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Diversity Within Foot and Ankle Surgery: A Systematic Review
Albert T Anastasio1, Justin Leal2, Alexis L Clifford2
1Duke Department of Orthopaedic Surgery, Durham, North Carolina.
Journal of Surgical Orthopaedic Advances
|June 27, 2025
Summary
Diversity in foot and ankle surgery remains low, especially in leadership roles. This systematic review highlights significant gender disparities, indicating a need for targeted strategies to achieve an equitable surgical workforce.
Area of Science:
- Orthopaedic Surgery
- Surgical Workforce Diversity
- Medical Education
Background:
- Historically underrepresented minorities and gender diversity are crucial for equitable healthcare.
- Foot and ankle surgery (FA) is a subspecialty where diversity metrics are not well-established.
- Understanding current diversity levels is essential for future workforce development.
Purpose of the Study:
- To systematically review and quantify gender diversity in foot and ankle surgery.
- To assess diversity at various professional levels, including leadership and research.
- To identify trends and disparities in representation within the field.
Main Methods:
- A systematic literature search was conducted adhering to PRISMA guidelines.
- Ten cross-sectional studies were included and assessed for quality using the STROBE checklist.
- Demographic data were extracted for FA applicants, attendings, program directors, and researchers.
Main Results:
- Significant gender disparities were observed across all levels of foot and ankle surgery.
- Females held a very low percentage of leadership positions, including Chair (5.5%) and Professor (0.9%).
- While female representation increased from 12% to 14% between 2010-2019, parity has not been achieved.
Conclusions:
- Foot and ankle surgery exhibits a notable lack of gender diversity, particularly in leadership and academic roles.
- Current diversity metrics fall short of equitable representation.
- Recognizing these disparities is the first step toward implementing targeted interventions for a more inclusive FA workforce.
