Background: Orthopaedic residency programs lack gender and race
diversity. This study examines the hypothesis that exposure to a required
course in musculoskeletal medicine in medical school is associated with a
higher rate of application to orthopaedic surgery residency programs by
Methods: All 122 medical schools in the United States were surveyed
in 2001 to determine whether they required dedicated course work in
musculoskeletal medicine, defined as a preclinical module or clinical
clerkship in orthopaedic surgery, rheumatology, or physiatry. Data from the
Electronic Residency Application Service were obtained for the class of 2002.
From these two sources, the rate of applications from students to orthopaedic
surgery residency programs was calculated as a function of exposure to a
required course in musculoskeletal medicine. Subgroup analysis was further
carried out for women and for African Americans, Latinos, and Native
Results: In 2002, there were 16,294 graduates of American medical
schools, of whom approximately 55% had mandatory instruction in
musculoskeletal medicine. The rate of application to orthopaedic surgery
residency programs was 5.7% among the students with required instruction
compared with a rate of 5.1% for students without such required instruction.
The rate of application for female students was 2.0% for those who had
required courses and 1.1% for the female students who had not had the required
courses. The rate of application for minority students in schools with
required courses was 8.2% compared with a rate of 6.1% for those students
without such exposure.
Conclusions: Required instruction in musculoskeletal medicine was
associated with a 12% higher rate of application to orthopaedic surgery
residency programs among all students (5.7% of those who received required
instruction compared with 5.1% of those who did not). The relative difference
was more pronounced among women (a 75% difference in the rate of application)
and minorities (a 35% difference in the rate of application). This study
suggests that required instruction in musculoskeletal medicine can help to
promote diversity in orthopaedic surgery residency programs.