A “Pathological Optimist’s View of the Residency Application Process

By Elizabeth Hofheinz, M.P.H., M.Ed., December 27, 2019 One joint preservation surgeon isn’t so interested in residency candidates who have nothing but orthopedic surgery on their minds. “I just interviewed 30 residency applicants today—the excitement and the anxiety were palpable. It is so amazingly difficult to be admitted to a program these days. Numerous applicants are trying to distinguish themselves by taking a year to conduct research prior to applying. Along with radiology and dermatology, orthopedic surgery is the most competitive specialty. I think it’s because the word is out that it is a great field that nicely blends clinical work, surgical workload, patient care, and research. There is something for everyone.” And part of that “everyone” is an increasing number of female applications, says this surgeon. “I’m a pathological optimist,” he says. “I believe there is room for every type of person in this specialty. This is truly great, and it is a wonderful specialty for all applicants. Historically it has been a very male dominated field, but I truly believe all genders can excel and enjoy orthopaedic surgery.” “There is research showing that increasing the number of female orthopedic faculty and residents is associated with a greater likelihood that female medical students would apply for an orthopedic residency. I believe although progress is slow in this area, we are improving.” And how does someone rise to the top? “I am not interested in someone who lives, eats, and breathes orthopedic surgery. It is important that candidates are well-rounded, for example, they have held jobs prior to applying for residency or they have played team sports. In this recent round, I met a competitive pianist and a competitive fly fisherman. The point is to demonstrate dedication to something no matter what it is…that shows drive. I worry that once someone who is too ‘narrow’ gets into the program then the expectations will be overwhelming and he or she will have nothing to fall back on.” “Aspiring orthopedic surgeons want to train at a place where they are taught how to operate; many are concerned that they will not get operative experience. It would be interesting to do a study to see if surgical outcomes are superior in trainees who have gone through an operative residency versus those who have not.” This need to conduct research as a prerequisite to an orthopedic surgery residency is new, says this surgeon. “I have met prospective residents who have already done 20 research papers! This is becoming the primary way of distancing oneself from the pack. In addition, demonstrating your willingness and capability to do research helps you obtain a mentor. Some students spend a year doing bench research or chart reviews in order to prove that they belong. And even though it can feel like busywork at times, it does show a desire to work hard and pay one’s dues.” To those vetting residents, this doctor advises, “Look for individuals who are not necessarily similar to you but have your work ethic. You want to enhance and enrich your program, so it is important to select the most qualified applicant—regardless of background.”

A “Pathological Optimist’s View of the Residency Application Process

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