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The programs (10, 24%) were largely deficient in formal curricula for residents focused on cost-effective care; informal interactions with faculty (17, 43%) served as the predominant mode of learning in this area. Easy access to the cost of tests or procedures was restricted for most residents (97%), with only 3% (13%) finding it straightforward. Orthopaedic surgery program leadership, faculty, and trainees lack consistent, cost-effecti