Acquisition of Medical Knowledge Varies During Allopathic and Osteopathic Orthopedic Surgery Residency Training

Abstract

Currently, little is known about the differences in medical knowledge acquisition between osteopathic and allopathic orthopedic surgery residents. The purpose of this study was to determine the relationship between Orthopaedic In-Training Examination (OITE) performance and training pathway in orthopedic surgery. This was a retrospective cohort study of all orthopedic surgery residents taking the OITE during the 2019–2020 academic year. Comparisons in OITE performance were made with parametric tests. A total of 4407 orthopedic surgery residents were in allopathic (86%) and osteopathic (14%) training programs. There was significant improvement in OITE performance between subsequent postgraduate year (PGY) levels among allopathic residents ( P <.001). Among osteopathic residents, OITE performance increased between PGY1 and PGY4 ( P <.001) but plateaued between PGY4 and PGY5 ( P >.05). At the PGY1 level, osteopathic residents had higher OITE performance than allopathic residents ( P <.001), but scores were equivalent at the PGY2 to PGY4 levels ( P >.05). At the PGY5 level, allopathic residents had higher OITE performance than osteopathic residents ( P <.001). Allopathic medical students scored higher on the Step 1 (248±19 vs 242±17, P <.001) and Step 2 (255±16 vs 250±15, P <.001) board examinations. Medical knowledge increases during orthopedic surgery residency. Disparities exist by training pathway, with osteopathic residents outperforming allopathic residents at the PGY1 level but then underperforming at the PGY5 level. Ultimately, this study provides insights into how resident promotion and training pathway impacts the acquisition of medical knowledge during orthopedic surgery residency. [ Orthopedics . 2023;46(6):379–383.]