AOA/CORD Recommended Guidelines on 2021-2022 Residency Recruitment

Statement Release Date: July 13, 2021

The following is a statement released by the AOA’s Council of Orthopaedic Residency Directors (CORD) and offers recommendations for Away Rotations and Interviews. Download the pdf of the statement here.

Away Rotation Recommendations

  • CORD encourages its members not to punish or retaliate against, in any way, students who have completed more than one away rotation.
  • CORD supports students in completing more than one away rotation, if allowed by their medical school’s guidelines, especially, for “orphan” students (those at schools with no orthopaedic surgery residencies or departments)


Surgical training has evolved from the rudimentary apprenticeship models of old but still relies upon hands-on experience and procedural based skill acquisition. Away rotations provide a multitude of essential experiences for learners and programs. Each program has a unique “personality”, and medical students gain valuable insight into how they can best learn within a procedural specialty. The opportunity for senior medical students to learn in different environments is essential to career development and the identification of the right residency program or type of residency program in which they will be most successful.

Residency programs can also see the students’ potential as future surgeons firsthand during these experiences. These rotations are not only essential for the evaluation process, but also for the mentorship and sponsorship of these students, especially for women and students from groups that are underrepresented in certain specialties in medicine. Letters of recommendation from faculty at away rotations are extremely valuable for students, as well as the programs to which they apply.

Our goal as a profession is to take a more holistic approach to student evaluation, and away-rotations are a major component of this evaluation. Without such experiences, we are forced to rely upon standardized test scores and standardized applications and CVs, prohibiting a true view of the students. It is far more likely for a student with below average test scores or a less ‘pedigreed’ application to be offered an interview and  match with a program if they have rotated at a program and demonstrated their potential as a future orthopedic surgery resident.

The notion that away rotations are prohibitively expensive is a false assertion. Based on a 2020 AAMC Report, in 2019, 73% of medical student graduates reported having education debt; median debt was $200,000 ($200,000 for those at public medical schools and $215,000 for those at private medical schools).. Over 95% of this debt is from tuition and fees alone. Assuming away rotations and interviews cost an applicant between $5,000-10,000, that equates to roughly 2-5% of their total debt. Additionally, many orthopedic surgery programs have established scholarship programs to defray these costs for underrepresented minority (URM) students or other students in need who are seeking support.

The purpose of the away rotation is more than allowing students to learn about the specialty and the program to which they are applying. For URM students, students from middle/lower tier medical schools, female/male/nonbinary students (who are not in the majority for their specialty), and students from programs where there is no specialty at their home institution, these away rotations are a source of mentorship and exposure to attendings/residents and their specialty of interest that might not exist at their medical school. These relationships established through rotations often continue even when a student matches at another institution, highlighting the unintended and potentially career limiting impact of systematically eliminating away rotations.


  • Programs are encouraged to participate in the CORD Universal Interview Offer Day (UOD). The structure recommended by AOA/CORD for program implementation is as follows.
    • All programs will send out interview offers on a pre-determined date.
      • The exact date of the UOD will be determined in the coming weeks after polling and discussion within the CORD community.
    • Programs should only offer as many interview spots as they have available.
    • Applicants will be able to accept interview offers 24 hours after interviews have been offered.
    • Each applicant will then have 48 hours to respond to the program without fear of the offer being rescinded (this does not ensure the specific date a student may desire, but solely the opportunity for an interview).
    • If an applicant declines an interview or there is no response in the designated timeframe, the program may extend an invitation to another applicant.
    • There will be no set timeline for the second or any subsequent waves of interview offers and may be offered at the program’s discretion.
  • CORD supports in-person residency interviews and supports programs’ decisions about whether to hold in-person or virtual interviews. To help students manage the cost associated with in-person interviews, programs within the same city or region could consider consolidating their interview dates.
    • If a student is not allowed to participate in person due to their school prohibiting such visits, they should be allowed to have a virtual interview opportunity.


Last year, the concept behind the proposal was to make the process more transparent for the applicants. Applicants knew when offers would be made, by which programs, and how long they had to respond. A survey of 2021 Match applicants indicated that 93% of applicants favored the UOD process continue next year. The majority felt that this improved the process and significantly decreased their personal stress and anxiety over what their colleagues experienced in prior years.

The indication of programs’ agreement to send out interview offers according to the UOD timeline can be listed on the Orthopaedic Residency Information Network (ORIN).

As with AOA/CORD support of away rotations, in-person interviews offer students and programs the opportunity to learn about each other in a more complete matter. In-person interviews and visits to a hospital and the program’s city allow for applicants to assess the program with the most available information possible. The value of networking with colleagues and co-residents is invaluable. Providing the applicants an opportunity to meet each other, see the diversity of the applicant pool, see how faculty and residents interact with each other and more clearly learn about the mission and culture of a residency program is incredibly important; these are not characteristics easily assessed with a virtual interview. Further, a visit to the program is an important opportunity for applicants and their significant others to imagine what five years of life in that geographic area would be like, which is a core element of a resident’s wellness and well-being.

Reference List

Collaborative Orthopaedic Educational Research Group (COERG). Financial Literacy in Orthopedic Residents: A COERG Survey. Not yet published. Accessed June 23, 2021.

Oladeji LO, Raley JA, Smith S, Perez JL, McGwin G, Ponce BA. Behind the Match Process: Is There Any Financial Difference Lurking Below the Specialty of Choice? Am Surg. 2016 Dec 1;82(12):1163-1168. PMID: 28234179.

Youngclaus J, Fresne JA. Physician Education Debt and the Cost to Attend Medical School: 2020 Update. Washington, DC: AAMC; 2020