CRITERIA INFLUENCING SELECTION IN THE CANADIAN RESIDENT MATCHING SERVICE (CARMS) FOR ORTHOPAEDIC SURGERY: A CROSS-SECTIONAL AND MULTICENTRIC SURVEY

The medical landscape in Canada continues to evolve, including the Canadian Resident Matching Service (CaRMS) for orthopaedic surgery residency programs. This ongoing change can create ambiguity for medical students navigating the application process, making it difficult to discern what individual programs value. Each program may have unique criteria when assessing applicants, adding to the uncertainty. As a result, students often turn to mentors, online platforms, and career advisors for insight. However, these sources may not always provide accurate or consistent information. To offer more clarity to medical students applying to orthopaedic surgery, we disseminated a survey to residency programs across Canada to assess the criteria deemed most important in selecting future residents. The primary objective of this cross-sectional, multicentric survey study was to identify the key selection criteria valued by orthopaedic surgery residency programs during the CaRMS process. Research ethics and board approval were obtained from the University of Toronto. An electronic survey was sent to all 17 Canadian orthopaedic surgery residency programs, targeting program directors, associate program directors, program chairs, and other members involved in resident selection. Using a five-point Likert scale, respondents rated various criteria grouped into categories such as clinical performance, interview performance, references, medical school performance, research productivity, career goals, and extracurriculars. Respondents were also asked to rate statements as negative, positive, or neutral, with space provided for additional comments. A numeric mean score was calculated for each factor to generate a final rank list of the most important selection criteria. A total of 25 orthopaedic surgeons involved in the selection process participated in the study, with 7 being program directors and 4 associate program directors. Of the 17 programs, 12 (70.6%) responded to the survey. The top three most important criteria identified by selection committee members were clinical performance at their institution (96%), interview performance (76%), and reference letters (64%). Conversely, the least important criteria were career goals (8%) and research productivity (4%). Within these categories, the three most important qualities were: “Exhibit professional behaviors in all aspects, including integrity, honesty, respect, compassion, and humility” (mean score 4.92, SD 0.4), “Demonstrate a commitment to excellence and a strong work ethic” (mean score 4.84, SD 0.37), and “Effectively work in a team environment and maintain positive relationships with colleagues” (mean score 4.76, SD 0.44). Additionally, 64% of respondents viewed having strong ties to the city of their institution positively. In contrast, applying to multiple specialties (44%), social media presence (84%), and established connections within the specialty (76%) were generally seen as neutral. This study reveals that Canadian orthopaedic surgery residency programs prioritize clinical performance, interview skills, and reference letters when selecting applicants, with professional behaviors and teamwork being highly valued. Academic standing, research productivity, and career goals were less significant. Factors such as social media activity and ties to the institution's city were largely seen as neutral. These findings provide valuable guidance for applicants, encouraging them to focus on clinical competence, professionalism, and collaboration throughout the CaRMS application process.