Dr. Matt Schmitz offers his perspective on the current landscape of orthopaedic residency selection. He notes that some attributes are difficult to quantify but nonetheless valued when identifying candidates, in a process without a “perfect blueprint.”
As orthopaedic educators, the question we face today is simple in form but complex in practice: how do we identify the “best and brightest” for orthopaedic residency training in 2026? Match Day recently brought a wave of celebratory posts from future orthopaedic surgeons who matched into excellent programs. Yet the flip side is sobering: early statistics show 1,652 applicants for 963 residency positions. That figure likely understates the pool, since some applicants apply to orthopaedics alongside other specialties, but even so, about 42% of orthopaedic applicants did not match.
For those of us involved in the residency selection process, this is a prompt to examine our methods in how we select candidates. Dr. Andrew Schoenfeld and Dr. Ayesha Abdeen discussed this on the March 3 podcast episode of Your Case Is On Hold, and it sparked a deeper reflection: with hundreds of applications and only five slots at my institution, how do we responsibly narrow the field to roughly 50 candidates for in-person interviews? In a new OrthoBuzz Resident Roundup post, Armin Pazooki poses the question from the medical student perspective: what exactly are we looking for in applicants?
The role of research in the application has grown. When I matched in 2004, I had one publication—in the Journal of Field Ornithology. Yes, ornithology. A single study on the nesting habits of three blackbird species. Today’s medical students often face what feels like an arms race in research and publication. But does sheer volume of research predict success in orthopaedics? Not necessarily. It’s not a level playing field; students from research powerhouses or those taking extra years for research may have advantages that don’t reflect innate potential as orthopaedic surgeons.
Beyond publications, programs look at other factors. Did an applicant play varsity sports at the collegiate level? Have they served in the military? Such experiences can signal coachability and the ability to perform under pressure. But again, not every candidate has these opportunities, and they aren’t universal indicators of future excellence in the field. Those experiences ring true to me simply because they are familiar to my own background, but that is a bias that I acknowledge and work hard to get past.
So what do I value in a candidate? Passion. A genuine desire to excel in orthopaedics. But how do you quantify that? It’s difficult, perhaps impossible, to assign a single score to determination or a drive for greatness. I look for grit—the capacity to persevere after adversity, to get knocked down and get back up. Orthopaedics is demanding: long hours, tough days, and inevitable setbacks. I also value coachability and ambition that extends beyond personal achievement. I want candidates who are striving for greatness, not just strong technical skills. Teaching surgical technique is within our remit as educators; instilling a deep, enduring desire for excellence is much harder.
In short, there isn’t a one-size-fits-all “right answer” or a perfect blueprint. I look for a good fit with my program, a fit that aligns with the program’s unique culture and style, while also considering the candidate’s unique strengths and attributes.
It’s a good problem to have: orthopaedics remains a highly competitive specialty, and outstanding medical students continue to vie for available spots. Yet the rubric for the “best candidate” remains imperfect.
Matthew R. Schmitz, MD
JBJS Senior Editor for Pediatrics and Social Media
Related post:
Rethinking Merit in the Ortho Match
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For what it’s worth I always felt the candidate’s work history was relevant. What did he or she do in the summer between school years? In high school, undergraduate university years and medical school. I felt you could identify a lot of the characteristics Matt identifies as important from the way the candidate spent his or her non-academic time.