Barriers to Increasing Diversity in Orthopaedics: The Residency Program Perspective

Area of Science:

• Medical Education
• Surgical Workforce Diversity
• Orthopaedic Surgery

Background:

• Orthopaedic surgery faces challenges in diversifying its racial and ethnic workforce.
• Limited data exists on perceived barriers to diversity within orthopaedic surgery residency programs.

Purpose of the Study:

• To identify barriers to improving racial/ethnic diversity in orthopaedic surgery residency programs.
• To understand the perspectives of program directors and coordinators on diversity initiatives.

Main Methods:

• A 17-question survey was electronically distributed to 155 orthopaedic surgery residency program directors and coordinators.
• Data was collected between November 2018 and April 2019, with a 48.4% response rate.
• Statistical significance was determined using a p-value of < 0.05.

Main Results:

• The primary perceived barriers included insufficient underrepresented minority (URM) faculty (69.3%), difficulty matching URM applicants (56%), and a low number of URM applicants (54.7%).
• Programs with higher percentages of URM faculty reported higher percentages of URM residents (p = 0.001).
• Participation in the Nth Dimensions and/or Perry Initiative programs was associated with a higher percentage of URM faculty (p = 0.004). URM residents had higher resignation/dismissal rates.

Conclusions:

• The lack of URM faculty is the most significant perceived barrier to increasing racial/ethnic diversity in orthopaedic surgery residency programs.
• A positive correlation exists between the percentage of URM faculty and the percentage of URM residents.
• Engagement with specific diversity initiatives (Nth Dimensions, Perry Initiative) is linked to increased URM faculty representation.