Background: This study was undertaken to update reports from 2004 to 2005 through 2008 to 2009, and 2009 to 2010 through 2013 to 2014, including 5 additional years of GME Track data. Our hypothesis is there have been no significant changes during the past 5 years in the distribution of Accreditation Council for Graduate Medical Education (ACGME)-accredited orthopaedics residency programs that train female residents, compared with the previous 10 years. Methods: Data for ACGME-accredited orthopaedics residency training programs in the United States were analyzed for 5 consecutive academic years (2014-2015 through 2018-2019). Programs were classified as having no women, 1 woman, 2 women, or greater than 2 women in training. Programs were analyzed for percentage of female residents and classified as having above the national average (>20%), similar to the national average (between 10 and 20%), or below the national average (<10%). Results: Analysis of the original 5 years (2004-2009) compared with the most recent data (2014-2019) demonstrated a statistically significant improvement in the number of programs training women (p < 0.001). From 2004 to 2009 to 2014 to 2019, the absolute number and percent of female trainees have increased (p < 0.001). Similar analysis of the middle 5 years (2009-2014) compared with the most recent 5 years (2014-2019) did not demonstrate a statistically significant change (p = 0.12). From 2014 to 2019, residency programs in the United States continue to train women at unequal rates: 37 programs had no female trainees, while 53 programs had >20% female trainees during at least one of these 5 years. Conclusions: Female medical students continue to pursue orthopaedics at rates lagging behind all other surgical specialties. Not all residency programs train women at equal rates. If the rate of training of female residents over the past 15 years were projected over time, we would not achieve 30% women within orthopaedics residency training programs until approximately 2060. Level of Evidence: III.

Diversity in the medical field has shown to be a beneficial factor in many aspects including research productivity and patient care. Understanding how the field of hand surgery has changed with regard to the diversity of its trainees may aid in providing more equitable and effective health care.

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Background: Evaluation of surgical skill competency is necessary as graduate medical education moves toward a competency-based curriculum. This study by the American Board of Orthopaedic Surgery (ABOS) and the Council of Orthopaedic Residency Directors (CORD) compares 2 web-based evaluation tools that assess the level of autonomy that is demonstrated by residents during surgical procedures in the operating room as measured by faculty. Methods: Two hundred and ninety-four residents from 16 orthopaedic surgery residency programs were evaluated by 370 faculty using 2 web-based evaluation tools in a crossover design in which residents requested faculty review of their surgical skills before starting a case. One thousand, one hundred and fifty Ottawa Surgical Competency Operating Room Evaluation (O-Score) assessments, which included a 9-question evaluation of 8 steps of the surgical procedure, were compared with 1,186 P-score evaluations, which included a single-question summative evaluation. Twenty-five different surgical procedures were evaluated. Results: There were no significant differences in rates of resident requests or faculty completion of the 2 scores. The most common surgical procedures that were assessed were total knee arthroplasty (n = 254, 11%), carpal tunnel release (n = 191, 8%), open reduction and internal fixation (ORIF) of stable hip fractures (n = 170, 7%), ORIF of simple ankle fractures (n = 169, 7%), and total hip arthroplasty (n = 166, 7%). Both instruments disclosed significant differences in competency among entry, intermediate, and advanced-level residents. The findings support the construct validity of the evaluation method. The survey results indicated that >70% of the faculty were confident that use of either the P-score or the O-score allowed them to distinguish a resident who can perform the surgery independently from one who needs additional training. Conclusions: This research has led to the modification of the O-score and the P-score into a combined OP-score instrument. The ABOS envisions that the OP-score instrument can be used with an expanded number of surgical procedures as a required element of residency training in the near future. Clinical Relevance: This study allows the profession of orthopaedic surgery education to take a leadership role in the measurement of competence for surgical skills for orthopaedic surgeons in residency training, an important clinically relevant topic to the practice of orthopaedic surgery.

The COVID-19 pandemic has disrupted every aspect of society in a way never previously experienced by our nation's orthopaedic surgeons. In response to the challenges the American Board of Orthopaedic Surgery has taken steps to adapt our Board Certification and Continuous Certification processes. These changes were made to provide flexibility for as many Candidates and Diplomates as possible to participate while maintaining our high standards. The American Board of Orthopaedic Surgery is first and foremost committed to the safety and well-being of our patients, physicians, and families while striving to remain responsive to the changing circumstances affecting our Candidates and Diplomates.