Introduction The year 2020 marked the first year in which a match under single accreditation took place. Both osteopathic (DO) and allopathic (MD) students would participate in the first match cycle without a dedicated DO match system. Our primary objective was to investigate how single accreditation has impacted the DO applicants attempting to match into surgical specialties. Our secondary objective was to investigate the impact of single accreditation at the program director (PD) level and whether or not this process would see a change in DO PD distribution in previously American Osteopathic Association (AOA)-approved programs. Method Information on number of applicants and post-match positions was gathered from AOA and National Residency Match Program (NRMP) websites. Credentials of PDs were obtained from the Accreditation Council on Graduate Medical Education website. Based on the available data, the following surgical specialties were compared for the years 2020, 2018, and 2016: General Surgery, Neurological Surgery (NSGY), Orthopedic Surgery, Otolaryngology/ENT (ENT), Plastic Surgery, and Thoracic Surgery. Data from 2016 were not included in the results as the AOA match results analysis was insufficient and unable to be directly compared to the NRMP data. Results of matched DO and MD applicants were compared using bivariate analysis. A p-value of <0.05 was considered significant. Results From the year 2018 to 2020, the DO applicants saw a decrease of 3% in the total number of matched postgraduate year 1 spots in surgical specialties. NRMP results from 2020 saw that 51.7% of DO applicants matched and 67.7% (p < 0.001) of MD applicants matched for the specialties examined. Percent of matched:applied for DO applicants was lower than MD applicants in the fields of NSGY (p < 0.001), ENT (p < 0.001), Plastic Surgery (p < 0.001), General Surgery (p < 0.001), and Thoracic Surgery (p = 0.011). After evaluating 60 former AOA General Surgery programs, 56% were found to have MD as PD. Another 26 former AOA surgical programs were investigated, and 58% were found to have MD PD. Conclusion Single accreditation has impacted the match process now that a large number of both MD and DO applicants are using the NRMP match system for postgraduate placement. Based on the available data, our results indicate that in the examined surgical specialties, there is a statistically significant difference in the number of MD and DO residents.

Purpose of Study: Workplace-based assessment is an opportunity for a learner to be assessed in their community of practice by an expert rater. The challenges and biases brought into this assessment relationship are complex. A shift towards Competency Based Medical Education in post-graduate residency education has triggered consideration of how to implement feasible assessment tools for the operating room, the in-patient ward, and the outpatient clinic. Competent performance in outpatient clinic is vital to surgical practice, yet no assessment tool currently exists to assess daily performance of technical and nontechnical skills of surgery residents. This project describes the development of a competency-based assessment tool, the Ottawa Clinic Assessment Tool (OCAT). Research Question: How does the OCAT demonstrate validity for measurement of surgical resident performance in clinic? Method: A consensus group of experts was gathered to generate ideas reflective of a competent ‘generalist’ surgeon in clinic. An entrustability anchor scale was developed. A six-month pilot study of the OCAT was conducted in orthopedics, general surgery and obstetrics and gynecology with quantitative and qualitative evidence of validity collected. Two subsequent feedback sessions, and a survey for staff and residents evaluated the OCAT for clarity and utility. Results: The OCAT was developed as a 13-item tool, with a global assessment item and 2 short answers questions. 44 staff surgeons completed 132 OCAT assessments of 79 residents. Psychometric data was collected as evidence of internal structure validity and relations with other variables. Analysis of feedback indicated the rating scale was practical and useful for surgeons and residents. Conclusions & Contribution to the Research Field: Surgical programs will require a daily clinic assessment tool to help define resident competency progression. Multiple sources of validity evidence collected in this pilot project demonstrate that the OCAT can measure resident clinic competency in a valid and feasible manner.

Purpose The purpose of this study was to quantify the number of surgical programs currently training osteopathic residents and to solicit advice for current osteopathic medical students who are interested in pursuing a surgical residency. Methods A questionnaire was sent to all listed Electronic Residency Application Service® (ERAS®) email contacts for the following specialties: General Surgery, Neurological Surgery, Orthopedic Surgery, Otolaryngology, Urology, Integrated Vascular Surgery, Integrated Plastic Surgery, and Integrated Thoracic Surgery. The questionnaire was sent a total of three times. Results Two hundred sixty-four of the 1,040 surgical residency programs responded to the questionnaire. Of these responses, 19% were formerly American Osteopathic Association (AOA) accredited programs. About 47.3% of responding programs indicated they are not currently training an osteopathic physician. One hundred thirteen programs provided additional comments on how osteopathic medical students may improve the competitiveness of their residency applications. These comments included increasing volumes of research activities, performing well on the United States Medical Licensing Exam (USMLE), and completing a sub-internship in the desired field or at a specific institution. Conclusion Osteopathic students still face many barriers to matching into surgical residencies. This study provides concrete steps students may take to increase the competitiveness of their application.