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Silvestre J, Ahn J, Dehghan N, Gitajn IL, Slobogean GP, Harris MB. Analysis of the diversity pipeline for the orthopedic trauma surgeon workforce in the United States. Injury 2024; 55:111695. [PMID: 38959676 DOI: 10.1016/j.injury.2024.111695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 05/23/2024] [Accepted: 06/19/2024] [Indexed: 07/05/2024]
Abstract
INTRODUCTION There is a lack of research on the state of racial, ethnic, and gender diversity in the emerging orthopedic trauma workforce. The purpose of this study was to analyze the training pathway for diverse candidates in orthopedic trauma as it relates to race, ethnicity, and sex. METHODS Self-reported demographic data were compared among allopathic medical students, orthopedic surgery residents, orthopedic trauma fellows, and the general population in the United States (2013-2022). Race categories consisted of White, Asian, Black, and Native American/Alaskan Native (NA/AN), and Native Hawaiian/Pacific Islander (NH/PI). Ethnicity categories were Hispanic/Latino or non-Hispanic/Latino. Sex categories were male and female. Representation was calculated at each stage of accredited training. Participation-to-prevalence ratios (PPRs) quantified the equitable representation of demographic groups in the emerging orthopedic trauma workforce relative to the US population. PPR thresholds were used to classify representation as overrepresented (PPR > 1.2), equitable (PPR = 0.8-1.2), and underrepresented (PPR < 0.8). RESULTS Relative to medical school and orthopedic surgery residency, fewer female (48.5 % vs 16.7 % vs 18.7 %, P < 0.001), Hispanic (6.1 % vs 4.5 % vs 2.6 %, P < 0.001), Black (6.9 % vs 5.0 % vs 3.1 %, P < 0.001), and Asian (24.0 % vs 14.3 % vs 12.2 %, P < 0.001) trainees existed in orthopedic trauma fellowship training. In contrast, more male (51.5 % vs 83.3 % vs 81.3 %, P < 0.001) and White (62.8 % vs 79.1 % vs 84.0 %, P < 0.001) trainees existed in orthopedic trauma fellowship relative to earlier training stages. There were zero NA/AN or NH/PI trainees in orthopedic trauma (PPR = 0). Relative to the US population, Hispanic (PPR = 0.14), Black (PPR = 0.25), and female (PPR = 0.37) trainees were underrepresented in orthopedic trauma. In contrast, Asian (PPR = 2.04), male (PPR = 1.64), and White (PPR = 1.36) trainees were overrepresented in orthopedic trauma. CONCLUSION Women, racial, and ethnic minorities are underrepresented in the emerging orthopedic trauma workforce relative to the US population, and earlier stages of training. Targeted recruitment and guided mentorship of these groups may lead to greater interest, engagement, and diversity in orthopedic trauma.
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Affiliation(s)
- Jason Silvestre
- Medical University of South Carolina, Charleston, SC, United States.
| | - Jaimo Ahn
- University of Michigan Medical School, Ann Arbor, MI, United States
| | - Niloofar Dehghan
- University of Arizona College of Medicine Phoenix, Phoenix, AZ, United States
| | - Ida L Gitajn
- Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
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Silvestre J, Moore M, LaPorte DM, Sabesan VJ, Van Heest A. Sex Diversity and Equity Among Fellows of the American Orthopaedic Association. J Bone Joint Surg Am 2024:00004623-990000000-01159. [PMID: 39052768 DOI: 10.2106/jbjs.24.00071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
BACKGROUND We hypothesized that women are underrepresented among fellows of the American Orthopaedic Association (AOA) relative to their prevalence among faculty at departments of orthopaedic surgery. METHODS Clinical faculty at departments of orthopaedic surgery that are affiliated with residency training programs were analyzed for AOA membership. Participation-to-prevalence ratios (PPRs) were calculated for men and women with AOA membership relative to their prevalence among orthopaedic surgeon faculty. A PPR of <0.8 or >1.2 indicated under- or overrepresentation, respectively. PPR values between 0.8 and 1.2 indicated equivalent representation. Sex disparities in AOA membership were explored by academic rank and orthopaedic subspecialty. RESULTS There were 4,310 orthopaedic surgery faculty, and 998 (23.2%) had AOA membership. Overall, women formed the minority of members in the AOA study cohort (11.4%), but they had equivalent representation relative to their prevalence among faculty (10.0%, PPR = 1.14, p = 0.210). In the AOA study cohort, women were the minority at each academic rank, including assistant professor (20.2% versus 79.8%, p < 0.001), associate professor (16.8% versus 83.2%, p < 0.001), and full professor (7.0% versus 93.0%, p < 0.001). However, women had greater representation in the AOA study cohort at each academic rank than would be expected based on their prevalence among faculty, including the assistant (PPR = 1.45), associate (PPR = 1.56), and full (PPR = 1.27) professor levels. Similarly, in the AOA study cohort, women were the minority in each orthopaedic subspecialty, but were only underrepresented in pediatric orthopaedics (PPR = 0.74). Women had greater representation in the AOA study cohort than would be expected by their prevalence among faculty in hand surgery (PPR = 1.51) and orthopaedic sports medicine (PPR = 1.33). In contrast, men had equivalent representation in each orthopaedic subspecialty. CONCLUSIONS Women form a minority group in the AOA, but they exhibit greater representation in the AOA than would be expected based on their prevalence among faculty at each academic rank, and they have greater representation than men, who exhibit equivalent representation across all academic ranks. Collectively, these results disproved our hypothesis, and suggest that women are participating in the AOA at rates that are greater than their prevalence among faculty. CLINICAL RELEVANCE Equitable participation of women in orthopaedic surgery is necessary to promote diversity and inclusion in the specialty. The AOA may be an important catalyst for future positive diversity and inclusion efforts within orthopaedic surgery.
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Affiliation(s)
- Jason Silvestre
- Medical University of South Carolina, Charleston, South Carolina
| | - Maya Moore
- University of Miami Miller School of Medicine, Miami, Florida
| | - Dawn M LaPorte
- The Johns Hopkins School of Medicine, Baltimore, Maryland
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Kabangu JLK, Amadi I, Adjei J, Eden SV. Advancing diversity in spine surgery: the critical role of professional societies and foundations. Spine J 2024:S1529-9430(24)00887-8. [PMID: 39059677 DOI: 10.1016/j.spinee.2024.06.569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Revised: 06/19/2024] [Accepted: 06/20/2024] [Indexed: 07/28/2024]
Abstract
This manuscript examines the challenges and initiatives within organizations associated with spine surgery to enhance diversity, equity, and inclusion (DEI), focusing on the systemic barriers that hinder the representation of women and underrepresented in medicine (URiM) minorities. Highlighting the contributions of pioneering individuals who overcame racial and gender discrimination to forge paths in these fields, it stresses the importance of professional societies and foundations in promoting DEI. Despite advancements, legal challenges and recent legislation in various states threaten to undermine DEI efforts, presenting a critical moment for organizations to reassess and reinforce their strategies. By detailing the roles of specific professional societies, foundations, and initiatives like the American Society of Black Neurosurgeons and Nth Dimensions, the manuscript underscores the necessity of targeted actions to ensure the progress toward a more inclusive and equitable spine surgery community.
