Mary K. Mulcahey’s research while affiliated with Loyola University Medical Center and other places

Introduction Orthopaedic surgery is one of the most competitive specialties. In 2024, 1,492 medical students applied to 916 orthopaedic surgery first-year training positions. There are no recent data examining trends in the number of away rotations performed by medical students interested in orthopaedic surgery. The purpose of this study was to enhance understanding about the significance of away rotations and home rotations for successfully matching into orthopaedic surgery. Methods In January 2024, the survey was distributed to orthopaedic surgery postgraduate year 1 (PGY-1) students at programs participating in the Collaborative Orthopaedic Education Research Group (COERG). The survey was distributed in March 2024 to 4th-year medical students who rotated at participating COERG residency programs. Data were collected on away rotations completed, motivations for participating, barriers encountered, and if the respondent matched at a program where they rotated. Results Survey responses were collected from 37 of 90 PGY-1 students (41.1%) and 62 of 325 4th-year medical students (19.1%). The study cohort consisted of 99 applicants from the 2023 and 2024 orthopaedic surgery residency match cycles. PGY-1 students and 4th-year medical students completed an average of 3.4 away rotations and applied to an average of 4.4. Eight of 62 4th-year medical students (12.9%) did not match, with their average number of away rotations being 3.75. Of the 91 respondents who matched, 50 (54.9%) matched at an outside program where they rotated during 4th year. Fifteen (16.5%) matched at their home program. Fifteen (16.5%) matched at a program they had no prior exposure to before the residency interview. Six (6.6%) matched at a program with prior exposure and no away rotation. Five (5.5%) matched at a program with geographical ties and no away rotation. Conclusion Medical students applying to orthopaedic surgery residency are completing more away rotations than noted in previous studies. Most medical students match at programs where they complete away rotations or their home program, which subsequently increases the importance of where students decide to do rotations and the number they complete.

Introduction Limited access to resources and stereotypes about orthopaedic surgeons may contribute to the low percentage of women and people of underrepresented in medicine (URiM) backgrounds in orthopaedic surgery. Several organizations have created resources to address these barriers, but medical students are unlikely to be exposed to the initiatives through traditional curricula. The purpose of this study was to (1) evaluate the ability of a 1-day virtual Diversity, Equity, Inclusion, and Accessibility (DEIA) summit to effectively reach URiM medical students, (2) increase medical students' knowledge of DEIA resources, and (3) augment the perception of diverse backgrounds in orthopaedic surgery. Methods A 1-day nationwide virtual summit was convened in October 2023. The summit invited residents and faculty leaders of diversity-focused orthopaedic organizations to speak with students in panel discussions and topic-focused breakout rooms. Pre- and postsummit surveys were used to determine whether the summit met the three goals. Results One hundred ninety-six medical students attended the summit. One hundred seventy-four surveys were received presummit, 106 surveys were received postsummit, and 60 students completed both. Most of the participants were female (n = 109, 63.0%), and many represented URiM backgrounds (n = 70, 41.7%). Postsummit, a notable number of survey respondents increased their knowledge about diversity-related opportunities (3.3% to 40%, P < 0.001). Participants who felt that their identity was welcome in orthopaedics nearly quadrupled from presummit (16.7%) to postsummit (63.3%) ( P < 0.001), and the likelihood of recommending orthopaedic surgery to another medical student from an URiM demographic increased by 58.6% ( P < 0.001). Among the 135 students who did not initially feel that their identity was welcome in the field of orthopaedic surgery, 124 (91.9%) rated changing stereotypes of the field as important to their decision to pursue a career in orthopaedics. Conclusions This study supports the ability for virtual summits to reach URiM students, increase their knowledge of DEIA resources, and augment their perceptions of diversity in orthopaedics. Level of evidence IV

Purpose The purpose of this study was to analyze the existing literature to determine if and how surgical residents are taught to dictate operative notes. The secondary aim was to compile perceptions regarding the teaching and quality of resident operative dictation (OD) and ways in which teaching might be improved. # Method A systematic review was performed following PRISMA guidelines. PubMed, CINAHL, Web of Science, and EMBASE were searched for studies related to operative note dictation in U.S. surgical residency programs from 2010-2023. Results The initial search yielded 782 results, which were screened by two independent reviewers (MVL and BCG), resulting in 9 studies that met the inclusion criteria. These studies, covering various surgical subspecialties, revealed that while 44%-67% of surveyed surgical residency program directors (PDs) prioritize teaching OD, only 17% currently provide formal education in this area. Notably, synoptic reports, which employ templates with discrete data fields, demonstrated significantly greater completeness (94.7%) compared to traditional dictated operative reports (66%). Completeness of resident OD did not correlate with level of training, and pertinent information was lacking at all resident PGY-levels. Educational interventions in the form of lectures and video instruction improved the completeness of OD by up to 22%. Conclusions Despite the crucial role of OD in patient care, medicolegal aspects, and billing, this review underscores a lack of routine and formal instruction of this skill in U.S. surgical residency programs. Limited studies suggest potential improvement through formal educational interventions. Future research should delve into the costs and barriers hindering the integration of formal dictation training, shedding light on why PDs have not universally adopted such initiatives.

