An updated analysis of shoulder and elbow questions on the Orthopedic In-Training Examination

Background: The Orthopedic In-Training Examination (OITE) is an annual examination for orthopedic surgery residents used to assess orthopedic knowledge across a national standard. Having an updated understanding of currently tested topics and resources is useful to help residents guide their education.Purpose: The purpose of this study is to analyze the shoulder and elbow domain of the OITE in an effort to provide current trends and commonly tested topics.Methods: All OITE questions related to shoulder and elbow topics over the years 2009-2013 and 2017-2020 were analyzed. Subcat-egories, the number and types of references used, publication lag time, imaging modalities, taxonomic classification, and resident per-formance were recorded.Results: Shoulder and elbow topics comprised 8.61% of all OITE questions from 2009-2013 and 2017-2020. The most commonly tested shoulder topics were rotator cuff arthropathy and reverse total shoulder arthroplasty (13.6%), followed by hemiarthroplasty and total shoulder arthroplasty (12.9%), rotator cuff-related pathology (12.9%), anterior shoulder instability and/or dislocation (10.2%), and general anatomy (10.2%). The most commonly tested elbow topics were trauma (21%), ulnar collateral ligament injuries (12.12%), general anatomy (10%), and arthroplasty (10%). Decisions regarding management or appropriate next steps (taxonomy T3) comprised 39% of all question types. The incorporation of imaging modalities continues to be an important component of the OITE questions. The Journal of Shoulder and Elbow Surgery (JSES), the Journal of the American Academy of Orthopedic Surgeons (JAAOS), the Journal of Bone and Joint Surgery (JBJS), and the American Journal of Sports Medicine (AJSM) comprised 65% of ar-ticles referenced in all questions over our analysis period.Conclusion: This study provides an updated analysis of trends within the shoulder and elbow domain of the OITE. Application of these data can aid residents in their preparation for the examination.Level of evidence: Survey Study; Other Published by Elsevier Inc. on behalf of Journal of Shoulder and Elbow Surgery Board of Trustees.