Trends in Racial,Ethnic,and Gender Diversity in Orthopaedic Surgery Sports Medicine Fellowships From 2007 to 2024

Abstract

Background:

Despite increases in gender, racial, and ethnic representation in medical school, orthopaedics continues to be recognized as one of the least diverse fields in medicine, as progress in achieving a more diverse orthopaedic community has not occurred nearly as rapidly.

Purpose:

To ascertain and discuss the current state of racial, ethnic, and gender demographic trends in orthopaedic surgery sports medicine fellowships from 2007 to 2024.

Study Design:

Descriptive epidemiology study.

Methods:

Fellowship demographic data were collected through the Accreditation Council for Graduate Medical Education. Data include gender, race and ethnicity, and total number of orthopaedic sports medicine fellows. Percentage equivalents were calculated for each group from 2007 to 2024. A χ² test for trend was conducted to determine if there was a significant change in the percentages of each race, ethnicity, and gender during the study period. Results were considered statistically significant at P < .05. The 114 fellows (3.2%) who did not report gender and 468 fellows (16.8%) who reported other or unknown were excluded from their respective analyses.

Results:

From 2007 to 2024, White non-Hispanic males composed the majority of sports medicine fellowship positions. White non-Hispanic representation ranged from 74.9% to 88.2%, Asian from 6.6% to 16.3%, Hispanic from 0.0% to 8.4%, and Black non-Hispanic from 1.5% to 6.9%. There was a significant increase in the proportion of Hispanic orthopaedic sports medicine fellows (P = .001) but no other significant changes among the racial and ethnic makeup of fellows. There was a significant increase in the representation of female fellows (P = .041), with a range of 5.4% to 13.2%.

Conclusion:

Our study reveals a significant increase in female and Hispanic representation among orthopaedic sports medicine fellows from 2007 to 2024, but no other racial or ethnic groups showed significant change. The disparities identified in our study suggest that systemic interventions throughout the orthopaedic education pipeline may be necessary to improve sports medicine fellowship diversity.