Allopathic and Osteopathic Residents Perform Similarly on the Orthopedic In-Training Examination (OITE)

Document Type

Journal Article

Publication Date



Journal of surgical education




allopathic residents; oite; orthopedic in-training examination; osteopathic residents; resident education; stigma


INTRODUCTION: There is a bias in the medical community that allopathic training is superior to osteopathic training, despite the lack of substantiation. The orthopedic in-training examination (OITE) is a yearly exam evaluating educational advancement and orthopedic surgery resident's scope of knowledge. The purpose of this study was to compare OITE scores between doctor of osteopathic medicine (DO) and medical doctor (MD) orthopedic surgery residents to determine whether any appreciable differences exist in the achievement levels between the 2 groups. METHODS: The American Academy of Orthopedic Surgeons 2019 OITE technical report, which reports the scores from the 2019 OITE for MDs and DOs, was evaluated to determine OITE scores for MD and DO residents. The progression of scores obtained during various postgraduate years (PGY) for both groups was also analyzed. MD and DO scores throughout PGY 1-5 were compared with independent t-tests. RESULTS: PGY-1 DO residents outperformed MD residents on the OITE (145.8 vs 138.8, p < 0.001). The mean scores achieved by DO and MD residents during PGY-2 (153.2 vs 153.2), 3 (176.2 vs 175.2), and 4 (182.0 vs 183.7) did not differ (p = 0.997, 0.440, and 0.149, respectively). However, for PGY-5, the mean scores for MD residents (188.6) were higher than those of DO residents (183.5, p < 0.001). Both groups had trends of improvement seen throughout PGY 1 to 5 years, with both groups showing an increase in average PGY scores when compared to each preceding PGY. CONCLUSION: This study provides evidence that DO and MD orthopedic surgery residents perform similarly on the OITE within PGY 2 to 4, thus displaying equivalencies in orthopedic knowledge within the majority of PGYs. Program directors at allopathic and osteopathic orthopedic residency programs should take this into account when considering applicants for residency.


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