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Affiliation(s)
- Jean-Luc K Kabangu
- Department of Neurological Surgery, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Iheanyi Amadi
- Department of Neurological Surgery, University of Kansas School of Medicine, Kansas City, KS, USA
| | - Joshua Adjei
- Department of Orthopaedic Surgery, University of Pittsburg, Pittsburg, PHL, USA
| | - Sonia V Eden
- Department of Neurological Surgery, Semmes-Murphey Clinic, Memphis, TN, USA; Department of Neurological Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
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Joshi A, Kim A, Hsu N, Aiyer A, Thompson JM. A Comparison of Demographic Diversity Between Orthopaedic Surgery Residents and ACGME Foot and Ankle Fellows From 2007 to 2022. FOOT & ANKLE ORTHOPAEDICS 2024; 9:24730114241263056. [PMID: 39086379 PMCID: PMC11289798 DOI: 10.1177/24730114241263056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2024] Open
Abstract
Background Academic medicine emphasizes the need to recruit a diverse workforce in graduate medical education. Orthopaedic surgery residency has demonstrated efforts to model program compositions with evolving US demographics. However, it remains unclear whether orthopaedic fellowships, particularly foot and ankle, also reflect these efforts. Methods Using the publicly available Accreditation Council for Graduate Medical Education (ACGME) Data Resource Book, a census of the gender and racial/ethnic identities of orthopaedic foot and ankle fellows, as well as active orthopaedic surgery residents, were compiled from 2007 to 2022. Linear trend analysis was conducted to evaluate the trends of orthopaedic residents and foot and ankle fellows, with a Pearson correlation for comparison. Results Prior analysis demonstrated no significant change in sex and ethnic diversity of fellows from 2006 to 2015. The majority of foot and ankle fellows were White (31%-69%) and male (63%-88%). Linear analysis demonstrated growing diversity in female and non-White active orthopaedic surgery residents. Similarly, there was an increasing number of female foot and ankle fellows (0%-38%) reflective of the trend in orthopaedic residency (12%-20%); however, there was no significant change among racial/ethnic identities. Pearson correlation analysis between the trend of orthopaedic residency residents and foot and ankle fellows suggests moderate correlation among female, Asian, and "Unknown" racial/ethnic categories. Conclusion The proportion of foot and ankle female fellows in ACGME-accredited fellowships has matched or exceeded the percentage of female orthopaedic residents. Despite increased diversity of orthopaedic surgery residents over the past 2 decades, ACGME-accredited foot and ankle fellowships do not yet reflect similar trends among racial/ethnic minorities. Level of Evidence Level III, retrospective cohort study.
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Affiliation(s)
- Aditya Joshi
- Department of Orthopaedic Surgery, Johns Hopkins University Schools of Medicine, Baltimore, MD, USA
| | - Andrew Kim
- Department of Orthopaedic Surgery, Johns Hopkins University Schools of Medicine, Baltimore, MD, USA
| | - Nigel Hsu
- Department of Orthopaedic Surgery, Johns Hopkins University Schools of Medicine, Baltimore, MD, USA
| | - Amiethab Aiyer
- Department of Orthopaedic Surgery, Johns Hopkins University Schools of Medicine, Baltimore, MD, USA
| | - John M. Thompson
- Department of Orthopaedic Surgery, Johns Hopkins University Schools of Medicine, Baltimore, MD, USA
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Middleton KK, Turner A. Racial and Ethnic Disparities in Sports Medicine and the Importance of Diversity. Clin Sports Med 2024; 43:233-244. [PMID: 38383106 DOI: 10.1016/j.csm.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Within orthopedics surgery as a specialty, sports medicine is one of the least diverse surgical subspecialties. Differences in minority representation between patient and provider populations are thought to contribute to disparities in care, access, and outcomes.
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Affiliation(s)
| | - Alex Turner
- University of Texas Southwestern Medical School, Dallas, TX, USA
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Pujari A, Johnson F, Little MT, Forsh DA, Okike K. Racial/Ethnic and Gender Diversity of Orthopaedic Journal Editorial Boards. J Bone Joint Surg Am 2024; 106:460-465. [PMID: 37713501 DOI: 10.2106/jbjs.23.00384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/17/2023]
Abstract
BACKGROUND In the current era of evidence-based medicine, scientific publications play a crucial role in guiding patient care. While the lack of diversity among orthopaedic surgeons has been well documented, little is known about the diversity of orthopaedic journal editorial boards. The purpose of this study was to assess the racial/ethnic and gender diversity of U.S. orthopaedic journal editorial boards. METHODS The editorial boards of 13 orthopaedic journals were examined, including 10 subspecialty and 3 general orthopaedic journals. Race/ethnicity and gender were determined for each editorial board member. The representation observed on orthopaedic journal editorial boards was compared with representation at other phases of the orthopaedic pipeline, as well as within the various subspecialty fields of orthopaedics. Logistic regression and t tests were used to evaluate these comparisons. RESULTS We identified 876 editorial board members of the 13 journals; 14.0% were Asian, 1.9% were Black, 1.9% were Hispanic, 2.4% were multiracial/other, and 79.7% were White. Racial/ethnic representation was similar across the subspecialty fields of orthopaedics (p > 0.05). The representation of women on orthopaedic editorial boards was 7.9%, with differences in gender diversity observed across subspecialty fields (p < 0.05). Among journals in the subspecialty fields of spine and trauma, female editorial board representation was lower than expected, even after taking into account the representation of women in these subspecialty fields (2.0% versus 9.0% [p = 0.002] and 3.8% versus 10.0% [p = 0.03], respectively). CONCLUSIONS In this study of 13 subspecialty and general orthopaedic journals, the representation of racial/ethnic minorities and women on editorial boards was similar to their representation in academic orthopaedics. However, these values remain low in comparison with the population of patients treated by orthopaedic surgeons. Given the importance of scientific publications in the current era of evidence-based medicine, orthopaedic journals should continue working to diversify the membership of their editorial boards.
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Affiliation(s)
- Amit Pujari
- Icahn School of Medicine at Mount Sinai, New York, NY
| | | | | | - David A Forsh
- Icahn School of Medicine at Mount Sinai, New York, NY
| | - Kanu Okike
- Hawaii Permanente Medical Group, Honolulu, Hawaii
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Proal JD, Maqsoodi N, Abela D, Curry EJ, Mesfin A, Li X. Academic and Demographic Characteristics of Pediatric Orthopaedic Division Chiefs in the United States. J Pediatr Orthop 2024; 44:e298-e302. [PMID: 38111289 DOI: 10.1097/bpo.0000000000002600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
INTRODUCTION Division Chiefs (DCs) and department leadership play an integral role within the service. The goal of this study is to assess the demographics and scholarly work of the leadership in pediatric orthopaedics services across the United States and comment on the role of diversity within leadership positions. METHODS Academic medical centers and pediatric hospitals were identified using the Electronic Residency Application Service website, the Pediatric Orthopaedic Society of North America website, and the Children's Hospital Association website. Leadership was identified using the hospitals' respective websites where data such as sex, race/ethnicity, fellowship institution, time since graduating fellowship, and academic rank were collected. Scopus database was used to determine h-indices and PubMed was used to determine the number of publications. RESULTS Of 196 academic centers and 223 pediatric hospitals identified, 98 had a designated DC of the pediatric orthopaedics division. The majority of the DCs were male (85.7%), and leadership positions at hospitals with academic affiliations had a higher proportion of female DCs than nonacademic centers ( P =0.0317). DCs were mostly white (83.7%), followed by Asian (12.2%), and African American (2.0%). The average time since fellowship was 21.1 years and the average h-index was 15.7. The average age of the DCs was 56.8 years old. Of those in academic settings, 48.5% held the rank of professor. The fellowship programs that trained the most DCs were Boston Children's Hospital (16.3%) and Texas Scottish Rite for Children (14.3%). DISCUSSION There is a paucity of available research on leadership characteristics in pediatric orthopaedic surgery. While progress has been made, there is still a lack of diversity that exists among leadership in pediatric orthopaedics, both within the academic setting as well as the private sector. The position of DC is held predominately by white males with a rank of either professor or no academic association. Intentional efforts are needed to continue to increase diversity in leadership positions within pediatric orthopaedic programs in the United States. LEVEL OF EVIDENCE IV.
