Trends in Leadership at Spine Surgery Fellowships

Abstract

Study Design. Cross-sectional study. Objective. To illustrate demographic trends among spine fellowship leaders (FLs). Summary of Background Data. No previous study in the orthopedic literature has analyzed the demographic characteristics or past surgical training of FL in an orthopedic sub-specialty. We attempt to illustrate demographic trends among spine fellowship leadership including fellowship directors (FDs) and co-fellowship directors (co-FDs). We also highlight the institutions that have trained these leaders at various levels. Methods. Our search for FDs was constructed from the 2018 to 2019 North American Spine Surgery (NASS) Fellowship Directory. Datapoints gathered included: age, sex, residency/fellowship training location, time since training completion until FD appointment, length in FD role, and personal research H-index. Results. We identified 103 FLs consisting of 67 FDs, 19 co-FDs, and another 16 individuals with a synonymous leadership title. 96.1% (99) of the leadership consisted of males while 3.9% (4) were female. The mean age was 52.9 years old and the mean h-index of the FLs was 23.8. FLs were trained in orthopedic surgery (n = 89), neurosurgery (n = 13), or combined orthopedic surgery and neurosurgery training (n = 1). The top fellowships programs producing future FLs were: Case Western Reserve University, Cleveland (n = 10), Washington University, St. Louis (n = 9), and Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia (n = 7). Conclusion. Spine surgery fellowship directors are more likely to have graduated from certain residency and fellowship programs. This finding could be a result of the training provided by these centers or the institution's predilection to select applicants that are more likely to later seek academic leadership roles post-training. Level of Evidence: 4

Trends in leadership at orthopaedic surgery sports medicine fellowships

“…One study in the field of general surgery, discussed the relationship between past residents’ rank lists to future academic career path[ 6 ]. Plastic surgery is another subspecialized field that has also evaluated leadership roles and trends in characteristics[ 7 , 8 ]. Previous studies in orthopaedics have considered the pertinent motivating factors impacting the applicant selection process of residency and FDs, as well as the selection process of medical students and residents when considering orthopaedic surgery as a specialty[ 9 - 15 ].…”

“…In discussions on appropriate or discrepant representation of gender and cultural diversity, the leadership within orthopaedics has come into focus[ 16 - 19 ]. Two other studies have described demographic characteristics for spine fellowship leaders and adult reconstruction FDs which similarly noted FDs are more likely to have graduated from certain residency and fellowship programs[ 7 , 20 ]. As in this sports medicine cohort, the spine and adult reconstruction cohorts might attract applicants with a predilection to later seek academic leadership roles post-training[ 7 , 19 , 20 ].…”

“…This data is similar to the results in the other orthopaedics FD demographic studies. Spine FDs’ mean duration from fellowship graduation to FD appointment was 8.59 years, while, adult reconstruction FD’s had a mean duration 9.55 years[ 7 , 20 ]. The average age of sports medicine FDs was 56 years-old.…”

“…The average age of sports medicine FDs was 56 years-old. Compared to an average age 52.85 years and 52.60 years for spine and adult reconstruction FDs, respectively[ 7 , 20 ].…”

Characteristics of Orthopaedic Sports Medicine Fellowship Directors

“…6,12,13 Recently, a cross-sectional study identifying leadership trends in spine surgery fellowships demonstrated that fellowship directors (FDs) are more likely to have graduated from certain residency and fellowship programs. 4 While these trends have been identified in orthopaedic spine surgery, there is no current literature describing these trends in sports medicine or any other orthopaedic subspecialty.…”