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Underrepresented Minority Applicants Are Competitive for Orthopaedic Surgery Residency Programs, but Enter Residency at Lower Rates

Poon, Selina MD, MPH; Nellans, Kate MD, MPH; Rothman, Alyssa MD; Crabb, Rocio A.L. MD; Wendolowski, Stephen F. MS; Kiridly, Daniel MD; Gecelter, Rachel MS; Gorroochurn, Prakash PhD; Chahine, Nadeen O. PhD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: November 1, 2019 - Volume 27 - Issue 21 - p e957-e968
doi: 10.5435/JAAOS-D-17-00811
Research Article

Introduction: Orthopaedic surgery residency programs have the lowest representation of ethnic/racial minorities compared with other specialties. This study compared orthopaedic residency enrollment rates and academic metrics of applicants and matriculated residents by race/ethnicity.

Methods: Data on applicants from US medical schools for orthopaedic residency and residents were analyzed from 2005 to 2014 and compared between race/ethnic groups (White, Asian, Black, Hispanic, and Other).

Results: Minority applicants comprised 29% of applicants and 25% of enrolled candidates. Sixty-one percent of minority applicants were accepted into an orthopaedic residency versus 73% of White applicants (P < 0.0001). White and Asian applicants and residents had higher USMLE Step 1. White applicants and matriculated candidates had higher Step 2 Clinical Knowledge scores and higher odds of Alpha Omega Alpha membership compared with Black, Hispanic, and Other groups. Publication counts were similar in all applicant groups, although Hispanic residents had significantly more publications. Black applicants had more volunteer experiences.

Conclusions: In orthopaedic surgery residency, minority applicants enrolled at a lower rate than White and Asian applicants. The emphasis on USMLE test scores and Alpha Omega Alpha membership may contribute to the lower enrollment rate of minority applicants. Other factors such as conscious or unconscious bias, which may contribute, were not evaluated in this study.

From the Department of Orthopaedic Surgery, Shriners for Children Medical Center, Pasadena, CA (Dr. Poon), the Department of Orthopaedic Surgery, LIJ Medical Center, Northwell Health, New Hyde Park, NY (Dr. Nellans, Mr. Wendolowski, Dr. Kiridly and Ms. Gecelter), Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY (Dr. Nellans, Dr. Rothman and Dr. Crabb), Department of Pediatric Orthopaedics, Cohen Children's Medical Center, Northwell Health, New Hyde Park NY (Mr. Wendoloski, Ms. Gecelter), The Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY (Dr. Gorroochurn), and the Department of Orthopaedic Surgery and Biomedical Engineering, Columbia University, New York, NY (Dr. Chahine).

Correspondence to Dr. Poon: spoon@shrinenet.org and Dr. Chahine: noc7@columbia.edu

Supported in part by NSF CAREER Award 1763281.

Dr. Poon or an immediate family member is a member of a speakers' bureau or has made paid presentations on behalf of and has received research or institutional support from Nuvasive. None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Nellans, Rothman, Crabb, Wendolowski, Dr. Kiridly, Gecelter, Dr. Gorroochurn, and Dr. Chahine.

Copyright 2019 by the American Academy of Orthopaedic Surgeons.
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