Falling Short: Why DEI Efforts in Orthopedic Surgery Residency Programs in the United States Need a Stronger Push
Main Article Content
Abstract
Background: In recent years, orthopedic residency programs in the United States have increasingly prioritized diversity, equity, and inclusion (DEI) efforts to address the longstanding underrepresentation of minorities, women, and disadvantaged individuals. Historically, orthopedic surgery has been one of the least diverse medical specialties, with a predominance of white male practitioners. The growing recognition of the importance of culturally competent care has driven residency programs to implement DEI initiatives, including mentorship programs, outreach to minority-serving institutions, and implicit bias training. The aim of this study is to understand the incorporation of DEI in the recruitment process within orthopedic residency programs.
Method: the orthopedic surgery residency program at Community Memorial Healthcare System in California conducted this survey study. It sought to evaluate the integration of DEI principles within U.S. orthopedic surgery residency programs. 28 residency programs encompassing 601 residents. The study utilized a 13-question survey to assess the prevalence of DEI initiatives, such as scholarships for underrepresented minorities (URM) and efforts to create a more inclusive training environment.
Results: Key findings show significant gender and racial disparities among residents, with 79% male and only 21% female. Underrepresented minorities constituted an average of 21% of residents, though this varied among programs. Despite some progress, only 43% of the surveyed programs had introduced DEI or URM visiting student scholarships, with most of these initiatives launched within the last five years. Challenges remain in matching scholarship recipients to residency programs, as 81% of programs reported that none of their scholarship recipients matched at their institution. Additionally, most programs do not provide additional support or mentorship for scholarship recipients, and 96% of programs have no plans to expand or modify their DEI efforts in the future.
Conclusion: Overall, the survey results highlight the progress and the ongoing challenges in promoting diversity, equity, and inclusion within orthopedic surgery residency programs. While some programs have taken steps to address these issues, much more work is needed to create a truly inclusive and equitable training environment for all residents, particularly those from underrepresented backgrounds.
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References
2. Tabaie SA, Schermerhorn JT, Baird M, Lattanza L, Ode G, Mesfin A. AOA critical issues: perceptions on the state of diversity, equity, and inclusion in orthopedic surgery: a survey of the AOA membership. JBJS. 2023 Dec 6; 105(23):1920-6.
3. Terle PM, Osakwe IC, Ierulli VK, Mulcahey MK. Diversity-related positions in orthopedic surgery residency programs. JBJS Open Access. 2023 Jul 1; 8(3):e23.
4. Piana LE, Burstein E, Criddle S, He E, Katarincic JA, Owens BD, Hsu RY. Diversity, Equity, and Inclusion in Orthopaedic Surgery: Local and National Efforts. Rhode Island Medical Journal (2013). 2024 Mar 1; 107(3):22-5.
5. Mason B, Ross Jr WA, Bradford L. Nth dimensions evolution, impact, and recommendations for equity practices in orthopedics. JAAOS-Journal of the American Academy of Orthopaedic Surgeons. 2022 Apr 15; 30(8):350-7.
6. They are underdeveloped, limiting their potential to drive meaningful change in the field. The absence of forward-thinking plans for expanding these scholarships highlights the need for greater institutional investment and a strategic, long-term approach to DEI efforts in orthopedic surgery (Shah et al., 2023).
7. Shah, K., Zhuang, T., Scott, B., Sobel, A., & Akelman, E. (2023). What Program Characteristics Are Associated with Resident Racial Diversity in Orthopaedic Surgery? An Analysis of Association of American Medical Colleges Data. JB JS Open Access, 8(1), e22.00056. https://doi.org/10.2106/JBJS.OA.22.00056
8. Bernstein, J. L., Wei, D. T., Gu, X., Campbell, M. S., & Edwards, M. H. (2022). Diversity, Equity, and Inclusion in Surgical Residency Programs: A Nationwide Analysis. Journal of Surgical Education, 79(3), 763-771. https://doi.org/10.1016/j.jsurg.2022.01.019
9. Mason, J. R., Loder, S. M., Matzkin, E. G., & Edmonson, A. M. (2016). Gender and Racial Disparities in Orthopaedic Surgery: A Review. Orthopedic Clinics of North America, 47(3), 429-439. https://doi.org/10.1016/j.ocl.2016.02.003
10. McDonald, M. A., Bell, T. M., & Johnson, D. E. (2020). Addressing Gender and Racial Disparities in Orthopaedic Surgery Education and Mentorship. Orthopaedic Research and Reviews, 12, 41-47. https://doi.org/10.2147/ORR.S259753
11. Discrimination against female surgeons is still alive: where are the full professorships and chairs of departments?. surgical neurology international 2017;8(1):93. https://doi.org/10.4103/sni.sni_90_17
12. Do orthopedic surgery residency program web sites address diversity and inclusion? hss journal ® 2021;18(2):235-239. https://doi.org/10.1177/15563316211037661
13. Comparative analysis of racial and gender diversity in orthopedic surgery applicants and residents from 2007 and 2019. journal of orthopaedic experience & innovation 2022;3(1). https://doi.org/10.60118/001c.31412
14. Liu, R. W., & Schneider, A. D. (2020). The Impact of Residency Size and Competition on Resident Diversity in Orthopaedic Surgery. Clinical Orthopaedics and Related Research, 478(9), 2031-2039. https://doi.org/10.1097/CORR.0000000000001073
15. Winfrey, L. E., McDonald, M. A., Bell, T. M., & Ortiz, J. A. (2022). Overcoming Barriers to Diversity in Orthopaedics: A Pathway to Inclusion. Journal of Bone and Joint Surgery, 104(15), e76. https://doi.org/10.2106/JBJS.21.02062
16. Comparative analysis of racial and gender diversity in orthopedic surgery applicants and residents from 2007 and 2019. journal of orthopaedic experience & innovation 2022;3(1). https://doi.org/10.60118/001c.31412
17. Impact of covid-19 on orthopedic surgery residency programs in algeria: a qualitative study. international journal of surgery global health 2022;5(6):e87-e87. https://doi.org/10.1097/gh9.0000000000000087
18. Arthroscopic training resources in orthopedic resident education. the journal of knee surgery 2014;28(01):067-074. https://doi.org/10.1055/s-0034-1368142