• Adam Y Nasreddine and Robert Gallo.
• Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut.
• J Bone Joint Surg Am. 2019 Dec 18; 101 (24): e134.

BackgroundThe competitiveness of orthopaedics and recent changes in the residency application process have resulted in increased costs to both applicants and programs. Our purpose was to investigate changes in the orthopaedic residency application process between 1992 and 2017. Also, we aimed to determine an ideal number of applications that each student can submit without jeopardizing his or her probability of matching into an orthopaedic residency slot while concurrently reducing the excessive number of applications that are received by program selection committees.MethodsRetrospective data from both the Electronic Residency Application Service (ERAS) and the National Resident Matching Program (NRMP) were collected and analyzed for changes in the characteristics of applications, applicants, and programs over the study period. Using these data, the probability of matching into orthopaedics through the years was calculated and compared in order to propose an ideal number of applications for a medical student to submit to match into an orthopaedic residency.ResultsOver the study period of 25 years, there has been an increase in the number of residency positions offered and a decrease in the number of applicants per offered position among U.S. senior medical students. Nonetheless, the average number of submitted applications per applicant significantly increased from 1992 to 2017, from 28 to 80 applications (p < 0.001). As a result, the overall costs to apply and review applications also have increased. There was no association between the increased number of submitted applications and the match rate. Our analysis showed that 50 applications per student offer is the most effective option without compromising the overall applicant match rate.ConclusionsBased on these data, we suggest encouraging students to limit the number of applications that they submit. This limit could reduce the cost for both applicants and programs while likely maintaining the current match rate and competitiveness of the specialty.

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