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Affiliation(s)
| | | | - Daniele Abela
- Department of Orthopaedic Surgery, Boston Medical Center, Boston, MA
| | - Emily J Curry
- Department of Orthopaedic Surgery, Boston Medical Center, Boston, MA
| | - Addisu Mesfin
- Department of Orthopaedic Surgery, MedStar Health, Columbia, MD
| | - Xinning Li
- Department of Orthopaedic Surgery, Boston Medical Center, Boston, MA
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Murali S, Harris AB, Snow M, LaPorte D, Aiyer A. The Mentee Perspective: Evaluating Mentorship of Medical Students in the Field of Orthopaedic Surgery. J Am Acad Orthop Surg Glob Res Rev 2023; 7:01979360-202311000-00001. [PMID: 37938911 PMCID: PMC10631613 DOI: 10.5435/jaaosglobal-d-22-00267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 06/02/2023] [Accepted: 09/18/2023] [Indexed: 11/10/2023]
Abstract
INTRODUCTION Mentorship is an invaluable facet of medical education. The purpose of this study was to analyze medical student perspectives of mentorship they received and the influence this has on their participation in the field of orthopaedic surgery. METHODS We conducted a cross-sectional study of medical students interested in pursuing orthopaedic surgery through an 18-question survey distributed through social media and e-mail. RESULTS Two hundred fifteen students completed this survey, with over 50% of students reporting that they have a mentor in orthopaedic surgery while 34% were actively seeking one. Most students found mentors through research opportunities (25%) and cold e-mails (20%). Common hurdles to mentorship were access (38%) and finding common time (30%). Peer mentorship had a higher mean satisfaction score in all domains, except facilitating matching, and there was a significant difference between groups (e.g., peer mentor versus program director; P < 0.001). Sex, race, and degree type were not significantly related to students' access to or their evaluation of mentors (P > 0.05 for all). CONCLUSION Overall, this study demonstrates that medical students across the nation rely on mentorship to guide them on their path to becoming an orthopaedic surgeon.
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Affiliation(s)
- Sudarsan Murali
- From the Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD (Dr. Harris, Ms. Snow, Dr. LaPorte, and Dr. Aiyer), and the Department of Orthopaedic Surgery, The University of Alabama, Birmingham, AL (Dr. Murali)
| | - Andrew B. Harris
- From the Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD (Dr. Harris, Ms. Snow, Dr. LaPorte, and Dr. Aiyer), and the Department of Orthopaedic Surgery, The University of Alabama, Birmingham, AL (Dr. Murali)
| | - Morgan Snow
- From the Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD (Dr. Harris, Ms. Snow, Dr. LaPorte, and Dr. Aiyer), and the Department of Orthopaedic Surgery, The University of Alabama, Birmingham, AL (Dr. Murali)
| | - Dawn LaPorte
- From the Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD (Dr. Harris, Ms. Snow, Dr. LaPorte, and Dr. Aiyer), and the Department of Orthopaedic Surgery, The University of Alabama, Birmingham, AL (Dr. Murali)
| | - Amiethab Aiyer
- From the Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD (Dr. Harris, Ms. Snow, Dr. LaPorte, and Dr. Aiyer), and the Department of Orthopaedic Surgery, The University of Alabama, Birmingham, AL (Dr. Murali)
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Fisher MW, Askew M, Baird M, Ozdemir S, Williams S, Ramirez V, Kilcoyne K, Dingle M. Pipeline to Military Orthopaedic Leadership: 20 Years of Race and Gender Diversity Trends Within Military Orthopaedic Surgery Fellowship Training. JB JS Open Access 2023; 8:e23.00019. [PMID: 37850210 PMCID: PMC10578742 DOI: 10.2106/jbjs.oa.23.00019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2023] Open
Abstract
Background The lack of trainees from underrepresented race and gender backgrounds in orthopaedic surgery fellowship training has been well reported in the literature. The purpose of this study was to investigate the demographic trends of federally sponsored military orthopaedic surgery fellows in the Army, Navy, and Air Force. We hypothesize that there has been an increase in women selected for fellowship but that there has been no change in the race demographics of military fellows over the past 2 decades. Methods A retrospective review of all available demographic data collected by the Army, Air Force, and Navy since the beginning of tracking federally funded fellowship training in orthopaedic surgery was completed (1998-2021). Data were grouped into 4-year periods for analysis to closely mirror the military assignment cycle. Results Three hundred sixty-two military orthopaedic surgery fellowship board selectees were included in our analysis. The proportion of women fellows increased from 3% (n = 2/69) over 2001 to 2004 to 21% (n = 17/82) during 2017 to 2020 (p < 0.05). Fellows who identified as White comprised 82% (n = 297) of the cohort during the study period. Individuals who identified as Asian were the next highest proportion of fellows at 4% (n = 16), followed by Black (n = 14, 4%) and Hispanic (n = 13, 3%). Individuals who identified as Native Hawaiian/Pacific Islander represented 1% (n = 3), and an additional 6% (n = 20) fellows identified as "other" or "undeclared." Over the 20-year study period, representation of Asian, Black, Native Hawaiian, and Hispanic fellows did not increase (p = 0.79, 0.81, 0.45, 0.34, respectively). Conclusions Within military orthopaedics, there has been increased representation of women in fellowship training over the past 20 years. However, the proportion of fellows from underrepresented racial and ethnic groups has remained stagnant. One barrier to improving gender and race representation is the currently imprecise and inconsistent collection of demographic information. Importantly, fellowship training has a direct effect on future leadership opportunities within the military orthopaedic surgery community. A more diverse leadership may help to inspire future generations of military orthopaedic surgeons. Level of Evidence IV.
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Affiliation(s)
- Miles W.A. Fisher
- Department of Orthopedic Surgery San Antonio Military Medical Center Fort Sam Houston, Texas
| | - Morgan Askew
- Alpert Medical School at Brown University, Providence, Rhode Island
| | - Michael Baird
- Department of Orthopaedics, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Sevil Ozdemir
- Michigan State University College of Human Medicine, East Lansing, Michigan
| | - Shaun Williams
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Valentina Ramirez
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Kelly Kilcoyne
- Department of Orthopaedics, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Marvin Dingle
- Department of Orthopaedics, Walter Reed National Military Medical Center, Bethesda, Maryland
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Didier AJ, Creeden JF, Pannell SM, Sutton JM. Trends in Racial and Gender Diversity Among Complex General Surgical Oncology Fellowship Trainees. Ann Surg Oncol 2023; 30:6824-6834. [PMID: 37351734 DOI: 10.1245/s10434-023-13743-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 06/01/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND This study examines trends in racial and gender diversity of trainees within Complex General Surgical Oncology Fellowships, and compares the racial and gender proportions of trainees across different fields to assess potential barriers to increasing diversity within surgical oncology training programs. METHODS Accredited Council for Graduate Medical Education (ACGME) data were queried to identify surgical trainees between 2013 and 2021. Trainees were identified based on self-reported race and gender and were stratified based on residency type and fellowship program type if applicable. Chi-square tests were used to assess differences between groups and trends. RESULTS A significantly lower proportion of individuals who are underrepresented in medicine (URMs) trained in surgical oncology fellowships (8.9%) compared with both the overall trainee pool (12.8%) and general surgery residency programs (13.1%) [p < 0.05]. There was no significant increase in URM representation in surgical oncology fellowships across the study period. Furthermore, there was a significantly lower proportion of females training in surgical oncology fellowships (38.6%) compared with the overall trainee pool (45.6%) [p < 0.05]. Despite a significant increase in female representation in general surgery residency and other surgical fellowships, there was no significant increase in female representation in surgical oncology fellowships across the study period. CONCLUSIONS This study identifies disparities in gender and racial minority representation within ACGME-accredited Complex General Surgical Oncology Fellowship training programs. While steps have been taken to expand diversity, more needs to be done to combat the systemic barriers that both racial minorities and women face during their training.
