Sex, Race, and Ethnic Diversity of the Emerging US Orthopaedic Sports Medicine Workforce is Limited

Purpose: The purpose of this study was to analyze the demographics and trends of orthopaedic surgeons entering the US orthopaedic sports medicine workforce over the past decade.

Methods: This was a cross-sectional study of allopathic medical students, orthopaedic surgery residents, and orthopaedic sports medicine fellows in the US (2013-2022) leveraging data from the Accreditation Council for Graduate Medical Education and American Medical Association. Disparities in demographic representation between orthopaedic sports medicine fellows and the 2020 US population census were quantified with participation-to-prevalence ratios (PPRs). A PPR between 0.8-1.2 was classified as equivalent representation and a PPR<0.8 was classified as under-representation, relative to the US population.

Results: The representation of female, Hispanic, Black, and Asian trainees decreased at each stage of the training pipeline to orthopaedic sports medicine fellowship training. In contrast, the representation of White trainees increased at each stage of the training pipeline. Over the study period, there were modest increases in female (9.9% to 12.6%) and Hispanic (1.2% to 1.7%) trainee representation in orthopaedic sports medicine. In contrast, Asian (16.6% to 5.6%) and Black (5.1% to 1.9%) trainee representation decreased. Relative to the US population, female (PPR=0.22), Black (PPR=0.30), Hispanic (PPR=0.19), Native Hawaiian/Pacific Islander (PPR=0.01), and Native American/Alaskan Native (PPR=0.00) trainees were underrepresented. In contrast, male (PPR=1.79), Asian (PPR=1.96), and White (PPR=1.36) trainees were overrepresented in orthopaedic sports medicine.

Conclusions: There is limited diversity in the emerging orthopaedic sports medicine workforce relative to the US population. Improvements in the representation of female, Black, and Hispanic trainees in orthopaedic sports medicine has been marginal relative to trends observed at US allopathic medical schools.

Clinical relevance: Promoting diversity and inclusion in the orthopaedic sports medicine workforce can create more surgical provider options for diverse patient populations in the US.