According to ACGME statistics, 640 residents complete orthopaedic residency training each year, and approximately 90% pursue fellowship training.
The Orthopaedic Foot & Ankle Fellowship Program Match, sponsored by the American Orthopaedic Foot & Ankle Society (AOFAS), is designed to be a transparent, unbiased process in which applicants are matched to foot and ankle fellowship programs on a competitive basis. Participation in the match requires graduation from an allopathic or osteopathic medical school; a fellowship position is dependent upon successful completion of an approved orthopaedic surgery residency program.
In 2016, 46 fellowship programs participated in the AOFAS-sponsored Orthopaedic Foot & Ankle Fellowship Match Program, and 74 positions were offered. A total of 62 applicants submitted rank lists. On Match Day, 56 of the slots were matched. Of the 52 US/Canadian applicants submitting rank lists, 100% matched on match day. Of the 8 international medical graduates who submitted rank lists, 2 matched on match day and 4 more matched in the post-match scramble.
Unlike orthopaedic residencies, most orthopaedic subspecialty fellowship programs are not ACGME-accredited. This is not a reflection of educational standards, but rather may be due in part to the strict requirements for ACGME accreditation and the effect that the accreditation status has on a program’s ability to organize and fund their fellowships.
Considerations when choosing an Orthopaedic Foot & Ankle Fellowship Program
Orthopaedic foot and ankle fellowship programs in the match are one year in length, generally from August 1 to July 31, with the exception of one program that currently offers a six-month fellowship. Some programs have one attending surgeon as mentor and one fellow, while other programs have multiple attendings and up to three fellows.
Some fellowships are affiliated with residency programs, and this offers opportunities for teaching and sharing the workload but also requires sharing the clinical experience. In fellowship programs that are not affiliated with residency programs, the fellow may function as the primary doctor for inpatient and/or emergency department care. This type of clinical setting often employs physician extenders, including physician assistants.
In ACGME-accredited programs, the fellow does not have the ability to bill or operate independently. Some non-ACGME accredited fellowship programs offer what is referred to as an “advanced clinical experience” and the fellow has the privileges of an attending surgeon and may take call, run a clinic, and/or operate and bill independently.
Research opportunities vary widely among programs. Clinical research opportunities, such as reporting a case series of a specific diagnosis or procedure, are often encouraged. Programs with basic science facilities may present other research options. Many programs have a formal requirement to complete at least one manuscript for publication during the year. In some programs, a fellow may be asked to author a review paper or book chapter.
Programs vary widely in their exposure to lower extremity trauma, and it is important to ask about this during the interview. Some programs are affiliated with one or more trauma centers and this experience is an integral part of the fellowship training. Other programs offer exposure to “cold trauma,” with delayed treatment of fractures, while still other programs focus on elective reconstruction cases and are not involved with trauma surgery.
The potential for call responsibilities should also be considered. Does the fellow cover urgent phone calls after hours? Does the fellow take general emergency department call as part of the fellowship program? How busy is the emergency department? Does the facility have a Level I or II trauma designation? Who has ultimate responsibility for patients treated by the fellow on call?
Location of the program is another important consideration. Some programs are in major metropolitan centers, and others are located in suburban or even rural areas. Patient populations and pathologies will vary depending on the location. There will also be differences in living expenses and lifestyles based on the location of the program. Some programs offer housing or subsidized housing so inquire about this during the interview.
Some fellowship programs provide opportunities to learn the “business” of medicine, and others may provide exposure to administrative or academic experiences. Ask about these opportunities during the interview.
Basic salary and benefits information is provided to AOFAS and is included on the Program Profile document. Salary and benefits will vary with each program and should be discussed during the interview process.
All programs should be willing to provide contact information for their former fellows. This can be a great resource so do not hesitate to contact a program’s former fellows as they were standing in your shoes just a few years earlier.
Tips for the Orthopaedic Fellowship Match Webinar
Tuesday, August 23, 2016
7:15 pm CT
interactive webinar open to all residents wanting to learn more about the match. The webinar is hosted by Brian Wolf, MD, Chair, BOS Fellowship Match Oversight Committee and the webinar faculty includes Fellowship Directors, a representative from the SF Match Matching Service and recent participants in the match process. Webinar participants will learn the history of the match, helpful match statistics for each subspecialty match for the past 4 years, tips from program directors’ and information on what to look for in choosing a fellowship. The participants will learn questions to ask when choosing a program and also have a chance to email questions to the faculty on the webinar. 2016 webinar recording
with any webinar questions.
International Medical Graduates
International (non US/Canada) medical graduate applicants must have completed the USMLE and be certified by the ECFMG to be eligible to participate in the SF match. The Program Profile identifies programs that accept international applicants as full fellows. Some programs offer research/observer positions outside the match and this may be of interest to some international medical graduates.
The Application and Interview Process
San Francisco Matching Service (SF Match (www.sfmatch.org
) administers the application receipt and distribution process as well as the match process and administration of the rank lists. The AOFAS offers special benefits to fellows who obtain their positions through the match or after match day from a program that participated in the match. Benefits include being listed on the AOFAS website as having completed an orthopaedic foot and ankle fellowship, free AOFAS membership with a subscription to Foot & Ankle International
during the fellowship year, and a 50% discount on AOFAS Candidate Membership dues during the first year of practice following completion of fellowship training. Fellows who accept a position from a program outside the match do not receive these benefits.
Program directors, faculty, and applicants are expected to conduct themselves in an ethical and courteous manner. This includes the timing of interview invitations scheduled by programs and cancellation of interviews by applicants.
Residents may visit programs ahead of the interview season for the purpose of learning more about foot and ankle and solidifying foot and ankle as their choice of sub-specialty. These visits, however, should be resident (and not fellowship program) initiated and should NOT constitute NOR substitute for the interview (nor should it be a guarantee of an interview or be used as a gateway for such). The program should not require this sort of visit or promise any preferential treatment in exchange for a visit.
To keep the match process as fair as possible for both applicants and programs, contact following interviews is limited. Programs are not allowed to contact applicants individually at any time after the formal interview but may send identical written communication to all applicants. Applicants may contact a program following an interview if any questions arise, such as salary, research, etc. Routine logistical questions may be answered by phone by the fellowship coordinator but if any questions are directed to fellowship faculty, the answers will need to be provided in written form to all applicants to that program. Programs are not permitted to discuss rank lists with applicants.
If an applicant is interviewed by phone, over the internet (Skype), or at another venue such as the AAOS annual meeting and then decides that visiting the program in person would be beneficial to his/her decision-making process, this subsequent visit would be considered the formal interview. After this interview, no oral communication with fellowship faculty may take place. Again, no discussion of ranking or pressure on an applicant to discuss ranking is permitted at any time.