Location, location, location: How does residency program leadership vary according to geographic region?

Abstract

Background: Faculty relationships are key to resident education. Residency applicants may find it more appealing to choose programs where the faculty have a similar background. With the addition of geographic preferences to the application process, applicants may find it beneficial to know general faculty makeup in each region. The purpose of this study was to evaluate the relationship of geographic location and orthopaedic residency leadership characteristics. Methods: The Accreditation Council for Graduate Medical Education (ACGME) and Doximity websites were queried in September 2022 to identify United States orthopaedic residency programs for the 2022-2023 cycle. Program attributes were categorized by region. Program leaders evaluated in this study consisted of Chairs, Vice Chairs, Program Directors (PDs), and Assistant PDs. Results: A total of 192 programs with 425 leaders were included. Leaders were mostly PDs (42.6%, n=181), men (88.7%, n=377), MDs (90.6%, n=385), and trained in the US (96.9%, n=412). The Northeast had the most programs (n=59, 30.7%) and leadership positions (n=136, 32.0%). The West had higher proportions of internationally-trained and women leaders (8.2%, P=0.046 and 18.0%, P=0.072), although the latter only trended towards significance. The South contained the lowest prevalence of internationally-trained leaders (0.8%, P=0.046). The Midwest exhibited the largest amount of DO leadership (16.0%, P=0.022). The Northeast had more surgeons subspecialized in hand/upper extremity (19.9% vs. 10.0%, P=0.033) yet relatively fewer in oncology (2.9% vs. 10.7%, P=0.041). Conclusions: Program attributes varied by region. This information is valuable to applicants and leaders as the field strives to strengthen and diversify its leadership.