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Review
. 2023 Oct 17;8(4):e23.00019.
doi: 10.2106/JBJS.OA.23.00019. eCollection 2023 Oct-Dec.

Pipeline to Military Orthopaedic Leadership: 20 Years of Race and Gender Diversity Trends Within Military Orthopaedic Surgery Fellowship Training

Miles W A Fisher  1 , Morgan Askew  2 , Michael Baird  3 , Sevil Ozdemir  4 , Shaun Williams  5 , Valentina Ramirez  5 , Kelly Kilcoyne  3 , Marvin Dingle  3
Affiliations
Review

Pipeline to Military Orthopaedic Leadership: 20 Years of Race and Gender Diversity Trends Within Military Orthopaedic Surgery Fellowship Training

Miles W A Fisher et al. JB JS Open Access. .

Abstract

Background: The lack of trainees from underrepresented race and gender backgrounds in orthopaedic surgery fellowship training has been well reported in the literature. The purpose of this study was to investigate the demographic trends of federally sponsored military orthopaedic surgery fellows in the Army, Navy, and Air Force. We hypothesize that there has been an increase in women selected for fellowship but that there has been no change in the race demographics of military fellows over the past 2 decades.

Methods: A retrospective review of all available demographic data collected by the Army, Air Force, and Navy since the beginning of tracking federally funded fellowship training in orthopaedic surgery was completed (1998-2021). Data were grouped into 4-year periods for analysis to closely mirror the military assignment cycle.

Results: Three hundred sixty-two military orthopaedic surgery fellowship board selectees were included in our analysis. The proportion of women fellows increased from 3% (n = 2/69) over 2001 to 2004 to 21% (n = 17/82) during 2017 to 2020 (p < 0.05). Fellows who identified as White comprised 82% (n = 297) of the cohort during the study period. Individuals who identified as Asian were the next highest proportion of fellows at 4% (n = 16), followed by Black (n = 14, 4%) and Hispanic (n = 13, 3%). Individuals who identified as Native Hawaiian/Pacific Islander represented 1% (n = 3), and an additional 6% (n = 20) fellows identified as "other" or "undeclared." Over the 20-year study period, representation of Asian, Black, Native Hawaiian, and Hispanic fellows did not increase (p = 0.79, 0.81, 0.45, 0.34, respectively).

Conclusions: Within military orthopaedics, there has been increased representation of women in fellowship training over the past 20 years. However, the proportion of fellows from underrepresented racial and ethnic groups has remained stagnant. One barrier to improving gender and race representation is the currently imprecise and inconsistent collection of demographic information. Importantly, fellowship training has a direct effect on future leadership opportunities within the military orthopaedic surgery community. A more diverse leadership may help to inspire future generations of military orthopaedic surgeons.

Level of evidence: IV.

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Conflict of interest statement

Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSOA/A560).

Figures

Fig. 1
Fig. 1
Racial and ethnic analysis of the women selected for fellowship during the study period.
See this image and copyright information in PMC

References

    1. Day CS, Lage DE, Ahn CS. Diversity based on race, ethnicity, and sex between academic orthopaedic surgery and other specialties: a comparative study. J Bone Joint Surg Am. 2010;92(13):2328-35. - PubMed
    1. Okike K, Utuk ME, White AA. Racial and ethnic diversity in orthopaedic surgery residency programs. J Bone Joint Surg Am. 2011;93(18):e107. - PubMed
    1. Ode GE, Bradford L, Ross WA, Carson EW, Brooks JT. Achieving a diverse, equitable, and inclusive environment for the Black orthopaedic surgeon: Part 1: barriers to successful recruitment of Black applicants. J Bone Joint Surg Am. 2021;103(3):e9. - PubMed
    1. Jiménez RL. Barriers to minorities in the orthopaedic profession. Clin Orthop. 1999;362(362):44-50. - PubMed
    1. Ayers CE. Minorities and the orthopaedic profession. Clin Orthop. 1999;362(362):58-64. - PubMed