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Affiliation(s)
- Alexander J Didier
- University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.
| | - Justin F Creeden
- University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
| | - Stephanie M Pannell
- University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
- Division of Colon and Rectal Surgery, Department of Surgery, University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
| | - Jeffrey M Sutton
- Division of Oncologic and Endocrine Surgery, Department of Surgery, Medical University of South Carolina, Charleston, SC, USA
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Steele M, Gianakos AL, Stamm MA, Mulcahey MK. Diversity in Orthopaedic Sports Medicine Societies. Arthrosc Sports Med Rehabil 2023; 5:100752. [PMID: 37645393 PMCID: PMC10461193 DOI: 10.1016/j.asmr.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 06/01/2023] [Accepted: 06/02/2023] [Indexed: 08/31/2023] Open
Abstract
Purpose The purpose of this study was to report demographic trends in terms of ethnicity/race and gender among the membership and leadership positions of the Arthroscopy Association of North America (AANA) and the American Orthopaedic Society of Sports Medicine (AOSSM). Over the years both AANA and AOSSM will increase in diversity through their committee membership and leadership positions. Methods AANA and AOSSM membership and leadership were reviewed for the years 2010, 2015, and 2020. Race/ethnicity was divided into Caucasian, Asian, African American (AA), Hispanic/Latin/South American (HLSA), and Middle Eastern (ME). Gender was limited to male or female, based on name and photographic depiction. Results Diversity in AANA and AOSSM committee and leadership positions is summarized in Table 1 and Table 2, respectively. In 2010, 166/191 (87%) AANA committee members were Caucasian, as compared with 125/186 (67%) in 2020. Asian committee members were similar in 2010 (13/191, 7%) and 2015 (13/216, 6%) but increased to 17/186 (10%) in 2020. HLSA committee members increased from 5/191 (3%) 2010 to 11/186 (6%) in 2020. AA committee membership increased from 2/191 (1%) in 2010 to 5/186 (3%) in 2020. The diversity of AANA Board of Director leadership positions increased, with Caucasian representation decreasing from 14/14 (100%) 2010 to 11/12 (92%) in 2020 and Asian representation increasing from 0% in 2010 to 1/12 (8%) in 2020, with HLSA, AA and ME remaining the same with 0/12 (0%). In AANA, men comprised 181/191 (95%) committee members in 2010 and 166/186 (89%) in 2020. The percentage of female committee members increased from 10/191 (5%) in 2010 to 20/186 (11%) in 2020. In 2010, 73/79 (92%) AOSSM committee members were Caucasian compared to 62/81 (77%) in 2020 with AA having the largest increase in committee members from 0% in 2010 to 6/81 (7%) in 2020 (Table 2). Within AOSSM, men comprised 73/79 (92%) committee members in 2010 and 70/81 (86%) in 2020. The percentage of female committee members in AOSSM increased from 6/79 (8%) in 2010 to 11/81 (14%) in 2020. Conclusion There has been a progressive trend toward increasing diversity in both committee membership and leadership positions in AANA and AOSSM from 2010 to 2020. Within AANA, there has been a decrease in the Caucasian representation from 87% in 2010 to 67% in 2020 and an increase in the female representation from 5% in 2010 to 11% in 2020. AOSSM demonstrated a similar trend, with Caucasian representation decreasing from 92% in 2010 to 77% in 2020, in addition to female percentage increasing from 8% in 2010 to 14% in 2020. Although there has been an increase in representation of minority and female orthopaedic surgeons within both societies, there is still room for more diversity and inclusion within committee membership and leadership. It is important to progress toward the understanding of the changes that need to be made and work to implement opening the field of orthopaedic sports medicine.
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Affiliation(s)
- Malia Steele
- Tulane University, New Orleans, Louisiana, U.S.A
| | | | - Michaela A. Stamm
- Harvard-Massachusetts General Hospital, Boston, Massachusetts, U.S.A
| | - Mary K. Mulcahey
- Harvard-Massachusetts General Hospital, Boston, Massachusetts, U.S.A
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Silvestre J, Thompson TL, Nelson CL, Adams BW. Diversity in Leadership at Musculoskeletal Oncology Fellowships in the United States. Cureus 2023; 15:e35688. [PMID: 37012945 PMCID: PMC10066706 DOI: 10.7759/cureus.35688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 03/01/2023] [Indexed: 03/06/2023] Open
Abstract
Musculoskeletal oncology fellowship directors (MOFDs) possess the unique ability to influence treatment paradigms in musculoskeletal oncology through teaching and research. Currently, the characteristics that define this important role including demographics, training characteristics, research activity, and grant funding are poorly defined. A list of musculoskeletal oncology fellowship programs was obtained from the American Association of Hip and Knee Surgeons and Musculoskeletal Oncology Fellowship Match. Bibliometric data including the h-index were abstracted from Scopus. Demographics, training, and federal grant characteristics were collected from academic websites. Comparisons were made using t-tests and data were presented as means ± SD. The average age at the appointment was 41±9 years and most were male (80%) and Caucasian (85%). Few had an additional graduate degree (10% MS, 5% PhD). The mean h-index was 23±15 resulting from 91±56 publications. There was a positive correlation between age and h-index (r=0.398, p=0.082). Four MOFDs (20%) had at least one National Institutes of Health research grant. Sex, race, additional graduate degree, and procurement of NIH funding were not associated with higher h-index values. Full professors had higher h-index values than assistant/associate professors (p=0.014). Women and racial minorities are underrepresented among leadership positions in musculoskeletal oncology fellowship programs. This study can help provide a benchmark for departments in orthopedic surgery and aspiring orthopedic surgeons for MOFD positions.
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Sharif-Askary B, Abdou SA, Charipova K, Sears ED, Giladi AM. Evaluating the Role of Mentorship in Career Advancement: A Survey of Women in Academic Hand Surgery. J Hand Surg Am 2023:S0363-5023(23)00024-2. [PMID: 36841663 DOI: 10.1016/j.jhsa.2022.12.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 12/07/2022] [Accepted: 12/20/2022] [Indexed: 02/27/2023]
Abstract
PURPOSE Despite the increasing percentage of women within the American Society for Surgery of the Hand, women remain underrepresented within leadership in academic hand surgery. Although this disparity in leadership representation may be improving, we aimed to investigate the role mentorship plays in advancing women in academic hand surgery. METHODS This is a survey-based, mixed-methods study. A written survey assessing themes in personal and professional experiences with mentorship was sent to hand fellowship-trained women. Inclusion criteria were the completion of a hand fellowship and current affiliation with an academic institution. An evolved grounded theory framework was used to evaluate the responses. Themes were identified based on common responses. RESULTS Of 186 eligible participants, 144 (85.2%) received the survey. The response rate was 48.6%. Respondents indicated that residency was the stage at which mentorship was most impactful (n = 25, 37%), and half of the respondents identified their desire to work in academic hand surgery during residency (n = 35, 50%). Obstacles to finding a mentor included lack of availability (n = 46, 67.7%), hesitance in searching for a mentor (n = 16, 23.5%), and searching for a mentor within an environment that was not conducive to success for trainees (n = 7, 10.3%). Most (84%) cited instances were the ones having the advice of a woman mentor was more impactful than that of a mentor who is a man. The reported need for same-sex mentorship fell into three categories: (1) insight into shared experiences, (2) assistance with conflict/bias management, and (3) support during career navigation. CONCLUSIONS The findings of this study demonstrate the need for high-quality mentorship during the residency with a specific emphasis on same-sex mentorship. CLINICAL RELEVANCE Our findings provide clear objectives related to improving access to and quality of mentorship. This foundational understanding will enrich mentor-mentee relationships, allowing for greater personal and professional success and satisfaction for both parties.
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Affiliation(s)
- Banafsheh Sharif-Askary
- The Curtis National Hand Center, MedStar Union Memorial Hospital, Baltimore, MD; Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, DC
| | - Salma A Abdou
- The Curtis National Hand Center, MedStar Union Memorial Hospital, Baltimore, MD; Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, DC
| | - Karina Charipova
- The Curtis National Hand Center, MedStar Union Memorial Hospital, Baltimore, MD; Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, DC
| | - Erika D Sears
- Section of Plastic Surgery, The University of Michigan, Ann Arbor, MI; VA Center for Clinical Management Research, Ann Arbor, MI
| | - Aviram M Giladi
- The Curtis National Hand Center, MedStar Union Memorial Hospital, Baltimore, MD.
