Abstract
Category:
Other
Introduction/Purpose:
Racial and gender disparities in the field of orthopedic surgery are well-documented in the literature. A diverse population of physicians and surgeons is imperative to foster progress in our field and improve the quality of the care provided to patients. To further address disparities within the field of orthopedic surgery, further analysis of demographic composition at various career timepoints is warranted. The purpose of this study was to describe the historical demographic composition of fellows, including race, ethnicity, and gender, within the subspecialty of orthopedic foot and ankle from 2007 to 2022.
Methods:
Gender, race, and ethnicity data were collected from the Accredited Council for Graduate Medical Education (ACGME) annual data resource books for all years available. Published data points included the total number of fellows, race and ethnicity (White, Asian, Hispanic, Latino or of Spanish origin, Black or African American, American Indian or Alaskan Native, Native Hawaiian or Pacific Islander, Multiple Race/Ethnicity, Other, and Unknown), and gender (male, female, and not reported). Percentage equivalents for racial and ethnic groups from 2011 to 2022 and gender groups from 2007 to 2022 were calculated. Trends in representation were analyzed by calculating Sen’s slope — the median of slopes calculated between all possible pairs of time points – to reduce sensitivity to outliers.
Results:
During the 12-year period, White, Asian, Hispanic, and Black fellows represented on average 80.7%, 14.7%, 1.9%, and 2.3%, respectively. Fellows that identified as Hispanic and Black were underrepresented throughout the study period, with several years of no representation. Male trainees made up the majority of foot and ankle trainees throughout the 15-year period, averaging 79.5%. There were no female foot and ankle fellows from 2007 to 2008. We found no significant trends (p > 0.05) in representation for any racial, ethnic, or gender group across the study period.
Conclusion:
Our analysis shows a persistent underrepresentation of racial and ethnic minorities and women among foot and ankle trainees. Racial and ethnic minority representation was below that of other orthopedic subspecialties. Female representation, while among the highest among orthopedic fellowships, falls short of parity and is in line with the current female orthopedic surgery resident representation. Targeted efforts are required to improve representation among foot and ankle orthopedic surgeons moving forward. Strategies should consist of early mentorship and exposure, continued career promotion, and, ultimately, retention within the field of orthopedic surgery.
