BACKGROUND: The claim that "50% of orthopaedic surgeons leave their first job within 2 years" did not originate from evidence. The purpose of this study was to investigate practice change rates among board- eligible orthopaedic surgeons using the American Board of Orthopaedic Surgery (ABOS) database. METHODS: We utilized information provided by orthopaedic surgeons taking the ABOS Part II Examination across 6 different years. Surgeons who trained outside of the United States and members of the uniformed services of the U.S. were excluded. Move rates within 2 years of starting practice and before the candidate's Part II examination were determined. All surgeons were then subcategorized as having followed a traditional or nontraditional certification timeline based on whether they took Part II of the examination within 2 practice years after becoming board-eligible. Candidate-specific variables were analyzed according to whether the surgeon did or did not change practices. RESULTS: Among 3,784 orthopaedic surgeons, 215 (5.7%) left their first practice within 2 years. On average, candidates sat for the Part II examination at a mean (and standard deviation) of 2.1 ± 1.1 years (range, 0.7 to 31.9 years) after reporting their first practice location. Seventy-six percent of surgeons took the Part II examination within a traditional timeframe. On average, nontraditional candidates left their first practice at a significantly higher rate than traditional candidates (20.5% versus 1.3%
p <
0.001), changed practices more often (1.5 versus 1.2 moves
p = 0.021), and moved farther (500.1 versus 304.4 miles
p = 0.023). Fellowship training and/or Part II examination subspecialty were not strongly associated with a surgeon leaving his or her first practice. CONCLUSIONS: While it is possible that >
5.7% of orthopaedic surgeons leave their first job during their early career, it is unlikely that many relocate within 2 years. This is especially true among orthopaedic surgeons pursuing ABOS certification within a traditional timeframe.