- The Internet is a popular resource for orthopedic fellowship applicants.
- 86% of OTF websites are accessible from Google and FREIDA.
- Accessible websites feature only 40% of fellowship applicant content.
- Accessibility and content of OTF websites are highly variable and largely deficient.
- Improvement of the accessibility and content of website information should be a future focus of OTF programs.
The Orthopaedic Trauma Fellowship Match facilitates the matching process for orthopedic residency graduates pursuing a career as orthopedic traumatologists. This match is supported by the Orthopaedic Trauma Association (OTA) and the San Francisco Matching Program (SFMP). Orthopedic trauma fellowship (OTF) programs are accredited by the OTA and may receive oversight by the American Council for Graduate Medical Education (ACGME), which defines uniform standards for fellowship training. 1
Studies have found that the internet is an important and popular resource for applicants researching residency and fellowship programs. 2-5 For many applicants, the internet is their initial and main source of information. 5 Unfortunately, training programs do not have standardized website accessibility and content.
Few studies have addressed online content on orthopedic fellowship programs, 4,6,7 and to our knowledge no one has studied online content on OTF programs. We conducted a study to assess the accessibility and ease of navigation of OTF websites and to evaluate the content on these sites. We wanted to identify content that applicants may reliably expect on OTF sites. Any deficits identified may be useful to fellowship programs and program directors interested in improving website quality. We hypothesized that the accessibility and content of online OTF content would be highly variable and largely deficient.
This study was conducted at New York University Hospital for Joint Diseases. On February 5, 2015, both the OTA database 8 and the Fellowship and Residency Electronic Interactive Database (FREIDA) 9 were accessed in order to create a comprehensive list of OTF programs. FREIDA, a catalog of all ACGME-accredited graduate medical education programs in the United States, is supported by the American Medical Association and provides cursory program information, including training program duration and number of positions per year.
The databases were reviewed for links to OTF program websites. An independent Google search for program websites was also initiated on February 5, 2015. The Google search was performed in the format “program name + orthopaedic trauma fellowship” to assess how accessible the program sites are from outside the 2 databases (OTA, FREIDA). Google was used because it is the most commonly used search engine. 10 The first 25 search results were reviewed for links to OTF websites. Programs without accessible links to OTF websites—from the OTA database, from FREIDA, or from the Google search—were excluded from content assessment.
Accessible websites were electronically captured to ensure consistency of content during assessment. OTF site content was evaluated using methods described in similar investigations. 4,5,11,12 In our dichotomous assessment of fellow education content, we awarded 1 point per content item on the website. The 10 education content items evaluated were call responsibilities, didactic instruction, journal club, research requirements, evaluation criteria, rotation schedule, operative experience, office/clinic experience, meetings attended, and courses attended. We also performed a dichotomous assessment of fellow recruitment content. The 10 recruitment content items evaluated were program description, application requirements, selection criteria, OTA link, SFMP link, location description, program contact information, fellow listing, faculty listing, and salary. Content items were chosen for evaluation on the basis of published OTF applicant experience. 13 Percentages of education content, recruitment content, and total content were compared by program location, number of fellows, ACGME accreditation status, 14 affiliation with a top 20 orthopedic hospital, 15 and affiliation with a top 20 medical school, 16 as in similar studies. 7,17
Chi-square tests were used to compare content by fellowship location, number of fellows, ACGME accreditation status, affiliation with a top 20 orthopedic hospital, and affiliation with a top 20 medical school. For all tests, the significance level was set at P < .05.
Of the 49 OTF programs identified with database queries, 9 appeared in both the OTA database and FREIDA, 39 appeared only in the OTA database, and 1 appeared only in FREIDA. There were 48 programs total in the OTA database and 10 total in FREIDA.
The OTA database had no OTF website links. Of the 10 OTF links in FREIDA, 3 (6%) were nonfunctioning, 6 (12%) had multiple steps for accessing program information, and 1 (2%) connected directly to program information. Therefore, FREIDA had a total of 7 accessible OTF links (14%). The independent Google