Underrepresented Minority Applicants Are Competitive for Orthopaedic Surgery Residency Programs, but Enter Residency at Lower Rates

Abstract

Introduction: Orthopaedic surgery residency programs have the lowest representation of ethnic/racial minorities compared with other specialties. This study compared orthopaedic residency enrollment rates and academic metrics of applicants and matriculated residents by race/ethnicity. Methods: Data on applicants from US medical schools for orthopaedic residency and residents were analyzed from 2005 to 2014 and compared between race/ethnic groups (White, Asian, Black, Hispanic, and Other). Results: Minority applicants comprised 29% of applicants and 25% of enrolled candidates. Sixty-one percent of minority applicants were accepted into an orthopaedic residency versus 73% of White applicants (P < 0.0001). White and Asian applicants and residents had higher USMLE Step 1. White applicants and matriculated candidates had higher Step 2 Clinical Knowledge scores and higher odds of Alpha Omega Alpha membership compared with Black, Hispanic, and Other groups. Publication counts were similar in all applicant groups, although Hispanic residents had significantly more publications. Black applicants had more volunteer experiences. Conclusions: In orthopaedic surgery residency, minority applicants enrolled at a lower rate than White and Asian applicants. The emphasis on USMLE test scores and Alpha Omega Alpha membership may contribute to the lower enrollment rate of minority applicants. Other factors such as conscious or unconscious bias, which may contribute, were not evaluated in this study.

Barriers to Increasing Diversity in Orthopaedics

“…These studies show that a heavy emphasis on USMLE Step 1 in orthopaedic surgery is more likely to select students from higher socioeconomic backgrounds who happen to be English-speaking Caucasian men. Poon et al found that between 2005 and 2014, URM applicants to orthopaedic surgery had greater numbers of volunteer experiences and publications, whereas Caucasian and Asian applicants had higher USMLE Step scores and AOA statuses 23 . If the latter application items are playing a larger role in screening applicants, it is unlikely that a residency will significantly change the ethnic/racial composition of their residents.…”

Exploring the Career Engagement, Interests, and Goals of Pharmacy Students Identifying as Underrepresented Racial Minorities

“…In other health care professions, such as orthopedic surgical residencies, URM applicants are enrolled at a lower rate than non-URM applicants, which may deter URM applicants, limit URM exposure to the field, and inhibit interaction with potential mentors. 33,34 More research must be done, and data must be shared by professional organizations like American Society of Health-System Pharmacy, to better understand URM interests and matching to residencies.…”

“…43 Career goals are thought to be influenced through the process of development and determined by two types of factors: 1) intrinsic factors, such as personal interest and 2) extrinsic factors, such as salary and cost of training. 33 Participants in this study selected job security as a key factor in career goals, which is related to both intrinsic and extrinsic motivators for work. 45 In addition, self-actualization was frequently selected as important career selection.…”

Mitigating Bias in Virtual Interviews for Applicants Who are Underrepresented in Medicine

“…A study by Poon et al. 5 showed that Orthopedic residency applicants who were White were more likely to get accepted despite Hispanic students having more publications and Black applicants having more volunteer hours. Bias - conscious or unconscious - was not investigated, but it is well known to be a factor that affects those UIM.…”