Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 May 15;9(2):e23.00124.
doi: 10.2106/JBJS.OA.23.00124. eCollection 2024 Apr-Jun.

Gender Diversity in Orthopaedic Surgery Residencies Does Not Translate to Accreditation Council for Graduate Medical Education-Accredited Fellowships

David Haddad  1 , Deborah Nelson  2 , Nathan Sherman  1 , Megan Tatusko  1 , Gregory DeSilva  1
Affiliations
Review

Gender Diversity in Orthopaedic Surgery Residencies Does Not Translate to Accreditation Council for Graduate Medical Education-Accredited Fellowships

David Haddad et al. JB JS Open Access. .

Abstract

Introduction: Gender representation among orthopaedic surgery applicants and residents has increased over the past two decades. The aims of this study were to evaluate trends of female fellows in ACGME-accredited orthopaedic subspecialties between 2007 and 2021, and to compare the fellowship trends of female representation to those of ACGME-accredited orthopaedic residencies.

Methods: We conducted a retrospective review of publicly available ACGME-accredited fellowship demographic data from 2007 to 2021. The distribution of genders (male vs. female) across subspecialties and orthopaedic surgery residency programs was compared. Chi-square, Spearman correlation, and logistic regression tests were performed to analyze the relationships between year, gender, and fellowship.

Results: Chi-square analysis demonstrated a significant relationship between gender and year for orthopaedic residency (p < 0.001), but not for any fellowship. There was a significant negative Spearman correlation between the two variables for hand (r(1844) = -0.06, p = 0.02) and sports medicine (r(2804) = -0.05, p = 0.01) fellowships. The negative Spearman correlation for pediatrics (r(499) = -0.09, p = 0.054) approached but did not reach statistical significance. Logistic regression analysis revealed that, holding year constant and comparing to orthopaedic residency, the odds of male participation increased by 173% (95% CI, 1.8-4.1) in spine, increased by 138% (95% CI, 1.7-3.3) in adult reconstruction, increased by 51% (95% CI, 1.3-1.7) in sports medicine, decreased by 41% (95% CI, 0.5-0.7) in hand, decreased by 36% (95% CI, 0.5-0.9) in foot and ankle, decreased by 48% (95% CI, 0.4-0.7) in musculoskeletal oncology, and decreased by 68% (95% CI, 0.3-0.4) in pediatrics.

Conclusion: Although the percentage of female orthopaedic residents in ACGME-accredited programs increased significantly from 2007 to 2021, this has not translated to ACGME-accredited fellowship positions. Future research optimizing methods to improve the representation of females in orthopaedic surgery should be considered.

Level of evidence: III.

PubMed Disclaimer

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/A626).

Figures

Fig. 1
Fig. 1
The number of ACGME-accredited orthopaedic surgery residency and fellowship programs from 2007 to 2021. ACGME = Accreditation Council for Graduate Medical Education.
Fig. 2
Fig. 2
The number of ACGME-accredited orthopaedic surgery residency and fellowship positions from 2007 to 2021. ACGME = Accreditation Council for Graduate Medical Education.
Fig. 3
Fig. 3
The number of females within ACGME-accredited orthopaedic surgery residency and fellowship programs from 2007 to 2021. ACGME = Accreditation Council for Graduate Medical Education.
Fig. 4
Fig. 4
The number of males within ACGME-accredited orthopaedic surgery residency and fellowship programs from 2007 to 2021. ACGME = Accreditation Council for Graduate Medical Education.
See this image and copyright information in PMC

References

    1. Association of American Medical Colleges. 2022 Fall Applicant, Matriculant, and Enrollment Data Tables. 2022. https://www.aamc.org/media/64176/download?attachment. Accessed 2023.
    1. Chambers CC, Ihnow SB, Monroe EJ, Suleiman LI. Women in orthopaedic surgery: population trends in trainees and practicing surgeons. J Bone Joint Surg Am. 2018;100(17):e116. - PubMed
    1. Haffner MR, Van BW, Wick JB, Le HV. What is the trend in representation of women and under-represented minorities in orthopaedic surgery residency? Clin Orthop Relat Res. 2021;479(12):2610-7. - PMC - PubMed
    1. Onuoha AC, Meadows AM, Faraj MT, Skinner MM, Day C, Ravi K. Comparative analysis of racial and gender diversity in orthopedic surgery applicants and residents from 2007 and 2019. J Orthop Exper Innov. 2022:31412.
    1. Dib AG, Lowenstein NA, LaPorte DM, Samora JB, Matzkin EG. The pioneering women of orthopaedic surgery: a historical review. J Bone Joint Surg Am. 2022;104(15):e66. - PubMed