Assessing Medical Student Preparedness for Orthopaedic Clinical Rotations: Insights from a Cross-Sectional Survey.

Introduction: Orthopedic surgery is highly competitive, requiring strong performance in research, exams, and clinical skills. Despite required competency on standardized exams, many students report low confidence in musculoskeletal (MSK) knowledge. These exams often fail to prepare students for the clinical demands of orthopedic rotations, which require a strong foundation in MSK anatomy and radiographic interpretation. This study aimed to assess medical student perceptions of preparedness and exposure to MSK anatomy and radiology during preclinical training. Methods: A cross-sectional survey was conducted at a local orthopedic research conference to evaluate self-reported preparedness among medical students planning to apply for orthopedic residency. The 13-question survey used a 1-5 Likert scale ("strongly disagree" to "strongly agree"). Eligible participants were students who had completed preclinical training but had not begun orthopedic away rotations. The survey was voluntary, anonymous and distributed via QR code. 41 of 48 students responded (85%). Data was collected via Qualtrics and analyzed using descriptive statistics. Results: Responses were grouped into five categories: curriculum evaluation, self-driven preparation, resource access, x-ray interpretation, and supplemental course value. While 67.6% felt well-prepared in MSK anatomy, only 23.5% felt prepared to interpret MSK radiography, while 55% felt unprepared. Most students (79.4% and 85.3%) spent extracurricular time on MSK x-rays and anatomy, respectively, and 76.5% struggled to find high-quality resources. Only 35.3% of respondents reported feeling somewhat confident in their ability to interpret x-ray if they were to be placed in an orthopedic away rotation, with zero respondents strongly agreeing and 41.2% feeling unconfident. All students agreed that formal MSK x-ray instruction would benefit them, and 91% endorsed a dedicated anatomy course. Conclusion: Students report low confidence and insufficient preparation in MSK radiology and anatomy, despite its importance for orthopedic success. Unanimous support for supplemental instruction highlights the need for improved educational resources. Clinical Relevance: Enhancing MSK anatomy and radiology training may improve student confidence, clinical performance on orthopedic rotations, and match success in orthopedic residency.