Category: Other Introduction/Purpose: Over the past three decades, the number of orthopaedic residency graduates pursuing subspecialty fellowship training has increased to over 90 percent. The percentage of advertised jobs requiring fellowship training has also increased to nearly 70 percent. As such, fellowship training has potential implications for both job availability and marketability. The purpose of this study was to evaluate job availability based on orthopaedic subspecialty in the United States. Methods: Job advertisements in 2019 were reviewed from the career center databases of the Journal of Bone and Joint Surgery, American Academy of Orthopaedic Surgeons as well as of individual orthopaedic subspecialty societies. Job listings were cross- referenced between databases to identify unique jobs within the United States, which were categorized by the orthopaedic subspecialty fellowship training required and by practice type (academic, private practice, hospital employed). To assess job availability, a ratio of applicants to job listings was calculated based on the number of matched candidates for nine subspecialty fellowships in 2019. Results: A total of 352 unique job listings were identified in 2019. Of the nine orthopaedic subspecialties, job availability was the highest for foot and ankle (1.1 applicants/job), adult reconstruction (2.0), and trauma (2.1). Job availability was lowest for sports medicine (6.3), shoulder and elbow (5.8), and oncology (5.7). (Figure 1) Across all subspecialties, hospital based jobs were most common (46.9%) compared to private practice (36.9%) and academic positions (16.2%). Within the foot and ankle subspecialty, private practice jobs were most common (45.8%) compared to hospital employed (43.8%) and academic positions (10.4%). Conclusion: Job availability for new fellowship graduates varies significantly based on orthopaedic subspecialty. At this time, subspecialists trained in foot and ankle, adult reconstruction and trauma appear to be in greatest demand. The reason for the differences in demand is likely multifactorial, but could include changes in population demographics as well as the labor force for individual subspecialties. Our findings have important implications for orthopaedic residents pursuing fellowship training, who must weigh both personal interest and financial considerations in their subspecialty choice.
An Analysis of Orthopaedic Job Availability in the United States Based on Subspecialty