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Kamalapathy PN, Raso J, Rahman R, Harihar S, Lozano-Calderon S, Hassanzadeh H. Orthopedic Surgery Fellowship Directors: Trends in Demographics, Education, Employment, and Institutional Familiarity. HSS J 2023; 19:113-119. [PMID: 36776521 PMCID: PMC9837408 DOI: 10.1177/15563316221091798] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 01/31/2022] [Indexed: 02/14/2023]
Abstract
Background: Fellowship directors are assumed to be distinguished in orthopedics, but the traits and training that have enabled them to achieve their leadership positions have not been assessed. Purpose: We sought to identify common demographics, research output, and educational trends of fellowship directors in orthopedics, with an emphasis on racial, ethnic, and gender diversity. Methods: We conducted a literature review to identify published studies on fellowship directors in orthopedic surgery and found 4 cross-sectional studies of fellowship directors in spine, arthroplasty, pediatrics, and sports medicine subspecialties. Another 4 accredited orthopedic subspecialties and their fellowship directors were identified using the American College of Graduate Medical Education Public Accreditation Data System for 2020-2021 and national fellowship directories. Data endpoints included race/ethnicity, age, sex, residency and fellowship training institutions, year of fellowship completion, year of hire at current institution, year of fellowship directors appointment, and h-index. The demographics and educational backgrounds for listed fellowship directors were collected from curricula vitae (CVs). Results: Of the 537 fellowship directors identified among 8 orthopedic subspecialties, the average age was 52.9 ± 2.2 years, 5.6% (N = 30) were women, 79.1% (N = 406) were white, 12.5% (N = 64) were Asian American, 3.7% (N = 19) were African American, 2.9% (N = 15) were Middle Eastern, and 1.7% (N = 9) were Hispanic/Latino. Oncology 20% (N = 4) had the highest percentage of female fellowship directors; 37.6% (N = 202) of fellowship directors were at the same institution they trained at for residency or fellowship. Their average h-index was 18.6 ± 3.7. Conclusion: This study of fellowship directors in orthopedics found that they have a high research output and a high level of institutional familiarity. We identified a need for greater diversity in these leadership positions in both gender and race/ethnicity.
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Affiliation(s)
| | - Jon Raso
- Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA, USA
| | - Rana Rahman
- Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA, USA
| | - Sanjana Harihar
- Department of Neuroscience, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Hamid Hassanzadeh
- Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA, USA
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Dingle M, Galvez MG. The Underrepresented Minority in Hand Surgery: Challenges and Strategy for Success. Hand Clin 2023; 39:73-78. [PMID: 36402528 DOI: 10.1016/j.hcl.2022.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Hand surgery is a subspecialty that requires additional fellowship training after a primary residency; a long and competitive journey to achieve success. An underrepresented in medicine (UIM) student's journey to becoming a hand surgeon in the United States adds another level of challenge given several defined obstacles. Despite the lack of representation, the chances of becoming a hand surgeon are difficult but not impossible. A comprehensive strategy for an UIM student to become a hand surgeon is outlined in detail.
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Affiliation(s)
- Marvin Dingle
- Department of Surgery, Uniformed Services University of Health Sciences, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889, USA
| | - Michael G Galvez
- Division of Plastic and Hand Surgery, Pediatric Hand and Upper Extremity Surgery, Valley Children's Healthcare, 9300 Valley Children's Place GE07, Madera, CA 93636, USA.
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16
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Abstract
Diversity in the Hand Surgery workforce improves the quality of care delivered, advances a wider variety of innovation within the field and leads to higher patient satisfaction, greater access to care and patient adherence to advice. An understanding of the data makes a compelling argument for change. Advocacy is necessary to stop the "leaky pipeline" of the loss of diversity in more senior and leadership roles. Hand surgeons who are both women and from underrepresented minority groups are especially vulnerable to bias from the health-care system, with focused support and mentoring required throughout their training and career.
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Affiliation(s)
- Angelo R Dacus
- Department of Orthopaedic Surgery, University of Virginia, 2280 Ivy Road, Charlottesville, VA 22908, USA.
| | - Brittany Behar
- Department of Plastic/Maxillofacial Surgery, University of Virginia, 2280 Ivy Road, Charlottesville, VA 22908, USA
| | - Kia Washington
- Division of Plastic & Reconstructive Surgery, University of Colorado, 12631 East 17th Avenue, Aurora, CO 80045, USA
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17
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Hastings KG, Freiman HD, Amanatullah DF, Gardner MJ, Frick S, Shea KG. A Pilot Program: Remote Summer Program to Improve Opportunity and Mentorship Among Underrepresented Students Pursuing Orthopaedic Surgery. JB JS Open Access 2022; 7:JBJSOA-D-22-00059. [PMID: 36338797 PMCID: PMC9624440 DOI: 10.2106/jbjs.oa.22.00059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
UNLABELLED The purpose of this study was to evaluate the impact of an 8-week remote summer program in supporting underrepresented students interested in orthopaedic surgery. METHODS We received 115 applications, and a total of 17 students participated in the program (14.8%). Nine faculty mentors were matched with 1 or 2 students each. The program delivered a curriculum from June-August 2021 consisting of (1) weekly instructional courses on research-related topics led by a content expert; (2) weekly faculty lectures discussing topics including orthopaedic topics, diversity in medicine, leadership, and work-life balance; and (3) a research experience paired with a faculty mentor and peer mentor. We surveyed students to measure skill progression, satisfaction, and overall program evaluation. Preprogram/postprogram evaluation, midprogram check-in, and student feedback surveys were collected. RESULTS Program participants represented a range of race and ethnic backgrounds, research experience levels, and various geographic locations across the United States. The cohort included a high rate of female (42%) and Black (35%) participants. On average, postprogram survey scores indicated that participants believed that the summer program improved their research skills (9.6 of 10), improved their orthopaedic interest (8.9 of 10), and improved mentorship and networking (9.1 of 10). For feedback surveys, 14 respondents of 15 total responses (93%) felt they were adequately matched to their faculty mentor. Twelve (80%) felt they had realistic deliverables for research projects within the 8-week program. Thirteen (87%) indicated they contributed to an abstract or manuscript as a coauthor. CONCLUSION Our findings indicate that students improved their research skills, interest, and confidence to pursue orthopaedic residency and mentorship/networks in the field. The long-term goal is to improve the accessibility and quality of mentorship for underrepresented students in order to foster an equitable pathway into the field of orthopaedic surgery.
