Use of an integrated, anatomic-based, orthopaedic resident education curriculum: a 5-year retrospective review of its impact on orthopaedic in-training examination scores.

Introduction: Experts have called for a comprehensive didactic curriculum in orthopaedic residency training. This study examined the effects of an anatomic-based, integrated conference program on annual Orthopaedic In-Training Examination (OITE) scores at a single orthopaedic residency program.

Methods: We implemented a new, integrated, anatomic-based curriculum in January 2005. Differences between scores were analyzed by postgraduate year (PGY) of training. OITE scores (percentile ranking and raw scores) of year 1 (PGY-2) through year 4 (PGY-5) residents exposed to the curriculum (2005-2009) were compared to prior PGY-2 through PGY-5 residents (2000-2004) who had experienced the previous unstructured curriculum. To evaluate for cohort effects, United States Medical Licensing Examination (USMLE) Step I scores for these 2 groups were also compared.

Results: Eight residents were exposed to the new conference program and 8 to the prior conference program. All residents' percentile rankings improved after exposure to the curriculum, although improvement was not statistically significant for all participants. The most dramatic improvements in OITE scores were seen for PGY-4 and PGY-5 residents, which improved from 65th to 91st percentile (P  =  .03) and from 66th to 91st percentile (P  =  .06), respectively. There were no differences between the cohorts in USMLE Step I scores.

Discussion: Initiation of an integrated, anatomic-based, resident conference program had a positive impact on resident performance on the OITE.