Diversity Based on Race, Ethnicity, and Sex Between Academic Orthopaedic Surgery and Other Specialties A Comparative Study

Background: Previous studies have demonstrated a lack of diversity in orthopaedics; however, it is unclear whether this observation is unique to orthopaedics or similar to other surgical fields. The present study compares diversity in the field of orthopaedics with diversity in other surgical and nonsurgical fields. To our knowledge, no previous study has placed this issue in a comparative perspective between specialties at both the residency and faculty levels. Methods: Public registries from 2006 and 2007 were used to determine the composition (according to race, ethnicity, and sex) of the orthopaedic workforce in the United States, including medical students, orthopaedic residents, orthopaedic faculty, and full professors. The diversity of orthopaedic residents and faculty was then compared with that in five other specialties. In addition, the applicant pools to orthopaedic and general surgery residencies were compared. Results: Within the 2006 orthopaedic workforce, there was a significant decrease in the representation of African-Americans, Hispanics/Latinos, Asian-Americans, and women from medical schools to orthopaedic residencies (p < 0.001). African-Americans, Hispanics/Latinos, and Asian-Americans were underrepresented among orthopaedic faculty compared with their representation in orthopaedic residency programs (p < 0.05). Furthermore, women and Asian-Americans were disproportionately underrepresented as full professors compared with their presence on the faculty at academic orthopaedic institutions (p < 0.05). When compared with other surgical specialties, African-Americans and Hispanics/Latinos made up a significantly smaller proportion of orthopaedic residents than general surgery residents and neurological surgery. Orthopaedic surgery had the lowest representation of female residents and faculty (p < 0.05 for all comparisons). In examining the applicant pool, orthopaedic surgery was less diverse than general surgery (p < 0.001). Furthermore, African-American and Hispanic/Latino orthopaedic applicants also submitted a lower average number of applications than Whites or Asian-Americans. Conclusions: Our findings suggest that on a comparative basis, orthopaedic surgery lags behind general surgery and other surgical and nonsurgical fields in terms of the representation of minorities and women. Thus, given similar capabilities and qualifications of applicants, a concerted effort could be made to recruit more diverse residents and faculty.