Swinford A.J.
      • Brown S.M.
      • Mulcahey M.K.
      Variety and complexity of surgical exposure, operative autonomy, and program reputation are important factors for orthopaedic sports medicine fellowship applicants.
      Although “surgical volume and variety” was not a listed factor in our survey, the respondents in our study found “specific procedures performed” to be the third-most important factor.
      It has been previously reported that orthopaedic residents place less value on research opportunities when ranking orthopaedic surgery fellowships.
      • Niesen M.C.
      • Wong J.
      • Ebramzadeh E.
      • et al.
      Orthopedic surgery fellowships: The effects of interviewing and how residents establish a rank list.
      Our study demonstrated that sports medicine fellowship applicants find research opportunities less important when ranking programs. Despite this minimal interest in research opportunities, there has been an overall increase in the number of publications among sports medicine fellowship applicants over the last several academic years.
      • DeFroda S.F.
      • Shah K.N.
      • Safdar O.
      • Mulcahey M.K.
      Trends in research productivity of residents applying for orthopedic sports medicine fellowship.
      This would suggest that applicants might not actually value the research itself, but instead perform research to improve their competitiveness as an applicant. Mayfield et al.
      • Mayfield C.K.
      • Bolia I.K.
      • Ihn H.
      • et al.
      Evaluation of sports medicine fellowships in the United States based on academic productivity.
      sought to rank orthopaedic sports medicine fellowships in the United States based on academic productivity. The authors found the top-5 programs to be (1) HSS, (2) RUMC, (3) University of Pittsburgh Medical Center (UPMC), (4) Mayo Clinic (Rochester), and (5) Boston Children’s Hospital. Of interest, 5 of the top-10 academic programs from this study were also included on the top-10 list from our study. Thus, although not all applicants weigh research opportunities when ranking programs, they often find program reputation to be an important factor and programs gain reputation through their academic impact.
      Our study found faculty member interactions to be one of the most important factors to applicants when ranking a fellowship program and, unfortunately, virtual interviews offer limited opportunities to engage with faculty. A recent study by Clark et al.
      • Clark S.C.
      • Kraeutler M.J.
      • McCarty E.C.
      • Mulcahey M.K.
      Virtual interviews for sports medicine fellowship positions save time and money but don’t replace in-person meetings.
      found that 43% of applicants thought virtual interviews negatively affected their personal connections with the fellowship program. Given the elimination of the financial and time burden associated with interview travel over the last 2 application cycles with virtual interviews, it is possible that this method of fellowship interviews could emerge as the new standard.
      • Peebles L.A.
      • Kraeutler M.J.
      • Waterman B.R.
      • Sherman S.L.
      • Mulcahey M.K.
      The impact of COVID-19 on the orthopaedic sports medicine fellowship application process.
      ,
      • Kraeutler M.J.
      An applicant’s review of virtual fellowship interviews: The new norm?.
      With virtual interviews, residents can participate in more interviews, minimize time away from residency training, and save upwards of $5,000 or more on travel. Consequently, both program directors and applicants are in favor of having the option to interview virtually, which suggests they will likely continue to play a role in future application cycles.
      • Clark S.C.
      • Kraeutler M.J.
      • McCarty E.C.
      • Mulcahey M.K.
      Virtual interviews for sports medicine fellowship positions save time and money but don’t replace in-person meetings.
      ,
      • Peebles L.A.
      • Kraeutler M.J.
      • Waterman B.R.
      • Sherman S.L.
      • Mulcahey M.K.
      The impact of COVID-19 on the orthopaedic sports medicine fellowship application process.
      ,
      • Kraeutler M.J.
      An applicant’s review of virtual fellowship interviews: The new norm?.
      However, as a result of the limited personal interactions afforded by virtual interviews, it is often difficult for applicants to assess a program’s “feel,” sense of community, nonstaged interactions, and life outside of the hospital setting.
      • Peebles L.A.
      • Kraeutler M.J.
      • Waterman B.R.
      • Sherman S.L.
      • Mulcahey M.K.
      The impact of COVID-19 on the orthopaedic sports medicine fellowship application process.
      As a result, residents may need other ways, such as social media and fellowship program websites, to learn about these programs without being able to see them and meet faculty in-person. One potential solution is the creation of unofficial applicant rankings such as those listed in this study.