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Affiliation(s)
- Katherine G. Hastings
- Department of Orthopaedic Surgery, Stanford University School of Medicine Stanford, California 94305 USA,E-mail for corresponding author:
| | - Halle D. Freiman
- Department of Orthopaedic Surgery, Stanford University School of Medicine Stanford, California 94305 USA
| | - Derek F. Amanatullah
- Department of Orthopaedic Surgery, Stanford University School of Medicine Stanford, California 94305 USA
| | - Michael J. Gardner
- Department of Orthopaedic Surgery, Stanford University School of Medicine Stanford, California 94305 USA
| | - Steven Frick
- Department of Orthopaedic Surgery, Stanford University School of Medicine Stanford, California 94305 USA
| | - Kevin G. Shea
- Department of Orthopaedic Surgery, Stanford University School of Medicine Stanford, California 94305 USA
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Snow M, McDaniel C, Bronheim RS, LaPorte D. Representation of Women and Underrepresented Minorities Among Grand Rounds Speakers in Orthopaedic Surgery. SURGERY IN PRACTICE AND SCIENCE 2022. [DOI: 10.1016/j.sipas.2022.100148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Barber LA, Jacobson J, Cornell CN. Diversity, Equity, and Inclusion at HSS Journal. HSS J 2022; 18:459-461. [PMID: 36263274 PMCID: PMC9527539 DOI: 10.1177/15563316221118564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 07/22/2022] [Indexed: 02/07/2023]
Affiliation(s)
| | | | - Charles N Cornell
- Hospital for Special Surgery, New York, NY, USA
- Weill Cornell Medicine, New York, NY, USA
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20
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Chrea B, Johnson H, Baumhauer J, Holleran A, Atwater LC, Poon S. A 10-Year Review of Designated Leadership Positions of the American Orthopaedic Foot & Ankle Society (AOFAS). FOOT & ANKLE ORTHOPAEDICS 2022; 7:24730114221133392. [PMID: 36340295 PMCID: PMC9629578 DOI: 10.1177/24730114221133392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background In 2019 the majority of US medical students were women (50.5%). However, despite this representation, female representation within orthopaedic surgery remains low when compared to male counterparts. Previously, the American Society for Surgery of the Hand (ASSH) and Pediatric Orthopaedic Society of North America (POSNA) published their gender diversity data. No such study has been conducted in the American Orthopaedic Foot & Ankle Society (AOFAS), which is the largest membership organization for foot and ankle-trained orthopaedic surgeons. This study sought to investigate whether increased female representation in the AOFAS membership roster is reflected in different levels within the organization. Methods The 2012-2022 membership rosters were obtained from the AOFAS and compared by gender. Volunteer, elected, and appointed leadership positions as well as rates of engagement were compared for each of the activities. Leadership positions were defined as committee chair, vice chair, or board of directors (BOD). When available, time for advancement through leadership positions to the presidential role was analyzed by gender. Comparative data were available for 2 other respective subspecialty groups, ASSH and POSNA, from previously published studies. Results Between 2012 and 2022, the percentage of female membership in the AOFAS has continued to increase from 7.5% (n=76) to 13% (n=163). Engagement in committee membership positions during this time has more than doubled from 11 of 26 (14.4%) to 57 of 163 (34.9%). When participation trends were evaluated by gender, women showed higher rates of committee involvement than their male counterparts. In 2021 compared to 2012, the percentage of female committee members more than doubled compared with their male counterparts (female 34.9% to male 23.2% vs female 14.4% to male 16.8%). This increase in female gender committee composition trend has been seen in the ASSH and POSNA, but it is more pronounced in the AOFAS. Representation of women in committee chair positions and elected positions has not seen this same parallel increase. Conclusion The female membership of the AOFAS has a similar gender composition to other orthopaedic subspecialities. Female membership within the society has increased over the past 10 years. The rates of female involvement within committee membership positions have seen a parallel increase. It will take time to mature into leadership roles as we continue to increase diversity within our respective subspecialty organizations. Inception of the AOFAS Diversity Equity and Inclusion and Women's Subcommittee demonstrate a continued emphasis on this core value within the society. Level of Evidence Level IV, cohort study.
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Affiliation(s)
- Bopha Chrea
- Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, OR, USA,Bopha Chrea, MD, Department of Orthopaedic Surgery and Rehabilitation, Oregon Health & Science University, 3303 S. Bond Avenue, Portland, OR 97239, USA. Emails: and
| | - Holly Johnson
- Department of Orthopaedics and Rehabilitation, Hospital for Special Surgery, New York, NY, USA
| | - Judith Baumhauer
- Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, NY, USA
| | - Amanda Holleran
- Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, NY, USA
| | - Lara C. Atwater
- Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, OR, USA
| | - Selina Poon
- Department of Orthopaedics and Rehabilitation, Shriners Hospital for Children, Pasadena, CA, USA
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Heisler CA, Botros-Brey S, Wang H, Tran A, Gaigbe-Togbe B, Leegant A, Hardart A. Money Matters: Anticipated Expense of In-Person Obstetrics and Gynecology Fellowship Interviews Has Greater Impact for Underrepresented in Medicine and Women Applicants. WOMEN'S HEALTH REPORTS 2022; 3:686-691. [PMID: 36000016 PMCID: PMC9394437 DOI: 10.1089/whr.2021.0114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 04/18/2022] [Indexed: 11/12/2022]
Affiliation(s)
- Christine A. Heisler
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
- Address correspondence to: Christine A. Heisler, MD, MS, Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, 202 S. Park Street, 2 East, Madison, WI 53715, USA.
| | - Sylvia Botros-Brey
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Urology, University of Texas Health San Antonio, Joe R and Theresa Lozano Long School of Medicine, San Antonio, Texas, USA
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Medical Education, University of Texas Health San Antonio, Joe R and Theresa Lozano Long School of Medicine, San Antonio, Texas, USA
| | - Hanzhang Wang
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Urology, University of Texas Health San Antonio, Joe R and Theresa Lozano Long School of Medicine, San Antonio, Texas, USA
| | - Ann Tran
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai Health System, Icahn School of Medicine, New York, New York, USA
| | - Bertille Gaigbe-Togbe
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai Health System, Icahn School of Medicine, New York, New York, USA
| | - Ava Leegant
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, USA
| | - Anne Hardart
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai Health System, Icahn School of Medicine, New York, New York, USA
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22
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Sharp S, Hixson A, Stumpff J, Williamson F. Understanding the Experiences of Black Women Medical Students and Residents: A Narrative Review. Front Public Health 2022; 10:879135. [PMID: 35774571 PMCID: PMC9237355 DOI: 10.3389/fpubh.2022.879135] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 05/23/2022] [Indexed: 11/24/2022] Open
Abstract
Background Few research studies examine medical students and residents with intersectional identities. In the emerging literature, data on Black women's experiences may be misrepresented and misinterpreted as studies aggregate data for women, students of color, and Black/African American men. As such, these studies do not account for the nuanced experiences of gendered racism that Black women students and residents may encounter during their medical education. Methods Using Crenshaw's intersectionality as an analytical tool, we conducted a narrative review to highlight how Black women medical students and residents are rendered invisible in the current literature on medical education. Results The results generated 13 citations specifically discussing Black women medical students and residents, with only six studies being empirical research. Conclusion We conclude that 13 articles is inadequate for understanding the experiences of these populations. Without centering Black women or using an intersectional lens, researchers could invalidate the lived experiences of this population and create barriers to the political resources Black women learners need to be successful. Moreover, the lack of intention behind addressing the needs of Black women can be viewed as complicity in the oppressive structures that serve to subjugate them.
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Affiliation(s)
- Sacha Sharp
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
- *Correspondence: Sacha Sharp ; orcid.org/0000-0002-1532-4783
| | - Ashley Hixson
- College of Education, University of Maryland, College Park, MD, United States
| | - Julia Stumpff
- Ruth Lilly Medical Library, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Francesca Williamson
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States
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Ethnic and Sex Diversity in Academic Orthopaedic Surgery: A Cross-sectional Study. J Am Acad Orthop Surg Glob Res Rev 2022; 6:01979360-202203000-00009. [PMID: 35258489 PMCID: PMC8906469 DOI: 10.5435/jaaosglobal-d-21-00321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 12/21/2021] [Indexed: 11/20/2022]
Abstract
Introduction: Although the diversity in orthopaedic residency programs has been studied, the diversity within academic orthopaedics has not. Methods: The board of specialty societies, five leading journals and the National Institutes of Health RePORTER tool, and three accreditation organizations were explored. Results: The board of directors comprised 220 (72%) Caucasians, 36 (12%) Asians, 4 (1%) Hispanic/Latinos, 29 (9%) African Americans, and 18 (6%) Other individuals; 250 (81%) were men, and 57 (19%) were women. The editorial boards comprised 288 (77%) Caucasians, 62 (16%) Asians, 14 (4%) Hispanic/Latinos, 8 (2%) African Americans, and 4 (1%) Other individuals; 341 (91%) were men, and 35 (9%) were women. The National Institutes of Health grant recipients comprised 117 (64%) Caucasians, 58 (32%) Asians, 4 (2%) Hispanic/Latinos, and 3 (2%) African Americans; 128 (70%) were men, and 54 (30%) were women. On average, Caucasians, Asians, Hispanic/Latinos, and African Americans received $776,543, $439,600, $420,182, and $494,049, respectively. On average, men and women received $759,426 and $419,518, respectively. The accreditation boards comprised 45 (82%) Caucasians, 6 (11%) Asians, and 4 (7%) African Americans; 45 (82%) were men, and 10 (18%) were women. Conclusions: Academic orthopaedic surgery does not resemble the United States. Residency, fellowship committees, and professional organization boards need to become aware of these disparities.
