Diversity, Equity, and Inclusion Content on Orthopaedic Surgery Fellowship Program Websites: A Cross-Sectional,...

Introduction The shift to virtual interviewing during the COVID-19 pandemic made program websites a central resource for residency and fellowship applicants, and applicants from groups underrepresented in medicine place particular value on programs that visibly demonstrate a commitment to diversity, equity, and inclusion (DEI). Orthopaedic surgery remains among the least diverse surgical specialties, and although professional societies such as the American Academy of Orthopaedic Surgeons (AAOS) have prioritized DEI, the extent to which these efforts are reflected on orthopaedic fellowship websites is unknown. This study evaluated the online presence of DEI-focused content across orthopaedic subspecialty fellowship program websites. Methods We performed a cross-sectional, observational website-content analysis. Fellowship programs across nine orthopaedic subspecialties were identified using the Fellowship and Residency Electronic Interactive Database (FREIDA) and AAOS fellowship listings and screened between March and May 2024. Programs with an accessible website were assessed for nine predefined DEI elements adapted from a previously published website-content framework. Program characteristics (geographic region, program size, and program type) were abstracted from FREIDA. Mean DEI counts were compared across subspecialties using one-way analysis of variance (ANOVA) with least-significant-difference (LSD) post-hoc testing, and adjusted models accounted for program size, type, and region. Results Of 450 fellowship programs identified, 448 had accessible websites and were analyzed. The mean number of DEI elements per program ranged from 4.22 (Pediatrics) to 5.76 (Foot & Ankle). The most frequently displayed elements were faculty photographs (385/448, 86%) and biographies (386/448, 86%), followed by DEI webpages (296/448, 66%) and DEI statements (293/448, 65%). Pediatrics and Shoulder & Elbow programs displayed significantly fewer DEI elements than the other subspecialties (p = 0.036). This difference persisted after adjusting for program size (p < 0.001) and program type (p < 0.001) but not for geographic region (p = 0.876). Conclusions Orthopaedic fellowship programs demonstrate substantial variability in the DEI content presented online, with several subspecialties underrepresenting these elements. Programs across subspecialties have an opportunity to strengthen and make more visible their DEI efforts on program websites.