Multicenter Survey of Resident Education in Professional Development and the Business of Orthopaedics: Are Residents Ready for Transition to Practice?

# Background Systems-based practice is a core competency of orthopaedic residency, yet there is no defined curriculum to address this area, which may leave residents with gaps in knowledge. # Objective The aim of this study was to assess residents’ understanding of systems-based practice and interest in incorporating these principles into curricula. # Methods In 2018 a survey was emailed to residents in programs across the United States evaluating comprehension in systems-based practice, and interest in specific domains of curriculum development: personal finance, value of orthopaedics, practice dynamics, transition to practice, work life balance, research, professional development, leadership development, international medical work, and law. Residents were categorized into subgroups based on years of training: junior (1-3) and senior (4-5), and nonparametric chi-squared analysis was performed between the groups. # Results Of 275 residents surveyed, 151 completed the survey for an overall response rate of 55%. Self-rated understanding of systems-based practice was statistically identical (p=1.00) between junior and senior residents; 91.4% of both groups indicated low comprehension of the systems-based practice competency. There was strong interest by the majority of respondents in further training in many domains. When subcategorized as junior and senior residents, the only significant differences in interest were in professional development (p=0.04) and transition to practice (p = 0.01) domains, with more junior residents expressing strong interest in further training in these topics. # Conclusions This study indicated that there is a gap in resident education in systems-based practice and that orthopaedic residents are interested in the enhancement of education in this domain.