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24
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Dixon G, Barqadle F, Gill E, Okoroafor W, Fromme B, Ganem J. Diversity, Inclusion and Cultural Competency in Pediatric Hospital Medicine Fellowship Programs. Hosp Pediatr 2021; 11:779-785. [PMID: 34312213 PMCID: PMC8336456 DOI: 10.1542/hpeds.2020-004515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The objectives with this study were to describe the current state of Pediatric Hospital Medicine (PHM) fellowship programs with regards to (1) diversity of fellows and programs' leadership, (2) current diversity and inclusion (D&I) programs and measures of their success, and (3) the state of cultural competency training. METHODS In 2018, fellowship directors of the 35 active PHM fellowship programs were invited to participate in a survey of diversity, inclusion, and cultural competency at PHM fellowship programs. Participants were invited via in-person invitations at the annual PHM fellowship directors meeting and through e-mail invitations from July to September to complete an online survey. RESULTS There was an 89% response rate of the survey. Most fellows, faculty, and program directors in PHM were female (74%, 70%, and 70%, respectively) and white (53%, 67%, and 60%, respectively). There were no African American, American Indian or Alaskan Native, or Native Hawaiian or other Pacific Islander program directors. Forty-five percent of programs reported that neither the fellowship program nor their hospital had a strategic plan that addresses D&I. Approximately 61% of programs had cultural competency training for fellows. CONCLUSIONS This is the first survey to report on the state of D&I in PHM fellowship programs. There is lack of racial and ethnic diversity in programs fellows, faculty, and directors. Although most programs have cultural competency training, strategic planning to promote D&I is not widely implemented among PHM fellowship programs.
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Affiliation(s)
- Gabrina Dixon
- Children's National Hospital and School of Medicine and Health Sciences, George Washington University, Washington, District of Columbia
| | - Fatuma Barqadle
- Children's Hospital Los Angeles and University of Southern California, Los Angeles, California
| | - Edward Gill
- Floating Hospital for Children at Tufts Medical Center, Boston, Massachusetts
| | | | - Barrett Fromme
- Department of Pediatrics, University of Chicago, Chicago, Illinois
| | - Jorge Ganem
- Dell Children's Medical Center of Central Texas and 10 University of Texas-Austin Medical School, Austin, Texas
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25
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Bradford PS, Dacus AR, Chhabra AB, Butler PD, DeGeorge BR. How to Be An Antiracist Hand Surgery Educator. J Hand Surg Am 2021; 46:507-511. [PMID: 33762091 DOI: 10.1016/j.jhsa.2021.01.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 01/19/2021] [Accepted: 01/23/2021] [Indexed: 02/02/2023]
Abstract
Racism that unjustly marginalizes black people in the United States is not a new concept. It underlies nearly every aspect of American history, leading to the systemic racism that is ingrained in our society today. With the recurrent theme of people of color having worse health outcomes than the majority community, it is important for hand surgeons to employ cultural competence and antiracist education to provide better care and support for patients, staff, students, and colleagues. In this article, we will provide a definitional framework, clinical examples, and practical pearls to promote change. To reduce racial and ethnic health care inequities and diversify the field of hand surgery, we must advocate on behalf of black and brown colleagues, staff, students, and/or friends to address racist policies and procedures.
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Affiliation(s)
- Perry S Bradford
- Department of Plastic Surgery, University of Virginia Health, Charlottesville, VA
| | - A Rashard Dacus
- Department of Orthopaedic Surgery, University of Virginia Health, Charlottesville, VA
| | - A Bobby Chhabra
- Department of Orthopaedic Surgery, University of Virginia Health, Charlottesville, VA.
| | - Paris D Butler
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania Health System, Philadelphia, PA
| | - Brent R DeGeorge
- Department of Plastic Surgery, University of Virginia Health, Charlottesville, VA; Department of Orthopaedic Surgery, University of Virginia Health, Charlottesville, VA
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Abstract
BACKGROUND Female physicians are underrepresented across a broad range of medical specialties, especially at senior levels. Previous research demonstrated poor representation of women in sports medicine leadership roles in the National Collegiate Athletic Association (NCAA) compared to their male colleagues. PURPOSE The purpose of this study was to evaluate the distribution of men and women among team physicians on the medical staffs of National Basketball Association (NBA) and Women's National Basketball Association (WNBA) teams in the last 10 years and assess regional differences in representation of female physicians. METHODS A Google search of publicly available data regarding team physician gender, medical specialty, and medical degree was conducted in October 2019 for team physicians in the NBA and WNBA over the last 10 years. Descriptive statistics were used to analyze the data. This data was then stratified by physician specialty and region of country in which NBA/WNBA franchises are located to provide regional comparison of team physician characteristics. RESULTS We identified 125 team physicians for NBA franchises. Of these, 122 (97.6%) were male and 3 (2.4%) were female. In the WNBA, a total of 28 physicians were identified. 20 (71.4%) were male and 8 (28.6%) were female. The Northeast had the highest proportion of female team physicians, with 5 of 18 (27.8%). Female physicians were represented in the remaining geographic regions as follows: 3 of 41 (7.3%) in the Midwest, 2 of 45 (4.4%) in the South, and 1 of 48 (2.1%) in the West. CONCLUSION This study demonstrates a substantial difference in the number of female physicians with leadership roles in both the NBA and WNBA compared to male physicians. It is important to try to understand what barriers female physicians face in their pursuit of upper level positions in sports medicine and to implement strategies to provide equal opportunities to both male and female physicians.
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Affiliation(s)
| | - Symone M Brown
- Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, LA, USA
| | - Mary K Mulcahey
- Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, LA, USA
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Odonkor CA, Leitner B, Taraben S, Adekoya P, Orhurhu V, Hirani S, Ike K, Lee R, Vanterpool S, Goree JH, Sully K, Poree L. Diversity of Pain Medicine Trainees and Faculty in the United States: A Cross-Sectional Analysis of Fellowship Training from 2009-2019. PAIN MEDICINE (MALDEN, MASS.) 2021; 22:819-828. [PMID: 33502490 PMCID: PMC8599803 DOI: 10.1093/pm/pnab004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Diversity and equity in medicine remain pivotal to care delivery. Data analysis on sex and racial diversity of pain medicine fellowship trainees and faculty in the United States are scant. We sought to characterize demographic and retention patterns among pain medicine fellows and faculty, who represent the emerging chronic pain management workforce. DESIGN cross-sectional retrospective analysis. METHOD We conducted an analysis of data from the American Association of Medical Colleges (AAMC) and the United States Accreditation Council on Graduate Medical Education (ACGME)-approved residency and fellowship training-programs for each year from 2009 through 2019, inclusively. We compared changes in sex, racial/ethnicity composition and retention rates of fellows and faculty in the United States by practice setting. RESULTS From 2009 to 2019, there was a 14% increase in the number of ACGME pain fellowship programs. From 2009 to 2019, the ratio of men to women pain fellows ranged from 5:1 to 3.7:1. Compared with their self-identified White peers, Asian (OR 0.44; 95% CI: 0.34-0.58), Black (OR 0.46; 95% CI: 0.30-0.72), and Native American/Alaskan Native (OR 0.26; 95% CI: 0.08-0.80) identifying individuals had significantly lower odds of being a pain fellow, P < 0.05. There was no significant difference in female (OR = 0.4, 95% CI: 0.148-1.09) and Black (OR 0.36; 95% CI: 0.11-1.12) program-directors. Pain-fellow in-state retention was 53%. CONCLUSIONS The demographics of pain medicine training programs reflect a persistent male vs. female gap with underrepresentation of racial minorities. Further research is needed to elucidate reasons underlying these disparities.
