Background: 

Multiple investigations in the past 50 years have documented a lack of racial/ethnic and gender diversity in the orthopaedic surgery workforce when compared with other specialties. Studies in other industries suggest that diversification of leadership can help diversify the underlying workforce. This study investigates changes in racial/ethnic and gender diversity of orthopaedic surgery leadership from 2007 to 2019 and compares leadership diversity to that of other surgical and nonsurgical specialties, specifically in terms of chairpersons and program directors.

Methods: 

Demographic data were collected from The Journal of the American Medical Association and the Association of American Medical Colleges. Aggregate data were utilized to determine the racial, ethnic, and gender composition of academic leadership for 8 surgical and nonsurgical specialties in 2007 and 2019. Comparative analysis was conducted to identify changes in diversity among chairpersons between the 2 years. Furthermore, current levels of diversity in orthopaedic leadership were compared with those of other specialties.

Results: 

A comparative analysis of diversity among program directors revealed that orthopaedic surgery had significantly lower minority representation (20.5%) when compared with the nonsurgical specialties (adjusted p < 0.01 for all) and, with the exception of neurological surgery, had the lowest proportion of female program directors overall, at 9.0% (adjusted p < 0.001 for all). From 2007 to 2019, orthopaedic surgery experienced no change in minority representation among chairpersons (adjusted p = 0.73) but a significant increase in female representation among chairpersons, from 0.0% (0 of 102) to 4.1% (5 of 122) (adjusted p = 0.04). Lastly, a significant decrease in minority and female representation was observed when comparing the diversity of 2019 orthopaedic faculty to orthopaedic leadership in 2019/2020 (p < 0.05 for all).

Conclusions: 

Diversity in orthopaedic surgery leadership has improved on some key fronts, specifically in gender diversity among chairpersons. However, a significant decrease in minority and gender representation was observed between 2019 orthopaedic faculty and 2019/2020 orthopaedic leadership (p < 0.05), which was a trend shared by other specialties. These findings may suggest a more pervasive problem in diversity of medical leadership that is not only limited to orthopaedic surgery.

中文翻译：

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学术骨科手术领导中的种族、民族和性别多样性

背景： 

过去 50 年的多项调查表明，与其他专业相比，骨科手术劳动力缺乏种族/民族和性别多样性。其他行业的研究表明，领导力的多样化有助于使基础劳动力多样化。本研究调查了 2007 年至 2019 年骨科手术领导的种族/民族和性别多样性的变化，并将领导多样性与其他外科和非外科专业的领导多样性进行了比较，特别是在主席和项目主任方面。

方法： 

人口统计数据来自美国医学协会杂志和美国医学院协会。汇总数据用于确定 2007 年和 2019 年 8 个外科和非外科专业学术领导的种族、民族和性别构成。进行了比较分析，以确定两年间主席的多样性变化。此外，将目前骨科领导力的多样性水平与其他专业进行了比较。

结果： 

对项目负责人多样性的比较分析显示，与非外科专业相比，骨科手术的少数族裔比例显着降低（20.5%）（所有调整后的 p < 0.01），并且除神经外科外，女性的比例最低总体而言，项目主管占 9.0%（调整后的 p < 0.001）。从 2007 年到 2019 年，骨科手术在主席中的少数族裔代表没有变化（调整后的 p = 0.73），但主席中的女性代表显着增加，从 0.0%（102 人中的 0 人）增加到 4.1%（122 人中的 5 人）（调整后的 p = 0.04)。最后，在将 2019 年骨科教师的多样性与 2019/2020 年骨科领导力的多样性进行比较时，观察到少数族裔和女性的代表性显着下降（全部 p < 0.05）。

结论： 

骨科手术领导的多样性在一些关键方面有所改善，特别是在主席之间的性别多样性方面。然而，在 2019 年骨科教师和 2019/2020 年骨科领导之间观察到少数族裔和性别代表性显着下降（p < 0.05），这是其他专业共有的趋势。这些发现可能表明医疗领导的多样性存在一个更普遍的问题，不仅限于骨科手术。