Orthopaedic surgery is among the least diverse fields in all of medicine. To promote the recruitment of minorities, a commonly proposed strategy is to increase the exposure of minority medical students to orthopaedic surgeons and residents who are minorities themselves. This study examines the degree to which the racial/ethnic diversity of the orthopaedic faculty and residency program influences underrepresented in medicine (URM) medical students at that institution to pursue a career in orthopaedics.
Using data provided by the Association of American Medical Colleges, we identified all US medical schools that were affiliated with an orthopaedic department and an orthopaedic residency program (n = 110). For each institution, data were collected on URM representation among the orthopaedic faculty and residents (2013 to 2017), as well as the proportion of URM medical students who applied to an orthopaedic residency program (2014 to 2018). The association between institutional factors and the URM medical student orthopaedic application rate was then assessed.
Of 11,887 URM students who graduated from medical school during the 5-year study period, 647 applied to an orthopaedic residency program (5.4%). URM students who attended medical school at institutions with high URM representation on the orthopaedic faculty were more likely to apply in orthopaedics (odds ratio 1.27, 95% confidence interval 1.04 to 1.55, P = 0.020), as were URM students at institutions with high URM representation in the residency program (odds ratio 1.45, 95% confidence interval 1.17 to 1.79, P < 0.001).
The benefits of a diverse orthopaedic workforce are widely acknowledged. In this study, we found that increased URM representation among the orthopaedic faculty and residents was associated with a greater likelihood that URM medical students at that institution would apply in orthopaedics. We also suggest a set of strategies to break the cycle and promote the recruitment of minorities into the field of orthopaedic surgery.
From the Department of Orthopaedics, Kaiser Moanalua Medical Center, Honolulu, HI (Dr. Okike), the Department of Orthopaedic Surgery, NYU Langone Orthopaedic Hospital, New York, NY (Dr. Phillips), the Department of Orthopaedic Surgery, University of Oklahoma, Oklahoma City, OK (Dr. Johnson), and the Center for Musculoskeletal Care, Yale School of Medicine, New Haven, CT (Dr. O'Connor).
Correspondence to Dr. Okike: firstname.lastname@example.org
The study was funded by the American Academy of Orthopaedic Surgeons (AAOS) through the AAOS Diversity Advisory Board. The funding source did not play a role in the investigation.
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. Okike, Dr. Phillips, Dr. Johnson, and Dr. O'Connor.
Investigation performed at the Kaiser Moanalua Medical Center, Honolulu, Hawaii.