Can a Strategic Pipeline Initiative Increase the Number of Women and Underrepresented Minorities in Orthopaedic Surgery?

Abstract

BackgroundWomen and minorities remain underrepresented in orthopaedic surgery. In an attempt to increase the diversity of those entering the physician workforce, Nth Dimensions implemented a targeted pipeline curriculum that includes the Orthopaedic Summer Internship Program. The program exposes medical students to the specialty of orthopaedic surgery and equips students to be competitive applicants to orthopaedic surgery residency programs. The effect of this program on women and underrepresented minority applicants to orthopaedic residencies is highlighted in this article.Questions/purposes(1) For women we asked: is completing the Orthopaedic Summer Internship Program associated with higher odds of applying to orthopaedic surgery residency? (2) For underrepresented minorities, is completing the Orthopaedic Summer Internship Program associated with higher odds of applying to orthopaedic residency?MethodsBetween 2005 and 2012, 118 students completed the Nth Dimensions/American Academy of Orthopaedic Surgeons Orthopaedic Summer Internship Program. The summer internship consisted of an 8-week clinical and research program between the first and second years of medical school and included a series of musculoskeletal lectures, hands-on, practical workshops, presentation of a completed research project, ongoing mentoring, professional development, and counselling through each participant’s subsequent years of medical school. In correlation with available national application data, residency application data were obtained for those Orthopaedic Summer Internship Program participants who applied to the match between 2011 through 2014. For these 4 cohort years, we evaluated whether this program was associated with increased odds of applying to orthopaedic surgery residency compared with national controls. For the same four cohorts, we evaluated whether underrepresented minority students who completed the program had increased odds of applying to an orthopaedic surgery residency compared with national controls.ResultsFifty Orthopaedic Summer Internship scholars applied for an orthopaedic residency position. For women, completion of the Orthopaedic Summer Internship was associated with increased odds of applying to orthopaedic surgery residency (after summer internship: nine of 17 [35%]; national controls: 800 of 78,316 [1%]; odds ratio [OR], 51.3; 95% confidence interval [CI], 21.1–122.0; p < 0.001). Similarly, for underrepresented minorities, Orthopaedic Summer Internship completion was also associated with increased odds of orthopaedic applications from 2011 to 2014 (after Orthopaedic Summer Internship: 15 of 48 [31%]; non-Orthopaedic Summer Internship applicants nationally: 782 of 25,676 [3%]; OR, 14.5 [7.3–27.5]; p < 0.001).ConclusionsCompletion of the Nth Dimensions Orthopaedic Summer Internship Program has a positive impact on increasing the odds of each student participant applying to an orthopaedic surgery residency program. This program may be a key factor in contributing to the pipeline of women and underrepresent...

Trends in Race/Ethnicity Among Applicants and Matriculants to US Surgical Specialties, 2010-2018

“… 15 , 42 Early exposure to surgical specialties through strategic support initiatives, such as summer internship programs, may help to describe these fields and establish mentorship relationships, which have been associated with significant increases in applicants who identify as URM. 13 , 14 Cochran et al 43 described a grounded theory model of successful mentorship in academic surgery that emphasizes the need for multiple mentors to engage with a diverse group of mentees over time, covering unique strategic domains as opposed to overreliance on fixed mentorship dyads.…”

“… 3 , 8 , 9 , 10 In response, surgical training programs across the US have engaged in initiatives aimed at increasing the number of individuals underrepresented in medicine (URM) based on the definition by the Association of American Medical Colleges (AAMC) as “those racial and ethnic populations that are underrepresented in the medical profession relative to their numbers in the general population.” 11 However, the impact of these efforts remains unclear. 12 , 13 , 14 , 15 This study used data from the AAMC to assess trends in the race/ethnicity of applicants and matriculants to surgical specialties between 2010 and 2018.…”

The Distribution of Underrepresented Minorities in U.S. Orthopaedic Surgery Residency Programs

“…A single-institution study demonstrated that the application rate for minority students doubled after the introduction of a mandatory third-year musculoskeletal medicine rotation 7 . A survey of all U.S. medical schools demonstrated a 35% increase in the rate of application to orthopaedic programs among minorities following the institution of dedicated coursework in musculoskeletal medicine 8 .…”

Dissecting disparity: improvements towards gender parity in leadership and on the podium within the Canadian Orthopaedic Association

“…26 35 These programmes have shown that exposure to the realities of orthopaedic surgery served to improve the negative perceptions that medical students had of orthopaedic surgery as a profession 26 and resulted in improved female applications to orthopaedic residency with an odds ratio of up to 66. 35 Implicit or unconscious bias, encompasses the attitudes and perceptions that people have towards other people, and exists outside of conscious knowledge. Implicit bias negatively affects all aspects of women's orthopaedic surgery careers and has been implicated in the challenge of attracting women to orthopaedic surgery, optimising career development for women, gender pay inequities, and the lack of leadership opportunities for women.…”