Trends of Underrepresented Minorities and Female Trainees in Orthopedic, Plastic, and Hand Surgery: Did We Do Better...

Orthopedic and plastic surgery are among the least diverse specialties, but recent initiatives have aimed to increase exposure and support of female and underrepresented minority (URM) trainees. Hand surgery incorporates trainees from both orthopedic and plastic surgery. This study aimed to evaluate trends in the presence of female and URM trainees from 2007 to 2023 in orthopedic, plastic, and hand surgery to provide an update on previous reports of diversity in these fields.

The Accreditation Council for Graduate Medical Education (ACGME) Data Resource Book was queried between 2007 and 2023 for all ACGME, orthopedic, plastic, and hand surgery trainees. For each subset, all available gender and race/ethnicity data were collected. Race/ethnicity was stratified into two cohorts: White/Asian and URM.

The percentage of female trainees steadily increased from 2007 to 2023 in all ACGME (40.5%-47.8%), orthopedic surgery (11.6%-20.3%), plastic surgery (21.8%-44.2%), and hand surgery (18.8%-35.2%). Logistic regression demonstrated a positive relationship between year and female trainees among all ACGME, orthopedic, plastic, and hand surgery. Female orthopedic trainees increased by approximately 3% in the first 10 years from 2007 to 2017; however, in the most recent 5 years, the representation rose more (5.6%) in half the time. The same trend is not reproduced for all ACGME, plastics, or hand trainees. Between 2011 and 2023, logistic regression demonstrated a positive relationship between year and URM representation among orthopedic and hand surgery trainees but not among all ACGME and plastics trainees.

Female and URM trainees have increased in both orthopedic and hand surgery from 2007 to 2023. Plastics surgery trainees have increased female, but not URM trainees.

This study provides an update on diversity among orthopedic, plastic, and hand surgery trainees, and highlights the progress made.