Evaluation of Demographic Trends Across US ACGME-Accredited Orthopaedic Surgery Fellowships.

Abstract

Introduction: Evaluating demographic trends in orthopaedic surgery fellowships is crucial to understanding the field's growth. Existing literature often focuses on diversity in orthopaedic leadership or specific subspecialties. The purpose of this study was to evaluate 10-year demographic trends (2012 to 2022) in Accreditation Council for Graduate Medical Education-accredited orthopaedic fellowships and identify regional demographic disparities from 2023 to 2024 to highlight recent demographic shifts.

Methods: Data from 2012 to 2022 were collected from the Fellowship and Residency Electronic Interactive Database and Accreditation Council for Graduate Medical Education census for each subspecialty: total programs, fellow/faculty sex, race/ethnicity, program-specific data (location, fellows' full names). Sex was classified using pronouns on biographical webpages. Statistical analyses assessed fluctuations across all years.

Results: The total annual proportion of female fellows ranged from 13.4% (68/508) to 19.1% (101/529), average annual increase: +1.86%. The average annual proportion of female foot and ankle fellows increased most (35.86%), ranging from 6.3% to 37.5%; the average proportion of female pediatric fellows decreased most (-1.48%), ranging from 22.9% to 51.2%. Adult reconstruction had the lowest female fellow proportion (5.7%); pediatrics had the highest (37.2%). Hispanic/Latino fellows increased most (+124.9%); Black/African American fellows decreased most (-16.1%). The South had the lowest female representation (fellows: 13.3%, faculty: 12.2%), the Northeast had the highest proportion of female fellows (32.9%), and the West had the most female faculty (19.6%).

Conclusions: This study found a slight increase in female representation in orthopaedic fellowships, although notable gender disparities persist, particularly in adult reconstruction and the South. This highlights the need for continued efforts to enhance diversity, focusing on specific disparities across regions and subspecialties.

Study design: Cross-sectional study: database/website evaluation.

Level of evidence: III.