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Characteristics of Hand Fellowship Applicants: An Analysis of Two Institutions
Ryan Edward Rebowe, MD1; Lindsay Beth Allred, MD1; Zhongyu Li, MD, PhD1; A Lee Osterman, MD2; Ethan R Wiesler, MD1
1Wake Forest University Baptist Medical Center, Winston-Salem, NC, 2The Philadelphia Hand Center, King of Prussia, PA

Background: Fellowships in Hand Surgery are very competitive. In 2016, there were 199 applicants for 166 positions in 82 programs. With the surplus of candidates, each applicant struggles to make himself/herself more attractive while each program must diligently evaluate this abundance of candidates. Literature regarding characteristics possessed by applicants is extremely limited. In this institutional collaboration, we sought to understand who is applying and which applicants are matching to the hand fellowship programs in 2016.
Methods: Applications to the Wake Forest School of Medicine and The Philadelphia Hand Center Hand and Upper Extremity Fellowship programs were reviewed in their entirety. Demographic and academic data were collected including the United States Medical Licensing Exam (USMLE) Step 1 score, number of publications, number of presentations, and number of honors and awards listed, and membership in Alpha Omega Alpha. Research experience, extracurricular activities, and work experience was reported inconsistently and was not recorded.
Results: 141 of the 199 (71%) candidates for the 2016 appointment year were reviewed between the two institutions. 119 (84.4%) of the applicants trained in orthopedic surgery, while 21 (14.9%) applicants trained in plastic surgery, and 1 (0.7%) candidate trained in general surgery. 113 (80%) candidates were male and 28 (20%) were female. 103 (73%) of the applicants were white and 38 (27%) were non-white. The average USMLE Step 1 score was 239.7(14.6). Each candidate listed an average of 5.5(4.4) honors and awards. 54 (38.3%) of the candidates were Alpha Omega Alpha members. Candidates averaged 5.5(5.3) total publications including 4.1(4.6) published peer reviewed articles or book chapters and 1.4(1.8) works submitted for publication. Candidates averaged 7.8(8.2) presentations including 4.2(5.7) national presentations, 1.3(2.0) regional presentations, and 2.3(3.4) institutional presentations. In comparison, the 5 unmatched applicants had an average Step 1 score of 224(Range 197-256), 4.4 (Range 0-10) honors and awards, and only 1 (20%) was inducted into AOA. These applicants averaged 5.4 (Range 0-12) publications and 11 total presentations (Range 1-19).
Conclusion: Matched applicants tended to have higher Step 1 scores, more honors and awards, and were more likely to be AOA members. Unmatched applicants did not differ in number of publications and averaged more publications than matched applicants. The majority of applicants are white males; however the proportion that are women and/or minorities is comparable to other specialties. In the future, additional information may be obtained by a complete review of all hand surgery applicants.


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