Applying to Orthopaedic Residency: How Is An Applicant's Parental Background Associated With Opportunity Equity?

Objective: To investigate relationships between orthopaedic residency applicants' parental educational attainment/occupations and their 1) demographic characteristics; 2) educational debt and scholarship funding; 3) medical school characteristics; 4) reported research, volunteer, and work experiences; and 5) match success.

Design: We analyzed Association of American Medical Colleges data for 10,697 applicants to orthopaedic surgery residency in the US from 2011 to 2021. Parental education was categorized as doctorate, master's, bachelor's, or no college degree, and the highest level was used. Parental occupation was categorized as physician, healthcare, working class, and STEMM (science, technology, engineering, mathematics, medicine) field. We analyzed applicant age, gender, and race/ethnicity; educational debt and scholarship funding; attendance at a private or top-40 NIH-funded medical school; number of research, work, and volunteer experiences reported in the Electronic Residency Application Service; and residency match success. Chi-squared and Student t-tests were used to assess differences between groups. Alpha = 0.05.

Results: Of the 19% of applicants who had a physician parent, 11% identified as underrepresented minorities compared with 15% of those without a physician parent (p = 0.004). Applicants with a parent holding a doctorate had less educational debt ($114,000 vs. $205,000, p < 0.001) and received less scholarship funding ($27,000 vs. $43,000, p < 0.001) than those whose parents had no college degree. A larger proportion of applicants with a STEMM parent (33%) attended a top-40 NIH-funded medical school compared with those without (30%) (p = 0.004). Applicants with a doctorate-holding parent reported more research and fewer work experiences (p < 0.001) and had a higher match rate (76% vs. 71%, p = 0.02) compared with applicants whose parents held no college degree.

Discussion: Among US orthopaedic surgery residency applicants, parental educational attainment was associated with differences in educational debt, extracurricular experiences, and match success. These findings underscore the need to support equitable opportunities for all aspiring orthopaedic surgeons.