Introduction This study aims to evaluate whether Instagram engagement data affect residency application volumes for orthopaedic surgery residency programs and rank the top 50 Instagram accounts associated with programs based on engagement. Methods Data from January 1, 2020 to June 30, 2023 were collected in August 2023 for Instagram metrics through Popsters social media analytic tool for business accounts and manually for nonbusiness accounts, as well as applicant numbers through the Association of American Medical College (AAMC) Residency Explorer Tool. Top 50 rankings were created from 2020 to 2022 based on engagement score, number of applicants, and growth in application numbers. Correlational analysis was done for programs with active Instagram accounts and full AAMC data from 2020 to 2022. A list of the top 50 most influential programs' Instagram accounts was compiled from January 1, 2020, to June 30, 2023, based on engagement scores including follower count. Results Of 210 programs, 163 (78%) had a total of 184 Instagram accounts. The average number of likes and comments per post for each account increased from 60 to 98 and 1.4 to 2.3 from 2020 to June 2023 ( r = 0.95 to 0.9). For the 153 programs with active accounts and corresponding AAMC applicant data from 2020 to 2022, an increase in average engagement score (2,938 to 3,483) and the number of applicants (636 to 824) were observed with a weak positive correlation (2020: r = 0.15, P = 0.06; 2021: r = 0.18, P = 0.02; 2022: r = 0.20, P = 0.01). Conclusion Instagram has become a useful tool that orthopaedic surgery residency programs are leveraging to highlight aspects of their programs to prospective applicants. The findings of this study demonstrate a positive correlation between social media engagement and applicant numbers from 2020 to 2022, with the strength of correlation increasing each subsequent year. Several influential orthopaedic surgery residency programs, based on high engagement scores, received the most applications in the previous three cycles, reinforcing the value of social media, particularly Instagram, in promoting residency programs.

» Increased professional, personal, and emotional stress can have compounding negative effects on physicians, which can be detrimental to teamwork dynamics, workplace environment, productivity, and personal well-being. Orthopaedic surgery, in particular, is a medical specialty that demonstrates high workplace demands, elevated rates of burnout, and low workplace diversity. » Professional coaching can help combat these challenges and facilitate professional success by providing an outlet for discussion and planning toward one's career development and goals. Coaches, generally nonphysicians, are trained and certified to advise and guide physicians in their professional career paths. » There has been demonstrated success in the utilization of professional coaching in various medical specialties and groups, including anesthesiology, primary care, general surgery, and female surgeon organizations. » The purpose of this review is to evaluate existing models of professional coaching to inform its use within orthopaedic surgery as a means of promoting well-being, physician success, and workforce diversity.

Wellness encompasses multiple dimensions of well-being, including physical, mental, emotional, social, and spiritual health. Prioritizing physician wellness is crucial for ensuring high-quality patient care and reducing the risks of burnout, depression, and other mental health issues. Poor wellness among physicians not only affects their personal and professional lives but also has a ripple effect on patient care. It is associated with higher rates of medical errors, lower patient satisfaction, and an increased risk of mental health disorders including anxiety, depression, substance abuse, and suicide. » Burnout is a significant issue among healthcare professionals, particularly physicians. It can lead to severe consequences like increased medical errors, job dissatisfaction, and a decline in both personal and professional well-being. Addressing burnout through coping mechanisms and better work-life balance is essential. Moral injury occurs when physicians are forced to act against their moral beliefs due to systemic flaws, leading to inner conflict. Unlike burnout, which is often attributed to individual resilience, moral injury points to issues within the medical system itself. » Anxiety and depressive disorders can alter an individual's ability to participate in work and daily function. Among orthopedic surgeons, burnout has been described as an occupational hazard associated with medical errors, as well as with physical and mental exhaustion. Orthopedic surgeons face a burnout rate ranging between 40% and 60%. Tragically, they also have the highest suicide rate, comprising 28.2% of surgeon suicides from 2007 to 2013. » More flexible work hours, adequate time off, and efficient workflow are methods that can be used to improve the work environment, as well as providing easy access to mental health counseling and confidential support groups. Research has shown that residents do not utilize employee assistance programs; however, programs with directors that regularly inquire about well-being has led to increased well-being and use of assistance programs and groups.