Improvement of Orthopedic Residency Programs and Diversity: Dilemmas and Challenges, an International Perspective

Background: To date, little has been published comparing the structure and requirements of orthopedic training programsacross multiple countries. The goal of this study was to summarize and compare the characteristics of orthopedic trainingprograms in the U.S.A., U.K., Canada, Australia, Germany, India, China, Saudi Arabia, Russia and Iran.Methods: We communicated with responders using a predetermined questionnaire regarding the national orthopedictraining program requirements in each respondent’s home country. Specific items of interest included the following: thestructure of the residency program, the time required to become an orthopedic surgeon, whether there is a log book,whether there is a final examination prior to becoming an orthopedic surgeon, the type and extent of faculty supervision,and the nature of national in-training written exams and assessment methods. Questionnaire data were augmented byreviewing each country’s publicly accessible residency training documents that are available on the web and visitingthe official website of the main orthopedic association of each country.Results: The syllabi consist of three elements: applied clinical knowledge, applied clinical skills, and professional andmanagement skills. The application of simulation techniques for both teaching and assessment are fundamental tomodern surgical education. The skill of today’s trainees predicts the quality of future orthopedic surgeons. The EuropeanBoard of Orthopaedics and Traumatology (EBOT) exam throughout the European Union countries should function asthe European board examination in orthopedics. We must standardize many educational procedures worldwide in thesame way we standardized patient safety.Conclusion: Considering the world’s cultural and political diversity, the world is nearly unified in regards to orthopedics.The procedures (structure of the residency programs, duration of the residency programs, selection procedures, using a logbook, continuous assessment and final examination) must be standardized worldwide, as implemented for patient safety.To achieve this goal, we must access and evaluate more information on the residency programs in different countries andtheir needs by questioning them regarding what they need and what we can do for them to make a difference.Level of evidence: III