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Examining the Outliers: Characteristics of the Most and Least Diverse Programs in Orthopaedics
Akinola Oladimeji1, Monique Chambers, Tyler N Kelly
1From the Department of Orthopaedic Surgery, University of Miami, Miami, FL (Oladimeji), the Department of Orthopaedic Surgery, Mercy Medical Center, Baltimore, MD (Chambers), the Department of Orthopaedic Surgery, University of Alabama at Birmingham Birmingham, AL (Kelly), the HSS Research Institute, Hospital for Special Surgery, New York, NY (Hidaka), and the Sports Medicine Institute; Hospital for Special Surgery, New York, NY (Ode).
Introduction:
In 2021, the American Orthopaedic Association (AOA) Orthopaedic Research Information Network (ORIN)was created to give applicants insight into orthopaedic surgery residency programs nationwide. This study uses this database to investigate the characteristics of residency programs based on their proportion of female and underrepresented minority in medicine (URiM) trainees.
Methods:
The number and proportion of URiM and female residents at 172 programs during the 2020-2021 academic year and 179 programs each during the 2021-2022 and 2022-2023 academic years were recorded. Each program was ranked based on the proportion of URiM or female residents and grouped into quintiles and deciles. Characteristics of programs (institution type, proportion of URiM or female faculty, United States Medical Licensing Exam (USMLE) scores, American Board of Orthopedic Surgery (ABOS) Part I board pass rates) were compared between the top and bottom deciles or quintiles.
Results:
Programs among the top decile for URiM representation had a mean 35% representation, whereas representation in the bottom decile ranged from 0% to 7%. Programs within the top decile for female representation ranged from a mean of 35% to 40%. The mean proportion of female residents among the bottom decile ranged from 0% to 7%. Top decile programs for racial diversity had a greater proportion of URiM faculty, whereas those in the top decile for female representation had more female faculty compared with bottom decile counterparts. Only four programs were in the top decile for both URiM and female representation. Top and bottom decile programs differed little regarding USMLE scores or ABOS Part I pass rates of their residents.
Discussion:
The results of this study support the notion that recruitment and retention methods among programs with more female and URiM representation are potentially different. In addition, programs with more diverse faculties tend to have more diverse residency classes and that programs with the highest and lowest diversity do not differ regarding standardized testing scores among matriculated residents.
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