The Sex or Race of Program Directors May Not Play a Significant Role in Impacting Diversity Among Orthopaedic Surgery Residents

Vani J Sabesan; Alessia Lavin; Gabriel Lama; Akshay V Daji; Clyde K Fomunung; Carlos A Fernandez; Garrett R Jackson; Lisa K Cannada

doi:10.1016/j.arthro.2024.03.036

The Sex or Race of Program Directors May Not Play a Significant Role in Impacting Diversity Among Orthopaedic Surgery Residents

Arthroscopy. 2024 Apr 7:S0749-8063(24)00259-7. doi: 10.1016/j.arthro.2024.03.036. Online ahead of print.

Authors

Vani J Sabesan¹, Alessia Lavin¹, Gabriel Lama², Akshay V Daji³, Clyde K Fomunung¹, Carlos A Fernandez¹, Garrett R Jackson⁴, Lisa K Cannada⁵

Affiliations

¹ John F. Kennedy, Hospital Corporation of America/University of Miami Orthopaedic Surgery Program, Palm Beach, Florida, U.S.A.; Palm Beach Shoulder Service at Atlantis Orthopaedics HCA Florida, Palm Beach, Florida, U.S.A.
² Florida International University Herbert Wertheim College of Medicine, Miami, Florida, U.S.A.
³ John F. Kennedy, Hospital Corporation of America/University of Miami Orthopaedic Surgery Program, Palm Beach, Florida, U.S.A.
⁴ John F. Kennedy, Hospital Corporation of America/University of Miami Orthopaedic Surgery Program, Palm Beach, Florida, U.S.A.; Palm Beach Shoulder Service at Atlantis Orthopaedics HCA Florida, Palm Beach, Florida, U.S.A.; Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri, U.S.A.. Electronic address: grjackson.md@gmail.com.
⁵ Novant Health, Charlotte, North Carolina, U.S.A.

PMID: 38593927
DOI: 10.1016/j.arthro.2024.03.036

Abstract

Purpose: To identify the influence of residency program characteristics, including the presence of under-represented minorities in medicine (URiM) and/or female program directors (PDs), on the race and sex distribution of orthopaedic surgery residency trainees.

Methods: All active and Accreditation Council for Graduate Medical Education-accredited orthopaedic surgery residency programs from 2017-2021 that reported usable information in the Residency Explorer Tool were included. Data collected included program characteristics, as well as faculty and resident sex distribution, ethnicity, race, and demographic characteristics. The PDs' specific sex, ethnicity, race, and demographic characteristics were collected using residency program websites. The prevalence of factors in programs with the top quartile of female and URiM residents was compared with that in programs with the bottom 3 quartiles.

Results: Data were obtained from 148 of 200 Accreditation Council for Graduate Medical Education-accredited programs (3,694 residents). The 52 excluded programs had no usable information in the Residency Explorer Tool or on an identifiable program website. Overall, 15.9% of residents in orthopaedic surgery residency programs were women and 14% were under-represented minorities. The rates of female PDs and chairs were 12.4% and 6.9%, respectively, whereas those of URiM PDs and chairs were 8.3% and 4.6%, respectively. Programs with more female residents were not associated with female PDs (P = .79) or URiM PDs (P = .48). Programs with a greater percentage of URiM residents were not associated with URiM PDs (P = .16). Larger programs (P = .021) and university-based programs (P = .048) had a greater percentage of female residents. Orthopaedic residency programs with visa sponsorship had a greater percentage of URiM residents (P = .017).

Conclusions: Programs with a higher percentage of female or URiM residents did not show a significant association with having female or URiM PDs. Larger programs and university-affiliated programs were more likely to have a larger percentage of female residents, whereas programs that offered visa sponsorship had a higher percentage of URiM residents.

Clinical relevance: This study highlights factors influencing diversity among orthopaedic surgery residents. Although the presence of female or URiM PDs does not influence the percentage of female or URiM residents, other program characteristics such as size, affiliation, and visa sponsorship offer potentially actionable insights for promoting greater diversity in orthopaedic training. Doing so may increase under-represented groups within the field and could ultimately impact patient care and improve health care equity.