Analysis of gender diversity within orthopedic shoulder and elbow surgery fellowship programs

While there is an increasing number of women matching into orthopedic surgery, they continue to be under-represented among the various subspecialties of orthopedic surgery. Few studies have looked at gender diversity within the shoulder and elbow specialty specifically. This study seeks to evaluate recent trends in gender diversity among faculty and trainees within orthopedic shoulder and elbow surgery fellowship programs.

A cross-sectional analysis of faculty and program directors was conducted on 33 American Shoulder and Elbow Surgeons fellowship programs using publicly available data (August 2024). Deidentified data on fellows from 2019 to 2024 was acquired through a combination of the San Francisco Match, reaching out to individual American Shoulder and Elbow Surgeons fellowship programs, and publicly available information. The chi-square test of independence and Fisher's exact test were used to compare categorical variables. The Pearson correlation coefficient was used to test for a relationship between the number of female fellows and time.

Of 33 programs with 157 shoulder and elbow faculty, 7 (21.2%) had at least 1 female on faculty, with only 1 (3%) having female fellowship directors. Female faculty made up 5.1% of shoulder and elbow surgery faculty overall. Of 175 total fellows identified within the 6-year period, 21 (12%) were female. Geographic distribution of programs was as follows: 12 (36.4%) Northeast, 7 (21.2%) South, 6 (18.2%) Midwest, and 8 (24.2%) West. Northeast programs made up 57.1% of all programs with female faculty, whereas Midwest and West programs made up the last 42.9%.

Despite an increasing proportion of women entering orthopedic surgery as well as shoulder and elbow fellowship programs, our findings suggest that women remain under-represented shoulder and elbow surgery fellowship faculty and director positions. Interestingly, there was no association between shoulder and elbow fellowship programs with female faculty and the likelihood of having a female shoulder and elbow fellow.