Trends in Medical Training and Leadership at Academic Orthopedic Programs

Abstract

Introduction: When deciding on which programs to rank or fellowships to enter, medical students and residents may assess the program's prestige and specialty training opportunities. This report aimed to analyze the demographics of orthopedic department chairs and program directors (PDs), focusing on the prestige of their orthopedic training and medical school. Secondary data included fellowship, higher-level education, sex, professorship, years of practice, and total published research.Methods: We used U.S. News and Doximity to rank 192 medical schools and 200 orthopedic residency programs based on prestige rankings, respectively. We searched for the department chair, vice-chair, and PD via program websites, Council of Orthopaedic Residency Directors (CORD), Orthopedic Residency Information Network (ORIN), personal websites, LinkedIn, and Doximity. Subsequently, we searched for each individual's demographic information, education and research history, employment history, and medical school attended.Results: We gathered data on 268 orthopedic surgeons with leadership positions at academic hospitals. Of the 268, 115 were department chairs, 15 were vice-chairs, 126 were PDs, 11 were both the chair and PD, and one was vice-chair and PD. Of the 268 physicians, 244 physicians were male (91.0%), while 22 were female (9.0%). The average residency reputation ranking overall was 59.7 ± 5.7. More specifically, for chairs, the average was 57.0 ± 8.3 (p < 0.005), and for PDs, the average was 63.6 ± 8.0 (p <0.005). There was no significant difference between chairs and PDs (p = 0.26).Conclusion: Orthopedic leaders were found to have trained at more prestigious programs. This trend could be explained by increased research opportunities at more prestigious programs or programs attempting to increase their own reputation. 9.0% of the leaders identify as female, which is comparable to the 6.5% of practicing female orthopedic surgeons. However, this further demonstrates a need for gender equity in orthopedic surgery. Assessing trends in the training of orthopedic surgeons with leadership positions will allow a better understanding of what programs look for in the hiring process.

Orthopedic Surgery Residency Program Rankings and Gender Diversity

“…In a more recent study, Elkadi et al found that 11.6% of program directors were female as of 2022 [ 17 ], which contrasts the results of our study of 17% of program directorship being female and the results of the Meadows et al study of 9% [ 6 ]. While this suggests an increase in female program directorship from 2020 to 2020, it is less than the percentage obtained in our investigation.…”

“…While this suggests an increase in female program directorship from 2020 to 2020, it is less than the percentage obtained in our investigation. We examined program directors from the top 100 programs based on reputation, while Elkadi et al assessed those from 200 orthopedic residency programs, suggesting increased female representation in program directorship at higher-ranked programs [ 17 ]. Indeed, a paper investigating the characteristics of leadership in “top-tier” orthopedic surgery residency programs supports this, as they found that higher-tier programs had a larger proportion of women leaders with statistical significance after examining 193 programs [ 18 ].…”

Orthopaedic surgery residency program ranking and the current state of leadership: what are the characteristics of the leaders in the “Top-tier” programs?

“…Neither of these studies described the leadership in the context of Doximity rankings. To the knowledge of the authors, only one previous study looked at the relationship between orthopaedic program leadership and program ranking 18 . The study evaluated the rankings of the residency programs and medical schools in which the chairpeople, PDs, and vice chairs involved in the 2020-2021 leadership (identified N=268) trained, but it did not analyze the relationship between these leaders and their current residency programs 18 .…”

“…To the knowledge of the authors, only one previous study looked at the relationship between orthopaedic program leadership and program ranking 18 . The study evaluated the rankings of the residency programs and medical schools in which the chairpeople, PDs, and vice chairs involved in the 2020-2021 leadership (identified N=268) trained, but it did not analyze the relationship between these leaders and their current residency programs 18 . The present study is thus the first to the authors’ knowledge that evaluates characteristics of the leadership according to program ranking.…”

AOA Critical Issues: The Status of the Vice Chair Position in Orthopaedic Surgery Departments in 2023

“…During the last 10 years, and more profoundly in the last 5 years, the number of vice chair positions in academic orthopaedic departments has changed, from rare to quite common. However, details remain scarce, as noted in a 2022 study on orthopaedic leadership in which a comprehensive search of available public information identified only 15 orthopaedic vice chairs 5 . There is no clearinghouse with information on vice chair positions, and such information is lacking on department websites and in other resources.…”