      Limitations

      There are several limitations to this study. Our survey had a relatively low response rate and, therefore, the results may not reflect the opinions of all current/previous orthopaedic sports medicine fellowship applicants. The survey was sent to all applicants of one particular fellowship program over the last 5 application cycles, and therefore there may be bias based on the location or other aspects of this program. Response bias plays a role in this study, as applicants who matched to fellowship programs not typically perceived as a top program may have been less likely to complete the survey. Also, this survey may be impacted by recall bias as applicants might incorrectly remember their exact attitudes and rank lists before and after the application cycle. Not every respondent completed all of the survey questions. Lastly, the list of important fellowship aspects was not exhaustive and may not have included every aspect of the sports medicine fellowship application process that applicants find important. Applicants may also rank factors differently depending on how they were interpreted.

      Conclusions

      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.

      Supplementary Data

      Appendix

      Appendix Table 1Complete List of Survey Questions
      Q1. In which application cycle did you participate?
      Responses: “2017-2018”, “2018-2019”, “2019-2020”, “2020-2021”, “2021-2022”
      Q2. Prior to completion of the application cycle, what did you consider to be the top-10 orthopaedic sports medicine fellowship programs in the United States, based on operative and nonoperative experience, faculty, game coverage, research, and work/life balance? Please rank your top-10 programs, with 1 being the best.
      Responses: N/A, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 for each ACGME accredited orthopaedic sports medicine fellowship program
      Q3. How many programs did you apply to in your top-10 list?
      Responses: 0, 1, 2, 3, 4, 5, 6, 7, 8, 9 ,10
      Q3a. Why did you not apply to all of the programs in your top-10 list?
      Responses: “Programs did not fit my preferences”, “I did not think I was competitive for these programs”, “Both”
      Q4. Upon completion of the application cycle, what did you consider to be the top-10 orthopaedic sports medicine fellowship programs in the United States, based on operative and nonoperative experience, faculty, game coverage, research, and work/life balance? Please rank your top-10 programs, with 1 being the best.
      Responses: N/A, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 for each ACGME accredited orthopaedic sports medicine fellowship program
      Q5. The personalities of the attendings I met on my interviews influenced my rank list decisions.
      Responses: “Strongly Agree”, “Agree”, “Neutral”, “Disagree”, “Strongly Disagree”
      Q6. Rank the following aspects of a fellowship program that were most important to you when deciding which programs to apply to with 1 being the most important and 9 being the least important.
      Responses: “Reputation”, “Location”, “Specific Procedures Performed”, “Faculty Members”, “Sports Team Coverage Opportunities”, “Research Opportunities”, “Private Practice”, “Academic Hospital”, “Number of Fellows”
      Q7. Did you apply to programs at an academic medical center or private practice institution?
      Responses: “Academic Medical Center”, “Private Practice”, “Both”
      Q8. Which type of practice do you want to join, or did you join after you have completed your fellowship?
      Responses: “Academic Medical Center”, “Private Practice”, “Academic Medical Center/Private Practice Blend ‘Privademic’”, “Hospital-Employed”, “Other (please specify)”
      Q9. In which region of the country is your residency program located?
      Responses: “Northeast – CT, MA, NH, NJ, NY, PA, RI, VT”, “Midwest – IN, IL, IA, KS, MI, MN, MO, NE, ND, OH, WI”, “South – AL, AR, DC, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA, WV”, “West – AZ, CA, CO, HI, NV, NM, OR, UT, WA”
      Q10. What is your age?
      Responses: “<25”, “26-30”, “31-35”, “36-40”, “41-45”, 46-50”, “>50”
      Q11. With which sex do you most identify?
      Responses: “Male”, “Female”, “Transgender Male”, “Transgender Female”, “Gender Binary Non-Conforming”, “Other”, “Prefer Not to Say”
      Q12. Are you of Hispanic, Latino, or Spanish origin?
      Responses: “Yes”, “No”
      Q13. How would yo

      u describe yourself? (Check all that apply)
      Responses: “White”, “Black or African American”, “American Indian or Alaska Native”, “Asian”, “Native Hawaiian or Pacific Islander”, “Other”

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