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Affiliation(s)
- Charles A Odonkor
- Department of Orthopaedics and Rehabilitation, Division of Physiatry, Yale School of Medicine, Yale New Haven Hospital, New Haven, Connecticut
| | - Brooks Leitner
- Medical Scientist Training Program, Yale School of Medicine, New Haven, Connecticut
| | - Salam Taraben
- Frank H. Netter School of Medicine, Quinnipiac University, Hamden, Connecticut
| | - Peju Adekoya
- Department of Anesthesia, Critical Care and Pain Medicine, Division of Pain Medicine, Johns Hopkins Hospital, Baltimore, Maryland
| | - Vwaire Orhurhu
- Department of Anesthesia, Critical Care and Pain Medicine, Division of Pain, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Salman Hirani
- Department of Pain Medicine, Division of Anesthesiology, Critical Care, and Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Kenneth Ike
- Department of Anesthesia, Grady Memorial Hospital, Emory University School of Medicine, Atlanta, Georgia
| | - Roger Lee
- Division of Anesthesiology and Pain Medicine, Kaiser Permanente Northern California, Walnut, Creek, California
| | - Stephanie Vanterpool
- Department of Anesthesiology, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee
| | - Johnathan H Goree
- Department of Anesthesiology, University of Arkansas for Medical Science, Little Rock, Arkansas
| | - Kate Sully
- Integrated Rehab Consultants, Chicago, Illinois
| | - Lawrence Poree
- Department of Anesthesia, University of California San Francisco, San Francisco, California, USA
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Shah KN, Ruddell JH, Scott B, Reid DBC, Sobel AD, Katarincic JA, Akelman E. Orthopaedic Surgery Faculty: An Evaluation of Gender and Racial Diversity Compared with Other Specialties. JB JS Open Access 2020; 5:JBJSOA-D-20-00009. [PMID: 32803101 PMCID: PMC7386543 DOI: 10.2106/jbjs.oa.20.00009] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The American Academy of Orthopaedic Surgeons has adopted the strategic goal of evolving its culture and governance to become more strategic, innovative, and diverse. Given the charge to increase diversity, a focus on assessing and increasing diversity at the faculty level may help this cause. However, an analysis of gender and racial diversity among orthopaedic faculty has not been performed. The purpose of this study was to evaluate faculty appointments for underrepresented minority (URM) and female orthopaedic surgeons. We also aim to draw comparisons between orthopaedic surgery and other specialties.
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Affiliation(s)
- Kalpit N Shah
- Department of Orthopaedic Surgery, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island
| | - Jack H Ruddell
- Department of Orthopaedic Surgery, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island
| | - Brandon Scott
- Department of Orthopaedic Surgery, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island
| | - Daniel B C Reid
- Department of Orthopaedic Surgery, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island
| | - Andrew D Sobel
- Department of Orthopaedic Surgery, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island
| | - Julia A Katarincic
- Department of Orthopaedic Surgery, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island
| | - Edward Akelman
- Department of Orthopaedic Surgery, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island
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O'Reilly OC, Day MA, Cates WT, Baron JE, Glass NA, Westermann RW. Female Team Physician Representation in Professional and Collegiate Athletics. Am J Sports Med 2020; 48:739-743. [PMID: 31922898 DOI: 10.1177/0363546519897039] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Although a sex-based balance in US graduate medical education has been well-documented, a discrepancy remains in orthopaedic surgery. In orthopaedic sports medicine, the representation of women as team physicians has not previously been characterized. PURPOSE To quantify the sex-related composition of team physicians of select National Collegiate Athletic Association (NCAA) Division I collegiate and professional teams. Additionally, the authors assess the sex-related composition of orthopaedic surgeon team physicians specifically and compare these proportions to the sex-related composition of orthopaedic surgeon membership of the American Orthopaedic Society for Sports Medicine (AOSSM). STUDY DESIGN Cross-sectional study. METHODS Publicly available sex-related data were collected for team physicians in select NCAA Division I collegiate conferences and professional sports organizations. Subspecialty characteristics and sex distribution were described by use of percentages. Chi-square tests were used to assess whether sex distributions of team physicians in collegiate and professional sports were (1) representative between the populations of female and male physicians compared with the general public and (2) representative of the sex-based composition of orthopaedic surgeons nationally. RESULTS Women represented 12.7% (112/879) of all team physicians and 6.8% (30/443) of all orthopaedic surgeons (P < .0001). More than half (53.9%; 413/767) of male and 26.8% (30/112) of female team physicians were orthopaedic surgeons. In collegiate athletics, women comprised 18.1% of all team physicians and 7.7% of orthopaedic surgeon team physicians. In professional sports, women comprised 6.7% of all team physicians and 6.3% of orthopaedic surgeon team physicians, with the greatest proportion in the Women's National Basketball Association (31.3%). CONCLUSION Women comprise a minority of team physicians in select NCAA Division I collegiate and professional sports organizations. When compared with the composition of AOSSM orthopaedic surgeon membership, expected female orthopaedic surgeon representation varies between conferences and leagues with little statistical significance. Although efforts have been made to increase sex-based diversity in orthopaedic surgery, results of this study suggest that barriers affecting female orthopaedic surgeons as team physicians should be identified and addressed.
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Affiliation(s)
- Olivia C O'Reilly
- Department of Orthopaedics and Rehabilitation, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Molly A Day
- Department of Orthopaedics and Rehabilitation, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - William T Cates
- Department of Orthopaedics and Rehabilitation, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Jaqueline E Baron
- Department of Orthopaedics and Rehabilitation, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Natalie A Glass
- Department of Orthopaedics and Rehabilitation, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Robert W Westermann
- Department of Orthopaedics and Rehabilitation, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
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30
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Poon S, Abzug J, Caird M, Cho RH, Luong M, Weiss JM. A Five-year Review of the Designated Leadership Positions of Pediatric Orthopaedic Society of North America: Where Do Women Stand? Orthop Clin North Am 2019; 50:331-335. [PMID: 31084835 DOI: 10.1016/j.ocl.2019.03.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Despite the growing number of women entering medical school, female representation among orthopedic surgery is the lowest compared with all areas of medicine. In 2014, 47.7% of students entering medical school were women, but only 13.7% of orthopedic residents were women. Pediatric orthopedics have been successful in enrolling women compared with other orthopedic subspecialties. This is an investigation of female representation among the Pediatric Orthopaedic Society of North America membership roster, providing insight into the effect on the increased gender diversity in the membership of an organization and its correlation with leadership positions at different levels within the organization.
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Affiliation(s)
- Selina Poon
- Orthopaedic Surgery Department, Shriners for Children Medical Center, 909 South Fair Oaks Avenue, Pasadena, CA 91105, USA.
| | - Joshua Abzug
- Department of Orthopaedics and Pediatrics, University of Maryland School of Medicine, 1 Texas Station Court, Suite 300, Timonium, MD 21093, USA
| | - Michelle Caird
- Pediatric Orthopaedic Department, University of Michigan, 1540 East Hospital Drive, Ann Arbor, MI 48109, USA
| | - Robert H Cho
- Orthopaedic Surgery Department, Shriners for Children Medical Center, 909 South Fair Oaks Avenue, Pasadena, CA 91105, USA
| | - Marilan Luong
- Research Department, Shriners for Children Medical Center, 909 South Fair Oaks Avenue, Pasadena, CA 91105, USA
| | - Jennifer M Weiss
- Pediatric Orthopaedic Department, Kaiser Permanente, 4760 Sunset Boulevard, Los Angeles, CA 90027, USA
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