Abstract
BACKGROUND: The impact of medical school rank and other demographic and institutional factors on orthopaedic match outcomes remains incompletely understood. This study analyzed match outcomes, controlling for medical school rank, biological sex, geographic location, match year, and other medical school characteristics. METHODS: Residents who matched from 2020 to 2022 were identified. Medical school US News rankings and residency Doximity rankings were obtained and divided into tiers. Sex, match year, residency and medical school locations, and historically black college and university (HBCU), public, private, allopathic, and osteopathic medical school information was identified from program websites and social media. International students were excluded. Chi square testing, Spearman correlation, and univariate and multivariate logistic regression were performed. RESULTS: Two thousand five hundred twenty-nine residents in 191 programs were included. From bivariate analysis, there was no association between match year and residency rank (p = 0.909). HBCU data were insufficient. Private and public schools had no difference (p = 0.871). Orphan graduates had worse odds (odds ratio [OR] = 0.136, CI = 0.112, 0.166). When controlling for the other variables, orphan status was insignificant (p = 0.0971). Relative to schools ranked 1 to 23, schools ranked 24 to 46 (AOR = 0.641, CI = 0.465, 0.882), 47 to 69 (adjusted odds ratio [AOR] = 0.0.336, CI = 0.246, 0.459), 70 to 93 (AOR = 0.310, CI = 0.222, 0.435), 95 to 124 (AOR = 0.156, CI = 0.106, 0.230), and unranked (AOR = 0.157, CI = 0.113, 0.217) resulted in worse odds of matching into higher-ranked residencies. Female (AOR = 1.59, CI = 1.33, 1.93) and allopathic students (AOR = 23.6, 16.4, 34.0) had better odds. Students who attended school in the same city as their residency program had better odds (AOR = 1.46), while those who attended school in a different city in the same state had worse (AOR = 0.694, CI = 0.575, 0.836). CONCLUSIONS: Female sex, medical school rank and location, and allopathic degree impact matching into a higher-ranked orthopaedic residency. LEVEL OF EVIDENCE: Nonclinical, No Level.