Trends in ACGME Accreditation of Orthopedic Surgery Fellowship Training

Jason Silvestre · Charles L. Nelson · Terry L. Thompson · James D. Kang

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Diversity and Career in Medicine Innovations in Medical Education Musculoskeletal Disorders and Rehabilitation

Abstract

Currently, most surgeons pursue subspecialty fellowship training. This study answers the following questions: (1) How does the rate of fellowship training in orthopedic surgery compare with that in other surgical specialties? (2) To what extent did adoption of Accreditation Council for Graduate Medical Education (ACGME) accreditation change from 2013 to 2021? Orthopedic subspecialties were analyzed for total number of fellowship programs and positions in the 2013 and 2021 Match. Rates of ACGME accreditation were analyzed via chi-square tests. In 2021, orthopedic surgery had the highest rate of fellowship selection (94%) relative to general surgery (77%), ophthalmology (66%), plastic surgery (63%), and otolaryngology (55%). Across all orthopedic subspecialties, the percentage of ACGME accreditation decreased among fellowship programs (53% in 2013 to 48% in 2021, P =.166) and positions (58% in 2013 to 50% in 2021, P <.001). Orthopedic sports medicine had the highest adoption of ACGME accreditation (100%), followed by hand surgery (99%), musculoskeletal oncology (67%), and pediatric orthopedics (56%). Significant increases in the adoption of ACGME accreditation were noted for orthopedic sports medicine (93% in 2013 to 100% in 2021, P =.016) and hand surgery (81% in 2013 to 99% in 2021, P <.001). There was a significant decrease in ACGME accreditation for adult reconstructive orthopedics (40% in 2013 to 24% in 2021, P =.042), driven by the increase in unaccredited fellowship programs. Accreditation of orthopedic subspecialty fellowship training has decreased with respect to the proportion of accredited training positions. More research is needed to understand the benefits of ACGME accreditation for fellowship training in orthopedic surgery. [ Orthopedics . 2024;47(1):57–63.]

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2015Graduates of Orthopaedic Residency Training Are Increasingly Subspecialized 2012Trends in the Orthopedic Job Market and the Importance of Fellowship Subspecialty Training 2014ACGME Accreditation of Orthopaedic Surgery Subspecialty Fellowship Training Programs 2019The Return on Investment of Orthopaedic Fellowship Training: A Ten-year Update 2017Factors Influencing Orthopedic Surgery Residents' Choice of Subspecialty Fellowship 2017Completion of Multiple Fellowships by Orthopedic Surgeons: Analysis of the American Board of Orthopaedic Surgery Certification Database 2019Future Demand for Total Joint Arthroplasty Drives Renewed Interest in Arthroplasty Fellowship

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