Barriers to Increasing Diversity in Orthopaedics

Abstract

Background: There are little data to explain why the surgical subspecialty of orthopaedic surgery struggles with improving the racial/ethnic composition of its workforce. The current work sought to determine what orthopaedic residency program directors and coordinators believe are the barriers to improving diversity at their own programs. Methods: Between November 17, 2018, and April 1, 2019, a 17-question survey was electronically distributed to the program directors and coordinators of 155 allopathic orthopaedic surgery residency programs. Seventy-five of 155 programs (48.4%) responded to the survey. A p-value of < 0.05 was used to determine statistical significance. Results: The most commonly stated barriers to increasing diversity within the orthopaedic surgery programs were the following: “We do not have enough minority faculty, which may deter the applicants” (69.3%), “We consistently rank minority applicants high but can never seem to match them” (56%), and “Not enough minorities are applying to our program” (54.7%). Programs with higher percentages of underrepresented minority (URM) faculty had higher percentages of URM residents (p = 0.001). Programs participating in the Nth Dimensions and/or Perry Initiative programs had a higher percentage of URM faculty as compared to the residency programs that did not participate in these programs (p = 0.004). URM residents represented 17.5% of all residents who resigned and/or were dismissed in the 10 years preceding the survey while also only representing 6% of all orthopaedic residents during the same time period. Conclusions: From the orthopaedic residency program perspective, the greatest perceived barrier to increasing the racial/ethnic diversity of residents in their program is their lack of URM faculty. Surveyed programs with more URM faculty had more URM residents, and programs participating in Nth Dimensions and/or Perry Initiative programs had a higher percentage of URM faculty.

Disparities in ACL Reconstruction: the Influence of Gender and Race on Incidence, Treatment, and Outcomes

“…Additionally, there was no significant improvement in racial/ethnic diversity among orthopedic residency programs over the same time period [107 • ]. A recent study similarly showed that Latino, African American, and Native American groups were significantly underrepresented in orthopedic residencies [108]. A more representative workforce from surgeon to physical therapists to athletic trainers may have a positive impact on disparities and treatment outcomes.…”

Effect of the COVID-19 Pandemic on the Orthopaedic Surgery Residency Application Process: What Can We Learn?

“…In addition, with orthopaedic surgery often cited being one of the least racially and sex diverse specialties in medicine, additional insight is needed concerning the influence of the pandemic on the diversity of applicants who applied, interviewed, and matched at orthopaedic residency programs. 24 - 26 …”

Current Perceptions of Diversity Among Head Team Physicians and Head Athletic Trainers: Results Across US Professional Sports Leagues

“…Survey-based demographic studies are often complicated by nonresponse and volunteer bias, which may skew results and produce incomplete data. 1 , 4 , 23 , 24 , 50 This study attempts to capture the entirety of HTP and head ATC perceived diversity, which may not be possible with survey techniques given the pitfalls mentioned above. Studies detailing associations among orthopaedic institutions’ faculty diversity, resident diversity, and the diversity of the applicant pool of medical students suggest the perception of diversity is an important factor.…”